Monday, July 10, 2006

Bioengineering in Society

This is the short version of a vision I have for the UW bioengineering department's strategic plan. I've posted the longer version in a comment.

Bioengineering is a term that includes many particular topics, but it is always associated with advances in medicine or biotechnology. Since its inception, the field has been synthetic. In the 1960’s, physicians and materials scientists collaborated to generate a solution enabling long-term kidney dialysis. The Teflon Scribner shunt led to Seattle’s prominence as renal failure treatment center and is but one example of ground-breaking interdisciplinary engineering work at the UW. Bioengineers may forget that it also set the stage for a situation in which a “God Committee” made decisions about which patients could receive the expensive dialysis procedure in a resource limited environment. In the end, federal health care policy was changed so that no renal failure patient would be refused treatment. The area of bioengineering that I believe should be tackled in the next 5-25 years is not a specific research program; it is the way that bioengineers think about their position in society.

As the bridge between basic biomedical research and practical implementation, bioengineers are uniquely positioned to think critically about the needs and expenses of the technology they are building. I believe that the best bioengineers will be able to integrate needs and opinions from society into the healthcare setting. They will be at the minimum competent communicators about issues in science, engineering and society.

My proposal is for the bioengineering department to deliberately invest in the dialogue among bioengineers about the social implications of the work they do. Several research strengths at the UW exist in the midst of important public discussions about science and society. Three of these are global health, stem cell research, and nanotechnology. Not only are there prominent researchers in each of these fields within or affiliated with the bioengineering department, but there are centers here focused on each of these topics. It is clear that faculty and students are committed to contributing to society in meaningful ways. The Grand Challenges in Global Health Care grant is an example that bioengineers at the UW are committed to the complex challenge of moving healthcare out of the resource intensive Western hospital environment into the home and beyond to developing countries.

I believe strongly that a deliberate effort to incorporate issues of social responsibility and public policy into science and technology would provide the foundations to develop individuals that will lead their fields in academia, the corporate sector and the public sphere. How would this be accomplished? I can imagine three techniques. The first is a prominent seminar series on campus focused on issues in engineering and society. Speakers must be qualified to discuss the social and political aspects of fields that they work with, not merely offer armchair analyses of public policy. Such a series could rotate between bioengineering related fields of global health nanotechnology, or stem cell science. Another technique – perhaps more effective but less prominent – at increasing knowledge and ideas about science and society is an ongoing discussion group that includes faculty and all levels of trainee. This could incorporate idealism, practicality and a breadth of ideas in a collegial environment that could engage student and teacher alike. The third, and perhaps most difficult implement would be a course focused on issues of engineering and society. Challenges here include finding the teaching resources, adding to an already heavy course load, and the artificiality of classroom discussion on social, ethical and political issues. Perhaps this would be best as a joint effort between departments. It will not be easy to incorporate concepts often relegated to liberal arts departments into a technical education, but creativity and dedication could result in significant gain. Bioengineers familiar with the global, social and political context of their work will be better prepared to tackle the current challenges in health care and lead us through the next century.

Here are some web resources for UW groups interested in science and society:

International Health Group:
http://depts.washington.edu/ihg/index.htm
Nanotechnology and Nanoscience Student Association:
http://students.washington.edu/nansa/index.html
Forum on Science Ethics and Policy:
http://www.fosep.org/

1 comment:

thomas said...

This essay is an extended version of a submission to the University of Washington’s bioengineering department’s call for ideas. The question asked was, “What do you think will be the hot ideas (medical, scientific or technical challenges) that Bioengineers should attack in the next 5-25 years?” The area of bioengineering that I believe should be tackled in the next 5-25 years is not a specific research program; it is the way that bioengineers think about their position in society. Bioengineering is a term that includes many particular topics, but is always associated with advances in medicine or biotechnology.

Since its inception, bioengineering has been a synthetic field. In Seattle in the 1960’s, physicians and materials scientists collaborated to generate a solution enabling long-term kidney dialysis. The Teflon Scribner shunt led to Seattle’s eminence as renal failure treatment center. The synthetic nature of bioengineering did not stop at meetings in the hallway and selective collaborations. Biomedical engineering departments emerged from collaborative programs consisting of individuals that saw the value in wedding basic science with applied technology to better health care. Even today, members of the bioengineering department at the University of Washington are enrolled in the schools of medicine and engineering. Instruction is also very collaborative in bioengineering. Undergraduates take the equivalent of both a pre-med and engineering class roster, and some graduate students have indicated that the diverse course requirements at the graduate level are too broad. It is my understanding that the curriculum committee engages in ongoing reform to improve education at the graduate level, but they have a difficult task: bioengineering is inherently schizophrenic, and to earn a degree with that name needs both breadth and depth of study.

