Final_Proposal_Prosthetics

Dante Cromartie
3361 p Ave 214-414-4426
Plano, TX 75074 dlc140130@utdallas.edu
______________________________________________________________________________
October 13, 2016
Ryan Finnie
Alex Schaedel
Ramya Akkala
Scott Johnson
Topic: Advancements in Prosthetics and Culture Shift.
Dear Team:
My reasons for contacting you all stem from the advancement of prosthetics and the
impending culture shift. As engineering majors specializing in software, mechanical and
biomedical engineering you can offer valuable insight on technologies from your individual
perspectives. I propose that we take on this challenge. With the advancement of technology comes
moral and ethical responsibility. As a pre-med/mechanical engineering major undertaking a career
in prosthetics, I am becoming skeptical about my future in industry. Whether or not the
implementation of certain prosthesis are ethical; whether or not human enhancement is a bad thing.
Help me to uncover these issues as we dive into this new technological age.
I have included an enclosed proposal to write a white paper on this issue. Feel free to contact me
of you have any questions or concerns.
Thanks,
Dante Cromartie
Dante Cromartie, Mechanical Engineer
University of Texas at Dallas | Senior Student
Cell: (214)-414-4426 | dlc140130@utdallas.edu
Enclosure

Advancements in Prosthetics and Culture Shift.
Presented to:
Ryan Finnie, ME.
Alex Schaedel, ME.
Ramya Akkala, BME.
Scott Johnson, SE.
Presented by:
Dante Cromartie, ME
Presentation Date:
October 13, 2016

TABLE OF CONTENTS
Page
List of Illustrations.………………………………………………………………………………..ii
Executive Summary……………………………………………………………………………....iii
Introduction……………………………………………………………………………………...1
Definitions…………………………………………….…...................................................1
History..…………………………………………………………………………………....1
Current Market Analysis…..…………………………………………………………………….2
2.1 War……………………….……………………………………………………………2
2.2 Disease………………………………………………………………………………...2
New Technologies and Advancements……….............................................................................4
3.1 Biomedical…………………………………………………………………………….4
3.2 Mechanical…………………………………………………………………………….4
3.3 Software…………………………………………………………………………..…...5
Layout…………………………………………………………………………………...............5
3.4 Timeline……………………………………………………………………………….5
3.5 Report type……………….……………………………………………………………5
Considerations and Conclusion…….……………………………….…………………………..5
References…………………………….…………………………………………………………..iv
Appendix: Mechanical advancements in further depth………………………………………….8

LIST OF ILLUSTRATIONS
Figures:
Figure 1: Amputations associated with Operation Iraqi freedom and Operation Enduring freedom
[8].
Figure 2: Limb level amputation by etiology [10].
Figure 3: Schematic of Hugh Herr’s active/passive foot [13].

EXECUTIVE SUMMARY:
Advancements in science and technology have always tested human resolve. Our
inability to fully predict the moral and ethical implications of these advancements causes us to
forgo their investigation. This lack of knowledge gives room for fear and deforms progression. It
has been seen in history as inquisitive minds pushed moral and ethical boundaries in fields like
medicine considering human dissection. In prosthetics, technology has progressed to a point
where human enhancement is in question. Global efforts to stomp out disability and disease
through the use of technology has prompted an idea of transhumanism. This document proposes
that we investigate this new ideology; how a prosthetic device can be used not for replacement
but to enhance the human condition. This proposal will investigate the history of prosthetics. It
will offer insight into the prosthetic market and explore new technologies that draw concern.

