Challenger: Case Study in

Engineering Ethics and

Communications
Tom Rebold
Adapted from Tufte, Visual Explanations
And
http://www.footnote.tv/mwchallenger.html

The Incident
January 28, 1986
Launch

About 80 seconds after Launch

The Investigation

O-Rings were a known problem

1970s: less safe than more expensive
alternative
1985: scorching becomes noticeable
Thiokol analysis shows worse on colder days
Launch constraint by NASA (waived every launch)
Thiokol Engineer Roger Boisjoly warns superiors
we could lose a flight

August 85: NASA Meeting, no changes

Later, Feynman calls this strategy Russian Roulette

Night Before Launch

Boisjoly and others: too cold, delay launch!
Until 53F

Management: how come some warmer

launches show scorching?
(crucial fact ignored--every single launch in cold
temperatures showed damage)

Thiokol management gets the engineers to

accept a launch recommendation.

Role of Communications
Chart used by Thiokol Engineers on Jan 27 before launch

A Revised Chart by Rogers Commission

Showing all launches
Temperature at
Challenger Launch, 32F

Obfuscation during investigation

Famous physicist Richard Feynman
performs experiment on television
Dips o-ring in ice-water
Shows greater stiffness
also complains about
slides, bullets

Edward Tufte, designer

Provides further damning
analysis of charts
Condemns PowerPoint

Another Communication Problem

Decisions

Knowledge of details

Epilogue
Several families sued NASA management
between $2 and 3.5 million per family.
Morton Thiokol paying 60 percent

Roger Boisjoly, Thiokol engineer

testified before Congress

sued Thiokol under a federal whistleblowing statute (lost)
left the company
underwent therapy for post-traumatic stress disorder
awarded the Prize for Scientific Freedom from the AAAS,
now lectures on workplace ethics issues (in Australia)

Thiokol gave up $10 million incentive fee

did not sign a document admitting to legal liability.

NASA bans commercial or military payloads from shuttle

launched on unmanned rockets