John Swales defines the term discourse communities as 'groups that have goals or purposes, and use communication to achieve these goals' (4). A discourse community is defined by the following six characteristics: The community has a broadly agreed set of common public goals, the community has mechanisms of intercommunication among their members, the community uses its participatory mechanisms primarily to provide information and feedback, the community utilizes and possesses one or more genres in the communicative furtherance of its aims, the community also owns genres and has some acquired lexis that are specific to the community in terms of jargon, and the community has a threshold level of members with a suitable degree of relevant content and discourse expertise. In such communities, members often come as novices, and due to their high level of commitment to the community, they “leave by death or other less involuntary ways” (4).
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The Discourse community that I chose to look into is the Biomedical Engineering community. Biomedical Engineering is the application of engineering principles and design concepts to medicine and biology for healthcare purposes. Biomedical Engineering is a relatively new field. In fact, it is the only engineering field that was developed post World War II(2). Although the field of medicine and Engineering had crossed path many times before, Biomedical Engineering was recognized as a field in the late 1960’s. the first biomedical engineering departments were formed at the University of Virginia, Case Western Reserve University, Johns Hopkins University, and Duke University(2). Since then many advancements has been made by the Biomedical Engineering community that has changed the quality of healthcare immensely.
The goal of the Biomedical Engineering community is public. It is to learn from each other, work together in hopes of new discoveries and communicate new findings done through research. The Biomedical Engineering community mainly uses published articles to communicate with one another. As the most formal and very informative means of communication, Biomedical Engineers publish results of their research in articles which are highly read by other Biomedical Engineers. Biomedical Engineers publish three academic journals: Cardiovascular Engineering and Technology (since 2010). Annals of Bioengineering (since 1972) and Cellular and Molecular Bioengineering (since 2008). Next to published articles, the Biomedical Engineers use an online media to communicate. The online website is used to connect with each other about jobs, upcoming events and conferences, new published articles and other information. The published articles can be considered as genres as it is understood by all Biomedical Engineers as a formal way to share research. When looking at the members of the community, since Biomedical Engineering is a relatively new form of engineering, it is hard to say who the “old timers” are. However, it is proper to call people who have the necessary education (undergraduate and beyond) and who have worked in industry or have done research for an appropriate amount of time people with authority in the community. The new comers to this community will be college students who are just starting to take Biomedical Engineering classes. They learn the appropriate language by paying attention in class, reading articles and involving in the Biomedical Engineering community.
The community of Biomedical Engineers is very exciting and composed of many intellectuals, however the conflicts and ethical dilemmas that members face are overlooked. The national society of professional Engineers has a set of code of Ethics for Engineers. The same way there are also many code of ethics for medicine. However, Biomedical Engineers have to combine both of these code of Ethics to work in a professional manner that is also morally acceptable. This can make the job of a Biomedical Engineer challenging. Therefore, a lot of conflicts are observed in this community. These include “conflicts of interest, research misconduct, animal experimentation, allocation of uncommon resources and clinical trials for new medical devices.”(3) Since Biomedical Engineering is very broad it is divided into subfields based on their major goals. In this paper, we will take look at some of the conflicts that exist in specific fields of Biomedical engineering.
The first area where Biomedical Engineers face the most ethical dilemma is in the cellular, genetic and tissue engineering. As a background the three terms can be defined as the following. “Cellular engineering is a field that attempts to control cell function through chemical, mechanical, electrical or genetic engineering of cells. Genetic engineering specifically aims to control the genetic material in cells. And tissue engineering is a field that aims to restore, maintain or improve the functioning of tissues or whole organs by means of biological substitutes that repair or replace these tissues or organs” (1). The most controversial topic in all three fields is the use of embryonic cells. When genes of eggs and sperms or embryos are modified, the future is very unpredictable, and it also affects future generation, thus some argue that it violates the rights of the future generation. Using embryonic cells is also controversial because the cells are harvested from embryonic cells that destroyed in the process or from aborted fetuses. And it has been objected that it is not ethical to kill or use human embryos because they are considered to be human beings by some people in the community. People on the other side of this argument argue that research using embryonic cells can help doctors diagnose a disease before a baby is born and give them a chance to treat it. However, this topic remains very controversial in the Biomedical Engineering community as a battle between morality and scientific advancement.
