Biomedical Engineering -- The New Frontier? By George F. McClure, Just as steam and the internal combustion engine were the drivers for the economy at the end of the nineteenth century, and computers and co mmunications led the longest-ever business expansion at the end of the twentieth century, the twenty-first century will see the harnessing of engineering technology for the literal benefit of man. The international Human Genome Project, begun in 1990, has ambitious goals: to map all of the human body's genetic codes by 2003, identifying more than 100,000 genes in human DNA and determining the sequences of the 3 billion chemical base pairs that make up human DNA. The information will be stored in databases and tools will be developed for data analysis. The ethical, legal, and social issues (ELSI) that may arise from the project will be addressed using project budget set-asides. In the United States, the National Institutes of Health (NIH) and the Department of Energy (DOE) support the project. At the IEEE Sections Congress '99, Dr. Frank Cerra described how advances in biomedical technology have changed already, and will change our lives still more in the not-so-distant future. Computational technology will aid in both diagnostics and reconstructive surgery. Continuous measurement of blood parameters for intensive-care patients has already become commonplace, saving countless lives. An automated, MRI-guided biopsy system already increases accuracy in tumor assessment while reducing hospital stays. Genes contain instructions for cells making particular proteins, mapped through the four chemical constituents of DNA. This four-letter code provides the hereditary mapping; an error in the code can cause a disease. Just one misplaced letter causes sickle cell anemia -- one of some 3,000 to 4,000 hereditary diseases. And, human gene therapy efforts are already under way in trials involving cystic fibrosis -- that gene was identified in 1989. Researchers identified two genes involved in a hereditary form of colon cancer in 1994; and blood tests should soon be able to detect high-risk individuals among the estimated one million Americans carrying misspelled copies of these genes. When a disease is detectable before it manifests itself, but has no prevention or cure, ethical problems arise. Such is the case for Huntington's disease. While a predictive test for high-risk families has been available for years, few individuals want to be tested, preferring uncertainty to the knowledge that they will be struck with a fatal disease. Once available, such knowledge might interfere with obtaining a job or health insurance. Another issue is whether patents should be issued for genome sequences to protect the investment of private entities that assist in the mapping project. For such reasons, NIH and DOE have devoted about five percent of the Human Genome Project budget to anticipating and resolving the ELSI likely to arise from the research. Dr. Cerra foresees new support systems that already are or will become new disciplines, such as computational biology, biomathematics, bioinformatics, and bioengineering. Benefits include not only the promise of cures for diseases, but also the prospect of growing new skin, for burn patients, or other needed organs. Embryonal stem cells can now be cultured and differentiated into almost any kind of cell. Liver cells have been cultured to form the bioartificial liver, currently in testing as a treatment for liver failure. In the future, new hearts may be grown on order, or limbs grown to replace those lost in accidents. Receptor proteins will be modified for a patient with diabetes to restore the blood sugar level to normal. Having passed through the age of the machine, we may now be on the threshold of a new golden age for man. This editorial has been reprinted from the May 2000 issue of IEEE-USA Perspectives. For more on this topic, see Dr. Cerra's address to Sections Congress '99. [ IEEE-USA ] Last Updated: May 3, 2000 |
