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? 

Ethical Issue:

• The designer is stuck between creating an affordable and accessible syringe that can be administered to LMIC’s while trying to keep the cost of the syringe low.
• The issue that arises is whether the designer will choose the side of either manufacturing a syringe that auto-disables and is more expensive or will he potentially allow the spread of disease, keeping the normal syringe currently in use. Keeping the current syringe allows for the spread of the disease which can affect medical personnel, which is detrimental to the medical system in a LMIC.
• The facts that we are presented with are as follows:
  • We (the designer) are working for the developing world
  • Constructing a auto-disable syringe will significantly add to the cost of the design, which can make it potentially unaffordable for some hospital and clinics
  • Single use syringes without the auto-disable function can enable the potential spread of the disease.
• Based on the facts the designer must decide whether to limit the availability and accessibility of the auto-disable syringe because of the economic barriers that arises for LMIC’s or whether to potentially spread the disease through the current syringe being used.

Stakeholders:

• Designer (Me)
• Medical Personnel / Healthcare workers
• Patients
• Hospital / Clinics 
• Company 

Motivations of Stakeholders: 

• Designer (Me)
  • Develop an affordable and safer syringe with a auto-disable function
  • Find a middle ground where the syringe can be administered safely without risking spreading disease while producing a product that is affordable for LMIC’s.
• Medical Personnel / Healthcare workers
  • Administer a syringe without risking spreading disease to other patients, people, and themselves.
• Patients
  • Get a safe syringe administered that is affordable 
• Hospital / Clinics 
  • Foster a healthcare environment where the risk of spreading the disease is low and patients can be treated in an affordable way.
  • Potentially subsidize patient treatment costs 
  • Care for both the healthcare workers and patients by allowing the use of a affordable and safer syringe 
• Company 
  • Fund the development of a auto-disable syringe 
  • Be a leading company in the development of safe syringes for the developing world 

Potential Solutions:

• Manufacture limited amount of auto-disable syringes for high risk situations
  • Pros
    • All patients would get some variant of the syringe. The higher risk patient would get more protection by being administered a auto-disable syringe while the lower risk patient would be administered the normal syringe. This can possibly be more affordable for hospitals and clinics. Since all patients get some variant of the treatment, it encourages more people to get treated, not fearing disease transmission. 
  •  Cons
    • Potentially spreading the disease by selectively choosing who gets the auto-disable syringes. This can produce some level of distrust with the hospital/clinic and patients. If we choose to charge everyone one base price, the price of the normal syringe would be higher and thus can limit the affordability and access of the treatment. Determination of the risk per patient might be too difficult to assess and can lead to administering the limited number of auto-disable syringes wrongly. 
• Use cheaper materials to make the syringes themselves in order to have money to add the auto-disable function
  • Pros
    • Larger access to safer to use syringes
  • Cons
    • Potentially lowers the quality of the syringe so defects might be more frequent. Research and development costs.
• Find alternative way of administering the treatment other than a syringe
  • Pros
    • Can be more easily administered without creating potential risks. Wide spread treatments because there are no limiting factors aside from potential economic barriers. 
  • Cons
    • Costs of research and development. It might not be possible to administer treatment differently. 
• Base supply of auto-disable syringes off of training of personnel. The less training means they would administer the auto-disable syringe, more training they would use the normal syringe. 
  • Pros
    • Everyone can have access to a variant of the syringe.
  • Cons
    • Medical training might be all around low so it would require more auto-disable syringes than normal syringes, thus the economic barriers would still be present. 
• Invest in better medical training and disposability
  • Pros
    • By ensuring high quality medical training, the likelihood of transmission based on administering the treatment would be low (transmission through other means can still be present). Education and training can be taught to new medical personnel from experienced ones so they can now ensure safely administering the treatment. Education and proper practices will continue to be present in the medical system of this country through generational education being passed down. 
  • Cons
    • Can cost a lot of money for high quality medical training. 
• Leverage economies of scale to reduce the price of production for auto-disable syringes
  • Pros
    • The mass production of auto-disable syringes would call for lower prices and thus more people can afford them. This leads to better access and affordability while simultaneously limiting transmission of the disease by using the auto-disable syringes. 
  • Cons
    • It would take too long for the company producing the syringes to grow large enough that they can produce them at a low enough price, comparable to the normal syringe. Might not be able to achieve that is low enough to make a difference (price reduction is too marginal).

Best Course of Action:

• Based on the potential solutions I have proposed, I believe the fifth solution would be the best course of action. By investing in proper medical training and practices it creates a generational chain where new medical staff can have access to the education and training needed to do their job safely. Education and training will be a long term solution, fixing a foundational issue rather than providing a bandage solution. This solution overpowers the need to produce a new product that is safer and instead it uses the same product in a safer way. Although this solution does have economic barriers, it provides developing countries with a platform to grow on by investing in education and training more. The rewards involved would be the country now having a better medical system that enables patients to be treated confidently and safely. The ethical issue of limiting the treatment due to economic reasons of not affording it are no longer an issue because patients can trust that the medical staff administering the treatment are greatly qualified and know how to handle high risk situations. Among the solutions brought up in class, the method of finding an alternative way of administering the test instead of using a syringe was probably the most popular. The downside to this is that it can very much be possible that after investing so much time and money there is no other effective way to administer the treatment besides intravenously. 

Impact of Solution:

• The economic impact of the solution would be rather small. It would allow for the continued development of the normal syringes so there wouldn’t be an increase in patient treatments costs. However, there would be an increase in costs for the hospitals or medical clinics to provide better medical training to administer the treatment more safely to mitigate the risk of spreading the disease. In terms of the technological impact, there would be no difference. However, the social impact of this decision to educate and provide better medical training and practices would be long-term educational growth in the medical industry of this country. The country can now have education passed down through training to help the medical system of the country be better fit to deal with high risk situations.