Step 1: Determine the facts in the situation

Critical Issue: The fundamental ethical issue in this case study was a dilemma the designer of a syringe faced on whether to build an auto-disable function on the syringe to avoid multiple uses of the syringe or to not to have the feature to make it cost-effective. If the designer was to have a built-in feature to avoid multiple usages of a syringe, then the spread of disease could be controlled since many diseases are spread through the use of contaminated use of syringes. However, this is not an ideal option for the designer since having this feature would drive up the cost of the product making it unattainable for people in low and middle-income countries which would spread the disease even more. 

An issue that is common in low and middle-income hospitals is that there is often no way to tell if syringes being used have been previously utilized. Every year, 16 billion injections are given in the developing world and it is estimated that 6.7 billion are done with reused equipment (Hutin). This is a serious problem and the designer wants to contribute to resolving it. So what the designer must decide is to either a) put in the safety feature in the syringe and raise the per-unit cost of the product making it inaccessible to a vast majority of the population, or b) not add the feature at all to make it accessible to people but risk the spread of blood borne diseases in the process. 

Step 2 & 3: Define the stakeholders and assess their motivations

As with many products, the designer must take into account the grounds on which the major stakeholders stand before he decides to proceed:

1)The designer: He knows that he wants to do not only what’s best for the consumers of low and middle-income countries but he also has to keep in mind that he needs to satisfy the company he is working for so that he can still keep his job.

2) Company: they are invested in this product because they are trying to better their reputation, do well for people in low-income countries, and ultimately make some sort of profit or at least break even.

3) Doctors: They want to treat patients to the best of their abilities and having a syringe that auto disables right after use would be a game-changing product for them which they can use to cure people instead of spreading disease.

4) Consumers: They want a product that is affordable and can cure their illness.

5) Hospital: Treat all of the patients while keeping the cost as low as possible so that it has enough money to run.

6) Investors: their motives will vary. However, a few of the overarching ones would be to make a profit, have a product that does not cost as much and maybe to help consumers in low and middle-income countries.

 

Step 4: Formulate (at least three) alternative solutions

What should the designer do in this situation?

Solution 1: He could design a feature that would be simpler, thereby saving some money during the production process. Perhaps he could implement some sort of color-changing material when designing the syringe. Unused syringes would remain one color and as soon as the syringe is used, maybe a spring mechanism would trigger and it would change the color of the syringe indicating to both the patient and the doctor that the syringe has been previously used. 

Here, he would be using virtue-based thinking as well as moral imagination to do what an exemplary person would do. By designing the syringe to change colors when used would avoid secondary usage and thereby stopping the potential spread of disease. 

Pro: cheaper alternative which will ultimately save people from contracting deadly diseases.

Con: Might be fragile. So needs to be handled with care.

How it upholds the stakeholders’ interests: Since the product is cheaper and works, it is easier for the consumers, doctors, and hospitals in low-income countries to attain it. The company, investors, and the designer himself should be satisfied since the product works and they can maintain their reputation.

Solution 2: The designer could decide to not add the safety feature to enable wide-scale accessibility. Although viable in the short term, this solution will cause problems in the long term since the syringes could be reused and potentially spread a deadly disease. 

Here, the designer is using consequence-based thinking since his rationale is that he is ultimately helping the most people by having the syringe priced low since they would otherwise not be able to access it at all. However, one shortcoming of this solution is that the product does not account for the potential spread of disease since the syringes can be used multiple times. 

Pro: the product is affordable and can save the lives of people in low and middle-income countries.

Con: oblivious to the potential threat of spreading dangerous contagions through the use of second-hand syringes.

How it upholds the stakeholders’ interests: the product supports the interests of the stakeholders since the doctors, and hospitals can purchase the syringes at an affordable price thereby being able to offer life-saving treatment to people with little to no income. The consumers also benefit from this approach. The investors and the company also profit since the product is likely cheaper to manufacture.

Solution 3:  The designer could perhaps not put in the safety feature on the syringe to keep the cost of the product low. However, they could make sure that every doctor and nurses are made aware of the dangers of second-hand syringe usage by having them sign a form that says they are responsible for making sure that the syringes are only used once unless there is a do or die situation where a person needs the syringe regardless of whether or not it’s new so that they survive.

Here, also the designer used consequence-based thinking since he is helping as many people as possible since he is making a trade-off by leaving out the auto-disable function to lower the price of the product.

Pro: the product is affordable and can save the lives of people in low and middle-income countries.

Con: overlooks the potential threat of spreading dangerous contagions through the use of second-hand syringes since not all the doctors might be willing to sign the form and they might even use it to treat patients if there are shortages.

How it upholds the stakeholders’ interests: the product supports the interests of the stakeholders since the doctors, and hospitals can purchase the syringes at an affordable price thereby being able to offer life-saving treatment to people with little to no income. On the other hand, consumers benefit from this approach since they would not have to worry too much about medical expenses. The investors and the company also profit since the product is likely cheaper to manufacture without the addition of the auto-disable design.

Step 5: Seek additional assistance, as appropriate –

These solutions were brainstormed as a team. We took into the consideration the motives of the stakeholders and tried to sum up three solutions that would meet all the ideals for the stakeholders.

Step 6: Select the best course of action

The ideal solution: 

The ideal solution here is to go with the color-changing syringe design. This would overall benefit all parties involved since the patients would get treatment at a semi-affordable price point and they can rest assured that they were not treated with contaminated syringes. It would also generally reduce the spread of blood-borne diseases that are known to spread through the use of second-hand syringes. Since the design is quite simple, doctors and nurses can exactly know whether or not the syringe was used. 

This option is better than the other two solutions listed above because, with this, there is a sure way of knowing that contaminated syringes are not being used. In the second and third solutions, various possibilities can result in the syringes being reused. For example, if there is a shortage of syringes and a patient in critical condition needs it, then a doctor might reuse a syringe just for the sake of saving the person’s life. This would risk the spread of diseases although the doctor had a good intention. The first option would be better suited for low and middle-income countries because it can help easily differentiate between a used and an unused syringe thereby reducing the risk of spreading disease.

Step 7: (If applicable) What are the implications of your solution on the venture.

Choosing this option would have a positive technological impact in countries where second-hand syringes are used to treat patients. With the newly designed syringe, both the patients and doctors can be aware of second-hand syringes are being used. The social impact could be that it can bring patients and doctors closer together since treatment would be affordable and more people would go to the doctors knowing that the risk of getting a deadly disease is minimal. The economic effect of this solution would be that it would reduce the cost of treatment while still making a significant impact on helping patients. Lastly, there could be a positive environmental consequence for this solution if the manufacturing company requests the doctors to return used syringes so that they could be used to make more syringes in the future. This could also prevent the syringes from being used multiple times.

Works Cited

Hutin, Yvan J F, et al. “Use of Injections in Healthcare Settings Worldwide, 2000: Literature Review and Regional Estimates.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 8 Nov. 2003, www.ncbi.nlm.nih.gov/pmc/articles/PMC261740/.