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The 6 Rs of Sustainability and the Hippocratic Oath

By | November 8, 2023 | 4 minute read

This article was originally published on MedTech Dive on November 6, 2023. It was republished with their permission. 


The Hippocratic Oath can serve as a guide not only for physicians, but also for medical equipment manufacturers. With sustainability moving to the forefront of product design, medical device manufacturers are embracing a “first, do no harm” approach that reverberates throughout the product lifecycle. A dual focus on patient and planet health is both noble and doable, and it can be accomplished more easily by considering the six Rs of sustainability — refuse, reduce, rethink, reuse, repair and recycle — in relation to the four principles of the Hippocratic Oath: beneficence, non-maleficence, justice and respect for the patient’s autonomy.

Principles 1 and 2: Beneficence and Non-maleficence

Innovation at the service of patient well-being is already at the heart of medical device manufacturing. “Next-use thinking” takes that one step further, acknowledging that our world has a huge impact on our health. It’s being applied systematically to medical device manufacturing to address raw material extraction, component choices, manufacturing processes and supply chain logistics. Engineers and executives are looking for a balance between environmental responsibility and corporate profitability. Fortunately, there is growing acceptance that the former needn’t come at the expense of the latter. Beneficence and non-maleficence can be interpreted as “doing well by doing good.”

Often, it begins with refusing to use harmful, hazardous or non-sustainable materials when alternatives exist. Medical devices can contain hazardous substances, from lead in CRT machines to cadmium in batteries. So while refusal can certainly be seen as an altruistic stance, it’s also a practical one, and it starts with device design and manufacturing. Patients may not have the luxury of choosing which medical devices are used in their care, but they certainly benefit from materials that are less harmful.

While refusal isn’t always feasible, reducing one’s impact on the environment almost always is. There are many options for manufacturers, including:

  • Reconsidering materials used to protect medical devices in transit
  • Reducing how much e-waste their equipment contributes to landfills
  • Minimizing space consumption within facilities through optimal inventory management, thus reducing their carbon footprint

These decisions start with rethinking sustainability from design through disposal by asking questions that illuminate environmental harms and stimulate solutions, including:

  • Will this device be repairable/recyclable, or is it better suited to being consumable (single use) for medical reasons?
  • Will designing a device to be repairable affect its performance? How will repair time affect patients?
  • What can be done across my supply chain to reduce carbon emissions?


Principles 3 and 4: Justice and Respect for the Patient’s Autonomy

Every day, choices are made about how best to treat a patient. That encompasses treatment protocols as well as the equipment used to diagnose, treat and heal them. From a sustainability perspective, justice and respect for the patient’s autonomy can be thought of as the right not to be harmed by the manufacture, use or disposal of the devices used in their care.

Manufacturers can improve their environmental stance by reusing the resources they consume in their manufacturing operations. When processes are designed with reuse in mind, new possibilities surface. For instance, sanitizing medical tools for reuse without excess chemicals can reduce the environmental impact of the decontamination process and lower costs over the long term.

Additionally, repairing medical equipment can extend useful life. When repair is thought of as part of the natural lifecycle of the product, decisions are made upfront that benefit environmentally and fiscally conscious customers. Manufacturers can offer global depot repair services to extend a medical device’s longevity and improve outcomes for patients well into the future. Outsourcing to a repair services expert helps to ensure that repairs are done promptly and professionally, with the proper functionality to protect patient health.

Finally, responsible recycling comes into play when the device can no longer be used safely and effectively. Manufacturers can design-in recyclable materials or make it easier to disassemble equipment. Additionally, IT asset disposition services help ensure proper disposal using eco-responsible de-manufacturing and parts harvesting processes that salvage parts and components for reuse/recycling rather than waste. When outsourcing any medical device repair or asset disposition operations, you must find a certified partner who can follow the stringent standards of the medical industry.

Collaboration Drives Innovation, Prosperity and Sustainability

Sustainability in technology and medical device manufacturing is a journey of incremental improvements that build upon one another through concerted efforts and collaborative partnerships. Explore the benefits of outsourcing to a trusted services partner for better business and patient outcomes in the whitepaper, “How to Outsource Medical Device Repair Services With Confidence.”


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