Dialysis is a process of cleansing the blood, remove waste products like urea through diffusion and excess fluids

through ultrafiltration from the body by passing it through a special machine with filter; it is primarily used to provide an artificial replacement for lost kidney function in people with renal failure. Kidney hold an important roles in maintaining human health, it maintain human body¶s internal equilibrium of water and materials when it is healthy. Therefore when kidney failure, a treatment have to be replace the work of kidneys used to do, although it is an imperfect replacement .There are two main types of dialysis, hemodialysis and peritoneal dialysis, both types of filters remove wastes and excess water from the blood in different ways and its risk and benefits. #Choice 1 As an engineer working for a company designing dialysis equipment for worldwide use, I am assigned to design a new dialysis machine. This dialysis equipment¶s target market is both economically-developed countries and thirdworld countries. Economically-developed countries are used to describe countries that have a high level of development according to economic criteria such as gross domestic product (GDP) and industrialization while third world countries refers to the economically underdeveloped countries with characteristics such as poverty, high birthrates and economic dependence on the advanced countries. Here are some examples of economically-developed countries and third world countries; United State of American, United Kingdom and Germany represent economicallydeveloped countries in the mean while countries in Middle East, South Asia and Africa represent third world countries. In economically-developed countries there are working dialysis systems; however in the third world countries access to dialysis equipment is limited. While designing the new dialysis machine, there are two choices in the design wise: first, using disposable filters that would be replaced with each patient; second, using a reusable filter that could be cleaned, autoclaved and reused with each patient but its price is 100 times more expensive. Both of these designs have advantages and disadvantage towards economically-developed countries and third world countries. Due to manufacturing and FDA approval costs, my company can only move forward on one design, therefore only one of the two designs will be select and this design must be suitable for worldwide use. Some analyses and researches were done on both designs and an optimal choice is selected based on beneficial for my company and also ethically.

As mention before. disposable filter is still preferable in the company¶s point of view because of less troublesome. and basically they will not purchase many dialysis machines but just one or two machines. . If they already purchased a dialysis machine. first design will be preferable because disposable filters will bring continuous flow of profit to the company instead of short term profit by second design although second design is expensive than first design. autoclaved. through the company¶s point of view. The reusable function of the filter increases the complexity of designing and manufacturing. Therefore. the first design of dialysis machine would have to replace the filter with each patient every time when they are undergoing dialysis treatment. Normally patient won¶t purchase dialysis machine for personal usage. they will not purchase a new until their machine is failure. and reused with each patient. only civil hospital or private hospital consist of dialysis machine. easier with high long term profit. hence increase more carefulness and cost to manufacture them. the cleaning process is undergo with the right procedure so the filter is not contaminate. I should not only do my job as an engineer to design a new and functional machine for the company but also design a profitable machine. In this situation. In design and manufacturing consideration. Although the first design is cheaper than second design but in long term wise. hence it is preferable in the company economically point of view. However. Second design dialysis machine involving an expensive reusable filter that could be cleaned. it is profitable for the company. almost all hospitals consists of at least one dialysis machine. As an employee of the company. In the meanwhile. therefore a number of disposable filters will have to be purchase from our company. the disposable design is not require fixed period maintenance but only warranty because disposable filter will not contaminate and danger patient¶s health.Dialysis machine¶s target market is mainly hospitals both government and private sector. Based on above discussion. our company will meet a hard time if the demand of dialysis machine in the market is saturated. target market of dialysis machine is mainly hospital. In economically-developed countries. second design dialysis machine is not preferable due to its reusable filter. However. so the target market of dialysis machine is small. but in third-world countries. dialysis center and maybe some of the specialist clinic. reusable dialysis machine require frequent fixed period maintenance to ensure the machine¶s filter is still under safe condition.

