Running Head: BIOMEDICAL ENGINEERING & TECHNOLOGY

Maintaining Health Now and for the Future: The Law and Ethics of Biomedical Engineering

Analyzed

Logan Brady

1B

First Colonial High School

Abstract
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This paper examines the laws and ethics and possible issues that arise with the studies and

research within the field of biomedical engineering. Topics of this paper will include personal

experiences of the author as well as analysis of several issues and concerns involving research

done with biomedical engineering. The author analyzes the laws that are currently implemented

to deal with research done within the United States as well as globally. The purpose of this paper

is to propose solutions and new legislation ideas to complement the work of the biomedical

engineers and their research currently and for the future.

The Law and Ethics of Biomedical Engineering Analyzed

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Biomedical engineering is a newly developed subject that has been emerging within

society for the past couple decades. The field of biomedical technology deals with all parts of the

medical field, ranging from organ transplant, mental health help, virus and disease identification,

as well as almost anything else. The field is innovative and inspiring to all medial creations and

research to come. Developments within the field of biomedical engineering are contemporary

and will allow for all people globally to be influenced by the ingenious challenges and problems

the work done by these researchers will overcome.

Biomedical Engineering is a confusing field of various endeavors, and it is extremely

easy to get lost or caught up in everything that the field entails. An example of how people learn

about some of the more basic ideas is through television; although sometimes, the learning may

be skewed due to dramatic effects aimed toward the audience. Greys Anatomy is a show in

which the beginning developments concerning biomedical engineering and developments. This

show typically stretches the truth of the medical issues that they pursue, but the idea that

medically engineered products could be used in replacement within any medical practices was an

idea that seemed all too practical to be overlooked. This television show lead viewers to believe

that biomedical engineering is the substitution or secondary use of physical or chemically

engineered products to be used in microbiological, general, or any sort/different field of surgery.

After research, biomedical engineering is professional defined as, the branch of engineering that

uniquely leverages the vast knowledge base of biology and medicine to solve problems focused

on healthcare and the human body (Gleason, n.d.).

According to Tom Ricci, author of How Bioengineers Are Enhancing the Quality of

Healthcare, there are nine sectors that the field of biomedical engineering breaks down into.

These sectors include but are not limited to bioinstrumentation, biomaterials, biomechanics,
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cellular and tissue genetic engineering, clinical engineering, medical imaging, orthopedic

bioengineering, rehabilitation engineering, and systems physiology.

Through careful dissection of the field, it has shown that these nine sectors are the most

important as well as capable when explaining the inner mechanics of the field. For easier

explanation and examination, these nine sectors are able to be split into two main categories.

These main categories are the physical and clinical implementation of bio medically engineered

products (what someone can actually see is happening) and theoretical development, or in other

words, the behind the scenes work that one cant see but knows is going on. Most of the sectors

fit into the physical being of the field, but the theoretical aspect is just as important. Especially,

when developing technology that must be extremely accurate and exact. Bioinstrumentation,

biomaterials, biomechanics, cellular and tissue genetic engineering, clinical engineering,

orthopedic engineering, and some parts of rehabilitation engineering all fit into the first physical

spectrum (Gleason, n.d.). Meanwhile, the other remaining sectors all fall into theoretical

developments; what is going on even if one is unable to see it (Gleason, n.d.).

Out of all these sectors, separation into these two main categories will help when

specifying the laws and other legal aspects and what exactly has been analyzed versus what has

not. The two sectors help to establish a common ground. Although there are several different

details that separate the works into their own categories, there are similarities that do help to

categorize them in a more composed fashion (Iltis, 2009). The physical part of biomedical

engineering is the type of innovative medical developments that more people would tend to hear

about, while the theoretical developments of biomedical engineering are less heard and thus less

discussed. Nonetheless, neither part is easier to judge and pull apart in terms of the law. Both

aspects of the biomedically engineered devices bring up issues that can be difficult to analyze
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and distinguish by one person. The field has been constantly developed, corrected, and added on

to as time has gone on. It is most important for this sort of work because there is never going to

be one case in which the researcher or research done is 100 percent correctly. For this reason,

many of the advancements within the field are a compilation of studies between various works of

researchers. Leading back into the two different aspects of the research, the physical side of the

work has the issue that there are more complications with the products and therefore more cases

of liability; So therefore, there is much more discussion concerning what parts malfunction.

