Biomedical Engineering Reference
In-Depth Information
to care for the terminally ill, and human
experimentation, which arise from the two
moral norms:
Discuss the moral judgments associated with
present policies regarding the regulation of
the development and use of new medical
devices.
(the provision of
beneficence
benefits) and
(the avoidance
nonmaleficence
of harm).
The tremendous infusion of technology into the practice of medicine has created a new
medical era. Advances in material science have led to the production of artificial limbs, heart
valves, and blood vessels, thereby permitting “spare parts” surgery. Numerous patient disor-
ders are now routinely diagnosed using a wide range of highly sophisticated imaging devices,
and the lives of many patients are being extended through significant improvements in resus-
citative and supportive devices, such as respirators, pacemakers, and artificial kidneys.
These technological advances, however, have not been benign. They have had significant
moral consequences. Provided with the ability to develop cardiovascular assist devices,
perform organ transplants, and maintain the breathing and heartbeat of terminally ill
patients, society has been forced to reexamine the meaning of such terms as
death, quality
of life, heroic efforts,
, and to consider such moral issues as the right of
patients to refuse treatment (living wills) and to participate in experiments (informed con-
sent)
and
acts of mercy
As a result, these technological advances have made the moral dimensions of health
care more complex and have posed new and troubling moral dilemmas for medical profes-
sionals, the biomedical engineer, and society at large.
The purpose of this chapter is to examine some of the moral questions related to the use
of new medical technologies. The objective, however, is not to provide solutions or recom-
mendations for these questions. Rather, the intent is to demonstrate that each technological
advance has consequences that affect the very core of human values.
Technology and ethics are not foreigners; they are neighbors in the world of human
accomplishment. Technology is a human achievement of extraordinary ingenuity and util-
ity and is quite distant from the human accomplishment of ethical values. They face each
other rather than interface. The personal face of ethics looks at the impersonal face of tech-
nology in order to comprehend technology's potential and its limits. The face of technology
looks to ethics to be directed to human purposes and benefits.
In the process of making technology and ethics face each other, it is our hope that indi-
viduals engaged in the development of new medical devices, as well as those responsible
for the care of patients, will be stimulated to examine and evaluate critically “accepted”
views and to reach their own conclusions. This chapter, therefore, begins with some defini-
tions related to morality and ethics, followed by a more detailed discussion of some of the
moral issues of special importance to biomedical engineers.
.
2.1 M
ORALITY AND ETHICS: A DEFINITION OF TE
RMS
From the very beginning, individuals have raised concerns about the nature of life and
its significance. Many of these concerns have been incorporated into the four fundamental
questions posed by the German philosopher Immanuel Kant (1724-1804):
What can I know?
