Professor Daniel Budny(University of Pittsburgh) once said in a lecture that the engineers are granted the ability to create the future with the condition that we can not make a single mistake. In some cases people trust our abilities with their lives. This is why it is important to become an registered engineer. Registering as an engineer, gives one the credentials required for employers and client to trust in one's ability to work in their field. It takes hard work and determination to receive the engineering license, but the world gives its due respect to those that obtain it. In order to become licensed, candidates must have completed a four-year college degree, work under a Professional Engineer for at least four years, pass two intensive competency exams, and earn their license from state's licensure board. Afterwards, an engineer must continue to improve and show competency in their careers. This despite the large list of requirements, obtaining a P.E. is well worth it because it proves I am a qualified to help create the future. Becoming one means that I accept the responsibility of my work, and anyone who becomes affected it. This is why PEs uphold the ethical codes to highest regard during practice. Becoming a PE, will also allow me to pursue higher level positions required by government and other institution. Overall, one should be registered in order to make an impact on society because their work impacts more than just themselves, it can impact everyone.
ROBOT ASSISTED SURGERY Robotic surgery is the new cutting edge technology that is changing the fields of bioengineering and medicine. Its potential ranges from 100% reduction of tremor in surgical cutting to remote controlled surgery [3]. The benefits have been obviously recognized by the public because robotic assisted surgeries have increased from five thousand surgeries in 2002 to seventy three thousand surgeries by 2009 [1]. Yet like any other form of technology, robotic surgery still has its technical issues, and improper use can lead to ethical dilemmas. Some ethical decisions that engineers must make are: should one notify appropriate authorities about flaws in project or continue with its development but risk lives of many people. Ethical codes for professional engineering have been created in order to prevent ethical issues from occurring, but when ethical dilemmas do occur it is the duty of the involved engineers to find a viable solution in accordance to the ethical guidelines. SCENARIO WITH VIOLATIONS A fellow associate and I are trying to develop a new attachment for a surgical robot that has better extraction techniques and gives doctors more maneuverability. The most common surgical robot used by doctors is known as the da Vinci Surgical System by Intuitive Surgical. With its three to four interactive arms equipped with endoscopic camera, the machine has tremendously improved the success rate of laparoscopic operations, but there are certain times when surgeons must actively intervene due to an odd angle or an awkward position which does not allow continuation of the robot’s use [2]. Our goal was to enable the robots to work in such circumstances, but recently the attachment model we designed performed poorly in test trials in which both of us discovered a major flaw in the device. The arm had too much maneuverability and miscalculations causes arm to be too forceful and thus a safety hazard for both patients and doctors. The only way to fix it was to redesign the entire arm, which would set the device development back by several months past the deadline if not abandoned, but the other engineer noticed that careful and sensitive use of arm appears to disguise flaws. In order to avoid having our bosses scratch the project, my colleague decided to forge the initial test results so that the numbers appeared to be promising and so that the arm can move on to the last stage of development before entering the market. VIOLATIONS BASED ON NSPE’S CODE In such situations, there are numerous ethical rules violated by my associate that require me to decide upon how I must act. The National Society of Professional Engineering’s (NSPE) Code of Ethics for Engineering is a set of ethical guideline which is used by all disciplines of engineering. The code contains 6 fundamental canons which separate into further more specific rules. The canons violated in the scenario are one and six. The first canon of NSPE’s states that, “Engineers shall hold paramount the safety, health, and welfare of the public” [5]. In other words, this states that the engineer must not danger others in whatever form of work that they are doing. The canon goes to explain that it is the engineer’s duty to report to appropriate professional body or authority when there is risks involved. In this scenario the engineer decides to continue the development of the arm attachment despite our notice of the serious flaws and thus refuses to tell our superiors. The same question shall also pertain to me on whether or not tell my superiors about flaws [5]. There are two independent consequences that can occur depending on the decision I make. The first option to notify our employers that the robotic arm attachment has a significant flaw. The best scenario would be that the employers extend the deadline to give us more time and the worst scenario would be that the project would be entirely discarded. Since this was a major project, the biomedical firm would lose a lot of revenue creating a financial burden since we would lose so many potential clients to competitors because our product was not finished in time. It would also give the firm a bad name since it did not uphold to everyone’s expectations. The second option is to go along with my partner in his decision. As mentioned previously before, the attachment appears to be working fine as long as one does not apply too much power, but that causes our clients to be unaware since my colleague and I would have decided to omit the very important information. There is no set regulation that states that doctors and other qualified technicians are required a certain amount of training to use these surgical systems. In a 2012 statistics, around 174 injuries and 71 deaths have occurred to patients due to the misuse of the da Vinci Surgical