1
INTRODUCTION:
It has been said that “technology has the power to heal, rehabilitate and extend human
experience and capability [13].” Technological advancements in the last century have
revolutionized prosthetics, producing more comfortable, realistic and efficient prostheses.
Scientists and engineers are continually pushing the limits of technology, in turn accelerating
prosthetic sciences at an exponential rate; one unmatched by bioethics. This advancement is
giving way to a “Transhumanist” or beyond human view of prosthetics, shifting culture from
human replacement to human enhancement, slowly skewing what it means to be disabled; what
it means to be human. As a pre-med/mechanical engineering major pursuing a career in
prosthetics, I welcome what new advancements software, mechanical and biomedical
engineering will bring to the field. However I am unsettled with the impending moral and ethical
implications that ensue. It is our job as engineers to investigate these this issue as we are on the
precipice of a revolution in prosthetics.
Definitions:
1. Prosthetics - The science and practice of measuring, designing, fabricating, assembling,
fitting, adjusting, or servicing a prosthesis [1].
2. Prosthesis - An artificial device used to replace or augment a missing or impaired part of
the body [2], more readily seen associated with limbs.
3. Transhumanism (“beyond human”) – The belief in transcendence through science,
engineering, and technology [6].
HISTORY:
History proves prosthetics is attributed to war and disease. The earliest recorded instance
of a prosthesis traces back to an ancient Egyptian mummy’s wood and leather toe [3].
Archaeologists believed the prosthesis dates from 1069 to 664 B.C., positing the loss due to
diabetic complications. The dark ages brought about war and diseases, disabling many in a time
where amputations were barbaric and bountiful, yielding low mortality rates. Surgical techniques
included the crushing of limbs prior to cutting and cauterizing them, or just directly sawing
through the bone. Amputations in this time period were essential for subsistence, thus giving rise
to Prosthetics. During the middle ages, the most notable prosthesis belonged to a German knight
named Gӧtz Von Berlichingen. His iron hand rendered him a 16th
century folk hero proclaiming
he could wield a stronger blow with his artificial limb as opposed to a blow with his natural one.
This is the first instance in history where a man is glorified for having a prosthesis. In the early
19th
century, the discovery of chloroform brought about advancements in surgical techniques that
greatly influenced prosthetics. Doctors were now able to administer this remedial form of
anesthetic which increased the mortality rate and number of amputees. Thus following the Civil
War in the late 19th
century, the demand for prosthetic limbs skyrocketed and an industry was
born, with J.E Hangar Company spearheading. James Edward Hanger was the first documented
amputee of the Civil War [4]. Following the Civil War, the conditions of World Wars 1 and 2
produced a market of disabled veterans. Diseases such as gang green, conditions of trench

2
warfare and the lack of antibiotics were key factors in the production of this market. However, at
this time there was no centralized effort to improve the quality of prosthetic limbs causing unrest
amongst our wartime veteran and heroes. In resolution, the National Academy of Science (NAS)
initiated a team, comprised of scientist, engineers and prosthetists, to explore alternatives and
determine the best ways a disabled veterans can be provided a prosthetic limb. The collaboration
was imperative as surgeons do not possess the necessary skill to define body mechanics,
hindering prosthetic design and advancement. The academy study concluded that the most
important part of a prosthesis is the socket design, rendering it the greatest issue in prosthetic
interface. NAS’s implementation of this research team marked the start of federal funding for
rehabilitation research [5]. Prosthetic solutions hence forth would be reached using science,
engineering and technology.
CURRENT MARKET ANALYSIS:
War:
As we know, the prosthetic market
can be positively correlated with
trends in war and disease. Although
they may seem uncommon, blast
injuries are not rare. In recent
decades, the number of terrorist
related events at home and abroad
have escalated. A “retrospective
analysis of bombing events” in the
U.S between the year 1983 and 2002
identified 36,110 bombing incidents
[7]. No one really cares to mentions
the posttraumatic effects of the blast
victims. Perhaps a child’s leg that
was crushed under a cement block,
now unable to walk; a father’s eye
ruptured due to airborne blast
debris, now unable to see. In
addition, the impending war or
terrorism plagues both our domestic and international communities in the traditional context of
war as well. Our troops abroad, deploying in areas such as the Middle East, are subjected to the
same types of traumas. According to statistics, provided by the Army Office of the Surgeon
General, the total number of individuals with amputations from the year 2001 to 2010 totaled to
1,552. Prosthetics can address many of these issues aiding in rehabilitation for the traumas blast
victims face.
Disease:
The most common diseases to be attributed to limb deficiency or amputation include, cancer and
diabetes. An instance in which cancer related amputations are necessary includes the rapid
Figure 1: Amputations associated with Operation Iraqi freedom
and Operation Enduring freedom