Whereas, theoretical developments of the works involved are more concerned with what

methods will effectively work to implement the engineered products into a patients body. This

causes issues with explanation and reevaluation of work done and how to explain to the patient

the process that which the researchers are going through to further progress the developments

(Iltis, 2009).

Personal Involvement and Interest

The Peirce-Cottler Laboratory is named after Dr. Shayn Peirce-Cottler. Dr. Peirce-Cottler

is a professor and researcher from the University of Virginia who studies and leads developments

within the field of biomedical technology. The lab research is focused around discovery of useful

biomaterials as well as methods that can be implemented to prove beneficial with encouraging

further developments.

Morgan Lataillade was one of the undergrad students who was working in the lab.

Morgan and Dr. Peirce-Cottler had been working on the experimental stage of their research,

they were working to find materials that would be sustainable and solid enough to print tissues

and parts of organs. The bio-printing work at first seemed very simple- all that had to be done

was fill the canisters with the materials that it was set to dispense and then submit the layout into
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the computer for the product that was being printed. Wrong, to fulfill a job well done there

needed to be much more thought put into the process. Products were often times not stable

enough to be used, constructing a layout was much more difficult than it seemed, and putting the

two together seemed utterly impossible when it actually became time to do so (S. Peirce-Cottler,

Personal communication, October 26, 2016). This is where the difficulties of biomedical

engineering are brought to attention.

Arising Issues

Lack of funding within this field is something that arises much too often. To solve the

issue that biomedical engineers faced with funding, the National Biomedical Research Act was

founded. This act ensures that half of the money that the federal government distributes to

studies goes to the National Institutes of Health and the FDA. This act ensures that the money is

being used in ways that will prove to beneficial for the majority of people. There are some

categories that are pre-set to where the money will go, but the general distribution of the funds

coming from the government should go to the interest-bearing obligations of that specific point

in time. The different areas of authorized use for the money granted includes precision medicine

initiative, advancing innovative neuro-technologies initiative, cancer moonshot initiative,

research on disruptive innovation, research on diseases concerning federal health help, work by

early career scientists, research efforts that increase potential for breakthrough discoveries,

development of medical products and, promotion of advancement of scientific research to

positively influence public health and advance innovation (Gleason, n.d.).

Misinterpretation between the different works of study is an issue that could prove to be

extremely problematic within the works and research of biomedical engineering. Although there

are several different sectors and fields, that is beyond the point. The point is, researchers need to
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communicate the full extent of their work to other researchers to ensure there is no

miscommunication if one researcher decides to build of another.

Although the works of biomedical engineering do seem to be something that will prove to

be of costly investment, it is research that will most definitely be beneficial to everyone in the

future (Rockey & Collins, 2013). The developments are something that have an infinite effect;

they are going to be long lasting and, hopefully further in the future, much more commonly

implemented. If research of these biomedical developments follows the positive innovative track

it is on right now, then the benefits the products will provide to society will far surpass the

expectations that anyone currently has.

Biomedical research is a thing that is becoming extremely beneficial and overall a good

thing within society today, except there have been times when research has been questionable

and has been brought to the attention of the government. In the case of the Willowbrook State

School Study and the Tuskegee Syphilis Study, researchers encouraged people to

intentionally become infected with the diseases so that medical testing and gene therapy could be

done to more effectively study how the diseases could be treated (Pecorino, 2002). The biggest

issue with the research was not necessarily the idea of it, but it is dealing with the idea of

vulnerable individuals. To protect these individuals, The Common Rule was established. It reads:

When some or all of the subjects are likely to be vulnerable to coercion or undue

influence, such as children, prisoners, pregnant women, mentally disable persons,

or economically or educationally disadvantaged persons, additional safeguards

have been included in the study to protect the rights and welfare of these subjects.

(Federal Policy for the Protection of Human Subjects (Common Rule), 2016)
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This issue is extremely important regarding biomedical studies and research. In order to

implement the studies more smoothly into society, it is imminent that people know, even if they

are not really concerned with biomedical studies at a certain point in time, that they are safe from

ever being mislead or taken advantage of when it comes to biomedical research. The Council for

International Organizations of Medical Sciences (CIOMS) works to put guidelines on human

research (biomedical research included).