System. The most common cause is that doctors are inexperienced in using the device [7]. If the arm goes into market it will increase the amount of injures since operators would be unaware that slight misuse can make the arm deadly to patients and themselves. The engineering firm would have to recall and refund all the clients and pay for injuries caused by their product. My associate may not notice the long term consequences at that time, but it can have drastic effects on other people’s lives. The next canon that was violated was the sixth canon which states that, “Engineers conduct themselves honorably, responsibly, ethically, and lawfully so as to enhance the honor, reputation, and usefulness of the profession” [5]. This canon has rather lengthy subcategories but the big one that we would violate is the subcategory which means the engineers should strive for the highest standard in honesty. Under this guideline, we should not distort or change the facts and let their employers know that project has not been successful [5]. The engineer however does in the scenario show direct violation of this because he forges the trial results to make it look like the design is a success to our bosses. This is because we would feel like we were not able to work at the expected level of competence displayed in bioengineering if we declared our product a failure [8]. However if our firm wishes to release our work, another engineer may discovers the flaw, and we would be put to shame anyway. VIOLATIONS BASED OFF BMES CODE The next ethics code is from the Biomedical Engineering Society (BMES). The society’s code has formatted differently from the NSPE’s ethics code because instead of having canons, BMES code is organized by the different situations such as training or research. The two situations that I should think about during my ethical decision making process is the Biomedical Engineering Professional Obligations, and Biomedical Engineering Research Obligation. The professional obligation refers to using integrity to achieve increased influence, competence, and honor of the biomedical engineering profession and to maintain the safety of the public with knowledge. The second point of the first obligation also closely emulates the statement of the first canon in the NSPE’s code [6]. If I allowed my partner to continue developing the flawed robotic arm attachment, then I would break this obligation because we would not be honest with our work and it would lead to the endangering of the public’s safety when doctors use the new arm attachment on patients undergoing surgery. Our actions will not be considered honorable because the arm attachment would become a big controversy in the biomedical field since it would injure patients and be counterproductive to ideals. The second BMES obligation that involves us would be the researching obligation because we headed design and testing of the extra arm for the robotics surgical systems. We were following the first part of the obligation until the discovery of the flaw because it says all legal, institutional, and other research guidelines must be followed. Learning about the flaw and adjusting the numbers from the test to give the perception that the arm is working properly would be a violation to this obligation. The second rule of research obligation would also be violated because we did not present the true initial trial data results accurately or clearly [6]. Our options are to follow the code, therefore trashing or restarting the arm, or choosing to use fake data. The difference is to admit fault for the arm now or later. WHAT ETHIC RULES DID WE FOLLOW? Despite the various ethical violations performed by the engineer, there were some ethical rules that we already chose to follow when we took on the project. For example, the second and fifth canon were already followed because we are skilled in the field of competence of biomedical engineering. It was the reason he and I were hired by the company and selected to lead the project. We did not use deceptive acts to mask our true qualifications. Also, we did start out with good intentions for the surgical arm attachment project because its purpose was to help doctors utilize the robotic surgical system at times that they initially could not [5]. MAKING THE DECISION Overall, I have to weigh the options and consequences that can be brought by whatever decision I make. I can either join my fellow colleague or make the decision based on the engineering ethic codes. One path would trash the work done on the robotic arm attachment and put the biomedical firm in financial burden with setbacks and loss of potential clients, and the other would save the company but would also have a negative impact on the medical field since so many innocent people seeking proper surgery would get injured. The answer to which path of decisions I make should take is simple, because the second set of consequence are unethical and against common morals. I decided it would be better to admit failure and stay honest in this field of work than to be dishonest because honesty is the “glue” that holds this profession together [8]. Also, it would not be right in any type of work, even those outside of engineering, to put other people in harm’s way. The ethical codes by many accredited professional groups were designed to guide engineers to make the right decision when presented in situations similar to the scenario I was presented with in this scenario. The goal of biomedical engineering is to increase a person’s robustness and to allow them to live longer and healthier lives, so it would be against all the values that biomedical engineering stands for when releasing a product that has a higher potential of harming patients than saving them. PROPER STEPS TO FOLLOW Since I decided to follow the ethical guidelines, I would follow all the rules that my project partner decided to violate. First I would alert my employers that the arm is not successful and state that it will not be ready to be released in the market at its current design due to the safety hazard issues. I should also inform my superiors about the intentions of my colleague who intended to release the flawed design into the market rather than admit our mistake. If he is willing to do it once, my associate