Biomedical Ethics for Engineers: Ethics and Decision Making in Biomedical and Biosystem Engineering (Biomedical Engineering Series)

433 Pages·2007·7.61 MB·English

by  Daniel A. Vallero

Biomedical Ethics for Engineers
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Biomedical Ethics for
Engineers: Ethics and Decision
Making in Biomedical and
Biosystem Engineering
Daniel A. Vallero, Ph.D.
AMSTERDAM • BOSTON • HEIDELBERG • LONDON • NEW YORK • OXFORD
PARIS • SAN DIEGO • SAN FRANCISCO • SINGAPORE • SYDNEY • TOKYO
Academic Press is an imprint of Elsevier
Academic Press is an imprint of Elsevier
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Contents
Preface xi
Done Is Good xiv
Structure and Pedagogy xvi
Notes and Commentary xix
Acknowledgments xxi
Bioethics Questions Posed in Text xxiii
Prologue: Bioethics – Discovery through Design
A Different Approach to Bioethics 3
Arguments for and Against Case Analysis 4
Driver’s Education Analogy 5
Example Case: Priming the Pump 6
Case Analysis 7
Notes and Commentary 8
Chapter 1
Bioethics: A Creative Approach
Thought Experiments 10
Teachable Moment: Trust 12
The Principle of Double Effect 12
Teachable Moment: The Engineer as Agent versus Judge 12
Amy the Engineer 15
Teachable Moment: Who Was Van Rensselaer Potter? 18
Credat Emptor 18
TeachableMoment:Capital Punishment, Abortion, and theDefinition of Human Life 20
The Good Engineer 21
Feedback and Enhancement of Design 22
Teachable Moment: The Good Engineer 24
The Profession of Engineering 25
Engineering Bioethics and Morality 26
Discussion Box: Ethics and the Butterfly Effect 27
“Small” Error and Devastating Outcomes 28
Technology, Engineering, and Economics 28
Teachable Moment: The Dismal Scientist versus the Technological Optimist 31
Engineering Competence 39
v
vi Contents
Engineering: Both Integrated and Specialized 39
Who Is a Professional? 40
What Is Technical? 41
Systematics: Incorporating Ethics into the Design Process 42
Notes and Commentary 43
Chapter 2
Bioethics and the Engineer
Major Bioethical Areas 51
Cloning and Stem Cell Research 52
Teachable Moment: Nanog 56
Human Enhancement 57
Patenting Life 57
Teachable Moment: Patenting Germplasm 58
Neuroethics 59
Organ Transplantation 60
Responsible Conduct of Human Research 60
Animal Testing 61
Is the Research Worth It? 63
Systematic Reality Check 66
Genetically Modified Organisms 67
Transgenic Species 68
Food 68
Environmental Health: The Ethics of Scale and the Scale of Ethics 70
Temporal Aspects of Bioethical Decisions: Environmental Case Studies 70
Agent Orange 71
Japanese Metal Industries 74
Minamata Mercury Case 74
Cadmium and Itai Itai Disease 75
Scale Is More than Size 77
Love Canal 78
Times Beach 79
Teachable Moment: The Whole Is Greater than the Sum of Its Parts 80
Active Engineering 81
Ethical Theories: A Primer 83
Truth 84
Psychological Aspects of Ethics 86
Teachable Moment: The Physiome Project: The Macroethics of Engineering
toward Health 89
Fairness 94
Value as a Bioethical and Engineering Concept 95
Technical Optimism versus Dismal Science 96
Notes and Commentary 98
Contents vii
Chapter 3
An Engineered Future: Human Enhancement
Professional Zeitgeist: How Engineers Think 106
Improvement versus Enhancement 109
Engineering Intuition 111
Engineers versus Economists 112
Intuiting Value 113
Deductive and Inductive Reasoning: Precursors to Intuition 114
Creativity 116
Moral Coherence 120
Creativity and Bioethics 122
The Ethical Quandary of Enhancement 124
Scientific Dissent 126
