Tuesday, July 24, 2007

War, On the Other Hand

Just down the road from where I teach in San Marcos, Texas, the Arredondo family lives in a suburb of San Antonio. Every now and then Rose, age ten, will rush inside the house and tell her father Juan, "There's another snake in the back yard, Daddy!" Then she follows her father outside and watches as he calmly walks up to the snake and picks it up with his bare left hand. Even if it tries to bite him on the hand, Arredondo shows no concern. My source does not report what he does with the snake after that, but it is safe to say that this particular snake never disturbs the peace of the Arredondo back yard again.

What is remarkable about this little scene is that two years ago, Arrendondo was on patrol in Iraq when a bomb severed his left hand. He survived to join the ranks of hundreds of soldiers who have lost all or part of a limb in the Iraq war. But the Army paid $65,000 for a new prosthetic hand developed by Touch Bionics of Edinburgh, Scotland, and after some months of training, Arrendondo can use it nearly as well as his intact right hand. Unlike previous electromechanical hands, the i-Limb has five independent motors, one for each finger and the rotating thumb. Sophisticated software uses myoelectronic signals from the muscles in Arrendondo's forearm to control each finger independently. Although a lifelike skin-colored covering is available for those who wish to blend into the non-amputee world unobtrusively, Arredondo, like many of his fellow amputee veterans, chose a transparent silicone covering which shows off the camouflage green-and-brown paint job on his plastic fingers.

Anyone familiar with the history of technology knows that war is one of the most effective cultural spurs for engineering advancements. All the great engines of destruction, from the crossbow to the hydrogen bomb, were developed for reasons of war. But while the ill wind of war spreads death and tragedy wherever it goes, those in the healing professions, including biomedical engineering, can beat the sword of war into the plowshare of better medications, treatments, and prosthetics. (I am now caught up on my mixed-metaphor quotient for the month.)

Devices like the i-Limb don't get invented overnight. The ideas that gave birth to the commercial product originated in research begun about twenty years ago under the sponsorship of Scotland's National Health, the government agency responsible for most health care in that country. When the technology was far enough along to be commercialized, the private firm Touch Bionics took over and now sells the device throughout the world.

So often, engineering ethics discussions concentrate on things that go wrong: disasters, accidents, fraud, coverups, and so on. But there is a strand in the discipline that says we should highlight good examples of engineering well and ethically done: projects that go right, people who benefit their fields and humanity in general. If all we talk about is how to do something wrong, how will anyone learn how to do it right?

Touch Bionics, and the government researchers before them, look like good examples to me. While there are unethical things you can do in any profession or field, a person who chooses biomedical engineering with the goal of developing better artificial limbs chooses an engineering career that will benefit humanity almost without question.

The choice of a career has profound consequences both for the person who chooses it and for the society he or she lives in. Sometimes it is made with maturity and judgment, but other times a person decides what to do with their life with less thought than they'd give to picking out a movie or a restaurant. At the same time, there are no guarantees that everything you do will end up being used in a way you would choose.

Suppose an engineer who was dead-set against war consciously chose to go into biomedical engineering and took a job with Scotland's National Health to develop the artificial hand that turned into the i-Limb. It is the nature of the case that one of the biggest customer segments for such products are amputees who lose limbs in combat. Can you say that the availability of good prosthetics encourages or supports war? I don't think so. Yet without that market and generous Department of Defense funding to support it, companies such as i-Limb might have more trouble staying in business.

Young people starting a career in engineering seldom consider such complexities as these, and I think that overall it is probably a good thing. If you start to worry about every little bad thing that might possibly happen to you, you'll never get out of bed in the morning. But as bad as war is, I'm glad that engineers working for companies like Touch Bionics have the imagination and dedication to pursue a good idea like the i-Limb over the many years it takes to bring it into reality.

Sources: The USA Today article describing the i-Limb appeared in the July 23, 2007 online edition at http://www.usatoday.com/tech/news/techinnovations/2007-07-19-bionic-hand-amputee_N.htm. Touch Bionics has a website that gives details about the i-Limb at http://www.touchbionics.com.

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