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

• Reusing syringes spreads disease
• Disposable syringes uses more plastic
• Making the syringes’ auto-disable after a single use is costly to the design
• Ethical Issue: Making a cheaper syringe provides the risk of spreading disease, but adding a safety feature makes it more unaffordable.

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

• Patients 
• Doctors/nurses
• Company
• Designer

Step 3: Assess the motivations of the Stakeholders

• Patients want to stay alive and be well. However, patients also wish for their medical treatment to be affordable in order to live their lives freely (without too much debt or ridden with disease).
• Doctors and nurses do not want liability and moral baggage. Doctors and nurses must also consider how much their equipment costs, how much the hospital can afford (to buy equipment), and how much the patients can afford (to pay for medical treatment).
• The company wants to make money. The company also wants to keep a good public image and avoid any controversies.
• Designer wants to create a design that a lot of people will buy. Designer also wants to follow the engineering principles and avoid any liability and moral baggage.

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 • Ethical Principle or code • Pros • Cons 

• Making a syringe with a safety feature
  • Ethical Code: Ensures the safety to the consumer (patient).
  • Pros: Stops the spread of disease due to staring a needle and obliges with general safety standards in the US.
  • Cons: Costs more, more hospitals will not be able to afford the syringes, and more patients will be unable to receive medical treatment (due to the hospital not having syringes or the patients not being able to afford treatment).
• Making a reusable syringe without a safety feature 
  • Ethical Code: Maximizes population health and uses scarce health resources efficiently.
  • Pros: Costs less, more hospitals will have access to syringes, and more patients will receive medical treatment.
  • Cons: Increases the risks of disease due to sharing a needle and potentially causing a wide epidemic.
• Having the patient decide which syringe to use
  • Ethical Code: Respects the autonomy of the patient.
  • Pros: Patients will understand the potential risks and financial costs and decides for themselves.
  • Cons: Hospitals would be required to buy both syringes (more hospitals will not be able to afford the syringes and more patients will be unable to receive medical treatment) .
• Making a reusable syringe without a safety feature but with a warning (either verbally or physically)
  • Ethical Code: Respects the autonomy of the patient and uses scarce health resources efficiently.
  • Pros: Patients will understand the potential risks when using the syringe and can decide whether to continue with the treatment or not. More hospitals will have access to syringes.
  • Cons: Increases the risks of disease due to sharing a needle and potentially causing a wide epidemic. Requires training and/or additional costs.
• Making a syringe with a safety feature. Charge more for the hospitals that can afford it, less/none for those that cannot
  • Ethical Code: Maximizes population health.
  • Pros: Stops the spread of disease due to staring a needle and obliges with safety standards. Provides the syringes to hospitals that can not afford it.
  • Cons: Has the potential of black market trading, creates resentment and feelings of unfairness.

Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection 

• Follow a supervisor’s input or company policy.
• Speak to Doctors/nurses/hospital board.
• Look into how severe the disease being treated is.
• Research disease transmission rates from reused syringes.
• Ask the patients about if they are willing to reuse the syringe.
• Look into the approaches that other companies have taken. 
• Engineering code of ethics: Hold paramount the safety, health, and welfare of the public.
• Inner reflection: What are you getting out of this? Do you really need to go against your morals for a product? How many lives will be saved and lost because of your decision?

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. 

I believe that the best course of action is to make the syringe without the safety feature, but have a warning to the patient. This warning could be verbally by the doctor or nurse, or physically by creating a mechanism where the syringe is shows a green signal when not used then a red signal when used, This would make syringes more accessible to hospitals, providing more medical treatment to patients, compared to making a syringe with a safety feature or having the patient decide which syringe to use. In addition, the patient will know of the risks due the warning, rather than just making the syringe without the safety feature and having the patients not know of the reusing of needles. This method will also avoid any potential black market trading or feelings of unfairness (which could be possible by charging more for the hospitals that can afford it and less/none for those that cannot). While this course of action may require training or additional costs, it would cost less than making the safety feature for the syringe. I believe that some patients are willing to be at risk of disease in exchange for receiving life-saving treatments, rather than not being able to receive life-saving treatments due to the hospital not being able to afford it or the patient not being able to afford it, bringing an overall benefit to the society.

Responses from teammates:

• • Spencer: First review company policy, and hospital needs. The syringe needs to be economically feasible to save people. Consider if the syringe can be produced and profitable. Assess transmission rates through used syringes vs impacts from the afflicting disease. Choose which one saves the most people.
  • Isabella: Make the syringe with the safety feature. Price varies by hospital, hospitals that can afford it pay more, those who cannot pay less.
  • Thaksheel: Pricing the syringe on a need basis where patients with the ability to afford the syringe will have a varying price set for their syringe with a safety. Effectively, the manufacturing and distribution will be net profitable 

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.

• The implications of my solutions on the venture are that technology is limited, the economic viability of the resources/features must be considered, the project should bring the most overall benefit, and the end-of-life of the project must be considered.
  • In the syringe situation, if we had more advanced technology, then maybe we could have made a cheap, affordable syringe that prevents the spread of disease, having no ethical issue at all. However, we are limited by our current technology, so we have to face the issue. For ThermoSolar, maybe we could have very efficient solar panels that didn’t need any cooling, rendering our project purposeless. However, we do not have such advanced technology, so ThermoSolar is working with current photovoltaic technologies.
  • In the syringe situation, the resources and features are evaluated economically. The company of the syringes must consider the costs of making the syringe and the revenue it would receive. With a higher cost to make the syringe, the more the syringe will be charged, making it more unaffordable for hospitals and patients. If the company does not make any profit, then they can not continue making the syringes, preventing all of the people to not receive medical treatment. For ThermoSolar, we are using commercial-graded salt to reduce the costs of the project. If we used a higher-graded salt, it may be more efficient; however, it would cost a lot more. We have determined that we should use commercial-graded salt to lower costs for consumers while still increasing the efficiency of the solar panel.
  • In my proposed course of action, I believe we should make the syringe without the safety feature, but have a warning to the patient. I believe that this would create a more overall good to the people, providing more affordable medical treatment to many more people of low-income families while notifying the people of the risks they will experience. By reducing the costs of the salt for our ThermoSolar project, we will be attracting many more customers, providing a more overall good to people with solar panels. Making our project affordable will allow families and companies to receive more power from their solar panels, reducing their pay-back period.
  • In the syringe situation, making disposable syringes uses more plastic. This will impact the land greatly, since most of these syringes will probably end up on a landfill. While my proposed course of action indirectly allows reusing syringes, it does help the plastic issue; however, it is not enough in the grand scheme of things. We do not have advanced technologies, as well as the economic resources, to make a cheap, affordable syringe that prevents the spread of disease while being easily (and cheaply) recyclable or disposable. For ThermoSolar, solar panel recycling, as well as the recycling of our product, is possible; however, there is no U.S. federal regulation on solar panel recycling. Our project could take responsibility in the recycling; however, that would greatly increase the price of our project. In addition, with our current technologies, solar panels are not completely recyclable (about 95% recyclable).