Prompt: While trying to develop a low-cost syringe for the developing world context, you (the designer) hit a crossroads. 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: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue.
The facts of this particular case are:
- I am a designer of a low-cost syringe for the developing world.
- The auto-disable feature will limit the potential spread of the disease but its cost will be unaffordable for some hospitals and clinics.
- The decision of constructing the syringe to auto-disable or not is what exactly needs to be decided.
- The ethical issue ultimately comes down to the decision of producing low-cost syringes without the safety feature that will further spread the disease versus producing high-cost syringes with the safety feature that will ensure that the patients will not spread the disease.
Step 2: Define the Stakeholders (those with a vested interest in the outcome)
The stakeholders with a vested interest in the design of the syringe include:
- Manufacturer/designers engineer the syringes to work as effectively and cost-efficiently as possible
- Hospitals and clinics supply the syringes
- Doctors and nurses are employed at these locations and use syringes as a priority tool for multiple medical procedures
- Patients receive treatment/testing through syringes
Step 3: Assess the motivations of the Stakeholders
The stakeholders with a vested interest in the design of the syringe include:
- Manufacturer/designer: wants to create an optimal design that does not jeopardize the lives of others but that is also not too expensive where no hospital or clinic will be able to afford it
- Hospitals and clinics: this group wants to obtain the most syringes as possible at the lowest cost and wants to ensure a stable supply; they rely on government funding and donations so they look to operate within a certain operating budget
- Doctors and nurses: want to use the syringe to help as many people as possible without harming anyone
- Patients: want the best affordable care as possible and to feel healthy as soon as possible
Step 4: Formulate (at least three) alternative solutions – based on information available, using basic ethical core values as guide
Approach 1
- Potential solution: Pose trials with volunteers with the low-cost syringe and see the results. If the spread is able to be kept at a manageable level, it may be best to still use the syringe.
- Ethical principles or codes: honesty, integrity, consequence-based-thinking (does what is best for a large number of people, other than the people volunteering for the trial)
- Pros: People will not be blindly using a syringe that may hurt them; they will be aware of the risks upon signing up to be a part of the trial. It would be useful to see the true effects of not having the safety feature and to see how much the use of the syringe makes the disease spread
- Cons: This approach may take longer to get the product to market, may be slightly expensive, and could harm the volunteers. It also could show devastating results that show the syringes severely contribute to the disease’s spread, ultimately wasting precious time and money.
Approach 2
- Potential solution: Implement the safety feature
- Ethical principles or codes: duty-based-thinking (do what you would want everyone to do), honesty, respect, duty to not harm others
- Pros: This approach would ensure the syringe auto-disabled after each single use and would mitigate the risk of spreading the disease to the people that are able to afford it
- Cons: This approach may be too expensive for hospitals and clinics to implement which would result in less people being able to be treated
Approach 3
- Potential solution: Keep investing in research and development. It may be worthwhile to keep designing a syringe that both limits the spread of the disease and is low-cost, or to try and source materials from other suppliers that are lower in cost.
- Ethical principles or codes: virtue-based-thinking (tied to character and the right thing to do), consequence-based-thinking (the greatest outcome for the greatest number of people), justice, judgement, duty to not harm others
- Pros: The final syringe design will hopefully be able to auto-disable while still remaining low-cost which will keep patients safe while also allowing the greatest number of people to have access to the product because of its low cost.
- Cons: This approach will take longer to get the product to market, may require additional researchers, and may be costly
Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection.
Due to the current pandemic of COVID-19, trials of vaccines have begun to be conducted. The trials have been conducted at U.S. clinical research sites and have enrolled approximately 30,000 adult volunteers. This previous case with COVID-19 illustrates the importance of trials for medical device objects and treatments on human subjects.
In terms of an inner reflection, I believe I would not be able to simply produce the syringes without the safety feature and risk spreading the disease further. It may do more harm than good, and if that is the case then it is not worth bringing the product to market at all. I also would not want to damage my reputation or the company that I work for’s reputation in the process.
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 the best course of action is the third approach: to keep looking for a solution. The trial could be a waste of time and money that could be concentrated on other research efforts. To implement the safety feature would be ideal, but because of its high cost it would not be accessible to a larger-scale of people. There needs to be a solution that is both cost-effective and safe, and in my opinion it is worthwhile to spend more time and money focusing on finding it.
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 final solution on the venture is that it may take a long time and it may take a while for the product to get the market. The venture’s technology will have to be reanalyzed and redesigned, and its cost will have to be low enough so that it is accessible to most hospitals and clinics. Once a solution is developed, it will be the best option for the greatest number of people.