3
spreading of tumors in the bone or muscle
of cancerous limbs. Although important, the
number of cancer related amputations is
rendered negligible in scope of dysvascular
amputations. Diabetes is a metabolic
disease in which a person’s body refuses to
produce insulin; the chemical responsible
for regulating the amount of glucose (sugar)
in the blood. Individuals with this disease
are at risk of developing cardiovascular
disease, coronary and cerebral vascular
disease, and a slew of stemming diseases. A
German case controlled study conducted in
1990 proved the strong associative link
between diabetes and dysvascular
amputations [9]. A nine year epidemiology
study conducted in the U.S in 1988
recorded the number of hospital discharges
involving individuals with limb
amputations or deficiencies [10]. The
number totaled to a striking 1,199,111
discharges with 82% of the amputations due
to vascular diseases. The study revealed a
major concern for the increasing risk of
dysvascular amputations amongst elderly
and minority populations. Figure 2 gives an
accurate depiction of the amputation levels
involving dysvascular, trauma and cancer.
Diabetes has proven to be not just a
domestic issue, but an international one as
well. In 2013 a global study consisting of
744 data sources, representing 144
countries, estimated the total number of
individuals with diabetes at 382 million
[10]. This number is projected to reach 592
million by the year 2035 corresponding to a
55% increase in the number of adults (20-
79 years) with diabetes.
There are countless other factors that
contribute to limb loss. Work related
accidents and congenial birth defects to
name a few. However, in analyzing the
trends of current war and diseases, today’s
prosthetic market proves highly viable, with
a concrete future. The direction of that
Figure 2: Limb level amputation by etiology

4
future however is highly dependent upon advancements in science and technology.
NEW TECHNOLOGY:
Moore’s law states that the number of transistors on an integrated circuit will double
every year. This importance of this law suggests the exponential growth of technology as
computers become smaller, faster and more affordable in foreseeable future. The advancement of
technology in the past two decades has revolutionized the prosthetic industry. We have reached a
point in time where the adoption of a prosthetic could enhance one’s own physical and mental
capabilities effectively giving rise to transhumanism.
Biomedical Advancements:
Recall that the greatest issue in prosthetics is prosthetic interface. As human beings we
are incapable of successfully attaching things to our body. Inventions such as the shoe still give
us blisters in this age of technological prowess. For decades the socket has been the fundamental
basis for prosthetic design; a socket prosthesis involves the insertion of a residual limb into the
apparatus. Recent advancements have looked to nature in order to bridge the gap between man
and machine, with remarkable findings. The invention of bone anchored prosthetics more closely
resembles the biomechanics of a human being in their natural state thus providing better
comfortability and mobility. A control study published in 2014 validates this claim [12]. Bone
anchored prosthetics involves the anchoring of a prosthesis directly into the bone through the use
of bolts and screws. Over the last few years the federal Food and Drug Administration (FDA)
was skeptical as prostheses of this design could greatly increase the user’s risk of infection. The
Osseoanchored Prostheses for the Rehabilitation of Amputees or (OPRA) device was the first
prosthesis of this design approved by the FDA in 2015. It features titanium components so the
patient’s bone does not reject it. The invention of bone anchored prostheses will revolutionize
the prosthetic industry bringing man one step closer to machine.
Mechanical Advancements:
Advancements in technology have
allowed engineers to build smaller and
more efficient motors and power sources.
Hugh Herr, a leading researcher in bionics
at MIT, has utilized this technology,
designing prosthetic legs that are fully
functional with actuators and motors that
mimic the mechanical properties of
tendons and muscles. His designs take the
passive idea of a prosthesis and render it
active. Passive prostheses are cumbersome
and cause the user to expend excess energy
on transport. The active approach to
prosthetics uses the science of mechanical
engineering and nature to design Figure 3: Schematic of Hugh Herr’s active/passive foot.