Current Laws and Precedents

In the case of Mattern v. Biomet, the issue concerning a bio medically engineered hip

replacement part became discussion when it began causing problems for the user after

implementation. Mr. Mattern originally sued the company, Biomet, in order to compensate for

the excruciating pain that came about a few weeks after he had the hip replacement surgery. The

case was handled in the United States New Jersey District Court. The prosecutor sued the

company, claiming that they were liable for the situation at hand. The defendants, Biomet, got

the case dismissed by the courts after claiming that they were not liable as a seller or

manufacturer. After examination of the product that was bringing about the issues, it was

determined that it was only one component of the entire implant that was used in the hip

replacement surgery. Therefore, the company was not held liable for the damages because it was

found that the actions of the company, putting together the implant with the parts they were told

to trust, was not the standing cause of the pain. For evidence for this trial, the defendant used the

guidelines of the Biomaterials Assurance Act. The act, allows trial courts to dismiss the

biomaterials suppliers from lawsuits prior to discovery (Mattern v. Biomet, 2013). The main

purpose of the act, or 21 US Code Sec. 1601, stands to be:

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The Biomaterials Access Assurance Act (BAAA), implemented in 1998, is an act

that was put into place to protect bulk manufacturers of biomaterials from being

liable for finished implants that they did not take part in making- they simply

supplied and sold a part for the implant to be made. The overarching idea of the

bill is to protect the rights and companies of the biomaterial suppliers.

This act is extremely exact when explaining the liability of the biomaterial suppliers with

all sorts of biomedical engineering (Charles & Richards, 1999). Even though this one case is

dealing with an orthopedic surgery, the act still applies to all sorts of studies and research. The

biomaterial manufacturers at Biomet did not furnish raw materials or any of the components that

were the cause of the problem or ultimately failed to meet the requirements of the enforced

contract. The act specifically defines raw materials and components to show this distinction. This

clear definition is done to ensure that liability is placed correctly when something does go wrong.

The discussion concerning progress and continued research within the field of biomedical

engineering and research has been something that several countries have been concerned with for

decades now. For example, the United States and the Russian Federation created an act in 1994

concerning biomedical developments and the very basic guidelines that will govern research

done within and between the two countries (Agreement between the Government of the United

States of America and the Government of the Russian Federation on Cooperation in the Fields of

Public Health and Biomedical Research, 1994). The agreement is split up into 14 articles, and

each article of the agreement divulges into a different basis that will stand to be the driving rules

behind all the research done. By the very fact that this document existed in 1994, it shows that

the biomedical research being done then was extremely crucial to the developments within the

medical world. Adaptations to the new times, even of the 90s, was up and coming, and this
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agreement shows that many countries, as opposed to solely the United States, were beginning to

recognize that.

The current issue that stands with the topic of biomedical developments is that there are

barely any laws that currently exist to govern the work the researchers are doing. The codes of

Virginia that are dealing with biomedical engineering resemble that of the United States because

vague and mostly concerning the distribution of research funds. Additionally, many of the

Virginia codes that are in place to monitor medical research and the funds were implemented

only within the last ten years. To get more details on the specific legislation that is required

within a code concerning the research done, Virginia code section 32.1-162.23 through section

32.1-162.31 was analyzed. This chapter of the Virginia code deals with the Christopher Reeve

Stem Cell Research Fund. The specifics of the code and fund divulge into nine different sections,

all which seem to be dealing with some sort of monetary subject or the duties of the board in

charge of the research (Virginia Code, 32.1-162.23-32.1-162.31). None of the information

entailing specifics and extent of what research can actually be done is included within the code.

The reason this proves to be extremely common when developing and dealing with legislation

concerning biomedical technology and developments is because people dont understand what

kind of limitations need to implemented. That is where the majority of the issue lies concerning

this topic; it is that there is misconception and simply misunderstanding of the topic of

biomedical engineering. For this reason, many legislators feel they should only create the

majority of their legislation surrounding the research limitations aspect because they arent

exactly sure what should be done within the field and so they may feel that it isnt their place to

put limitations on the creative process. These same factors tend to be true with federal laws as

well, just on a much larger scale. Concerning biomedical research and development, there is
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almost no legislation in the federal spectrum that outlines protocol or rules for projects being

done. The most distinct law that was found concerning actual content of the research projects

was the extent of what subjects could be used for experimentation. The extent of these guidelines

was discussed in the above section, Issues that arise, discussing the Tuskegee Syphilis Study.

