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Ethical Dilemma Therac 25 for: Doctors - Coggle Diagram
Ethical Dilemma Therac 25 for: Doctors
Relevant facts (7)
CGR: Compagnie Generale Radiologie. An established French radiology firm from which AECL got some of its technology for the Therac series of machines.
Dosimeter: radiation dose measuring device
25 MeV: 25 million electron volts. This is the electron beam used in Therac-25.
Therac-25: a medical linear accelerator that folds the electron beam back and forth. This allows for a higher energy beam to be produced.
Class 1 recalls: the most serious recalls in terms of health risks.
AECL: Canadian company that designed and manufactured the Therac-25.
While two software bugs were located as a cause of the radiation overdoses, they were not found until four more fatal radiation doses were administered by the machine. Physicians at Kennestone did not report the incident to the FDA or AECL as they could not agree on whether an accident had even taken place.
Stakeholders (5)
Patients subject to treatment using the Therac-25
Hospitals offering treatment with the Therac-25
Doctors liable to malpractice due to equipment malfunction.
Operators using the Therac-25
Software Engineers for the Therac-25, AECL as a whole
The doctor chooses to report the Therac-25 machine and initiate a class 1 recall on it.
Pros (4)
Other employees could have been fired, like the operator, if the doctor did not report the Therac-25 machine to be recalled.
The hospital the doctor worked at could have been sued by patients if they chose to not report the machine.
The doctor could have been potentially fired for not reporting the Therac-25 machine. Reporting it allows them to keep their job.
Reporting the machine will save future patients from harm.
Cons (4)
AECL quality assurance manager would lose trust and be fired because of bad assurance work.
Some patients may fail to find another available Therac-25 machine because the orginal machine they wanted to use may be the recalled one.
The hospital could lose money from not using the machine because of the recall.
The operator of Therac-25 could lose their position from the machine being recalled.
Who is harmed (4)
The programmer of the software needs more time to address the recall.
AECL the company that makes and produces Therac-25.
When the Therac-25 machine is recalled, anxious patients can’t use it for treatment.
Operators using the Therac-25.
Who benefits? (3)
Patients that need radiation therapy.
The AECL software engineers as they are able to avoid litigation for their software causing fatalities, while fixing the bugs, creating a better product, and expanding their knowledge base.
The doctor can keep his/her job because of reporting the Therac-25 machine.
Rights may be abridged? (1)
the first few people that used Therac-25 due to the fact they may have had the (higher) change of having radiation poisoning / death.
What if everyone took this path? (1)
It would cost AECL more money to recall the machine, including checking the programming system, hardware, software, etc.
All machines would be more reliable to use because doctors work carefully and take high responsibilities in assuring their equipment is in functional order.
The doctor chooses not to report the Therac-25 machine and continues to use it on patients.
Pros (4)
FDA approved.
The operator can continue their job and not be laid off due to the recall.
AECL can continue to produce machines and make money.
The hospital won't have to replace the machines as they are still using them.
Cons (4)
The hospital could eventually be sued for knowingly using a machine that harms patients.
Patients could possibly have their cancer worsened or other organ damage inflicted due to the radiation from Therac-25
The patients will continue to be harmed by the Therac-25 machine.
CGR unknowingly sells Therac series products without knowing it causes harm.
Who is harmed? (4)
The families of the patients seeing them in pain for unknown reasons.
People that created the Therac-25 software.
People needing radiation therapy.
The doctors allowing patients to use Therac-25 could potentially lose their jobs or be sued.
Who benefits? (3)
The operator benefits as they won't lose their job. If Therac-25 was recalled they could potentially no longer operate anything.
AECL
Rights may be abridged? (1)
The patient's rights as they are unknowingly being harmed by Therac-25 as they receive potentially lethal doses of radiation.
What if everyone took this path? (1)
Higher chances of people getting radiation poisoning/death to radiation.
Path Selected by Group:
The path selected is the doctor chooses to report the Therac-25 machine and initiate a class 1 recall on it. Though there are people that could possibly be hurt by this decision, hurting patients is far more harmful than someone losing their job. It is also a doctors job to help a patient as much as possible, lying about the harm of Therac-25 would be against the Hippocratic Oath.
List of future policy changes that would prevent dilemma. (3)
Return examinations for patients getting treatment with new equipment.
Running routine measurements of the radiation outputs in hospital treatment equipment to make sure there are no irregularities.
Run measurements of the appropriate radiation dose before the procedure, and run the machine on the settings to assure the proper output. Either at the start of the day for cost purposes, but ideally before each use.