ethics challenger case

8/8/2019 Ethics Challenger Case

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Preparations on for NASAs launch

of 25th space shuttle into space

SRM contractor-Morton Thiokol

Crew members:

Francis R. Scobee, Michael J.

Smith, Ronald E. McNair,

Ellison S. Onizuka, Judith A.

Resnik, Gregory B. Jarvis

Unique mission: TISP program

Sharon McAuliffe first teacher to

be in space

Long awaited launch already

delayed five times due to bad

weather & technical snags


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White arrow points to thesmall glow that can be

seen between Challenger

and the Solid Rocket

Boosters.


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Strong puffs of dark grey smoke - emitted

from the right-hand SRB.

The booster's casing ballooned under

stress of ignition-opening a gap through

which hot gases above 5,000 F leaked out.

The primary O-ring too cold to seal in

time. The secondary O-ring was not in its

seated position due to the metal bending.

No barrier to the gases, both O-rings were

vapourized across 70 degrees of arc.

As the vehicle approached Max Q, theperiod of maximum aerodynamic

pressure on the vehicle, it slammed

through the most intense wind shear ever

experienced to date in the space shuttle

program.

Camera apt res reysmoke

escapi from t e ri t- and


13/21

O-ring seal in its right solid rocket booster (SRB) failed

Seal failure caused a flame leak from the solid rocketbooster, which impinged upon the adjacent external fueltank

The flame caused structural failure of the external tank,and aerodynamic forces promptly broke up the orbiter

Failure of O-ring

Faulty design of solid rocket booster

Insufficient low temperature testing of O-ring materialand joints


14/21

The breakup of the vehicle began at an altitude of

48,000 feet.

Challengerveered from its correct attitude and was

immediately torn apart by abnormal aerodynamicforces .

The robustly-constructed crew cabin detached in

one piece and. Within ten seconds the cabin was

undergoing free fall.

The crew cabin impacted the ocean surface at

roughly 334 km/h, far beyond the structural limits

of the crew compartment or crew survivability

levels.


15/21

Engineers

Warned of dangers oflaunching a cold day

Robert Ebeling andRoger Boisjoly,engineers working onSRM project at Thiokol,

complained to AlanMcDonald and Thiokolmanagement about coldweather problems withsolid rocket motors

Managers

Ignored warnings,failed to reporttechnical concerns to their

superiors

Thiokol knew about the problemsince 1977; Almost half of theshuttle flights had experienced O-ring erosion in the booster fieldjoints. But management did notsupport the redesign task force


16/21

Ateleconference - to discuss the low temperature performance of the

boosters - held between engineers and management from Kennedy Space

Center, Marshall Space Flight Center and Morton-Thiokol

Engineers : If O-rings were

colder than 53F, there wasno guarantee the O-ringswould seal properly andtemperature forecasts for thelaunch day was 31F.

Alan McDonald appealed toNASAmanagement not tolaunch

Engineers refused to sign therecommendation

Marshall's SRB Project Manager,

Larry Mulloy: Data was inconclusiveand challenged the engineers

Managers believed O-rings could be

eroded up to one third of their

diameter and still seat properly,

regardless of the temperature

Recommendation stated that the cold

was still a safety concern, but data

inconclusive


17/21

Management was

Anxious to launch for economic considerations, political

pressures, and scheduling backlogs.

Economic Reasons Had to fly the shuttle soon to prove the Space Transportation

System's cost effectiveness and potential for commercialization.

Scheduling Backlogs

Launch pad had to be refurbished in time for next mission, for a

probe that would examine Halley'sComet, before Russia did so.

Political Consideration

President Reagan, in his State of the Union address, was going to

talk on education and was expected to mention the shuttle and

the first teacher in space, Christa McAuliffe

Jerald Mason, senior executive at Thiokol said,|TAKE OFF YOUR ENGINEERING HAT AND PUT ON YOUR MANAGEMENT HAT."


18/21

Unconcern for safety procedures

Due to the low temperature, a significant

amount ofice built up on the fixed service

structure that stood beside the shuttle.

Ice might be shaken loose and strike the

shuttle.

Launch postponed by an hour to give the

ice team the time to remove ice.

Launch escape system -undesirable due to

"limited utility, technical complexity and

excessive cost in dollars, weight or

schedule delays. Crew lives could have

been saved had ejector seat and full

pressure suits been used.


19/21

Found : NASA's organizational culture

and flawed decision-making processes,

a key contributing factor to the

accident.

NASA managers did not know ofThiokol's initial concerns about the

effects of the cold on the O-rings, and

did not understand that Rockwell

viewed the large amount of ice present

on the pad as a constraint to launch.

It concluded that:...failures in

communication...based on incomplete

and sometimes misleading

information, a conflict between

engineering data and management

judgments.

Included Neil Armstrong and

Chairman of State, William Rogers

It said, Challenger disaster

was "an accident rooted in

history.


20/21

Thiokol agreed to "voluntarily accept" the monetary penalty inexchange for not being forced to accept liability

NASA

Created a new Office of Safety, Reliability and QualityAssurance.

Initiated a total redesign of the space shuttle's solid rocketboosters.

Streamlined and cleansed communication line

Designed anonymous reporting system

Made astronauts more active in decision making process

Appointed a shuttle astronaut as NASA administrator

ButColumbia Accident still happened!

Columbia Accident Investigation Board: NASA failed to learn manyof the lessons ofChallenger - had not set up a truly independentoffice for safety oversight & the same "flawed decision making

process" that had resulted in theC

hallenger accident wasresponsible for Columbia's destruction.


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Engineers at managerial position should not ignore their own

engineering experience, or the expertise of their subordinate

engineers

Managers, even if with engineering experience, should

remember that they may not be up to date on current

engineering practices as are the actual practicing engineers.

If there is insufficient data, engineers should discourage

launching until all the facts were known about the problem.

Engineers should remember their implicit social contractwith society

Engineers should protect the safety and well-being of public

in all their professional efforts. This is part of the implicit

social contract all engineers have agreed to when they

accepted admission to an engineering college.

ethics challenger case

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