Analysis

Ethical Analysis Assignment Boeing 737 Max Safety System Was Vetoed, Engineer Says

A Boeing 737 Max in Renton, Wash. The company’s best-selling model remains grounded after

two fatal crashes.

By Natalie Kitroeff, David Gelles and Jack Nicas

Published Oct. 2, 2019 and Updated Oct. 29, 2019

A senior Boeing engineer filed an internal ethics complaint this year saying that during the

development of the 737 Max jet the company had rejected a safety system to minimize costs,

equipment that he felt could have reduced risks that contributed to two fatal crashes.

Boeing has provided the complaint, which was reviewed by The New York Times, to the

Department of Justice as part of a criminal investigation into the design of the Max, according to

a person with knowledge of the inquiry, who requested anonymity given the active legal matter.

Federal investigators have questioned at least one former Boeing employee about the allegations,

said another person with knowledge of the discussions, who similarly requested anonymity.

It is unclear what, if any, assessment investigators have made of the complaint.

The complaint, filed after the two crashes, builds on concerns about Boeing’s corporate culture,

as the company tries to repair its reputation and get the planes flying again.

Many current and former Boeing employees have privately discussed problems with the design

and decision-making process on the 737 Max, outlining episodes when managers dismissed

engineers’ recommendations or put a priority on profits. The engineer who filed the ethics

concerns this year, Curtis Ewbank, went a step further, lodging a formal complaint and calling

out the chief executive for publicly misrepresenting the safety of the plane.

During the development of the 737 Max, Mr. Ewbank worked on the cockpit systems that pilots

use to monitor and control the airplane. In his complaint to Boeing, he said managers had been

urged to study a backup system for calculating the plane’s airspeed. The system, known as

synthetic airspeed, draws on several data sources to measure how fast a plane is moving.

Such equipment, Mr. Ewbank said, could detect when the angle-of-attack sensors, which

measure the plane’s position in the sky, were malfunctioning and prevent other systems from

relying on that faulty information. A version of the system is used on Boeing’s 787 Dreamliner, a

new plane model.

Mr. Ewbank did not respond to requests for comment.

In both crashes of the Max, an angle-of-attack sensor is believed to have failed, sending bad data

to automated software designed to help prevent stalls. That software, known as MCAS, then

activated erroneously, sending the planes into irrecoverable nose dives.

Mr. Ewbank noted in the complaint, “It is not possible to say for certain that any actual

implementation of synthetic airspeed on the 737 Max would have prevented the accidents” in

Ethiopia and Indonesia. But he said Boeing’s actions on the issue pointed to a culture that

emphasized profit, in some cases, at the expense of safety.

Throughout the development of the Max, Boeing tried to avoid adding components that could

force airlines to train pilots in flight simulators, costing tens of millions of dollars over the life of

an aircraft. Significant changes to the Max could also have required the more onerous approval

process for a new plane, rather than the streamlined certification for a derivative model.

According to Mr. Ewbank’s complaint, Ray Craig, a chief test pilot of the 737, and other

engineers wanted to study the possibility of adding the synthetic airspeed system to the Max. But

a Boeing executive decided not to look into the matter because of its potential cost and effect on

training requirements for pilots.

The Dangerous Flaws in Boeing’s Automated System

Here’s why a system designed to stabilize the 737 Max may have caused two deadly crashes in

five months.

“I was willing to stand up for safety and quality, but was unable to actually have an effect in

those areas,” Mr. Ewbank said in the complaint. “Boeing management was more concerned with

cost and schedule than safety or quality.”

His account, and the description of the system’s benefits on the 787 Dreamliner, were backed up

by a former senior Boeing employee involved in the discussions, who spoke on the condition of

anonymity because of the continuing Justice Department investigation. The former Boeing

employee, who worked on the Max, confirmed that executives had discussed the system. The

employee said they had determined that trying to install such new technology on the 737 Max, a

plane based on a 1960s design, would be too complicated and risky for the project, which was on

a tight schedule.

But the former Boeing employee said Mr. Ewbank’s complaint overstated the importance of such

a system and understated the complexity of adding it to the 737 Max. This employee said Boeing

had installed the system only on the 787 Dreamliners, noting that it was unclear how or whether

the Max could similarly calculate synthetic airspeed, because it has fewer sensors. The employee

also did not recall Boeing executives citing the potential impact on pilot training when deciding

not to study adding the system.

A company spokesman, Gordon Johndroe, said in a statement, “Boeing offers its employees a

number of channels for raising concerns and complaints and has rigorous processes in place,

both to ensure that such complaints receive thorough consideration and to protect the

confidentiality of employees who make them.”

Boeing’s chief executive, Dennis A. Muilenburg, said in a speech on Wednesday that “it is

critical we take a step back to humbly look at our culture.”

“We’re taking action as a result of the accidents to reinforce our values of safety, quality and

integrity because we know we can always do better,” Mr. Muilenburg said at the Economic Club

of New York.

Shares of Boeing fell 2 percent in trading on Wednesday.

Peter Carr, a spokesman for the Department of Justice, declined to comment on the complaint.

Mr. Ewbank worked as an engineer at Boeing from 2010 to 2015, and was generally well

regarded by his colleagues, according to two people with knowledge of his work, who requested

anonymity to discuss a sensitive internal inquiry. Mr. Ewbank’s complaint said he had left the

company in part because he had become concerned that it was not making safety its priority. He

returned to Boeing in 2018 and is working on the development of a new 777.

Mr. Ewbank said he hadn’t filed a complaint during the development of the Max because, in

part, the “fear of retaliation is high.”

He stepped forward this year, he explained in the complaint, because of the “ethical imperative

of an engineer — to protect the safety of the public.”

“Boeing is not in a business where safety can be treated as a secondary concern,” Mr. Ewbank

wrote in the complaint. “But the current culture of expediency of design-to-market and cost

cutting does not permit any other treatment by the work force tasked with making executive

management’s fever dreams a reality.”

ETHICAL ANALYSIS QUESTIONS

Question One:

Chapter 2 of our course text outlines a process for analyzing ethical dilemmas:

a. Make sure you have a grasp of all of the available facts

b. List any information you would like to have but don't and what assumptions you should have

to make, if any, in resolving the dilemma

c. Take each person involved in the dilemma and list the concerns they face or might have on

what to do about a product and its safety issue

d. Develop a list of resolutions for the problem. Apply the various models for reaching this

resolution

e. Evaluate the resolutions for costs, legalities, and impact. Try to determine who each of the

parties will react to and be affected by each of the resolutions you have proposed

f. Make a recommendation for the actions that should have been taken

Analyze the ethical issues and implications in this Boeing manufacturing and communication

situation. Clearly use each of the six steps and make a recommendation for the action(s) Boeing

should have taken after the initial engineering recommendations were published. Make sure

your supportive analysis clearly supports your recommendation.

Question Two:

How would your recommendation have been received under the following tests: (evaluate each

separately)

* Blanchard and Peale

* Front of the Page Newspaper Test

* Laura Nash and Perspective

* The Wall Street Journal Model

Question Three:

What potential costs could/did/will Boeing sustain as a result of the crashes and subsequent

complaint issues? (Answer thoughtfully and completely)

Question Four:

In your opinion, does Boeing have an "ethical" culture? Why or why not? Be sure to provide a

clear, comprehensive basis to your response.