Showing the Personal Effects of Research

Biomedical studies are an area of medical developments that can relate and be beneficial

to just about everyone that takes an interest in this prescribed solution to a medical issue.

Although the extent of what medical cases biomedically engineered products can be used for is

slimmer than other solutions, the field overtime is quickly and steadily branching out to cover

more and more area. Out of all the medical fields, it seems that biomedical developments are

some that are able to be some of the most personalized fields of study(Ricci,n.d.). This stands to

be true for two main considerations. First, most biomedically developed products are done

personalized, or in other words, using a persons own tissue to biomedical print the cells or

products they are in need of. This is important because it makes the cells and projects more

adaptable, as well as the fact that when the the products are inserted or surgically implanted into

a persons body, the body will be more accepting and less likely to reject something that is

recognizable. There is always chance of complications with the biomedical products, but the

chances are much reduced with this personalization. Second, almost all people will be influenced

by biomedical technology and developments in the near future. The world isnt far off from

having everything in its entirety be run by technology, especially all developments completed

within the medical world. For this reason, people will become more familiar with studies, and the

idea of using biomedically engineered products within the medical field will no longer be an idea

of question but simply an action of habit. An additional beneficial aspect of biomedical research
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is that the entire is subject concerns cumulative research("BiomedicalEngineering;Reports

fromCenterforBiomedicalEngineeringDescribeRecentAdvancesinBiomedicalEngineering,"

2011). All of the research that has been done thus far is able to help researches build towards

what is to come and current projects that are in the works.

Changes within the Field

Although biomedical technology and developments are medical fields that have extended

possibilities, several questions are to arise when concerning the research. What laws can be

implemented so that the developments that are available can be of service to everyone

worldwide? It seems that currently it is mainly the United States and some countries within

Europe that dominate the research done within the field of biomedical studies and the

developments that follow this research. For this reason, this question is not as much concern for

the countries within which the research is being conducted. This question is mostly concerning

the countries that dont have as much access to these kinds of developments and these research

methods. Reasons for limited access to these possibilities is a compilation of numerous

prohibitions and provisions. In order to be of service and inspiration to these less advanced

countries, it would prove to be beneficial to recruit researchers from other countries to these

more developed countries to collaboratively work on biomedical research projects. Although it

would still be difficult to have the outspread of the actual biomedical research and developments

of these studies within the developing countries, due to cost and extenuating circumstances

concerning the availability of the products, the idea of the collaborative work is the get the ball

rolling for these developing countries.

Within this field of research, as well as many other technological developments, the idea

of liability is a factor that cannot be taken lightly. Currently, liability is the main discussion of
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many of the court cases that deal with the subject of biomedical technologies (Shirwaiker, Tan, &

Cohen, 2013). Actually, regardless of the field of medicine, this tends to be the case for many

medical cases taken to law. For this reason, there is an increased importance for there to be a

specification of laws in place to ensure that liability is not an issue, so that people understand the

agreement they are signing into- even more so for procedures that involve biomedically

engineered parts. To implement this plan, it would be most beneficial to enhance the extent of the

waivers that people currently sign when they agree to get a procedure done. In addition to this,

there needs to be a waiver from each company that allows them to be held liable only in the case

that is the part that they contributed is malfunctioning. This piece of information is extremely

vital to the liability process, mostly for the reason that there have been times when the doctors

who implanted the part werent at fault, the manufacturers who put the product together werent

at fault, but the providers of one sole part of the product had a piece that was the source of the

malfunctions (Shirwaiker, Tan, & Cohen, 2013). For this reason, even though the inclusion of

this extra paperwork may seem extensive, it is extremely necessary in helping to find which

party is liable if something were to go wrong. It is within the best interest, and therefore

necessary, for most people to complete this extensive paperwork so correct determination of

liability and fault can be placed.