5
more efficient and natural prostheses reducing ones metabolic cost of transport, as Herr has done.
[13]. His work, more accurately presented in his recent trip to UTD, has deemed him a hero
amongst the prosthetic/bionic community
Software advancements:
This new era in prosthetics is coupled with advancements in software. As the
functionality of prosthetic devices improves, more system and control monitoring is needed to
ensure the efficiency of the device. The emerging technology in myoelectrics is a case of such
software advancement. Myoelectric prostheses are operated through the use of electrodes placed
on the surface of the residual limb. These electrodes measure and amplify the Electromyographic
(EMG) signals from the residual limb. These signals are received and interpreted by a controller
which in turn operates the motors in the prosthesis. This technology is more readily used in
today’s prosthetic hands and elbows. An example would be the “Luke Arm.” In recent
advancements the Defense Advanced Research Projects Agency (DARPA) has built the most
advanced prosthetic in industry. It features brain control of a prosthesis through the use of highly
sophisticated software and sensory tech, a revolutionary prospect in prosthetics.
LAYOUT:
Timeline:
Choosing to write a research paper on this topic will be relatively straightforward. Prosthetics
has been around since the time of the early Egyptians with a well recorded history. There are
numerous articles online that depict the history of prosthetics. Academic journals with new
research studies are bountiful as this new age of prosthetics gives excitement to the industry. We
will take a fundamental approach as I have done in this proposal, examining the new
technologies and assessing their moral and ethical implications. We will consider the opinions of
professionals in industry exposing the two different perspectives.
Report type:
I propose that we write a white paper to inform our fellow engineers about this issue. As a team
we can determine the best philosophical approach to address the issue. This will help our
audience understand our perspective, offering insight to their own personl decisions.
CONCLUSION:
The rate of advancement in prosthetic technology is unmatched by bioethics. We are in a
time where bioethical issues must be discussed in order to correctly foster this new age. As a
student pursuing a career in prosthetics, I am uncertain of the role I must play in this new age.
The soil is beginning to shift underneath my feet with the culture of prosthetics, shaking lose the
moral and ethical values I once thought fixed. This unclear boundary is giving rise to
transhumanism at home and abroad. On one end there is a belief we should endeavor to eliminate
diseases and disability through technology. On the other, skepticism of the cost to accomplish
such a feat. How does one come to define being disabled? How does one define being human?

6
At what point does man begin to make himself in his own image? I propose that we further
investigate this issues, finding insights and looking to the histories for clarity. As scientists and
engineers, it is our role to foster this new era of technology as the bioethical battle begins with
prosthetics.

