STOP/Fieldwork & Mountaintop reflection

1. Achievements
   1. Fieldwork
   2. Multiple contacts in Almaty
   3. Divided up our project into specified teams
   4. IRB
2. Challenges
   1. Communication with Kazakhstan team
   2. Communication with Hong Kong team (air filter)
3. Further Plans
   1. Regularly meet with our teams at Haileybury
   2. Conduct study
   3. Plan forms of outreach

CINQ 388 Ethical Decision-Making Methodology 

Step 1: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue. 

1. Facts: 
   1. Without auto-disable safety feature → low cost (accessible) + risk of spreading disease
   2. With auto-disable safety feature → higher cost + safety

1. Ethical issue:
   1. Should we prioritize accessibility or safety?
      1. Should I help 10 people or should I help 100 people although certain amount of people might be exposed to another disease?

Step 2: Define the Stakeholders – those with a vested interest in the outcome 

Step 3: Assess the motivations of the Stakeholders 

1. Hospitals/clinics – primary stakeholder – customer
   1. Interest: Helping those who are in need to achieve and maintain their optimal health; sustaining their operation through financial security
2. Patients – primary stakeholder – end user
   1. Interest: Achieving and maintaining their best health; having access to health services regardless of their socioeconomic status (health equity)
3. Designers/manufacturers/insurance companies – secondary stakeholders 
   1. Interest: Using technology to better human life; making profit to sustain their business
4. Government/regulatory body – secondary stakeholders
   1. Interest: Securing the safety of the country and its citizens; serving the best for its citizens

Step 4: Formulate (at least three) alternative solutions – based on information available, using basic ethical core values as guide

 Approaches [1/2/3: repeat for every action] 

• Potential solution: Designing the high-cost syringe and finding funding to make it accessible
• Ethical Principle or code: Duty-based thinking
• Pros: Safe health practice can be established
• Cons: Needs the involvement of third stakeholder (government + insurance companies) to step in and manage the financial aspect of the product to secure the accessibility among general public

• Potential solution: Designing the low-cost syringe and formulating disposal instructions/regulations
• Ethical Principle or code: Consequence-based thinking
• Pros: As accessibility is secured, many more people can be helped regardless of their socioeconomic status.
• Cons: Needs to practice strong disposal regulations to prevent possible spread of disease

• Potential solution: Design both syringes and let people make their own decisions
• Ethical Principle or code: duty-based thinking
• Pros: People will have choice.
• Cons: Those with lower socioeconomic status will be disproportionately affected by the possible spread of disease through low-cost syringe.

Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection [RESEARCH the necessary informations]

• WHO guideline: Safety-engineered syringes to prevent re-use
• CDC guideline:  Syringes should be discarded after single use and should not be re-used
• Incidence of syringe transmitted diseases: Acute hepatitis C virus cases rose 3.5-fold from 2010-2016 and majority of new cases are due to injection drug use.
• The growth market for disposable syringes: With this growth comes cheaper costs, which could aid in solving this problem

Step 6: Select the best course of action – that which satisfies the highest core ethical values. Explain reasoning and justify. Discuss your stance vis-a-vis other approaches discussed in the class. 

1. Designing both high and low-cost syringes to secure both accessibility and safety, and also working with third stakeholders to formulate and reinforce strict regulations on syringe disposal to prevent misuse
   1. Pros:
      1. Making options available
      2. Securing safety through safety feature in high-cost syringe and safety regulation in low-cost syringe
      3. Incorporating both consequence and duty-based thinking
      4. Prioritizing both safety and accessibility
   2. Cons:
      1. Needs third party involvement on regulations to prevent possible health disparity

Step 7: (If applicable) What are the implications of your solution on the venture. Explain the impact of your proposed solution on the venture’s technology, economic, social and environmental aspects. An abridged version (6-step) of the 9-Step Process from “Applied Ethics Case of the Month Club”; adapted from methodology developed by Andy Lau @ Penn State.

• Technology: 
  • High-cost syringe: using technology to better human life 
  • Low-cost syringe: less technology to decrease the cost 
• Economic: 
  • High-cost: designers and manufacturers and make profit and sustain their business
  • Low-cost: everyone will have access 
• Social: reducing health disparity by introducing low-cost product and strong regulations
• Environmental: 
  • Low-cost: could lead to less pollution because it has less parts