Bioethics and the engineer - Biomedical Engineering Desk Reference - page 778

inputs in the production frontier, labor, and capital. 61
In this model, if a lamp is produced in five hours by
3 people, then the lamp is worth 3 5 ¼ 15 man-hours.
On the other hand, the subjective theory of value holds
that goods have no ''intrinsic'' value, outside the desire of
individuals to have the items. Here, value becomes
a function of how much an individual is willing to give up
in order to have that item. 62
Similarly, the marginal theory of value accounts for
both the scarcity and the desirability of a good, holding
that the utility rendered by the last unit consumed de-
termines the total value of a good. The main difference
between the labor theory of value (and the concept
of intrinsic value) and marginal theory of value is that
the former accomodates a form of value derived from
utility - from satisfying human desire. 63
Furthermore, the common understanding of the term
''value'' generally means that the item is of importance
for one reason or the other. At the same time, to say
something is ''valuable'' would mean that it costs a lot of
money, meaning that a high demand for the item in so-
ciety has driven the prices up. Therefore, person A might
value her beaded necklace because she derives pleasure
from it, but her diamond necklace would be considered
valuable, because of the large number of other members
of the society that also feel they would derive pleasure
from it (which causes a high demand that increases the
price).
The so-called diamond - water paradox, is a notewor-
thy example of the role of scarcity in economic value
theory. Diamonds, which have relatively little use, i.e.,
only aesthetic value, have an extremely high price when
compared to water, which is essential to life itself. The
example illustrates the importance of scarcity in the
economic value. Here, as diamonds are far scarcer than is
water, they have the higher price. However, this is situ-
ational. In the middle of the desert, where water is ex-
tremely scarce, someone would almost certainly be
willing to pay more money for water than for diamonds.
Thus, that person would value water more highly.
Since utility is a common metric for value in bio-
medicine, the differing definitions should give us pause.
Often, the design's value as perceived by decision makers
is what drives ethics. However, we may be defining value
in substantially different ways.

have given us their trust. The implications for justice are
that it is much easier to export ''canned'' answers and
solutions to problems from our vested viewpoints. This
view must span time and space. What will the product
performance look like in ten years if the project is
implemented? What happens if some of the optimistic
assumptions are realized? The users will be left with the
consequences. It is much better, but much more diffi-
cult, to see the problem from the perspective of those
with the least power to change things. We are empow-
ered as professionals to be agents of change. So, as agents
of change and justice, engineers must strive to hold par-
amount the health, safety, and welfare of all the public,
we must be competent, and we must be fair.

Value as a bioethical and engineering
concept

In engineering, one might consider ''value'' through the
idea of value engineering. This concept was created at
General Electric Co. during World War II. As the war
caused shortages of labor and materials, the company was
forced to look for more accessible substitutes. Through
this process, they saw that the substitutes often reduced
costs or improved a product. 58 Consequently, they
turned the process into a systematic procedure called
''value analysis.''
Value engineering consists of assessing the value of
goods in terms of ''function.'' Value, as a ratio of function
to cost, can be improved in various ways. Oftentimes,
value engineering is done systematically through the four
basic steps: 59 information gathering, alternative genera-
tion, evaluation, and presentation. In the information
gathering step, engineers consider what the requirements
for the object are. Part of this step includes function
analysis, which attempts to determine what functions
or performance characteristics are important. In the next
step, i.e., alternative generation, value engineers consider
the possible alternative ways of meeting the requirements.
Next, in evaluation, the engineers assess the alternatives in
terms of functionality and cost-effectiveness. Finally, in
the presentation stage, the best alternative is chosen and
presented to the client for the final decision. 60
In the realm of economics, value is considered to be
the worth of one commodity in terms of other com-
modities (or currency). There are three main value the-
ories in economics. The first, an intrinsic theory of value,
holds that the value of an object, good, or service is
contained in the item itself. These theories tend to
consider the costs associated with the process of pro-
ducing an item when assigning the item value. For ex-
ample, the labor theory of value, a model developed by
David Ricardo, holds that the value of a good is derived
from the effort of its production, reduced to the two

Technical optimism versus dismal
science

The National Academy of Engineering has declared:

Engineers and their inventions and innovations have
helped shape the changes that have made our lives more
productive and fruitful. 64