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Journal of Long-Term Effects of Medical Implants
Abstract of "Drug-Eluting Stents: Some Lessons for the Ethics of Medical Nanotechnology"
George J. Agich
BGeXperience Program, Senior Research Fellow Social Philosophy and Policy Center Bowling Green State University, Bowling Green, OH 43403; and Ohio State University School of Medicine, Columbus, OH 43210
Much of the literature on the ethics of nanotechnology advocates broad ethical principles such as the precautionary principle, the bioethical principles of autonomy, beneficence, nonmaleficence, and justice, or the ethical concept of professional responsibility. Such approaches are thought to shape ethical considerations relevant for the work of nanoscientists and engineers. However, these approaches often lack specificity or practical salience. They fail to provide appropriate or workable normative guidance for defining areas of ethical concern with any precision; hence, they have limited practical ethical utility. This limitation can discourage or lead to superficial or misleading ethical assessment of nanoscience-related ethical concerns, which is a particularly acute problem in the area of medical applications of nanotechnology. A useful nanoethics should alternatively provide models for interdisciplinary critical analyses of the complex range of normative values shaping the development and deployment of nanomedical technologies. But where can such models be found? This paper examines whether the drug-eluting stent (DES), an implantable medical device for the treatment of cardiovascular disease, can provide a model for exploring the technical, ethical, and social value-related aspects nanoengineered implantable medical devices. I argue that due to its hybrid material, mechanical, biochemical, and clinical applications to a complex and serious clinical problem, DES is an apt technological analogue for nanoengineered implantable devices. This paper identifies how DES provides a map for the normative questions that engineers and physicians will encounter in developing nanoscale technologies for implantable medical devices. These normative issues in medical nanotechnology include economic, ethical, regulatory, and policy questions, and concerns about social costs and benefits, as well as issues of patient rights and safety, all of which figure prominently in the case of DES.
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