7
RESOURCES
[1]"Prosthetics." Mosby's Medical, Nursing, & Allied Health Dictionary. Elsevier Inc. (Mosby),
2001. Health Reference Center Academic. Web. 12 Oct. 2016.
[2]Prosthesis. (n.d.). Retrieved October 12, 2016, from http://www.merriam-
webster.com/dictionary/prosthesis
[3] W. A. Wagle, "Toe prosthesis in an Egyptian human mummy," American Journal of
Roentgenology, vol. 162, no. 4, pp. 999–1000, Apr. 1994.
[4]"From Amputee to Entrepreneur.," Army Magazine, vol. 64, no. 11, pp. 51–51, Nov. 2014.
[5] J. McAleer, "Mobility redux: Post-world war II prosthetics and functional aids for veterans,
1945 to 2010," The Journal of Rehabilitation Research and Development, vol. 48, no. 2, p. vii,
Feb. 2011.
[6] [1] S. Lilley, Transhumanism and society: The social debate over human enhancement.
Dordrecht: Not Avail, 2014.
[7]Zara R. Mathews MD and Alex Koyfman MD, "Blast Injuries," The Journal of Emergency
Medicine, vol. 49, no. 4, pp. 573–587, Oct. 2015, Art.ID. 6.
[8] Hannah Fischer, "United States Military Casualty Statistics: Operation Iraqi Freedom and
Operation Enduring Freedom," in CRS Report for Congress, Paper RS22452, Congressional
Research Service, 2010, pp. 1–9.
[9] C. Trautner, B. Haastert, G. Giani, and M. Berger, "Amputations and diabetes: A case-control
study," Diabetic Medicine, vol. 19, no. 1, pp. 35–40, Jan. 2002.
[10]T. R. Dillingham, L. E. Pezzin, and E. J. Mackenzie, "Limb amputation and limb deficiency:
Epidemiology and recent trends in the United States," Southern Medical Journal, vol. 95, no. 8,
pp. 875–883, 2002
[11]L. Guariguata, D. R. Whiting, I. Hambleton, J. Beagley, U. Linnenkamp, and J. E. Shaw,
"Global estimates of diabetes prevalence for 2013 and projections for 2035,"Diabetes Research
and Clinical Practice, vol. 103, no. 2, pp. 137–149, Feb. 2014
[12] K. Hagberg, E. Hansson, and R. Brånemark, "Outcome of Percutaneous Osseointegrated
Prostheses for patients with unilateral Transfemoral amputation at Two-Year follow-
up," Archives of Physical Medicine and Rehabilitation, vol. 95, no. 11, pp. 2120–2127, Nov.
2014.
[13]H. M. Herr and A. M. Grabowski, "Bionic ankle-foot prosthesis normalizes walking gait for
persons with leg amputation," Proceedings of the Royal Society B: Biological Sciences, vol. 279,
no. 1728, pp. 457–464, Jul. 2011.

8
APPENDIX
Mechanical advancements in further depth:
Mechanical advancements in science and technology in the last century are responsible
for some of the most realistic and efficient prosthetics to date. Scientists and engineers have
made leaps in the area of material science, producing materials that offer the means to maximize
the efficiency and personalization of prosthetic devices. Concerning socket designs, scientists
and engineers have developed materials that respond to electrical stimulus providing support or
relief in areas of need. In the traditional sense of mechanical engineering, batteries, motors and
transmissions have miniaturized offering greater variability of system configurations. In other
words, we have added more pieces to the already complicated puzzle. The consistency of
Moore’s Law allows for this advancement birthing into existence smaller and more efficient
components. It has allowed for the transformation of the prosthetic device from passive to active.
History of Active Prosthetics:
Thought history the view of a prosthetic devices has been a cumbersome one. To lose
ones leg/arm and know that you can never return to full limb functionality turns one bitter. What
if you could return near normal limb functionality with a prosthetic device? What if you could
surpass it? Advancements of the 21st
century have done just that, restoring hope and redefining
disability with active prosthetics. Traditionally prosthetics or the late 19th
and early 20th
centuries
have been passive offering little aid in mobility. They were concoctions developed by your local
handy man or smith to be simple and cost effective. It wasn’t until the collaboration of
prosthetists and engineers that the shift from passive to active began. An active prosthetic is one
of great complexity, comprised of motors and actuators that work together to mimic limb
functions. Engineers have partitioned prosthetic devices offering more degrees of freedom and
range. For example, take your traditional casted molding for a hand. Technology has provided
the means for engineers to add small motors and sensors aiding in mobility and control. For
design purposes we shall analyze Hugh Herr’s PowerFoot Biom Ankle and how it increases the
efficiency of the walking gate. It is first necessary to define the phases of a gait cycle [1].
Gait cycle:
A walking gate cycle consists of 2 steps, right heel down to right heel down again. This
cycle is broken up into two phases, the stance phase and the swing phase.
Right Stance Phase:
The stance phase makes up about 60% of the gait cycle. It is broken up into four components,
heel strike; mid stance; active propulsion; passive propulsion.
1. Heel strike – From heel contact of right foot to toe off of left foot.
2. Mid-stance – Toe off of left foot to heel lift of right foot.
3. Active propulsion – Heel lift of right foot to heel contact of left foot.
4. Passive propulsion – Heel contact of left foot to toe off of right foot.

