Ethics for bioengineering scientists: treating data as clients

This book aims to act as an ethics textbook for what it terms ‘bioengineering students’: scientists working with medical technologies either in research or clinical practice. It is aimed at an American audience. The book’s title might suggest a substantial part of it would be dedicated to arguing that bioengineering scientists should treat data as the primary object of their ethical commitment. Yet, this is not the case. Rather, the book covers a vast array of medical science-related humanities topics, which turns out to be a double-edged sword.

It was not clear to me at first what is meant by ‘bioengineering scientists’. Perhaps this term has a well-defined meaning in the U.S.A.? Notwithstanding, the book is aimed at scientists who work with medical technologies, either in their development, evaluation, or clinical application. As such, these practitioners occupy a niche on the border of clinical practice and science, with the book’s focus mostly on those with engineering skills. The author tries to accommodate this niche by presenting the history of the development of all three foundational professions relating to this field: engineering, medicine and science.

While some of the historical coverage crosses national borders, the focus is on the developments in the U.S.A. However interesting it may be to study how medical device regulation developed in the U.S.A., how professional societies there came about, or how the Food and Drug Administration (FDA) does its job, this is likely to be of little professional use to those working outside of the U.S.A.

While the book has a strong focus on ethics, it also tries to cover a lot of topics that are tangential to ethics. The introductory chapters review not only the aforementioned historical developments in the three primary professions, but also the history of ethics and other relevant branches of philosophy. This is laudable, since scientists may be poorly versed in these important subjects. Yet, as this is not a long textbook, the exploration of each topic is inevitably shallow. For example, while the author introduces the reader to the concepts of inductive and deductive reasoning and their application in science (p. 21) these are insufficiently detailed. Perhaps it would have been better for the author to direct the reader to key texts on logic in science and focus more on the ethics, which I think is somewhat lacking. A clear example of this is Winet’s coverage of the history of Scholasticism without mentioning Thomas Aquinas, despite his great influence on virtue ethics, natural law theory and teleology. Similarly, there is no mention of Beauchamp and Childress’ Principlism, despite it being foundational to modern bioethics. While the breadth of the text is an attractive feature to the curious reader seeking a fully comprehensive text, it is questionable whether all the many concepts are introduced to the reader accurately. For example, the term ‘fertile crescent’ is mentioned in a couple of places in the book (see e.g. p. 9), but the author uses it to describe an area that stretches from ‘Europe to East Asia through India’ (p. 253), but more commonly this area seems to only denote the region stretching from North East Egypt to Iraq or Iran. Another example is the lack of discussion on the interbreeding between the various Homo species when human evolutionary ancestry is described (see e.g. pp. 36–37). While these are small issues, particularly when considering the focus of this book, one expects more rigour from an academic text. Moreover, these issues compound the problems with some of the concepts that are more pertinent to bioengineering scientists’ day-to-day work. For example, the author tells the reader that scientific article reviewers are not paid to review manuscripts (p. 210), but that this is part of the professional responsibility of scientists. Such a concept might seem puzzling to undergraduate students, and perhaps the author should have elaborated on it. Similarly, it is uncertain what Winet means in stating: ‘[a] scientist functions professionally as a logical positivist. We assume that the scientist, toward whom this book is directed, is a positivist and need not be a logical positivist.’ (pp. 19–20). It is also unclear whether the concept of a ‘truth professional’ (p. 20) is something that the author has coined himself or if it is taken from pre-existing literature. Certainly, more attention should have been given to it, as it is likely to surprise some of the readers that medicine is regarded as a truth profession, whereas science is not.

There are also some problems with how the book has been edited. While Winet’s writing is accessible, it sometimes lacks an appropriately academic tone: ‘Einstein’s predicted “gravity waves” were not detected for another 100 + years.’ (p. 18). The author asks the reader to ‘[p]ay particular attention to the bolded sections’ (p 98), but it is not at all clear where these are. Figure 12.2 (p. 208) is illegible, though it would probably be useful if it were set horizontally. Other issues include some abbreviations not being explained on their first use, and references are occasionally given in the form of weblinks without other pertinent bibliographic details (in the case of Figure 12.1 (p. 207) the link denotes the location of the file in a user’s computer rather than the location on the internet!).

There are, however, some positive aspects of this book that are worth mentioning. It offers helpful examples of educational activities for teachers in the ‘enrichment’ sections located at the end of each chapter. These could be adapted to suit students at both undergraduate and postgraduate levels, whether they are studying applied science, medicine or philosophy. Another of the book’s strength are the numerous tables and appendices which serve as handy references to key concepts, terminology, and timelines.

In summary, this book is unlikely to be suitable as an ethics textbook for bioengineers working outside of the U.S.A., unless they are particularly interested in the USA’s medical device regulatory landscape. Neither, despite its title, is it a book that will help those wishing to delve deeper into the ethical dimensions of data science. It is also not an outstanding textbook on ethics. That said, it might be a good starting point for scientists with an interest in medical humanities looking for a first stepping stone into the subject, as long as they keep in mind the book's limitations.