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BRAIN-CONTROLLED PROSTHETIC ARM MAY CAUSE NERVE DAMAGE
Tyler Pastorok (typ10@pitt.edu)
McGlone Prostheses has just released a new prosthetic
arm that works using a brain-computer interface to give the
patient control of and feeling through a mechanical arm. I
am the current leader of the engineering team that designed
the mechanical part of the arm that is being used in
conjunction with the brain-computer interface. The system
works by surgically implanting neural sensors in the brain to
detect brain activity. This information is then sent to a
decoder, which converts the signals to commands for the
arm to read and execute. The system also works in reverse.
There are sensors all throughout the surface of the arm that
detect pressure. These pressure signals are then encoded and
sent to the brain to simulate touch. This requires very
invasive and precise surgical procedures, but can immensely
improve the lives of many.
team, rather than as an individual. We discussed what
should be done about this issue and unanimously agreed to
tell our supervisors and encourage them to inform the
patients who have had the system implanted. This would
most likely mean that a large majority of patients would opt
for the surgery to replace the old system with the new one,
and McGlone Prostheses would have to compensate the
patients not only for the new surgery, but for emotional
damages as well. The surgery alone costs an average of
$150,000 and has been performed on just over 1000 patients
in the world. This means that the financial damage done is
well over $100 million just for the surgeries. Unfortunately,
due to the immense financial and reputational damage that
would be done to the company, the owners of McGlone
Prostheses have decided to keep the information quiet, and
hope that none of the patients contract a severe enough form
of Parkinson’s to cause the system to malfunction.
THE MALFUNCTION
THE DILEMMA
As the head of the mechanical engineering aspects of this
project, I assigned my team to different aspects of testing.
Due to issues and large delays within the decoding algorithm
team, we were rushed through the testing process by my
supervisors. We tested the system by sending signals to and
from a simulated brain, and confirming the arm behaved as it
was supposed to. A section of my team was assigned to
simulate disabled brains. Due to being rushed, this team
overlooked some very severe cases of Parkinson’s disease in
which the rapid movement in the prosthetic is too intense for
the motors, causing the system to overheat. First of all, this
causes the arm to stop working, which, depending on what
the patient is doing, could lead to damage of property and
possibly even life. Not only can this lead to malfunctions in
the arm itself, but the overheating can cause a chain reaction
of failures in the system, which can potentially lead to
permanent nerve damage in the patient.
Fortunately, we have discovered this problem before any
patients have had issues with the system. Furthermore, we
have even fixed the problem and finalized a new design that
has been tested in more detail, and the motors have been
able to hold up to worse cases of Parkinson’s than have ever
been recorded. The issue is that Parkinson’s develops later
in a patient’s life and cannot be tested for before early
symptoms start to show. Additionally, the potential severity
of the disease cannot be precisely determined. This means
there is no safe way to determine which patients will have
issues with the original arm, and isolate the replacement
surgeries to only them.
Prior to releasing our part of the product, the mechanical
team and I agreed to take the blame for any mistakes as one
Pros of Informing the Public
BRAIN CONTROLLED ARM
University of Pittsburgh, Swanson School of Engineering 1
2015-11-03
The decision to inform the public would be based
primarily off of the moral obligation I hold as an engineer,
and offers little to no personal gain. It does not take much
research to find that it is morally wrong to withhold such
information from the public. The preamble of the NSPE
Code of Ethics for Engineers states that “engineers are
expected to exhibit the highest standards of honesty and
integrity” [1]. While there are many other clauses within
this code that describe the ethical issues of withholding this
information, they can all be generalized into the category of
honesty and integrity. There is no denying that to exhibit
such honesty and integrity, I should release the possibility of
such a tragic malfunction to the public immediately.
Furthermore, the ASME code of ethics states that “Engineers
shall hold paramount the safety, health, and welfare of the
public” [2]. Informing patients of the overheating issue will
prevent those who contract severe Parkinson’s from
suffering from nerve damage. Replacing the majority of
already-implemented systems will mostly likely result in
replacing prostheses in many patients that will not develop
such a severe form of Parkinson’s; however, the damage
done to these patients (both physically, emotionally, and
financially) will be far less than if patients do experience
nerve damage from the malfunction. With this trade-off in
mind, informing the patients of the issue keeps in line with
my obligation to regard the safety of the public. While these
are only two reasons to release the information, they carry
immense weight in this dilemma.
