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

 

1. Developing a low-cost syringe for developing nations is critical to ensure access to safe medical equipment.
2. Adding an auto-disable feature to the syringe significantly increases the cost, but removes the risk of spreading disease through open needles not being disposed of properly. 
3. Without the auto-disable feature there is a risk of syringe reuse which can lead to the spread of disease.

 

Ethical Issue: As the designer, we must balance the need for affordability with the need for a safe design of the syringe. With that, we must decide what the best course of action is for releasing the syringe and what design will maximize benefit to the developing world health community while minimizing the spread of disease. 

 

 

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

 

1. Regulatory bodies such as FDA
2. Patients in the developing world
3. Healthcare workers who perform injections
4. Hospitals in low resource environments
5. The designer and their team
6. Insurance companies
7. Manufacturers of the syringes
8. NGOs focused on healthcare in the developing world
9. Government’s of nations that will be impacted by the introduction of the syringe
10. Local communities and public health

 

 

Step 3: Assess the motivations of the Stakeholders

 

1. Regulatory bodies want to ensure safety standards are met.
2. Patients want access to affordable and safe healthcare. 
3. Healthcare workers want to use medical devices that are simple and safe.
4. Hospitals aim to use cost effective medical equipment. 
5. As the designer, ethical and financial motivations both play a factor into the design process.
6. Insurance companies want to keep liability as low as possible. 
7. Manufacturers want to keep production costs as low as possible.
8. NGOs prioritize the health of the public first.
9. Governments will not want to bring medical equipment into the nation that is going to cause the nation more harm. For example, the spread or introduction of disease. 
10. Local communities and individuals have a stake in preventing the spread of disease.

 

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

 

Solution 1: 

 

Release two different versions of the syringe, one with the auto-disable feature for hospitals and clinics that can afford it and one low-cost version without the safety feature and with red tape warnings and labels. 

 

Ethical Principle or code:  

 

Beneficence- doing good by providing equipment that will be beneficial to the health of communities

Justice- fair distribution of syringes and needles to those in need

Promotes accessibility while maintaining safety standards.

 

Pros: 

• Multiple options are available based on need: Hospitals that are in the most financial need will still be able to access syringes that do not have the safety features, while those hospitals that can afford it are able to get syringes with the safety feature built in.
• Safety feature is still included and recommended.
• Even without the safety feature, syringes will have red tape and warning labels that will contribute to the proper disposal of syringes 

 

Cons: 

• The costs will be higher for safety feature version
• production costs will be higher as two separate versions will be produced
• Will take time and research to develop a more cost efficient feature
• Syringes with only the red tape may not be handled properly ultimately leading to the spread of disease

 

Solution 2:

 

Finish the design of the syringe as is and start mass manufacturing without the safety component.

 

Ethical Principle or code: 

Beneficence- doing good by providing syringes to those in need.

 

Pros: 

• Low-Cost and ready design
• Will increase the total amount of syringes created, purchased, and used
• Low-income environments will be able to get syringes 

Cons: 

• Great potential risk for spread of disease, human health at risk
• Safety feature will never be implemented 
• No way to tell what amount of disease was/was not spread from our syringes 

 

Solution 3:

 

Release the syringe with only the safety feature version.

 

Ethical Principle or code: 

Non-maleficence- does no harm and no risk of spreading disease from our syringes. 

 

Pros: 

• Syringe will be safe to use and prevent the spread of disease
• No additional worker training or education required on disposal

 

Cons: 

• Syringe will be more costly leading to the target market not being reached fully
• Low-income environments will not have access to the syringes they need
• Hospitals may turn to other companies for a cheaper alternative 

 

 

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

 

The engineering code of ethics emphasizes prioritizing safety in healthcare designs which also aligns with the ethical principle of nonmaleficence. Based on past data, syringes with no safety feature will lead to an increase in disease as they are not disposed of properly. Not only spreading disease, these unprotected needles will lead to additional needlestick hazards. Personally, I know that if we release our devices exclusively with no safety feature it is very possible that our company will do more harm than good. 

 

REVISED

• Identifies stakeholders and their motivations
• Defends the best course of action vis-a-vis other approaches.
• Analyzes impact of the decision on the venture

 

1. Regulatory bodies want to ensure safety standards are met. They are on top of investigating upcoming products that will be used on human subjects.Their job is to screen these new products. Our new syringe is part of their work.
2. Patients want access to affordable and safe healthcare. Like the story prompt suggests, a low-cost and accessible syringe will lessen the financial burden for patients all over the world. However, the syringe will be the most impactful in areas where healthcare is not guaranteed. This will leave more patients being saved potentially.
3. Healthcare workers want to use medical devices that are simple and safe. Healthcare Workers are interested in saving and supporting their patients. With safe syringes at their disposal, they can carry out their work and secure human lives.
4. Hospitals aim to use cost effective medical equipment. If these syringes are affordable and low-cost to make, hospitals can save money with these new syringes. Hospitals can allocate their budget to other needed supplies. 
5. As the designer, ethical and financial motivations both play a factor into the design process. With a successful syringe made, the designer can spread their work around the world and gain recognition. Furthermore, with  a successful design and a ready market available that needs that design, the designer will definitely be gaining profit.
6. Manufacturers want to keep production costs as low as possible. Low prices equate to more products being produced. More products produced mean more various customers reached and  willing to pay for these products
7. NGOs prioritize the health of the public first.They can promote the syringe and aid in delivering these syringes to areas needed most. This will boost and bolster their focus and image on supporting human rights.

 

If we were to fulfill the solution of producing these syringes despite having the faulty safety feature, we would create a lot of risk and false hope for the majority of our stakeholders. I think hospitals, NGOS, and especially the patients would suffer the most. There may be instances where the syringes do work and everybody (all stakeholders) win and gain the maximum benefit. However, there is that chance of the syringes failing and producing harm. Knowing this information and still moving forward with the production of these syringes will create a lot of backlash amongst the public.This will ruin the reputations of the stakeholders involved and especially the designer will be held accountable. Furthermore, the blueprint of the syringe would be discarded and not further revised.

 

Another solution posed is to release the syringe with the correct safety feature on. However, the cost of making that syringe will be transparent to the public. This syringe will no longer be low-cost and instead be sold as a regular syringe. Stakeholders involved in selling, distributing, and manufacturing the syringe will receive benefit as the design is circulating. Hospitals will still be able to use the product, but not all patients will have access to this syringe and not all patients can afford this type of healthcare. This solution is half win and half lose. However, this solution is not revolutionary as it does not create a huge impact and solve the larger issue at hand.Furthermore, the solution does not bring anything new to the market. However, compared to solution 1, patients who do have access to this syringe will be guaranteed safeness. The only downside is that only a select amount of patients will have access to this syringe.

 

The other solution is to not release the syringe at all, but instead to release the blueprint and designs of the syringe.The designer gets ro have some recognition as their designs are being circulated, but are open to revisions and modifications. Compared to the other solutions, nothing will be mass produced. The designer will be known for their transparency and efforts instead, thus instilling credibility. Hospitals and NGOs will not have a faulty syringe to work with, but will be on the lookout for further revisions in the future. Patients will not be at risk as the original syringe will not be produced at all. Unfortunately, there is nothing that will serve the patients this time around. However, this solution is the best one as moral principles are applied and the focus is still on securing human health and life. The downside is that nothing changes in the market and no profit will be made. Only good credibility is introduced.