Ethical Dilemma: AIDS and Needles Case Ethical dilemmas, also considered as moral dilemmas, are circumstances that require a decision to be made between two choices, a moral and an immoral act. According to ethical dilemmas' assumption, the chooser will follow the societal norms i.e. the procedures of law or religious teachings, while making his choice that is ethically impossible (Your Dictionary 1996-2016). Employees have to choose between the company's success, as they have strong pressures to perform and their personal attractions for an easy way out. Thus, as employees face many dilemmas throughout their career, the company should arrange for their training and should assist them in taking the right decision. (Mann n.d.) People can take ethical decisions only when they recognize an issue or situation as ethical, therefore developing this ethical issue awareness should be the first step in the direction of business ethics. (Ferrell, Fraedrich & Ferrell 2011, p. 61)

Describe the facts you feel underpinned the ethical dilemma in the case.

As observed in the presented case, the initial ethical dilemma is faced by the medical practitioners, where on one hand they have a question of life and death as patients under care are fighting for their lives, while on the other lies their own health and safety. So, their moral obligation is to save their patients as per their Hippocratic Oath, while their own safety pulls them in the opposite direction. Some facts underpinned this ethical dilemma, prevalent in medical fraternity, are as follows:

1. Doctors are vulnerable to infection of the HIV virus by pricking their fingers easily with needle, scalpel, bone fragment or any other sharp tool, while operating on AIDS patients.

2. The highest degree of risk is for nurses, as their routine work includes drawing blood, giving an injection to an AIDS patient, removing an intravenous system, etc. and hence can easily prick themselves with the needle they are using during the job.

3. Getting pricked by the needle, often known as Needlestick injuries, occur frequently in large hospitals and about 80% of reported occupational exposures to HIV, among health care workers, have been accounted.

4. Needlestick injuries not only posed the risk of getting infected with HIV virus, but numerous other bacterial, fungal, viral, and parasitic infection can be transmitted, amongst which Hepatitis B is another dangerous infection.

5. The high-stress emergency situations, in which nurses work, require rapid action, as well as they are frequently pressed for time as they need to take care of both, sizable number of patients as well as their highly changing demands and needs.

II. Who was the decision-maker in the selected case, and what conflicting demands did they have to accommodate?

Becton Dickinson, one of the largest manufacturers of medical supplies used in U.S., was the decision-maker in the selected case. After the completion of their field tests in 2001, Becton Dickinson had to take the decision of marketing these new syringes with the protective sleeves and about the sizes which they need to market initially. Hospital personnel and nurses were very enthusiastic and positive about its usage when they saw the product. Although, this protective sleeve was compatible with all the major syringe sizes, including 1cc, 3cc, 5cc, and 10cc syringes, the company decided to market only a 3cc version of the syringe with protective sleeve. However, the 3cc syringes account for about half of all syringes used. In addition, they preferred using the larger sizes-5cc and 10cc syringes, when drawing blood. Yet, the company, ignoring the conflicting demands of the hospitals and nurses, marketed only 3cc syringe in 2002 under the trademarked name Safety-Lok Syringe.

In addition, despite being warned by medical practitioners about the pricing of the product (as hospitals would be unable to adjust their budget too much if price of the safety syringe is too high), Becton Dickinson decided to sell the 3cc safety syringe to hospitals and doctors' offices between 50 to 75 cents in 2001. No information was available about the cost of the new safety syringe but is estimated at between 13 and 20 cents each. The company again ignored the demand by hospitals of low pricing and decided to sell on a higher price. However, the company had dropped the price to 26 cents per unit, by 2003.

III. What was the initial ethical dilemma faced by the decision-maker in this case?

Since the early 1980s, the risks of infectious life-threatening illnesses by using syringes and needles, in health care practitioners had been thoroughly recorded. Over half of all the syringes and needles utilized by U.S. health personnel were being mass-produced by the...

Even though the numbers of cases due to emerging crisis were increasing, Becton Dickinson decided not to modify its syringes. Instead of taking the call to redesign its syringes and demonstrate a proactive approach in addressing the needs of medical fraternity, it only inserted a warning in every box of needled syringes about the dilemma involving needle-sticks as well as of the dangers of dual-handed recapping.
Although shortly after Charles B. Mitchell acquired approval from the patent office and patented his unique design involving a syringe holding a tube surrounding the body of the syringe that can be pulled away to cover as well as guard the syringe's needle, Becton Dickinson bought from him, a special license, to produce it.

IV. Using the Utilitarian, Kantian, Rights, and Distributive Justice approaches to ethical decision-making, provide an analysis of the ethical dilemma.

a) Utilitarianism

While analysing the case using a utilitarian approach, initially one needs to recognize various available courses of action. Secondly, one needs to assess all those likely to be affected by the action, in the long and short run, and about the profits or harms resulting from the action. And lastly, one should choose the action accordingly, which will produce maximum benefit and the minimum harm. The ethical action, as utilitarianism aims, would be the one that produces maximum benefit for the maximum people. (Velasquez, Andre, Shanks & Meyer 2015)

Steps involved in Utilitarian Analysis

1. Recognise the ethical dilemma --The central ethical dilemma on the Becton Dickinson's part was to market the safety syringes with protective shield, in all the sizes and remain ethically correct or, alternatively, market the safety syringe in only one syringe size and aim for the maximum profit.

2. Who all are getting affected by the actions, directly or indirectly -- The action taken by Becton Dickinson, i.e. marketing the product in just 3cc syringes, directly affected the medical practitioners. The health of the entire medical practitioners' community' was at stake as both doctors and nurses frequently use these unprotected syringes. However, other dealers were affected indirectly as they could also have manufactured the safety syringes in all the sizes and could have earned profits, ending the monopoly of Becton Dickinson.

3. What are the good or bad consequences in the long and short run, for all those who are affected --The good consequences would only be for Becton Dickinson, as they were poised to have an edge over competition; maximum profits for these safety syringes; having the exclusive license. The bad consequences, as stated earlier, would be for the health care professionals, as they would get no help from the manufacturer, for their safety as well as for the other suppliers of medical equipment.

4. Analyse the result on the basis of quantity, duration and severity -- The result would have brought bountiful monetary gains for Becton Dickinson, over a period of 5 years, as they continued marketing of only 3cc syringes at high prices, for five years. However, the consequences were deadly for many health care workers, as evident by the case of Maryann Rockwood, discussed in the case study, who got infected using unprotected syringe in 2005 even after the safety syringes have been introduced.

5. Assess the result and choose the action which you think would yield the best -- The result of the unethical action chosen by Becton Dickinson is evident through the above discussion, which brought the maximum good only for Dickinson. However, the ethical action, as per the norms of utilitarianism, should have been the production of safety syringes with the whole range of syringes available at the minimum possible prices, which would have produced the greatest good for the larger population. Additionally, to compensate their expenses on purchasing the exclusive license and increase his profits, Dickinson can later sell the design to one or two competitors at their discretion, at a much higher price than they had paid for it.

b) Kantianism

Immanuel Kant, stressed that the ethical life is centred on rules and duty. It is not the consequences of an action but the human reason. According to Kant, considerate reasoning has the power to outline ethical laws that binds all rational beings together. As a rational being, we should respect the prestige of other rational beings while taking an action or decision, that is, we can rationally develop ethical laws for other rational beings to follow when encountering similar situations.

Steps involved in Kantian Analysis

1. Recognise the ethical dilemma -- The central ethical dilemma, as expressed earlier, on…