Case study 1: Smart meters and conflicting values as an opportunity to innovate

Ethical Question:

How should conflicting values between the benefits of smart meters and the concerns of privacy
and control be weighed and addressed?

Summary of Main Issues:

The case explores the introduction of smart meters, which use digital technology to measure and
report energy usage, in the context of conflicting values among stakeholders. Some stakeholders,
such as energy companies and government regulators, are interested in the economic and
environmental benefits of smart meters, including more efficient energy usage and cost savings.
Others, however, are opposed to smart meters on the basis of privacy concerns, potential health
risks associated with electromagnetic radiation, and the social and economic inequalities that
may arise if low-income households or vulnerable populations are disproportionately impacted
by the technology.

Facts and Questions

Relevant Facts Questions that Remain:

 How can the potential risks and

 Smart meters are being introduced in
countries around the world as a way to
improve energy efficiency and reduce
costs.
 Some stakeholders have expressed
concerns about privacy, health, and
social equity related to smart meters.
 The benefits of smart meters include
more accurate energy usage data,
benefits of smart meters be measured
and evaluated in a fair and
comprehensive way?
 What measures can be taken to
address the concerns around privacy
and health risks?
 How can social equity be ensured in
the implementation of smart meters?
 reduced energy bills, and reduced
greenhouse gas emissions.
Stakeholder values
Stakeholders
Individuals and households
Private companies and
utility providers
Government and regulatory
bodies
Values of each stakeholder Bioethical principle(s) given
priority
Individuals and households Autonomy and Respect for
may value privacy, control Persons
over their energy usage, and
the potential cost-savings of
more efficient electricity use.
Maximizing Benefits
Private companies and utility
providers may value the
potential profits and benefits
of implementing smart meters.
Government and regulatory Maximizing Benefits/
bodies may value Minimizing Harms
environmental sustainability,
energy efficiency, cost
savings, and the potential
benefits for public health.
 Health advocates and Low-
income households
Potential health risks Beneficence and justice
associated with
electromagnetic radiation,
Social and economic equity,
protection from unfair burden

Principle and elements

Principle and elements The study meets the elements The study does not meet the
of this principle because… elements of this principle
because…
Respect for persons It acknowledges the vulnerable populations may be
 Respect right to make importance of respecting the disproportionately impacted
choices, hold views, and autonomy and privacy of by the technology and may not
take actions according to individuals who may be have adequate resources to
personal beliefs. impacted by the rollout of protect their privacy or health
 Protect those with reduces smart meters. concerns.
capacity to make their own It also recognizes the need to
choice. obtain informed consent from
 Ensure voluntary individuals who may be
participation. impacted.

 Provide informed consent,

explaining harms and
benefits.
Beneficence  it recognizes the potential it acknowledges the potential
 Minimize the harm/risks to benefits of smart meters in risks associated with the
the greatest extent. reducing energy usage and technology and the need for
 Maximize the potential greenhouse gas emissions. further research and
benefits.  smart meters have the evaluation.
potential to reduce energy
  Ensure that the rights and usage and costs, which can
well-being of the patient benefit society and the
take precedence over the environment. However,
needs of science.
Justice  it does not adequately
 Justly distribute benefits address the potential social
and burdens of the and economic inequalities
research that may arise from the
 Guard against vulnerable implementation of smart
populations. meters.
 Ensure fair selection of  More specifically, the
research participants. study lacks a
 Guard against coercion comprehensive plan for
and undue influence. ensuring that vulnerable
 Avoid potential financial populations are not
or other conflicts of unfairly burdened by the
interest. technology.

Justification

The case study illustrates the complex ethical issues that arise in the context of new technologies
with potential benefits and risks for different stakeholder groups. To ensure that bioethical
principles are prioritized and that social equity is maintained, it is important to engage in
transparent and inclusive dialogue among stakeholders, and to develop comprehensive plans for
evaluating and addressing potential risks and benefits. In this case, measures such as robust data
protection policies, informed consent protocols, and initiatives to support vulnerable populations
could help to promote the ethical implementation of smart meters. Ultimately, a multidisciplinary
approach that integrates ethical, social, and scientific perspectives is essential for ensuring a
balanced and equitable approach to new technologies.

