What Happens When Device Design Runs Counter to Your Morality and Ethics?

Recently, I was at a family function and a relative approached me to ask if I had heard of a suicide machine that’s coming out in Switzerland. They know the industry I cover and were surprised to find me completely unaware. So, of course, I had to look into this device.

The Sarco Capsule (short for sarcophagus) is a portable suicide-assist device that requires no physician intervention. Instead of delivering drugs to achieve its goal, the Sarco replaces oxygen within the sealed pod with nitrogen. This results in a relatively rapid process in which the subject succumbs due to hypoxia (low levels of oxygen in body tissues). The cost for using the device is only $20 (the price of the nitrogen gas).

The organization behind the development of the Sarco is Exit International, a non-profit euthanasia-focused entity. Founded in Australia by Dr. Philip Nitschke, who is also credited as the inventor of Sarco, believes “it is the fundamental human right of every adult of sound mind, to be able to plan for the end of their life in a way that is reliable, peaceful, and at a time of their choosing.”

Sarco cost approximately $710,000 to develop and took 12 years. The pod accommodates a person who is about 5’7” tall, but a larger version is in development for couples who wish to “exit” together. The cost for future pods is anticipated to be priced just over $16,000.

The minimum age for using the capsule is 50, but it has been reported that exceptions may be made based on specific circumstances (i.e., seriously ill individuals) for those over 18.

Before even being able to enter the Sarco, one must pass a psychiatric evaluation to verify mental capacity. Then, inside the pod, the person must answer a series of questions to confirm their identity and, most importantly, that they understand what is coming. Once the nitrogen gas process is started, there is no “abort” option. The final response acknowledging comprehension of what is about to take place is the last action the person will take.

Switzerland was chosen due to its lack of laws regarding assisted suicide (the only caveat is the individual must initiate the act themselves). The first use by a human participant is expected to take place within the next few months, but details are not being shared as the organizations involved do not wish to generate further media attention around the specific act.

From a medical device design perspective, the Sarco is impressive. Fellow sci-fi fans may think of it as resembling the coffin in which Spock was shot into space in Star Trek II. Others may think it looks like the pod in which Superman arrived on Earth after leaving Krypton. The fact the unit is portable means it can be brought to a serene setting for a person’s final moments.

Of course, the unit brings with it a flurry of controversy (as does the topic itself). Regardless of your opinion of assisted suicide, it’s fairly easy to understand why this device would generate such debate.

For me specifically, however, it makes me wonder about the ethics of medical device design. If you worked at a company that was developing a device to facilitate something you disagreed with, would you continue to work for the company? Assisted suicide is the example here, but there are a number of areas where a person’s morality and personal ethics could run counter to the company for which they work. What about devices that facilitate an abortion? How about stem cell research? You can even remove the specific device or medical application from the equation, such as in the case of animal testing. Many find this reprehensible, regardless of the potential benefits for humans gaining access to a new device being tested on the animals.

The easy answer to this, of course, is the person is free to quit their job and go elsewhere. Sure, that’s true, but it’s not exactly that simple. If you have a family to support, one that relies on your paycheck to get by, are you going to be willing to ease your stance against a device being developed that you view as morally questionable? Would you set aside religious beliefs as you continue to work on a product that facilitates an action that goes against those same beliefs?

It’s not an easy situation to be in, for certain, and hopefully one that most don’t have to face. But it does make for an interesting discussion. Should you be so inclined, perhaps bring it up with colleagues and see where a respectful conversation can go. I don’t want to encourage conflict within the workplace, but spirited debate (while again, respecting each other) seems like a reasonable exercise. And feel free to share any details with me—or reach out to discuss further. 

Sean Fenske, Editor-in-Chief
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