9
Right Swing Phase:
The swing phase makes up about 40% of the gait cycle. It has once component.
1. Toe off of right foot to heel contact of the same foot.
Analysis of Biom Ankle on walking gate:
Hugh Herr, a leading researcher
at MIT and a double amputee has
revolutionized the prosthetic market
with his Biom Ankle Design. It is
the first prosthetic device that offers
active plantar flexion replacing
functionality of the calf muscles
and Achilles tendon. Having a
traditional passive prosthetic foot
fixed at a ninety degree angle offers
no shock absorption or ankle
propulsion hindering the efficiency
of ones walking gate. The user of
such a device has to
overcompensate for the lack of
mobility overloading his/her muscles and joints leading to joint and cardiovascular issues. The
implementation of Herr’s active prosthetic will greatly reduce future healthcare cost resulting
from an inefficient walking gate. The Biom Ankle works of the principle on bionic propulsion
[2]. Referencing figure #, the blue spring stores elastic potential energy during dorsiflexion while
the red stores elastic
potential energy during
plantarflexion. During the
gait cycle the system
configuration modulates the
stiffness of the two springs
effectively absorb and
distribute forces mimicking
that of a natural limb. In
stance phase, the heel strike
component of the walking
gate is referenced by CP of
fig #. During this phase the
prosthesis outputs a stiffness
to the red spring for shock
absorption to prevent foot
slap [2]. In mid-stance,
referenced by CD in figure

10
#, a stiffness is applied to the blue spring dependent upon the recorded ankle torque at that
instant. This is done to achieve a smooth rotation of the ankle through CD. The final two
components of stance phase are referenced by PP in figure #. Active propulsion namely “Start of
push-off” occurs only if the measured torque of the ankle at that instant is greater that the
predefined torque threshold usually set by the user for comfortability purposes. If the condition is
false then the prosthetic device will remain in phase CD until the swing phase is initiated (when
toe leaves the ground). If condition is true then the system proceeds to the active propulsion
phase of the gait. In this the prosthetic device offsets the ankle torque by providing a stiffness to
the blue spring. This stiffness propels the prosthetic device off the ground through the passive
propulsion phase and into the swing phase. Swing phase is subdivided into 3 stages to control
foot clearance and heel striking when walking/running. Referencing SW1 in figure #, initially the
foot is rotated to a predefined position/angle for foot clearance. SW2 represents the rotation of
the foot back to its initial equilibrium condition in preparation for a heel striking; this is where
the foot makes a ninety degree angle with the representative shine bone. SW3 represents the
setting of the prosthetic heel strike angle based on feedback data from the previous gait cycle.
The foot is the
rotated to that
angle thus
beginning a new
gate cycle.
Through
advancements in
technology and
careful system
integration Hugh
Herr was able to
design an active
prosthetic capable of improving the users metabolic cost of transport. Noted were improvements
by an average of 14 % when compared to that of a traditional passive prosthetic [2]. Compared to
non-amputees Herr has successfully normalized the walking gate of unilateral transtibial
amputees (below knee). Referencing figure #, Herr has actually enhanced the performance of
unilateral transtibial amputees walking at speeds up to .88 meters per second. In numerous
interviews Herr has repeatedly stated that he wants to transform how people view disability. He
has done this by successfully designing a prosthetic device capable of outperforming a natural
limb. The Biom Ankle, being made of aluminum, titanium, plastic and carbon fiber, offers a
heavy foot comparable to that of a 190lb man. This is of no consequence as users have
repeatedly stated that the weight is a non-factor. Claims have been made of the prosthetic device
outlasting the non-amputated limb as fatigue is analogous to the swapping of a battery. What
does this mean for the future of prosthetics? How do we move forward ethically if man can make
himself stronger and faster through bionics? These are questions that have been neglected by the
scientific community for the past century. Not so long ago, the idea of bionic humans was a
fictitious dystopian dream that had no physical, moral or ethical implications. Mechanical
advancements in science and technology has aided in bringing this discussion to the forefront of

