Case Study:
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: Determine the facts in the situation – obtain all of the unbiased facts possible. Clearly state the ethical issue.
- We are a designer and have developed a syringe for the developing world
- Adding an auto disable feature adds a significant cost
The ethical issue is that if the company continues to develop and administer the syringes, they are putting the patients at risk for exposure to other diseases. However, the hospitals and clinics cannot afford the safe syringe. The designer must decide to continue on with the expensive syringe, or develop a new and more affordable option.
Step 2: Define the Stakeholders – those with a vested interest in the outcome
The stakeholders are as follows:
- Hospitals
- Clinics
- Company who created the syringe
- Specific designers who work on developing the syringe
- Doctors and Nurses
- Patients
- Manufacturing Company
Step 3: Assess the motivations of the Stakeholders
- Hospitals/Clinics
- Cost, want to provide it to as many patients as possible
- Company who created the syringe
- Want to sell their product, make a profit, and have their product look appealing to hospitals. They want to maintain or increase a positive reputation
- Specific designers who work on developing the syringe
- Reputation, profit,
- Doctors and Nurses
- Safety, readily available and successful for getting rid of the disease, keep as many people from harm
- Hospital Administrators
- Treat patients while keeping the cost of supplies low
- Patients
- Safety, cost effective, readily available
- Manufacturing Company
- Wants to make a profit, product quickly
Step 4: Formulate (atleast three) alternative solutions – based on information available, using basic ethical core values as guide
Alternative Solutions
- Potential course of action #1 1: Add the safety feature to the syringes
- Ethical Principle or code: Duty and Virtual based thinking. This option provides patients with the safest administration of the drug or vaccine.
- Pros
- Safer for patients
- Reduces the spread of disease
- Protects reputation
- Cons
- The syringe will not be cost effective. Therefore not a lot of people in lower income areas will be able to get the vaccine.
- If the company continues with the expensive syringe, that could give the company a bad imagine that they are only concerned with making money and not helping as many people as possible.
- This will increase the number of people with diseases, and may increase the number of deaths in the communities.
- Children may lose parents, and the children will become orphans.
- Potential course of action # 2: Don’t add the safety feature
- Ethical Principle or code: Consequence- based thinking. The syringe will be developed at a low cost for more people to have access to, but it will increase the risk of potential diseases.
- Pros
- Cost effective
- More readily available in the developing world
- Manufacturing company can begin production immediately
- Cons
- If the safety feature is not added, there may be an increase in the spread of diseases because of the re-use of syringes.
- If the syringes are re-used there may be an outbreak of different diseases (HIV). This may increase the number of deaths in the communities.
- The syringe without the safety feature is dangerous because people will reuse the syringes.
- If the company continues with the syringe without the safety feature, the company may develop a bad reputation. They may be seen as wanting to distribute the syringes to the highest number of people possible. If this syringe causes increased infection and the development of more diseases, the company may be seen as an unsafe company. They could lose business, which could impact the success of the company.
- Potential course of action # 3: Redesign the syringe itself
- Ethical Principle or code: Consequence, duty, virtue-based thinking. People will receive a low-cost, and safe way of receiving the drug without spreading other diseases.
- Pros
- Safer for patients
- Reduces the spread of disease
- More affordable (hopefully)
- Cons
- The company will lose a lot of time and money to recreate an entirely different product.
- The partnerships that the company has made for the development of the syringes may lose money as well for the development.
- The new product may not work either, so the company will have lost even more time and money to start again from the beginning for the third time.
Step 5: Seek additional assistance, as appropriate – engineering codes of ethics, previous cases, peers, reliance on personal experience, inner reflection.
If I were designing a product to administer drugs and vaccines to patients, I would want to make sure that I was producing the safest option at an affordable price. If I was in the developmental stage of this syringe and realized that a lot of people would not be able to afford the syringe because of the safety feature, I would take the time to redesign to have the safest more affordable option for developing world countries. Safety is not something that should be overlooked. An article by Okwen et al. states, “From a public health perspective, unsafe reuse is not cost saving. The costs of nosocomial infections resulting from unsafe reuse are borne by the patients, who may face stigmatizing illness without knowing how they became infected” (2011). This article states the many reasons why it is imperative that there are safe ways of administering drugs and vaccines to people in developing world countries. The safety of others should not be taken lightly.
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.
A resolution to this problem would be redesigning the entire syringe, or even getting rid of the syringe itself. I would change the drug administration’s technique to using an aerosol spray. This way, the aerosol cannot pass diseases, such as HIV to other people. A designer could change the development of the aerosol sprays which could potentially save money. This will make it more affordable to the developing world countries. If the aerosol sprays are more affordable, it will increase the number of hospitals and clinics that have access to the drug, which will decrease the amount of disease spread in that country. This solution maximizes the benefit because hospitals and clinics all have access to this drug (due to the aerosol spray being more affordable). This minimizes the risk because more people will be able to receive the drug, thus lessening the spread of diseases. From a developers standpoint they may argue that the amount of time and cost it will take to redesign a new product will impact their company. They may be frustrated that they were close to the finished product, and now they have to start over.
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 this new design will be increasing the access to the drug for developing world countries and decreasing the spread of disease. The aerosol sprays will be less expensive and more readily available to a higher number of hospitals and clinics that cannot afford the original syringes with the auto disable feature. If the company continued with the safety feature, there would be fewer people that had access to the drug. If the company continued without the safety feature it was more likely to increase the chances of people developing diseases. The solution of the aerosol spray solves both of those issues. The ventures technology, economic, social, and environmental aspects would impact many people. From an economic standpoint, more people would be able to afford the drug. It could possibly decrease the cost to make each device due to the change of materials needed to develop it. However, the company will have lost a lot of time due to having to start from the beginning with the design and development of the device. The company will potentially keep and get more clients due to the increase of safety of the drugs administration and the cost.
Okwen, M. P., Ngem, B. Y., Alomba, F. A., Capo, M. V., Reid, S. R., & Ewang, E. C. (2011). Uncovering high rates of unsafe injection equipment reuse in rural cameroon: Validation of a survey instrument that probes for specific misconceptions. Harm Reduction Journal, 8, 4. doi:http://dx.doi.org.ezproxy.lib.lehigh.edu/10.1186/1477-7517-8-4