This is because of disposable filter decreases the rates of infection and contamination while disposable filter simplifies some of the operation aspects of dialysis and make it convenient. our design would be an improvement. and cleaning of used filters. autoclaved process follow the AAMI standard. Due to this reason. the second design with higher startup cost but is cheaper in the long-term use will be selected. the mortality risk and hospitalization risk are increased if compare with using disposable filter dialysis machine. The reason is because the reusable filter would require a sufficient level of training to clean. there are a need for technician training. This trend has further declined in recent years due to that presence of disposable filter. The second design. According to an article. data collected during the period of 1976 to 2002 by the Centers for Disease Control and Prevention (CDC) reveal that approximately 20% of dialysis centers using the reusable dialysis machine in 1976 and increasing to 80% in 1997. Contaminated filter cannot be used again for dialysis to prevent patient have second infection. In third world counties point of view. Errors can range from collection. this is unclear in the practical setting where human errors are bound to affect aspects of reuse processes. labeling. . autoclave them. However. Since in economically-developed countries.In economically-developed countries point of view. if untrained personnel is cleaning them could be more dangerous and might cause the filter contaminated. dialysis machine with reusable filter is not suitable for third world country. they are affordable for either design and also have professional skills on dialysis or medicine. and subsequently declining to approximately 60% in 2002. However. room maintenance for safely and sterilization and extensive quality assurance program that are inevitable. therefore other consideration will take in account. storage. if only economical consideration is taking in account. dialysis machine with a reusable filter is an economically and safe machine for dialysis treatment if the cleaning. so dialysis machine with disposable filter is preferable. A few studies are stated that with using the reusable dialysis machine. record keeping. When using the dialysis machine with reusable filter. third world countries which have limited access to dialysis equipment and professional or skilled people. economic consideration have to be take in account to reduce cost of purchasing dialysis machine.

The selection will both meet the economically and ethically requirement. The company is able to earning the profit at the meanwhile helping people. which is limited in third world countries. we can achieve a win-win solution for everyone. As discuss above. This is a difficult situation to choose between two designs. the first design is preferable for economically-developed countries due to its convenient and safety purpose and company¶s point of view which will bring a long term profit to the company. If second design is selected. second design is preferable but in professional skill and safety consideration. . the dialysis machine with disposable filter. However. When taking economic consideration. The purchase of disposables in the third world is difficult and not typically funded by charitable organizations and government entities that might be willing to purchase or donate the equipment. An optimal selection of the design of dialysis machine will be selected based on the different point of view we discussed above. regardless which design is selected. discount on purchasing filters will be provided by our company and also charitable organization. I will choose first design as the company design because it is more practical and profitable to go on with first design. another unethical issue is faced. it is unethical as it is dangerous for untrained personnel to control the machine. Hence. first design is preferable. when dialysis machine is sold to third world countries.Both designs have their own advantages and difficulties in third world countries. Third world countries might able to afford the cost of purchasing the dialysis machine with disposable filter but not able to afford long term purchasing filters. The second design requires trained person to control the machine. if first design is selected. In conclusion. unethical issue faced because third world countries is not able to afford long term purchase of filter. company will also faces ethical issue. Through this solution. The unethical issue faced by third world country can be solved by finding fund or charitable organization linked with our company. The company will be labeled as an unethical company which only concern about the profit of the company.

but its secondary infection rate is very high and is unethical to sell this machine to hospital.00002%). In economical point of view.0001%) but yet reasonable price which is affordable by mostly hospital in the world. there is still a probability for the patients have secondary infection. the third design will be preferable due to its almost zero secondary infection rates. We can see that in these three designs. The first design is the cheapest but with highest secondary infection rate (0. three designs of machine with same function but different secondary infection rate are introduced. The third design will have a secondary infection rate of 1 in 5000000 and cost 100 times the first design. This is because no matter how secure the machine is. In ethically point of view. In economicallydeveloped countries.1%). mean that they are able to afford the second design dialysis¶s treatment fee. I will choose the second design with low secondary infection rates (0. the second design is 10 times expensive than the first design but lower secondary infection rate (0. the secondary infection rate is near to 0 percentages but never decreased to zero. To reduce the second infection. they have a healthy lifestyle compare to the third world countries residents. A design will be choose based on the economically and ethically issue. hence a result the number of people have kidney failure will be less and the secondary infection will not obvious. the first design will definitely be the preferable design due to its low cost of manufacturing and also low selling price. The third design is the most expensive design but with lowest secondary infection rate (0. but it is not practical to design this machine because it is too expensive and not affordable for most of the hospital or patients. The first design will have a secondary infection rate of 1 in 1000. . Definitely it will make a difference if the design was primarily for the economically-developed countries or for third-world countries. The second design will have a secondary infection rate of 1 in 1000000 and cost 10 times the first design. Therefore. such an infection in a patient with kidney disease could result in long-term injury and increased risk of death.0001%) than the first design.#Choice 2 Secondary infection is a risk in dialysis. Most people in the economicallydeveloped countries have mid-level or above income.

Not only that. . In conclusion. second design is the most suitable design for both type of country. third world country resident which have low quality of lifestyle so rate of people have kidney failure as malnutrition is more compare to economically-developed country. since it cover them economically and also ethically. so the rate of secondary infection will be higher. most people is come from low income family therefore although second design has lower cost compare to third design but still they might not able to afford the high payment for the treatment.However in third world country. In this situation. due to the number of patient is more.