11
political consciousness. The idea of bio-integration has prompted an idea transhumanism. One
could be so bold to consider Hugh Herr a Transhumanist. However bold his intentions are to
completely expunge disability we must be wary of the moral and ethical implications that ensue.
We shall analyze a hypothetical.
Hypothetical case 1:
Consider John, a bilateral transtibial amputee (both legs amputated just below the knee)
who has been using the Biom Ankle Prostheses for more than a year. John wakes up late and
speeds to work. He doesn’t usually use the handicapped parking spaces out of an internal
conflict, but today there are no spots available and he is already late. John then decides to park in
the handicapped spot. He hops out his ford and begin jogging to the entrance of his workplace.
Immediately John hears someone behind him yelling “Stop!” To his surprise it’s a police officer.
“You parked in the handicapped spot sir,” he exclaimed.” John hesitates and remembers that he
is wearing Wranglers and boots. “I’ll have to write you a ticket,” says the officer. John replies,
“But sir, I don’t have any legs.”
Analysis:
In this scenario we skew the line of disability. The implementation Herr’s Bionic Ankles has
enhanced John’s limb functionality making his disability undiscernible to the police officer. The
emerging field of bionics begs to distinguish between a prosthetic device and a bionic device.
Merriam Webster defines Bionics as
1. Having normal biological capability or performance enhanced by or as if by electronic or
electromechanical devices [4].
2. Comprising or made up of artificial body parts that enhance or substitute for a natural
biological capability <a bionic heart> [4].
Recall the definition of a prosthetic device from Merriam Webster.
4. An artificial device used to replace a missing or impaired part of the body [5], more
readily seen associated with limbs.
With these two definitions we establish our case for replacement vs enhancement. Nowhere in
the definition of prosthetics is the word enhance mentioned. However when it comes to Bionics
we find it is mentioned in each definition. This gives rise to the question, “Should John be
allowed to park in the handicapped spot with enhanced bionic ankles?”
Case for:
John is still handicapped. If he didn’t have the bionic ankles or if they were to stop functioning
then he would become disabled again. He should be allowed to park in the handicap spot.
Case against:
Handicap by Webster- A disadvantage that makes achievement unusually difficult sometimes
offensive; a physical disability.

12
John is not disadvantaged nor is it difficult for him to walk. In addition to normal mobility his
bionic ankles give him an unfair advantage. He should not be allowed to park in the handicap
spot.
Conditional case:
John should not be allowed to park in the handicap spot “if” his Bionic Ankles are functioning
properly. If there is a complication and his bionic devices fail then he should be allowed to park
in the handicap spot.
There are numerous variations and perspectives one can adopt to build cases for and
against John. The defining factor here is how we view disability. Where do our views fall on the
replacement vs enhancement spectrum? It is this variability that prompts conflict. The newly
emerging bionics industry offers many challenges in addressing these ethical issues. Although
this was just a parking spot scenario, the future of bionics promises many moral/ethical issues to
come. As technology continues to advance, bionics will advance with more and more
technologies rivaling that of the biological human. Let’s not wait until they reach our doorstep.

13
References
[1]"Gait analysis: Fundamentals, methods of analysis, normal gait," 2016. [Online]. Available:
http://emedicine.medscape.com/article/320160-overview#a1. Accessed: Dec. 5, 2016.
[2]S. K. Au, J. Weber, and H. Herr, "Powered ankle--foot Prosthesis improves walking
metabolic economy," IEEE Transactions on Robotics, vol. 25, no. 1, pp. 51–66, Feb. 2009.
[3] H. M. Herr and A. M. Grabowski, "Bionic ankle-foot prosthesis normalizes walking gait for
persons with leg amputation," Proceedings of the Royal Society B: Biological Sciences, vol. 279,
no. 1728, pp. 457–464, Jul. 2011.
[4]Merriam-Webster, "Definition of BIONIC," 2016. [Online]. Available: https://www.merriam-
webster.com/dictionary/bionic. Accessed: Dec. 5, 2016.
[5]Prosthesis. (n.d.). Retrieved October 12, 2016, from http://www.merriam-
webster.com/dictionary/prosthesis

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