Recommendation
 1. Engage in transparent and inclusive dialogue among stakeholders to understand their
concerns and perspectives.

2. Develop a comprehensive plan to evaluate and address potential risks and benefits
associated with smart meters, including data privacy, potential health risks, and social
equity.

3. Prioritize bioethical principles when evaluating the risks and benefits of smart meters,
including respect for persons, beneficence, and justice.

4. Implement measures such as robust data protection policies, informed consent protocols,
and initiatives to support vulnerable populations to promote a balanced and equitable
approach to smart meter implementation.

5. Ensure that vulnerable populations are not unfairly burdened by the technology by
providing resources and support to those who may be impacted.

Case study 2: Testing a newly developed artificial heart

Ethical question

Should a biomedical engineer test a newly developed artificial heart on a dying patient who has
no other medical options?

Summary of main issues

A biomedical engineer has developed a new artificial heart and must decide whether to test it on
a dying patient who has no other medical options. This decision involves balancing the potential
benefits of the artificial heart against the risks to the patient's life.

Facts and Questions

 Relevant Facts Questions that Remain:

 Are there any other patients who could

 The patient has no other medical
options and is going to die without the
intervention of the artificial heart.
 The artificial heart has been developed
and is ready for testing.
 There are risks associated with testing
the artificial heart on a human subject.
benefit from the artificial heart?
 Have animal tests been conducted? If
so, what were the results?
 What are the specific risks associated
with testing the artificial heart on a
human subject?
 What are the potential benefits of the
artificial heart?

Stakeholder values

Stakeholders Values of each stakeholder Bioethical principle(s) given

priority

Patient Potential benefits of the Beneficence, Respect for

artificial heart. persons

Biomedical engineer Advancement of medical Beneficence

technology.

Medical community Advocacy for patient safety Non-maleficence, Beneficence

Principle and elements

Principle and elements The study meets the elements The study does not meet the
of this principle because… elements of this principle
because…
Respect for persons The patient is given the choice it is unclear if the patient fully
 Respect right to make to participate in the testing of understands the risks
choices, hold views, and the artificial heart associated with being the first
take actions according to patient to receive the new
personal beliefs. technology.
 Protect those with reduces
capacity to make their own
choice.
 Ensure voluntary
participation.
 Provide informed consent,
explaining harms and
benefits.
Beneficence  The potential benefits of the effectiveness of the
 Minimize the harm/risks to the artificial heart could artificial heart is unknown and
the greatest extent. potentially add to the it could pose more harm than
 Maximize the potential medical field and save good to the patient.
benefits. future patients' lives.
 Ensure that the rights and
well-being of the patient
take precedence over the
needs of science.
Justice  The patient is given the  this could be seen as unfair
 Justly distribute benefits opportunity to receive a as this option is not
and burdens of the treatment that is not yet available to other patients
research available to the public. who may need it.
 Guard against vulnerable
 populations.
 Ensure fair selection of
research participants.
 Guard against coercion
and undue influence.
 Avoid potential financial
or other conflicts of
interest.

Justification

While there are risks associated with testing the artificial heart on a human subject, the potential
benefits for the patient who has no other medical options cannot be ignored. By respecting the
patient's autonomy and giving them the option to participate in testing the artificial heart, the
principle of respect for persons is upheld. The biomedical engineer has a duty to advance
medical technology, and the potential benefits of the artificial heart align with the principle of
beneficence. The medical community must prioritize patient safety, but also has a duty to
promote innovation in medical treatments that may benefit patients. Society values innovative
medical treatments, which aligns with the principle of beneficence. Overall, the potential benefits
of the artificial heart justify the risks of testing it on a dying patient who has no other medical
options, as long as the patient's autonomy is respected, and measures are taken to minimize risks
and ensure patient safety.

Recommendation
the recommendation would be to proceed with the testing of the artificial heart on the dying
patient who has no other medical options, with the patient's informed consent and with proper
measures taken to minimize risks and ensure patient safety. The potential benefits of the artificial
heart for the patient outweigh the risks, and respecting the patient's autonomy is paramount. The
biomedical engineer and medical community should also prioritize patient safety while
advancing medical technology and promoting innovative medical treatments that may benefit
society.