It is into this environment that I offer another aspect of bioengineering that I have not heard much discussion about within the department. We are living in what has already been labeled the century of biotech. It is remarkable how fast biology has progressed from what was virtually an amateur pastime in the nineteenth century to now the leading non-defense public science expenditure in the United States. Healthcare is the largest single sector of the American economy, and bioengineering is directly connected to this phenomenon, for better or worse. As the bridge between basic biomedical research and practical implementation, bioengineers are uniquely positioned to think critically about the needs and expenses of the technology they are building. I believe that the best bioengineers will be able to integrate needs and opinions from society into the healthcare setting. They will be at the minimum competent communicators about issues in science, engineering and society.

The position of bioengineering within society can be described in numerous ways, and the department has taken some steps to expose students and faculty to the intersection between technology and society. A quick perusal of the bioengineering curriculum revealed that one course, BIOE 481, includes in its syllabus the heading, ‘bioengineering and society,’ which I imagine includes a lecture or two about issues in research integrity, the importance of safety in device design or the cost benefit analysis of technology and its impact on society. A very important course sequence on technology commercialization is also offered, and this invariably covers issues of whether a potential product is needed by society, what the cost burden might be to hospitals, and certainly the regulatory environment for medical devices. I have not had the opportunity to take any of these classes, so cannot speak for the quality of the instruction.

My proposal is for the department of bioengineering to make a deliberate investment in the dialogue between scientists and engineers about the social and political implications of the work they do. The University of Washington is uniquely situated to provide both cases for study and the means to carry them out. Three research strengths at the UW are also in the midst of important public discussions about science and society. These are: global health, stem cell research, and nanotechnology. We must not exclude from the strengths list centers of expertise in systems biology, tropical diseases and cancer treatments that all depend on collaboration with bioengineers. Not only are there prominent researchers in each of these fields within or affiliated with the bioengineering department, there are centers focused on each of these topics just down the street or across campus. Many students are in these labs. It is clear that faculty are also committed to contributing to society in meaningful ways. The Grand Challenges in Global Health Care grant that was awarded to Dr. Yager and colleagues is an example that bioengineers at the UW are committed to the complex challenge of moving healthcare out of the resource intensive environment.

It is clear that UW bioengineering does excellent science. We all know from the presentations made by Dr. Kim what our status in research funding from the NIH is! The present call for innovative ideas will yield many excellent suggestions of how to further the technological and scientific supremacy of our department and our field. I believe strongly that a deliberate effort to incorporate issues of social responsibility and public policy into science and technology would provide the foundations to develop individuals that will lead their fields in academia, the corporate sector and the public sphere. How would this be accomplished? Briefly, there are three techniques. The first is a prominent seminar series on campus focused on issues in engineering and society. Speakers must be qualified to discuss the social and political aspects of fields that they work with, not merely offer armchair analysis of public policy. Such a series could center on bioengineering related fields of nanotechnology, stem cell science or global health. Another technique – perhaps more effective but less prominent – at increasing knowledge and ideas about science and society is an ongoing discussion group that includes faculty and all levels of trainee. This could incorporate idealism, practicality and a breadth of ideas in a collegial environment that could engage student and teacher alike. The third, and perhaps most difficult implement would be a course focused on issues of engineering and society. Challenges here include finding the teaching resources, adding to an already heavy course load, and the artificiality of classroom discussion on social, ethical and political issues. Perhaps this would be best as a joint effort between departments. It will not be easy to incorporate concepts often relegated to liberal arts department into a technical education, but creativity and dedication could result in significant gain. Bioengineers familiar with the global, social and political context of their work will be better prepared to tackle the current challenges in health care.

There are several models of groups on the UW campus that are striving to link science and technology to social issues. Curiously, each of these is student led. The International Health Group (IHG) in the school of medicine is targeted to preparing medical care providers for careers in global health. With support from the school of medicine, this group was a predecessor, model and think tank for the recently inaugurated Department of Global Health. The IHG has run elective courses, coordinated a resource for medical study abroad, and held very successful weekend symposia attended by national experts. The Nanotechnology and Nanoscience Student Association has as one of its missions to inform the public about what nanotechnology is and is not and aims to facilitate interdisciplinary discussions about nanoscience. Finally, the Forum on Science Ethics and Policy (FOSEP) is a graduate student and post-doc organized group committed to increasing dialogue about how science impacts and is impacted by science policy. (I am a director of this group.) FOSEP holds discussion groups, a seminar series, reading groups and public forums to facilitate these discussions. These student groups work hard to plan and host and raise money for events that address conflict, confusion and uncertainty about the interaction between science and society. They train students to be leaders, and interject ideas about science and society into the work we do every day. By this metric, such groups are successful. They can accomplish only as much as their dedicated leaders can accomplish after they leave the lab. Students then graduate, and the effectiveness of the groups wax and wane.