Engineering vs medicine

W. Richard Bowen begins his book, Engineering Ethics: Outline of an Aspirational Approach, with an anecdote about a “young woman with outstanding academic achievements in science and mathematics” who applied to study engineering, motivated by the thought that, as an engineer, she could “make a contribution to the well-being of others.”

However, after visiting the university she had applied to, she left with the perception that engineering was a discipline more focused on technical ingenuity for its own sake, rather than a discipline that was focused on changing the world for the better, and she decided to study medicine instead.

The following (tongue-in-cheek) debate between an engineering student and a medical student develops this idea, considering whether engineering can compare with medicine as a profession that people might choose if they are motivated by the thought that their profession, and their own individual work, will make a valuable contribution to others.

ENGINEERING STUDENT: I can’t believe I had to endure another engineering ethics lecture! Do they ever end?

MEDICAL STUDENT: You should be so lucky. We have far more ethics taught to us in medicine than you guys. Then again, in medicine we have issues to do with consent, confidentiality, abortion and euthanasia. What is there to talk about in engineering ethics?

ENGINEER: I don’t know. I wasn’t really listening.

MEDIC: In my case, if I make a mistake, someone could die. In your case, someone might end up with a dodgy phone!

ENGINEER: Are you joking? Engineers can kill people every bit as well as doctors. In fact, I bet we kill many more people than doctors. Think of all the weapons we make that kill thousands of people.

MEDIC: Fair enough, I hadn’t thought of that. Hey, maybe you do need ethics teaching to stop you from making weapons.

ENGINEER: Then a number of doctors would be out of a job patching up the people we blow up.

MEDIC: I think we’d be quite happy with that.

ENGINEER: But there are good reasons for making weapons. Unless you’re a pacifist – and you’re not – then you agree there are situations in which we need a military. And they have to be armed somehow.

MEDIC: Maybe.

ENGINEER: But we don’t just kill people with weapons. More than a million people are
killed a year by car crashes.

MEDIC: But that isn’t the engineer’s responsibility, is it.

ENGINEER: I’m not sure. But don’t forget about plane crashes, dodgy bridges, nuclear disasters, mining accidents, oil spills. Even when a doctor tries to kill people, they typically only kill a dozen or so. An engineer can kill hundreds – or thousands – without even trying!

MEDIC: Wow. By comparison, we are paragons of virtue. Come to think of it, I can’t imagine a more virtuous profession.

ENGINEER: I wouldn’t be so quick. I mean, sure, doctors are there to help people, but generally you work one person at a time. We can affect the lives of millions.

MEDIC: So finding cures for leprosy, TB, puerperal fever and smallpox were small fry, were they? And what about antibiotics? Any one of those has saved thousands if not millions of lives. What does engineering have that comes close to those?

ENGINEER: OK, so it’s not just one person at a time. However, engineering isn’t just about cars and bombs. Think about irrigation, which has led to the draining of huge areas of land such as the Netherlands or East Anglia, and the watering of other areas which would otherwise be barren. Without engineering, people would still be using medieval strip farms. They could barely feed themselves, let alone everyone else.

MEDIC: You do have a point there.

ENGINEER: Even in the field of health care, I bet that engineers have a greater impact than medics.

MEDIC: That’s pushing it a bit.

ENGINEER: Not at all. The British Medical Journal had a vote in 2006 about the greatest advance in medicine, and do you know what their answer was?

MEDIC: Antiobiotics?

ENGINEER: No! I’ll give you a clue. It wasn’t the medical profession that can take the

MEDIC: I don’t know.

ENGINEER: Sanitation. Clean water. Think how few cases of dysentery you have to deal with. People used to die from sicknesses which have been largely eradicated thanks to flushable toilets. And then there are advances in building technology allowing people to live and work in better quality houses rather than Victorian slums, heating for those houses in winter and air conditioning in summer. There are also better quality roads and transport systems, thanks to engineers. You may laugh at me wanting to work on cars, but doctors these days rely on patients and medicine coming to them in ambulances and refrigerated vehicles respectively. You couldn’t perform a heart transplant without engineering!

MEDIC: OK, OK. I get it. You do some good stuff as well.

ENGINEER: And who do you think makes the artificial heart valves you put into the patients? Or the pacemakers? Or the artificial hips and knees? All come from engineering!

MEDIC: Okay, I said. Okay.

ENGINEER: And don’t think that medics can take all the credit for drugs either! That’s us too – that’s the chemical engineers. And how about the future? What can medicine offer down the road?

MEDIC: The sky’s the limit there. Now that we’re getting a better understanding of genes and have the human genome mapped we can really look at engineering humans so that we have fewer diseases. We may be able to completely eradicate genetically-inherited disease, and accurately predict a person’s chance of getting cancer or heart disease in a way that helps them modify their lifestyle in time to avoid the worst. The drugs and technology we’re developing can extend both the length and the quality of life. And you?

ENGINEER: Those are some pretty good things, I’ll admit. But aren’t they just toys for the rich? I mean, who benefits from them? Rich people in rich countries. What are you doing for the poor in less wealthy countries? Engineering offers solutions to less wealthy countries through designing cheap wells, providing irrigation and enabling the building of hospitals and transport systems.

MEDIC: Yes, but other engineers spend their time working on luxury cars and private jets. And come to think of it, it’s cars, jets and other so-called “feats” of engineering which have led to the mess we’re in with the world’s climate. That’s a pretty big stain on the profession’s reputation, I’d say.

ENGINEER: I don’t think that you can blame a profession for the unintended consequences of its past actions. We don’t hold doctors today responsible for the deaths of people who were prescribed leeches in the thirteenth century!

MEDIC: No, but there is a slight difference in the time delay between medieval blood-letters
and 20th century polluters.

ENGINEER: Fair enough. And I accept that engineers may still be contributing to global warming by not finding solutions quickly enough while continuing to produce goods that make the situation worse. However, short of returning to living in houses of wattle and daub and farming with the family cow, how are we going to resolve the problem of global warming without engineers?

MEDIC: So society paid you to get us into this mess and now society should pay you to get us out of it? I think you’ve missed your vocation – politics sounds more your thing.

ENGINEER: Ha ha. Seriously, though, if we want to maintain anything like our current standards of living, the solution will come from engineers. Wind farms, solar power, more efficient vehicles… it is engineers who will be developing these technologies.

MEDIC: Hmmmm. I don’t know. Fancy a beer?

Extracted from Engineering In Society
As Edited by Rob Lawlor


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