The margin of error is something when dealing with biomedical engineering that is never

really discussed all that much. It is an idea that people want to believe barely ever happens,

because they dont want to consider that a procedure that someone chooses to provide benefits

could have a possible backlashing negative effect. The error and success rate of some of the more

complicated procedures tend to have a lower percentage than some of the easier procedures, as

obviously expected. The issue that is found is that since most of the developments are so new,
BIOMEDICAL ENGINEERING & TECHNOLOGY 14

there is an issue with deciding on how to correctly implant the products and whether or not they

are going to work (Crawford, n.d.). Noah Crawford, a prior student of Pittsburgh University, was

faced with a dilemma when given the task to construct a personalized trachea for one of the

largest benefactors for the hospital where they were working at the time. The group knew that the

chance that their project would fail was close to being almost 100 percent. The chief of surgery

where they were working put the pressure on their group because he wanted their hospital to be

ground breaking and push innovation even more forward. The group found several issues with

their model and after a long and tedious process couldnt seem to figure out what exactly they

needed to do (Crawford, n.d.). This is only one example of where the margin of error was much

wider than almost anyone would realistically expect. Of course it would almost never be

expected that the product was 100 percent perfect, but the fact that something could be just about

100 percent ineffective is simply shocking. For this reason, it is the job of current and future

researchers to come to ensure that this margin of error concerning the biomedically engineered

products is closed to a much smaller percentage before they are even thought about using the

products on patients. In essence, this process all leads back to the idea of liability. If the margin

of error with the products is much smaller, then less patients will need to worry about claiming

which party is liable because hopefully, the smaller margin of errors would lead to less

complications with the surgeries.

Besides the entire idea of liability and the lessened margin of error, a more solid plan

needs to be developed to help ensure that the products that biomedical engineers are working on

are being of benefit globally. It is simply unethical to completely dispose of the researchers own

personal thought and to tell them what they can and what they cannot study, but for researchers

who may be interested, and therefore qualified, there should be money federally mandated to
BIOMEDICAL ENGINEERING & TECHNOLOGY 15

specifically chosen researchers in each country to collaboratively work to solve the worlds most

pressing problems. Not to say that this isnt already occurring on a smaller scale, but it would be

in the best interest of all people to compose this type of research team to find the solutions the

world and its people have been searching for. Pressing diseases such as Aids, HIV, hepatitis, etc.

all are deadly diseases that have faced the world for thousands of years now. Therefore, setting

aside money for the research that can be done to benefit a much wider spectrum of people is

something that needs to be changed if the people of the world want biomedical engineering to

begin to have a wider spread than it already currently has.

Conclusion

Biomedical engineering is a subject that can constantly be developed throughout time-

the work involving this subject is never done. The most inspiring part of all the research done

within this field is that the work is continuously building. There are constantly more and more

components that can be researched to build upon the next. Although issues do arise concerning

the funding or mechanics behind the research, there are never enough limits to stop the

innovation that is sparked with the idea of infinite possibilities for the human bodies and the

remedies found to solve the existing maladies. Solving the future problems is just as important as

solving the future problems. Biomedical engineering is without a doubt a research field within

which the world will continue to benefit. When researchers are able to find a method to more

widely spread the research and methods will be a time when the world is unstoppable. The

medical field is something that will always be of need and of service to everyone. Biomedical

engineering, and its approaches, is just the start of the beginning for what medical ventures the

future world will entail.

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References

Biomedical Engineering; Reports from Center for Biomedical Engineering Describe Recent Advances

in Biomedical Engineering. (2011, May 26). Retrieved October 25, 2016, from

http://search.proquest.com/docview/867392135/fulltext/AD79039DFBBB4D5BPQ/4?

accountid=3785

Biomedical engineers. (2015, December 17). Retrieved October 13, 2016, from

https://www.bls.gov/ooh/architecture-and-engineering/biomedical-engineers.htm#tab-2

Brey, P. (n.d.). Biomedical engineering ethics. (eds.), A Companion to Philosophy of Technology.

Blackwell. Biomedical Engineering Ethics. Retrieved December 14, 2016, from

https://www.utwente.nl/bms/wijsb/organization/brey/Publicaties_Brey/Brey_2009_Biomed_Engi

neering.pdf

Chandler, D. (2008, February 15). MIT researcher addresses biomedical engineering challenges.

Retrieved December 01, 2016, from http://news.mit.edu/2008/aaas-biomedical-0215

Charles, W. F., Ph.D., & Richards, E. P., III. (1999). The Biomaterials Access Assurance Act of 1998.

