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ETHICS IN BIOENGINEERING: ISSUES WITH THE BIONIC EYE
Natalie Garda (nag61@pitt.edu)
INTRODUCTION
As engineers, we face various ethical dilemmas in our
everyday work environment. These setbacks can be anything
ranging from political issues, to public safety concerns, to
problems with colleagues and bosses in the workplace.
Engineers are required to follow a very specific code of ethics.
We impact the everyday lives of virtually everyone living
around us in the world and necessarily must take the rules and
obligations of the engineering field very seriously. The one
statement that really encompasses the entire idea behind the
code is this: “The services provided by engineers require
honesty, impartiality, fairness, and equity, and must be
dedicated to the protection of the public health, safety, and
welfare” [1]. We take the lives of millions of others into our
hands when designing products and/or services, and taking
any back-roads to accomplish a goal potentially places all of
those lives in grave danger.
As a bioengineer, this is especially true for my profession.
We work very closely with those in the medical field, and
consequently the patients under medical care. Anything done
underhandedly to get a bioengineered device through to the
market could very well result in immediate life-changing
consequences to the patient that the device was intended to
help. Recently, I encountered an ethical dilemma in my
workplace in which I was forced to reference the codes of
ethics. Although some decisions are hard to make as an
engineer, the codes help tremendously to guide you in the
right direction in your ultimate choice in the end.
In addition to the codes though, engineers must also
consider previous clinical cases that provide insight into the
outcome of a certain situation that they may similarly find
themselves in. Lastly, engineers must also keep a network of
people around to confide in if necessary. These people need
not be engineers, but rather they must be individuals that the
engineer feels comfortable turning to in a time of need. The
following information outlines the different references that an
engineer should keep available at his or her fingertips in the
case that he or she finds oneself in a difficult ethical situation.
My Ethical Dilemma
Over the past few years, I as a biomedical engineer have
worked on a project to advance the efficiency of the artificial
eye (also known as the “bionic” eye). Recently, my boss
asked myself and my teammates to push to get our product
tested and used on a willing “trial patient” so that it could be
put on the commercial market as soon as possible. Although
the original product, the Argus II, had already been approved
for use in humans and put on the market, I did not feel
comfortable pushing our advanced product through for use
University of Pittsburgh, Swanson School of Engineering 1
Submission Date 2014-10-28
quite yet. It was a difficult decision to refuse to follow my
boss’s orders to promote our device since it has the potential
at this point to help so many individuals who suffer from
visual impairments. However, it also is not guaranteed to be
safe at this point, and after speaking with a few individuals
in the field and referencing the engineering codes of ethics, I
feel that ultimately I made the ethical decision.
THE ENGINEERING CODES OF ETHICS
Across the board, all engineers must ultimately follow
the same general code of ethics, which includes all of the
essential fundamentals important to engineering, as well as
the major rules of practice, and any professional obligations
that engineers must abide by [1]. However, each individual
branch of engineering has its own simplified code of ethics
of which those engineers in that specific field must also
follow. Most of the points of the codes helped lead me to
my final decision to go against my boss’s orders; other
points did not contribute to my choice in the slightest.
Below are highlighted the fundamental canons that either did
or did not aid me in my ultimate decision to refuse the
request of my boss.
Helpful Canons
The most helpful canon that impacted my ultimate
decision was the one that stated that engineers shall, “Hold
paramount the safety, health, and welfare of the public” [1].
When considering the safety of our advanced product, I was
still having some doubts. Just based upon this fact in
relation to the code, I determined that it was against the code
to approve for the product to be placed on the market for
trials in patients when I had high doubts regarding the safety
of the device.
Another two canons which helped me to address the
ethical approach to my choice were that engineers may
“issue public statements only in an objective and truthful
manner” and “avoid deceptive acts” [1]. By agreeing to
allow the product to be sent out for testing in humans despite
the fact that I found the product potentially unsafe would
have gone against the requirement to be truthful in all cases.
I would have been deceiving those patients in need of the
device if I had approved of the product and declared it safe
for utilization in humans when in fact I highly doubted this.
In addition, I would have been going against the biomedical
engineering health care obligations canon which states that
engineers must respect the rights of patients and consider the
possible negative consequences of their work [2].