Notes and Commentary 134
Chapter 4
The Bioethical Engineer
Professional Trust 139
Codes of Ethics: Words to Live By 142
Discussion Box: The Code of Hammurabi 143
Limitations of Codes of Ethics 147
Risk Shifting: Organochlorine Pesticides 147
Right of Professional Conscience 152
Groupthink and the Right of Conscience 156
Animals and Engineers 158
Teachable Moment: Confined Animal Feeding Operations and the Moral
Standing of Animals 159
Making Ethical Decisions in Engineering 160
Discussion Box: Four Persons Who Changed the Way We Think about Nature 162
John Muir 162
Rachel Carson 162
Christopher Stone 163
Gaylord Nelson 164
Notes and Commentary 164
Chapter 5
Bioethical Research and Technological Development
Beyond Regulation 169
Integrity 169
Teachable Moment: The Therapeutic Misconception 173
viii Contents
The Experiment 173
The Hypothetico-Deductive Method 174
Research Conflict of Interest 175
Teachable Moment: Truth and Turtles 176
Professionalism 178
Technology: Friend and Foe 178
Teachable Moment: Medical Device Risk 179
Risk Homeostasis and the Theory of Offsetting Behavior 180
Artifacts 182
Automation and Mechanization of Medicine 183
Professional Consideration: Do Engineers Have Patients? 184
Technological Reliability 185
Low Tech Engineering 189
Information Technology 190
The Ethics of Nanotechnology 193
Notes and Commentary 195
Chapter 6
Bioethical Success and Failure
Teachable Moment: Engineering Measurement 201
Measurements of Success and Failure 203
Technological Success and Failure 203
Risk as a Bioethical Concept 205
Safety, Risk, and Reliability in Design 206
Probability: The Mathematics of Risk and Reliability 206
Discussion Box: Choose Your Risk 210
Reliability: An Ethics Metric 214
Reducing Risks 217
Risk as an Ethical Concept 220
Risk-Based Ethics: The Syllogism Revisited 223
Causation 225
Biographical Box: Sir Bradford Hill 226
Notes and Commentary 228
Chapter 7
Analyzing Bioethical Success and Failure
Medical Device Failure: Human Factors Engineering 232
Teachable Moment: How to Analyse a Medical Device 233
Utility as a Measure of Success 234
Failure Type 1: Mistakes and Miscalculations 236
Failure Type 2: Extraordinary Natural Circumstances 236
Failure Type 3: Critical Path 237
Contents ix
Failure Type 4: Negligence 243
Failure Type 5: Lack of Imagination 244
Bioterrorism: The Engineer’s Response 244
Dual Use and Primacy of Science 246
Social Response of Engineering to Terrorism 248
Success Paradigms 248
Characterizing Success and Failure 249
Accountability 249
Value 250
Case Analysis 250
Notes and Commentary 258
Chapter 8
Justice and Fairness as Biomedical and Biosystem
Engineering Concepts
Fairness and Distributive Justice 263
Discussion Box: Harm and the Hippocratic Oath 271
Teachable Moment: Disposal of a Slightly Hazardous Waste 272
Solution and Discussion 272
Though Experiment: Who Is More Ethical? 274
Professional Virtue and Empathy 277
Teachable Moment: Albert Schweitzer and the Reverence
for Life 277
Reason 279
Teachable Moment: Abortion, Fairness, and Justice 280
Utility 281
Teachable Moment: Utility and Futility 283
Precaution as a Bioethical Concept 285
Discussion Box: The Tragedy of the Commons 286
Notes and Commentary 287
Chapter 9
Sustainable Bioethics
Green Is Good 291
Sustainability 292
Teachable Moment: Rational Ethics and Thermodynamics 293
Life Cycles and Concurrent Engineering 300
Case Study Box: SIDS, A Concurrent Engineering Failure 301
Discussion Box: The Coffee Cup Debate 305
The Bioethics of Combustion 307