Retrieved October 25, 2016, from http://biotech.law.lsu.edu/IEEE/ieee31.htm

Crawford, N. (n.d.). Dealing with ethical issues in bioengineering. Retrieved December 01, 2016, from

http://www.pitt.edu/~nnc4/writingassignment3.pdf

Ethics codes collection: Biomedical engineering. (n.d.). Retrieved December 14, 2016, from

http://ethics.iit.edu/ecodes/node/3243

Federal policy for the protection of human subjects ('common rule'). (2016, March 18). Retrieved

December 8, 2016, from http://www.hhs.gov/ohrp/regulations-and-policy/regulations/common-

rule/
 BIOMEDICAL ENGINEERING & TECHNOLOGY 17

Gleason, K. (n.d.). What is biomedical engineering. Retrieved December 8, 2016, from

https://www.rit.edu/kgcoe/biomedical/about/overview

Iltis, A. S. (2009). Vulnerability in biomedical research. Journal of Law, Medicine & Ethics, 37(6), 6-

11. Retrieved October 21, 2016.

Lucas, J. (2014, September 25). What is biomedical engineering? Retrieved October 14, 2016, from

http://www.livescience.com/48001-biomedical-engineering.html

Mattern v. Biomet Inc., Biomet Fair Lawn, LLC (United States District Court, D. New Jersey March

28, 2013) (Google Scholar, Dist. file).

May, Delegate. (2008, February 8). Legislative Information System. Retrieved October 25, 2016, from

http://lis.virginia.gov/cgi-bin/legp604.exe?081%2Bful%2BHJ248H2

New prosthetic arm technology. (2016, December 14). Retrieved December 14, 2016, from

http://www.startribune.com/new-prosthetic-arm-technology/406417145/

Pecorino, P. A. (2002). Willowbrook experiments. Retrieved November 30, 2016, from

http://www.qcc.cuny.edu/socialsciences/ppecorino/MEDICAL_ETHICS_TEXT/Chapter_7_Hum

an_Experimentation/Case_Study_Willowbrook_Experiments.htm

Peirce-Cottler, S. (2016, October 26). Biomedical engineering at UVA biomedical department [E-mail

interview].

Ricci, T. (n.d.). How Bioengineers Are Enhancing the Quality of Healthcare. Retrieved October 25,

2016, from https://www.asme.org/engineering-topics/articles/bioengineering/bioengineers-are-

enhancing-quality-of-healthcare

Rockey, S., & Collins, F. (2013, September 24). One nation in support of biomedical research? | NIH

Extramural Nexus. Retrieved November 16, 2016, from

https://nexus.od.nih.gov/all/2013/09/24/one-nation-in-support-of-biomedical-research/
 BIOMEDICAL ENGINEERING & TECHNOLOGY 18

Shirwaiker, R., Tan, Z., & Cohen, P. (2013, August). Regenerative Medicine Manufacturing. Retrieved

October 25, 2016, from

http://search.proquest.com/docview/1430985025/9EF58B35FE784AEDPQ/14?accountid=3785

21 U.S. Code 1601 - Findings. (n.d.). Retrieved October 25, 2016, from

https://www.law.cornell.edu/uscode/text/21/1601

Two MIT faculty named 2016 fellows of the National Academy of Inventors. (2016, December 13).

Retrieved December 14, 2016, from http://news.mit.edu/2016/two-mit-faculty-named-2016-

fellows-national-academy-inventors-1213

United States & Russian Federation, US Department of Health & Human Services, Department of

State. (1994). Agreement between the government of the United States of America and the

government of the Russian Federation on cooperation in the fields of public health and

biomedical research. Moscow.

Virginia Code, 32.1-162.23-32.1-162.31 (2016).

Volkers, N. (2010, December 17). Engineering solutions to biomedical problems. Retrieved December

10, 2016, from http://www.sciencemag.org/careers/2010/12/engineering-solutions-biomedical-

problems

Warren, E., Sen. (2016, March 3). Text - S.2624 - 114th Congress (2015-2016): National Biomedical

Research Act. Retrieved October 25, 2016, from https://www.congress.gov/bill/114th-

congress/senate-bill/2624/text