While trying to develop a low-cost syringe for the developing world context, you (the designer) hit a cross-roads. Constructing the syringe to auto-disable after a single use, an important safety feature, significantly adds to the cost of the design – making it potentially unaffordable for some hospitals and clinics. However, if you don’t add the safety feature, you are enabling the potential for the spread of disease. How do you as a designer proceed?
Step 1:
Problem 1: Without the auto-disable safety feature, it might be possible for people to misuse the syringe, enabling the potential for the spread of disease.
Problem 2: If the safe syringe is too expensive, it won’t be used for those for whom it was developed.
Ethical question: do you forgo the safety feature, and potentially put people at risk, to keep the syringe affordable, or do you keep the feature and potentially keep the syringe out of the hands of the people who would benefit the most.
Facts: You are the designer of the auto-disable syringe, adding the auto-disable option makes the syringe more expensive. The syringe must be low cost but not adding the safety feature is a hazard.
Step 2: Stakeholders
Hospitals/Medical centers
Doctors/nurses
Patients
Designers
Company
Step 3:
- Hospital/med center admin
- Trying to help as many people as possible within the budget
- Reputation/treat spread of disease
- Bring in Profits
- Designer
- Making sure our design is safe, accessible, helpful
- keep job
- Patient
- some will prioritize treatment over safety
- better safe than sorry
- receive treatment at lost cost/risk
- Doctors/nurses
- Do no harm
- Help as many as possible while prioritizing safety and reduce the risk of spreading disease
Step 4: Three alternative courses of action include: (1) forgoing the auto-disable feature and focus on education; (2) provide an incentive (cheaper replacement) for returning syringes after a single use without the auto-disable function;and (3)partner with drug companies and combine auto-disable syringe with medication and allow return of syringe for cheaper refill of drug
- Forego the single-use feature and invest in user-focused education
- Ethical Principle: If the syringe is too expensive, they won’t get to the individuals who need them most
- Pros: less expensive, more available
- Cons: Risk of using inappropriately increased; risk of infection
- Ethical Principle: If the syringe is too expensive, they won’t get to the individuals who need them most
- Offer incentive to users to return syringe after single use for a cheaper replacement
- Ethical Principle: People who need the product can afford it
- Pros: cuts down on medical waste, encourages recycling/ safe handling of medical waste
- Cons: Risk of using inappropriately increased; risk of infection
- Ethical Principle: People who need the product can afford it
- Pair the single use syringe with a medication and allow users to return the syringe for a refill of the medication (single use epipen return for a refill of the med)
- Ethical Principle: Eliminate the risk of inappropriate use
- Pros: no risk of spreading infection for misuse of syringe
- Cons: largely dependent upon relationship with drug companies, need for method of returning
- Ethical Principle: Eliminate the risk of inappropriate use
Step 5:
- What incentives to doctors/hospitals/medical facilities have for collecting “sharps” already and how can we use this as a segue to our recycle program
- How well does recycling work for other things (paper, plastic, etc) in our target area
- How can we determine whether a syringe was used more than once when it has been returned and how do we handle returned syringes if they have been overused
Step 6:
The best course of action that satisfies the highest core ethical values is to forgo the single-use feature and replace it with a cheaper reactant paper that changes color once the syringe is used. Then offer the user the incentive to return the syringe after only a single use for a less expensive replacement. Misused, returned syringes would still be replaced, but more training might be necessary. The money saved by forgoing the single-use safety measure should be used to: educate the users of the potential risks of using the syringes more than once; simple, inexpensive method for return; and cost-effective replacements in lieu of misusing the single-use product.
Step 7:
There are several implications of my solution on the venture. In terms of the technology, while the auto-disable may seem like a good solution to the misuse problem, the cost would preclude its use for the very ones for whom it is intended. Rather than focus on preventing misuse, a better idea is to educate the individuals who are at the highest risk of misuse. If they understand the scientific reasoning behind the single-use, they might be more inclined to use the product correctly. The economic implications include decreased health care costs for the treatment of infections spread by misusing syringes. In addition, if recycling syringes is lucrative enough, it might lead to other recycling ventures, which is a very positive environmental implication. Socially speaking, educating people as to why reusing syringes is unhygienic and unsafe might lead to curiosity regarding other areas of cleanliness and hygiene.