Tyler Pastorok
responsible for ending a whole company worth of
employees’ careers.
Cons of Informing the Public
Releasing the details of the possible malfunction will
potentially bring about many short term ramifications to
myself, as well as my team of engineers and the company as
a whole.
I have decided, however, to ignore the
ramifications that will be brought on the company since I
believe that they have already made the wrong choice by
withholding the details of the malfunction. First of all, I
almost certainly will lose my job at McGlone Prostheses
since releasing this information is going against the
instructions I have been given. Not only will this affect me,
but the rest of my engineering team will be blamed for
overlooking this issue with victims of Parkinson’s. It is one
thing for me to determine the fate of my own career, but my
decision likely determines the fate of my colleagues’ careers,
as well. While most of the reasons not to release the
malfunction are personal ramifications, this choice does
violate two areas of interest in the NSPE Code of Ethics.
This code states that “Engineers shall not disclose, without
consent, confidential information concerning the business
affairs or technical processes of any present or former client
or employer” [1]. By releasing the issue, I am releasing
confidential information from my employer. This code also
states that “Engineers shall perform services only in the
areas of their competence.” The reason that my actions may
violate this statement is that my concerns are based on a
mental disease: an area in which I don’t have formal
education, and am basing my opinions solely on statistics
about Parkinson’s that I have found through other research.
SIMILAR RECALL
Recalling a medical procedure is no small feat, and is
definitely not an easy process. Johnson and Johnson had an
extreme situation where they had to recall their DePuy ASR
hip replacements, which cost them over $4 billion in
lawsuits [3]. $4 billion is a menacing number, and seems to
depict a grim future for McGlone Prostheses if issues arise
with this brain controlled prosthetic arm. Johnson and
Johnson was able to recover, however, and this is in part
because they took responsibility for their mistake and carried
out the necessary actions to move past it. Taking into
consideration the fact that McGlone Prostheses is on the
cutting edge of brain-computer technology, it is likely that
they will be given support in cleaning up their mess if they
take responsibility instead of hoping the public does not find
out.
PROFESSIONAL OPINIONS
To aid myself in debating this ethical dilemma, I have
consulted two well-respected and successful engineers, both
of whom are close to me and have faced ethical dilemmas of
their own in the past. The first of which is Alex Houriet. He
is a chemical engineer that is currently working in the
advancement of graphene and recently encountered a similar
situation. He was rushed through testing and released a
product that later turned out to have problems that were
overlooked due to the insufficient tests. Mr. Houriet did
make the decision to inform his supervisors, who listened to
his advice and recalled the product. Mr. Houriet told me that
despite the short term financial damage done to the
company, he stands by his decision as it was the morally just
one, and because he made the morally just decision, he has
been able to advance his career. The second professional I
turned to is Dr. Lenskold, a decorated brain surgeon whom
has a much deeper understanding of the physiological side of
the prosthetic system in question. She informed me that the
second surgery patients will have to go through to replace
the system is well worth it when the risk of the malfunction
is taken into account. Dr. Lenskold also brought about the
point that by informing the public, I am putting the decision
to replace the system in the hands of the patients, rather than
the hands of the company. Patients do still have the option
to take their chances and hope they don’t develop severe
enough Parkinson’s. Both of these professionals agreed that
promoting the safety of the patients takes clear ethical
priority over the damage that will be done by revealing the
mistake.
All Things Considered
In terms of the codes of ethics that I am obligated to
abide by, I believe that there is more support in favor of
informing the public. The use of the word paramount by the
NSPE when describing the importance of the safety and
health of the public means that this statement should be held
above others in situations that apply to conflicting clauses.
