Doctors are a completely invalid comparison. Is your healthcare system hurting people? Yes, of course it is.
With a doctor, the patient and their family is highly motivated to ensure the doctor is doing their best to avoid harm in a high stakes and high cost transaction.
When you get doctors more removed from patients (say large commercial medical organisations or vaccines or medicines), then “doctors” can often make the same selfish decisions against the diffuse interests of those they affect.
And the implication that engineers are the only vital part in an organisation that has the agency of choice is amazing. Equivalent statements could be:
* The only way it stops is if managers start refusing
* The only way it stops is if shareholders start refusing
Those statements are clearly ludicrous, yet somehow it makes sense that engineers are responsible for choice?
I do believe us engineers need to try and act responsibly, and I do think using social pressure against unethical engineers is valid. But some anarchistic belief in self-policing is totally unrealistic. Likewise ethical guidelines do not seem to really help much in other professions like accountancy, legal or journalism. Our legal, regulatory, and political systems are there to help mitigate these types of issue.