Ethical Decision-Making Post

 

Facts/Ethical Issue:

• Syringe designer
• The addition of the auto-disable function significantly adds to the cost of the design
• The auto-disable function after use is an important safety feature
• The syringe will only be single-use and not cost-effective for its low usage at such a high price
• Not adding the safety feature is a safety hazard and potential for spread of diseases
• The syringe design price must be low cost in order for hospitals and clinics in low-income areas or developing countries to be able to afford it
• Since the medication will be readily provided inside the syringe, if the auto-disable function is used, then the vaccine can become ineffective due to freezing/heating exposure
• Should the syringe be low cost and accessible to get to more patients or, instead, should the syringe contain the auto-disable function in order to help prevent the potential spread of diseases?

 

Stakeholders:

• Self (Designer)
  • Maintain job
  • Try to gain more experience/improve skills
  • Possibly make a name for yourself by making a revolutionary design that is cost-effective
• Company
  • Get revenue from making/selling products
  • Help make a product that can help patients in developing countries
• Hospital/Clinics
  • Treat spread of diseases
  • Buy Cost-effective, but effective products to use for their employees (medical staff) and consumers (patients)
• Doctors/Nurses/Staff
  • Help patients from getting diseases or illnesses or help treat them for it
• Patients
  • Get health treatment safely at a low cost

 

Three Alternative Solutions:

1. Oral Vaccine Immunization
   • Oral vaccinations are already being used for some diseases such as Cholera and Typhoid, so oral vaccines could become the main focus to further develop to be able to target a wider selection of viruses and bacterias. 
   • Pro: Would not need trained doctors or nurses to inject the vaccine, which is very helpful for rural underdeveloped countries.
   • Cons: The research needed to create an effective oral vaccine could be costly and take a long time to develop. The oral vaccine would also be most effective if the administered route mirrors that of the natural infection site.
   • Ethical Principle: Consequence-based thinking

 

1. Teach the medical professionals/staff preventative measures against needlestick injuries

• • Teach medical staff in developing countries how to reduce the potential of needlestick injury through recorded instructional video tapes/CD’s that they could watch after being sent to them.
  • Pro: Much cheaper method and most likely will be very helpful for many who did not have that prior knowledge, like how they can use a traditional syringe and needle which they can laying the needle cap on a safe and stabilized surface before trying to insert the needle inside the cap without touching the needle cap until the needle is mostly inserted inside. They could also be taught how to properly discard their needles and other hazardous materials into a designated hazard bin.
  • Cons: Language differences might get in the way as there are different dialects, so they could possibly mistranslate/misunderstand some of the instructions given verbally while showing how to do it. The videotape/CD could get lost in the mail or take a long time to reach them since they might live in rural areas. It does not help save the patients who are already inflicted by the disease and are in need of the vaccine to help them survive and prevent spreading it to others.
  • Ethical Principle: Consequence-based thinking and virtue-based thinking

1. Fundraising or reach out for extra funding
   • Get more funding, so that the cost of adding the safety feature is not an object that can get in the way of it being sold cheaply to needed areas.
   • Pros: The safety feature can be added and sold cheaper than the initial thought of the final marketing price
   • Cons: Could take more time to be able to get enough funding to make a lot of these syringes to sell
   • Ethical Principle: Care-based thinking
2. Skin Patch microneedles

• • Very viable to be used for vaccination as it can just be attached to the skin for the vaccination to occur and can expand vaccination coverage in developing countries. Has been used and developed in many scientific researches and has given excellent results (such as the microneedle skin patch for tetanus vaccine inducing superior immune response in pregnant mice which allowed for a 100% survival rate of their infants which in comparison to the pregnant mice given tetanus shots intramuscularly, none of their infants survived past 6 weeks, this shows amazing progress in coming closer to creating a more cost-effective and extremely viable vaccination option)*.
  • Pros: It is making great strides in scientific research already, so it is possible to create an effective vaccine using microneedle skin patches. Would be much more cost-effective and less dependent on medical professionals to administer it.
  • Cons: Could take more time to develop, which might potentially allow for the disease to spread to more areas while waiting for it to be developed and sold.
  • Ethical Principle: Consequence-based thinking

 

Best Course of Action:

• The best course of action would be to try to get more funding, send mostly visually-focused instructional videos against needlestick injury to medical staff in developing countries after contacting them ahead of time about it, and to use the remaining funding to develop effective and cheap microneedle skin patches. The instructional videos can help reduce the amount of needlestick injuries occurring from the lack of prior knowledge about preventative methods – reducing the spread of diseases through injury, meanwhile, the cost-effective and viable skin patch vaccines to be further developed and sold, so that no potential hidden, but enormous errors or mistakes can happen unlike if they were to be rushed to develop it. 
• This approach seems like the best option as it provides more time to further develop the vaccine and make it effective, much easier to apply, and very cost-effective (also potentially environmentally sustainable if the patches are made with recyclable materials). The skin patch vaccine would be able to be used for a wide variety of vaccination uses and it would be infused into the skin and transmitted into the bloodstream much faster than the oral vaccine (which would be limited to mostly intestinal infections as those are the most effective approaches for it to be used).

 

Impact of the solution on venture:

• This solution would be able to be the most economical, social, and environmental choice as it is able to be much cheaper than needle vaccinations, be more affordable to people of all social classes, and be more environmentally sustainable than plastic, single-use syringes. The full development of this technology would be revolutionary not only in the healthcare system, but also socially, economically, environmentally, and in the medical and microbiology science fields. The assistant that the instructional videos could provide to rural communities and for allowing more time to develop the product after getting more fundraising for designing this revolutionary product for all to use, it seems like the best and most realistic option to select to allow the improvement of better vaccine designs. 

 

• The downsides of this solution would be problems such as not being able to attain enough money and time to create this device and test it out before making it available to purchase. This could take many years or more than a decade to get enough money, experiment and develop the product, test it out, make it affordable, and possibly sustainable. If the product is not sustainable then it could pollute the environment like plastic syringes are and it could probably be more expensive as it is non-recyclable. Furthermore, if the company decides to increase the product’s price in order to make more profit out of it, then this could mean that hospitals and clinics in developing countries will either not purchase them (which would mean that the product was not able to deliver on its promises and it could damage the company’s finances as they have spent a lot of time and money towards producing and marketing this product) or not be able to purchase many of the skin patch needles (which means many patients will not be able to receive the vaccine through a skin patch needle and the medical professionals will not be able to prevent needle-stick injury from happening to them if they run out of the skin patch needles or not have any to use because of its high cost, which defeats the purpose of the product).

 

*E. Stein Esser, AndreyA. Romanyuk, Elena V. Vassilieva, Joshy Jacob, Mark R. Prausnitz, Richard W. Compans, Ioanna Skountzou,“Tetanus vaccination with a dissolving microneedle patch confers protective immune responses in pregnancy”, Journal of Controlled Release,Volume, 236, 2016, Pages 47-56, ISSN 0168-3659,

(http://www.sciencedirect.com/science/article/pii/S0168365916303935)