This means that even though I am releasing confidential
information, and that I am concerned based on a small piece
of information outside of my expertise, it is more important
that I promote the health of the patients with the prosthetic
arm. To do so, I should publish the details of the
malfunction. Since this comparison nullifies the ethical
standards in support of withholding the information, the only
reasons left not to release the information are the
ramifications to myself and my colleagues. While I am
personally ready to accept the consequences of my mistake,
I do believe that it is not my right to determine the fate of
my colleagues’ careers. Since I did not directly make the
mistake that lead to this malfunction, I cannot honestly
report on the situation without also damaging at least one of
my colleagues’ careers. Additionally, the fact that McGlone
Prostheses withheld this information could possibly do
enough damage to end the company, so I could be
MY DECISION
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Tyler Pastorok
In order to be as fair as possible to all parties involved in
this dilemma, I will inform everyone already involved that I
will be releasing the details of the malfunction to the public.
I will first inform my team of engineers, offering them the
opportunity to assist in the publication of our findings. This
will provide anyone on my team the opportunity to join me
in making the ethically just choice, and upholding our
integrity as engineers. After this, I will inform my
supervisors: giving them one last chance to take
responsibility and inform the patients themselves. My hopes
in doing this is that McGlone Prostheses will understand that
their only chance left of recovering from this mistake is
releasing the information themselves. If I am successful in
persuading McGlone Prostheses to do this, I will be able to
solve the problem while not violating any parts the codes of
ethics previously mentioned. In doing this, I will be able to
prove to the engineering community that I am willing to take
responsibility for the mistakes I’m involved in, and abide by
the regulations set forth by the community.
ADDITIONAL SOURCES
(2014). “Public Health and Safety—Delay in Addressing
Fire Code Violations.” National Society of Professional
Engineers.
(online
article).
http://www.nspe.org/sites/default/files/BER%20Case%20No
%2013-11-FINAL.pdf
R. Wilson. “Ethical Issues of Brain Computer Interfaces
(BCI).” International Association for Computing and
Philosophy.
(online
article)
http://www.iacap.org/proceedings_IACAP13/paper_41.pdf
“To Release, or Not to Release: An Engineer’s Perspective.”
Stanford
biodesign.
(online
article)
http://biodesign.stanford.edu/bdn/ethicscases/21releasequesti
on.jsp
“The Cost of Integrity.” webGuru. (online article).
http://www.webguru.neu.edu/professionalism/casestudies/cost-integrity
S. Lenskold. (2015). Email
A. Houriet. (2015). Email
ADVICE TO OTHERS
ACKNOWLEDGMENTS
Reflecting on this entire issue, it is evident to me that
there was a very easy way of preventing all of this from
happening before the prosthetic arm was released. All I had
to do was resist the pressure applied by my supervisors to
test the system in less time than needed. The costs of
delaying the release of the prosthetic arm would have been a
drop in the bucket compared to the millions, or even billions,
of dollars that will be spent attempting to clean up the mess
that McGlone Prostheses has created. Because I allowed my
supervisors to rush my team and me through testing, there
are now over 1000 patients recovering from surgery that will
have to repeat the entire process in order to protect
themselves against nerve damage that could be caused by
our system. I advise anyone, not just engineers, to avoid
cutting corners at all costs, because the long run
consequences of cutting corners will far exceed the extra
time and money needed in the short run to get it right the
first time.
I would like to thank my team of engineers at McGlone
Prostheses for assisting me in the development and testing of
the prosthetic arm. I would also like to thank the National
Society of Professional Engineers and The American Society
of Mechanical Engineers for providing the community with
sound ethical guidelines. I give a final thank you to my
fellow professionals, Alex Houriet and Samantha Lenskold
for offering advice towards my decision in this difficult
dilemma.
REFERENCES
[1] (2007). “NSPE Code of Ethics for Engineers.” National
Society of Professional Engineers. (Online article).
http://www.nspe.org/resources/ethics/code-ethics
[2] (2012). “Society Policy” American Society of
Mechanical
Engineers.
(Online
article).
https://www.asme.org/getmedia/9EB36017-FA98-477E8A73-77B04B36D410/P157_Ethics.aspx
[3] (2015). “DePuy ASR Hip Recall Information.”
Drugwatch.com.
(Online
Article).
http://www.drugwatch.com/depuy-hip/recall.php
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Tyler Pastorok
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