The “End-Use Problem”

When people speak of the “end-use problem” in engineering ethics, they are speaking about the question of whether or to what extent engineers are responsible for what others do with the technologies that the engineers have helped to design, manufacture, or maintain.

In Chapter 4, we examined an argument that engineers, at least those who worked on medical life-support technology, bear guilt because of the harm resulting from the overuse of life-support technology. That was a stringent argument that engineers are accountable for the end use of their work. I argued that it was too demanding because engineers are not in a position to foresee that the technology would be so misused and in fact there are other interventions, such as the requirement that health care facilities respect living wills and other so-called advance care directives, that directly address the problem of misuse and allow life-support technology to continue to benefit patients with whom it is appropriately used.