would be more likely to do it again if he is involved in a similar situation in the future. Our employers would make a decision on whether to go back to the design stage or to abandon the project. My associate would be put under review because forging data results is a serious issue in any science and technology related profession. In order to follow the code in doing profession work with integrity, I would also have to report the original data results that show the arm was performing poorly [8]. To withhold the original data would violate the sixth canon of NSPE code of ethics and the BMES research obligation since withholding the data would be a form of distort the truth. Overall, I mentioned in the scenario that the first model of the surgery robot arm was a failure, but in reality most first prototypes usually are failures. Proper analysis of the causes of failure is what leads to developing good products. Some engineering projects require years of design and testing before it becomes ready for the market. The da Vinci surgical robot system was first conceptualized and designed in the mid-1990s. However it was not send to FDA for approval until early 2000s and only became widely accepted as a standard medical equipment in hospitals from 2007 and onwards. Therefore only designing one prototype should never been the approach the other engineer and I should have taken. That was what led us to the scenario with the ethical dilemma in the first place [1]. SYNOPSIS Despite the breathtaking advancements of robotic-assisted surgeries in the fields of bioengineering and medicine, one must still follow some form of ethical code, because improper use can be dishonest and immoral since it can put other people’s lives in danger. For biomedical engineers, the standard code of ethics followed should be by the National Society of Professional Engineering and by the Biomedical Engineering Society. In the scenario with ethical dilemmas, an engineer and I were in charge of developing a robotic arm attachment that enabled better maneuverability. However, our prototype had serious flaws which caused it to be a safety hazard in some trial tests. Since the deadline was approaching, my colleague decided to forge test results after realizing there was no quick solution to fixing our problem, and we would miss the deadline set by our superiors. If I followed along with the plan, our product would become available on the market which could cause large numbers of injuries to patients. If I chose the alternate path, which was to alert superiors and stay honest to my work, then my company would suffer financially due to loss of clients. Out of the six fundamental cannons of the NSPE’s code, two canons were explicitly discussed to help me make my ethical decisions. The first one states that the engineer should not endanger the public, and general welfare for whatever reason, and the second one states that the engineer should work with integrity, and not distort the facts in order to appear as a success. Similarly, the BMES’s codes has two different obligations that would be violated by the other engineer’s method to dealing with the scenario. The first was the pursuit of career with honor, competence and integrity and to maintain the safety of public. Both would be violated by pushing the development of the flawed product. The research obligation asks for the data to be presented in an honest, accurate fashion. My solution to what to do in this ethical crisis is to tell my employers that the project is unsuccessful and present to them the original data results. It would also be my duty to mention my engineering partner, who had shown intent of being unethical. No one ever wants to be in a scenario as one in this essay, but if one is then his/her best solution is always to be honest and follow the ethical codes.
REFERENCES [1] N. Sharkey, A. Sharkey. (2013). “Robotic Surgery: On the Cutting Edge of Ethics.” Computer. (Online article). http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=6374197. pp. 56-64 [2] R. Muradore, D. Bresolin, et al. (2011). “Robotic Surgery.” Robotics & Automation Magazine. (Online article). http://ieeexplore.ieee.org/stamp/stamp.jsp?tp=&arnumber=6016596. pp. 24-32 [3] J. Selber. (2012). “Robotic Surgery.” Reconstructive Microsurgery. (Online article). https://www.thieme-connect.com/ejournals/pdf/10.1055/s-0032-1324408.pdf. pp. 433-434 [4] S. Kay. (2013). “Remote Surgery.” Light Speed. (Online essay). http://www.pbs.org/wnet/innovation/episode7_essay2.html. pp. 1-2 [5] (2007).”NSPE Code of Ethics for Engineers.” NSPE. (Online Article). http://www.nspe.org/Ethics/CodeofEthics/index.html [6] (2013). “Biomedical Engineering Society Code of Ethics.” BMES. (Online Article). http://bmes.org/files/2004%20Approved%20%20Code%20of%20Ethics(2).pdf [7]R. Rabin. (2013).”New Concerns on Robotic Surgeries.” The New York Times. (Online Essay). http://well.blogs.nytimes.com/2013/09/09/new-concerns-on-robotic-surgeries/?_r=0. D4 [8] D. Vallero. T. Jonathan. (2007, March). Biomedical Ethics for Engineers. [Online]. Available: http://site.ebrary.com/lib/pitt/docDetail.action?docID=10186166&p00=biomedical%20ethics [October 26, 2013]. pp. 274-275 ADDITIONAL SOURCES E. Datteri. (2013, March). Science and Engineering Ethics. [Online]. 19(1). Available: http://link.springer.com/article/10.1007%2Fs11948-011-9301-3 [October 25, 2013]. pp. 139-160 F. Graur. M. Frunza, et al. (2010). New Trends in Mechanism Science. [Online]. 5. Available: http://link.springer.com/chapter/10.1007%2F978-90-481-9689-0_53 [October 25, 2013]. pp. 457-465 R. Satava. (2010). “Ethical Dilemmas in Laparoscopic, Robotic, and Advanced Surgical Technology.” Society of Laparoendoscopic Surgeons. (Online Essay). http://laparoscopy.blogs.com/prevention_management_3/2010/10/ethical-dilemmas-in-laparoscopic-robotic-and-advanced-surgical-technology.html ACKNOWLEDGEMENTS I would like to thank Mrs. Brink and other librarians for pointing me in the right direction for research. I would like to thank the writing instructor at Writing Center for helping me improve my paper and letting me know I misinterpreted the objective of essay. I would like to thank my engineering writing instructor, Ms. Ferda for help me during my confusion on essay and replying to my numerous emails.