Natalie Garda
The final helpful canons that I was able to reference were
those that require engineers to be honorable and responsible
in order to uphold the reputation not only of an employer or
client, but that of the entire profession as well [1]. Pushing
for an unsafe product to go out onto the market could have
damaged not only my reputation, but the reputations of my
employer as well as my teammates and the entirety of my
engineering discipline as well.
to decisions in the engineering discipline. Post 9/11, there
was a bioterrorism scare in which U.S. governors and
officials contracted anthrax from letters that were sent to tem
laced in Bacillus anthrasis spores [6]. This caused the
general public to become very panicked about the potential
threat of a bio terroristic war and showed how the public
reacts to the worst possible situation in particular in an
engineering case/issue.
Unhelpful Canons
ETHICS REFERENCES SPECIFICALLY
FOR BIOENGINEERS
The only canon from the general engineering code of
ethics that did not apply to my issue states that engineers must
“perform services only in areas of their competence” [1].
Since the product is completely in my line of work and I am
qualified to create such devices, I would not have been out of
line in a sense of competency. In the Biomedical Engineering
Society Code of Ethics, the canon addressing training
obligations was also very unhelpful in helping me to
formulate an ethical decision. Since I am not in a branch of
my field which requires me to train others, this entire canon
discussing the appropriateness of what to convey to trainees
did not contribute at all to my judgment [2].
In comparison with all of the other branches of
engineering, bioengineering is by far the most complex of
them all when it comes to ethics associated with the field.
Instead of taking the natural properties of matter and energy
resources and fitting them for human use, bioengineering
actually “extends engineering theory and practice into the
lifeworld… It makes the resources of life available to life
itself” [7]. Because of this fact, bioengineers must selfreflect upon their decisions much more than the typical
engineer would.
Carl Mitcham writes multiple different examples of
ethics in bioengineering, which he makes widely available to
anybody who needs to reference them. He also addresses in
another article that “the complexity of formulating a
bioengineering ethics arises from the need of bioengineering
to be coherent not only with the ethics of engineering but
also with those of biology, medicine, and the physical
sciences” [8]. Bioengineering encompasses multiple
different fields of study and must necessarily include all of
the codes of ethics associated with each branch. The greater
issue though then becomes the fact that overlapping ethics
leads to conflicting views and a sense off confusion as to
what is correct or incorrect will arise more often.
Due to the complexity of the ethics specifically
associated with bioengineering, the additional references
available become very useful and important and should be
consulted often whenever an ethical issue arises.
CLINICAL CASES
Other beneficial resources that engineers can reference
when faced with an ethical dilemma are case studies. These
documents outline previous cases dealing with ethical issues
and address questions that come up in many similar
circumstances. They introduce a different perspective and
give insight into potential outcomes that other engineers may
not have originally thought of.
For example, in one case regarding a device to help
attach vessels to the aorta of the heart more easily during
surgery many questions arise about the usefulness of such a
technology. For device in early stages, questions such as
“Does developing stepping stone technologies really make
sense from a business perspective?” must be addressed [3].
It most likely makes more sense to hold off on the “stepping
stone” and create a more long-term, permanent fixing
device. This applies directly to my situation in developing
the artificial eye; I had to ask myself, “Does it make sense to
put something on the market that we will need to change in
the near future anyway?” This will cause people/patients to
doubt our products if we constantly have the need to alter
them to improve them.
Another question that many of these case studies
consider is, “Who will be affected by the ethical decision
and how?” [4, 5]. For instance, a study based upon research
and the false publication of information reflects upon how
that particular issue impacts everyone associated with the
false publication, as well as any members of the general
public who read the article and believe what is said.
A concluding case study that I personally found to be
very influential deals with the ethics of how the public reacts
PERSONAL REFERENCES I TURNED TO
As an engineer, it is important to confide in many
different people and sources in order to get outside
assistance and many varying opinions. This is especially
true when dealing with a difficult decision.
Throughout my decision making process in this specific
case, I contacted a few people who have helped me
throughout the course of my engineering career. I first
contacted Shawn Kelly, a professor at Carnegie Mellon
University and one of the original designers and contributors
to the artificial eye. He advised me to hold off on any
decision to move forward with trials of the newly advanced
product until I found it appropriate. One question that he
asked me was, “Would you rather sacrifice the life of
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Natalie Garda
someone else for your own profitability, or sacrifice the life
of your device at the expense of another person’s wellbeing?” [9]. This really struck me deep and ultimately made
my decision for me; I was not about to put another person’s
health at risk for any reason, whether it meant losing my job
for not following orders, or losing the support of my team
for failing to push forward to get the device we worked so
diligently on approved.