Another area that members of the biomedical Engineers face conflict is in the area of Biomaterials, prosthesis and implants. In the field Biomaterials, “non-biological synthetic or natural materials are developed and used to interface with biological systems to replace, treat, augment or support tissues, organs or functions of the body.“(1) Biomaterials is vital for the development of prosthesis and implants. The conflict that arises due to using prosthesis and implants is the issue of dignity and human identity. This is because prosthesis and implants involve the addition of artificial materials to the human body and replacement of tissues and organs by manmade materials. Therefore, some members of the community are concerned that if these process makes the person less of human and where we can draw the lines as to how far we can replace human biology. While others argue, that humans are more than their organs and body parts and that if we as Biomedical Engineers can build body parts that can help someone who has lost the functionality of a certain part of their body, we have an obligation too.
The third area that we can look at is Biomedical Imaging and Optics. “Biomedical imaging is the application of engineering methods to detect and visualize biological processes”(1). Biomedical imaging is very useful because it helps to detect and diagnose diseases, allow doctors to have a live image of the human body and is minimally or non-invasive. The ethical dilemma rises mainly due to diagnostic imaging. Some believe that diagnostic imaging is leading to excessive diagnostic. Patients might get diagnosed with diseases to which no form of medication or therapy is available for or indicate the probability of getting a disease. This put medical specialists with the obligation to inform patients of disease they cannot do anything about hurting the morale of both the practitioner and the patient. Therefore, the community have been questioning the design of imaging technologies and if they should make imaging technologies that are specific to bodily conditions. Another ethical issue is under brain imaging. The technology of imaging is so advance that products of brain images can tell about a patient’s mental states, thought pattern and course of action. However, this technology raises an issue of privacy, mental manipulation and gives specialists power to control people. Thus, members of the Biomedical Engineering community have to be aware of this conflict when working in this field.
The last area of conflict in the Biomedical Engineering community that will be discussed in this paper in in the field of Neural Engineering. Neural Engineering is a new field in neuroscience that “uses engineering techniques to study and manipulate the central or peripheral nervous systems.”(1) As a complicated field, neural engineering is known to be involved in controversial animal and human subject research. Since it mainly involves studying the brain, the clinical trials are likely to be invasive. Much like Biomaterials, Neural Engineering had raised some ethical concerns when it comes to human identity and dignity. Since treatments involve adding artificial machines to the brain, society has questioned how much that affects a person’s identity and if that person is to be considered a robotic machine if most of their brain is affected by artificial intelligence. In addition, conflicts rise up because neural devices can be manipulated and used against the patient to control behavior, mood and so much more. Another ethical issue that Neural Engineering raise is if neural engineering should be used to make artificial devices that enhances human beings for instance by increasing motor control, sensory abilities, physical or emotional strength. This also raises questions of responsibility: can humans still be held morally responsible for their behavior when their brain has been engineered by others to function in a certain way. Neural manipulation also raises a conflict of responsibility. This is if whether patients who have artificial devices in their brains will be held responsible for their actions in a court of law if their brain had been designed to perform in a certain way. Neural Engineering is by far the most complicated field that raises conflicts among the Biomedical Engineering community because it involves the human brain which we do not know much about.
In conclusion, the world is full of Discourse communities which are communities that have the same goal and use several communication methods to achieve those goals. In this paper we looked at the Discourse community of Biomedical Engineers. As a relatively new Engineering field, this community is made out of members who chose to use the principles of Engineering and apply it to medicine to improve the healthcare quality of their community. We also looked at how their major form of communication is through published articles. The main focus of this paper is discussing the conflicts that members of this community face. As a community that has to answer to the code of ethics of both Engineering and medicine, we looked at the ethical dilemmas that different fields of study under Biomedical Engineering has to tackle. The main Engineering fields that we looked at are cellular, tissue and genetic engineering, Biomaterial, prosthesis and implants, biomedical imaging and optics and Neural Engineering. Being aware of the conflict in the community will allow future members or people who are considering to be part of this community what to expect when entering this field and how to best overcome them.