Engineering, as a profession, has ethical obligations to society that go beyond the simple application of technology as learned in science and engineering courses. Bioethics, a required course for bio/biomedical engineering students at our university, seeks to supplement technological aspects of bio/biomedical engineering by engaging students in an analysis of the effects of bio/biomedical engineering developments on society, focusing on safety of the public as a primary ethical concern.
In this course, students are educated on a variety of ethical tools that enable them to analyze fictional and realistic cases. Students are evaluated individually, as well as in groups, with a particular focus on the ethical issues developed in a group case project. Upon completion of the course, students will be able to recognize, articulate, and resolve ethical issues within the arena of bio/biomedical engineering. As part of a new initiative to deepen student’s awareness of the multifaceted nature of bioethical issues, students partaking in the bioethics course in Spring 2019 were asked to incorporate aspects of sustainability in their final project case analysis. Sustainability is defined as balancing social needs, environmental impact, and economics so current and future generations can thrive. From an academic perspective, sustainability often focuses on the tradeoffs and interplay between these three elements which are often referred to as the triple bottom line.
For the final project, each group chooses/identifies a case for analysis. Cases can be drawn from student experiences; an ethical dilemma that has affected someone they might know; be a hypothetical case based upon a situation that has ethical ramifications that students find interesting; or an in-depth exploration of a historical case with dubious ethical justification.
Students are asked to utilize methodologies, such as utilitarian approach, discussed in class to develop a resolution (recommendation) for their case. Each group presents their case in class and then documents their case for final evaluation. Evaluations, which are all conducted by the course instructor, are conducted in three dimensions: quality and flow of presentation; indications of significance; and choice and application of methods of moral reasoning. During the Spring 2019 offering of the bioethics course, forty-one students were enrolled, resulting in eight groups/projects. As part of their final project instructions, students were provided with prompts to help them identify sustainability impacts in their respective cases. Specifically:
>> Are there direct and/or indirect social implications of your case’s outcomes at scale and over the long term?
>> Are there direct and/or indirect economic implications of your case’s outcomes at scale and over the long term?
>> Are there direct and/or indirect environmental implications of your case’s outcomes at scale and over the long term?
Furthermore, students were presented with an example of how conflicts arise within the triple bottom line: for a medical product choosing a one-time use option for distribution may reduce costs, reduce the risks for the end user in terms of contamination but, detrimental to the environment; and asked which options presented should be prioritized?
While students’ selected case studies focus on bioengineering ethical dilemmas, we hypothesized that using the triple bottom line sustainability framework for a bioethics course would improve the ability for students to recognize and articulate tensions and tradeoffs between other design values as well (the triple bottom line of social, environment and economic). More specifically, we hypothesized that students identify and consider more ethical dimensions with the sustainability framework than without.
A qualitative comparison between Spring 2018 and Spring 2019 cases was conducted to gain insight into the effect of incorporating sustainability in bioethics on the number and types of dilemmas that students recognize and articulate. Two datasets (~30,000 phrases and words each) were derived from student submissions while removing references. The datasets were compared for the prevalence of words and phrases. In the 2019 section, there was an increase in the consideration of environmental factors on ethical dilemmas. While several teams were able to use sustainability to identify additional factors that shaped the ethical dilemma, there were still some teams who, despite being prompted with sustainability questions, chose to focus mainly on social and economic impacts more than environmental.
In summary, the sustainability triple bottom line adds to students’ critical thinking of bioethics, however, not all aspects of sustainability may directly impact some of the ethical dilemmas that bio/biomedical engineers face. Based on this preliminary analysis, the instructors acknowledge that more specific course material and bio/biomedical examples ought to be developed to highlight the environmental implications of bioethical dilemmas.
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