Engineering ethics is professional ethics, as opposed to personal morality. It sets the standards for professional practice, and is only learned in a professional school or in professional practice. It is an essential part of professional education because it helps students deal with issues they will face in professional practice. The best way to teach engineering ethics is by using cases-not just the disaster cases that make the news, but the kinds of cases that an engineer is more likely to encounter. Many cases are available, and there are methods for analyzing them. Engineering ethics can be taught in a free-standing course, but there are strong arguments for introducing ethics in technical courses as well. Engineering is something that engineers do, and what they do has profound effects on others. If the subject of professional ethics is how members of a profession should, or should not, affect others in the course of practicing their profession, then engineering ethics is an essential aspect of engineering itself and education in professional responsibilities should be part of professional education in engineering, just as it is in law and medicine. Probably few engineering educators would disagree with these claims; their implementation in engineering education is another matter.

Cerebral oedema is well documented as a significant cause of death in patients with fulminant hepatic failure1 2 and in a series from this unit was found in 80% of cases at necropsy.3 The exact relation between cerebral oedema and the metabolic derangements underlying encephalopathy in hepatic failure is uncertain, but in an experimental devascularisation model of acute liver failure in the pig we found a progressive rise in intracranial pressure after surgery which was attenuated by the early administration of methylprednisolone in high doses.4 Since the introduction of continuous monitoring of intracranial pressure in patients with fulminant hepatic failure we have also found that bolus doses of mannitol intravenously can lead to a temporary lowering of intracranial pressure.5In a randomised controlled clinical trial of patients with fulminant hepatic failure and grade IV encephalopathy we have assessed the value of both dexamethasone given prophylactically and mannitol to reverse such cerebral oedema. We have also evaluated the effect on survival of these specific treatments. Methods PATIENTSForty-four patients were studied (17 men and 27

Perhaps the most common reason science and engineering faculty give for not including 'ethics' (that is, research ethics, engineering ethics, or some discussion of professional responsibility) in their technical classes is that 'there is no room'. This article 1) describes a technique ('micro-insertion') that introduces ethics (and related topics) into technical courses in small enough units not to push out technical material, 2) explains where this technique might fit into the larger undertaking of integrating ethics into the technical (scientific or engineering) curriculum, and 3) concludes with some quantified evidence (collected over more than a decade) suggesting success. Integrating ethics into science and engineering courses is largely a matter of providing context for what is already being taught, context that also makes the material already being taught seem 'more relevant'.

No abstract

We now have three major approaches to ethics education in engineering, science, and similar professional programs: (1) free-standing courses in ethics; (2) modules, that is, large-scale insertions of ethics instruction into technical courses (for example, an hour-long discussion of conflict of interest or screening a pedagogical movie such as Incident at Morales); and (3) micro-insertions, that is, small-scale insertions of ethics instruction into technical courses, resulting in a dozen or so "ethics minilessons" during a semester, each lasting only a few minutes. What we describe here is an experiment in the application of micro-insertion to graduate students in engineering. Though it is now only "a work in progress," it is already interesting both for what it has achieved and for the central problem of assessment it has yet to solve. We hope it will suggest other projects both for introducing ethics across the curriculum and for evaluating what has been achieved. We are also hoping for help with that central problem.