Another individual that I spoke with in my confused and
indecisive state was my cousin Katie, whom I am very close
with. I told her how my teammates and I had worked so
hard on the advancements put into the Argus II, and my
employer wanted it put through to the trial levels. I also
informed her of my concerns though. She was very helpful
and told me not to rush through anything. She went through
a law degree, worked as a lawyer for many years, then
decided to return to school to be a doctor. She explained to
me that rushing through to the next stage of something,
whether it be life in general, or something at work was
completely unnecessary [10]. As many people as our device
could potentially help in its early stage that it is currently in,
she convinced me that it would, without a doubt, help twice
as many people if we decided to hold off and perfect the
device before sending it out for trials.
REFERENCES
[1] "National Society of Professional Engineers (NSPE) Code
of Ethics." Encyclopedia of Science, Technology, and Ethics.
(2005). Vol. 4, C. Mitcham, Ed. Detroit: Macmillan
Reference
USA.
(online
reference).
http://go.galegroup.com/ps/i.do?id=GALE%7CCX34349007
59&v=2.1&u=upitt_main&it=r&p=GVRL&sw=w&asid=87
c9723b3e76c70d32bec8abc11fa982. pp. 2189-92
[2] "Biomedical Engineering Society Code of Ethics." The
Biomedical Engineering Society. (2004). (online reference).
http://bmes.org/files/2004%20Approved%20%20Code%20o
f%20Ethics(2).pdf.
[3] “Incremental Development.” Stanform biodesign.
(online article).
http://biodesign.stanford.edu/bdn/ethicscases/11incremental.
jsp.
[4] “ ‘Borrowing’ Without Permission.” webGuru Guide for
Undergraduate Research. (online article).
www.webguru.neu.edu/professionalism/casestudies/borrowing-without-permission.
[5] “It’s All About Sharing...” webGuru Guide for
Undergraduate Research (online article).
www.webguru.neu.edu/professionalism/case-studies/its-allabout-sharing.
[6] (October 2, 2013). “Microbiologists Respond to
Bioterrorism.” Online Ethics Center for Engineering. (online
article).
www.onlineethics.org/Resources/Cases/Bioterrorism.apsx.
[7] C. Mitcham. (March 1990). “Ethics in Bioengineering.”
Jornal of Business Ethics. (online article).
www.jstor.org/stable/25072029. p. 227-231
[8] G. Bugliarello. (2005). ”Bioengineering Ethics.”
Encyclopedia of Science, Technology, and Ethics. (online
article). http://go.galegroup.com/ps/i.do?. p.190-193
[9] S. Kelly. (2024, January 29). Email.
[10] K. Hanak. (2024, January 23). Interview.
CONCLUSION: MY NOTE TO OTHER
ENGINEERS FACING ETHICAL
DILEMMAS
Engineers must have a wide range of references to turn
to for reference and/or assistance when they come to an
issue in their line of work. While the codes of ethics are
usually helpful, an array of close friends or family is also
necessary to keep close by to discuss more personal
connections to an engineering issue. Occasionally, a
problem within your engineering discipline may not be
answered simply through the code of ethics that you are
expected to follow. Rather, the issue might hit closer to
home for an engineer, who begins to think more about his or
her morals than the codes. At this point, no information
about previous cases, similar issues, or code regulations will
help an individual to make a smart decision. Instead, one
will need to turn to those people that he or she is closest with
and confide in them for assistance, whether that person be an
engineer or not.
No matter what the ethical issue or setback may be,
engineers must be able to confide not only in the codes of
ethics in engineering but also in one another. No one branch
of engineering can work independently of itself; each
separate field requires at least one other to make it truly
effective and the ability to confide in the members not only
of your own branch but of other branches as well is vital to
the success of an engineering group.
ACKNOWLEDGEMENTS
I would like to thank my writing instructor, Emelyn
Fuhrman for her helpful suggestions in my writing
assignment 2, which helped to contribute to this paper. I
would also like to thank Adam Cotter for revising my paper.
Finally, I would like to thank my cousin, Katherine (Cooper)
Hanak for her assistance and support through my pursuit
towards a bioengineering degree.
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