Ethical Dilemma: Continue to use or discontinue using.
Doctors ethical responsibility is to treat and save as many lives as possible with the Therac 25. But, it is unethical to continue to use the Therac 25 if it injures or causes the death of even one patient.

Continue to Use

Pros

Discontinue Using

Pros

Stakeholders

Doctors

Patients

Relevant Facts

Doctor's ability to treat patients safely is at stake.

Patients lives are at stake.

AECL claims it was virtually impossible to overdose a patient with the machine.

AECL

Patients would continue to receive life saving treatment

Doctors could save more lives by treating patients

Cons

Could severely injure or kill other patiens

Doctors/Hospitals could be sued for injuring or killing patients

Who could be hurt?

Patients could be injured or killed.

Doctors/hospitals could be sued

Who could benefit?

Patients could continue to receive life saving treatment

Doctors could continue to treat and save patients lives

Whose rights may be abridged?

Patients right to not be subjected to potentially unsafe treatment methods.

What could have been done differently or should be done in the future?

AECL should not have removed the hardware safeguards and only relied on the software for all error checking and safeguards. Machines such as this that use system critical software should be thoroughly tested and include as many safeguards as possible including hardware in the future.

Decision is to Discontinue Using because it is not worth the risk of serious injury or death to even one patient. Older methods could still be used to safely treat patients until the problems with the Therac 25 are resolved.

Cons

Could deprive other patients of life saving treatment in cases where the machine functioned properly.

Older and more time consuming methods of treatment would have to be used.

Patients would not be severely injured or killed by the machine

Doctors/hospitals would not face malpractice law suits.

Who could be hurt?

Patients who were not harmed when the machine worked properly would not receive treatment.

Patients' families may suffer a loss if their family member did not receive treatment.

Who could benefit?

All patients would benefit from not being possible severely injured or killed by the machine.

Doctors/hospitals would not face lawsuits.

Whose rights may be abridged?

Patients right to receive the best treatment in cases where the machine worked properly and saved lives.

Hospital

Patients family would suffer loss of loved ones.

AECL could continue to sell more Therac machines

AECL removed the hardware safeguards that were included on earlier machines and relied solely on the software for error checking on the Therac 25

Patients' families

AECL would have to immediately test and review the entire machine to figure out the bugs and why it was causing overdoses,

Patients' families would not lose loved ones due to radiation overdoses.

Patients' families would not lose loved ones due to a machine malfunctioning.

Programming Errors resulted in administered radiation that was over the prescribed dosage resulting in 6 confirmed deaths

AECL failed to have the software code independently reviewed before implementation.

AECL didn't properly test the machine prior to its manufacture and use at the hospital.

Doctors could be held responsible for the AECL not working properly.