Medical Ethics: The Insideousness of Bias

Obesity biasThe New York Times had an enlightening article about bias in its Science section this week. Apparently a study of the interactions between patients and their primary care physicians suggests that doctors are more pleasant, encouraging, empathetic, kinder—just nicer, in short—to their normal weight patients than they are to those who are obese.

From the article:

‘“It’s not like the physicians were being overtly negative or harsh,” said the lead author, Dr. Kimberly A. Gudzune, an assistant professor of general internal medicine at the Johns Hopkins School of Medicine. “They were just not engaging patients in that rapport-building or making that emotional connection with the patient.” …While such expressions of concern and empathy are not remarkable on their own, what was surprising was how absent they were in conversations with overweight and obese patients. And statements like these are no small thing. Studies show that patients are far more likely to follow a doctor’s advice and to have a better health outcome when they believe their doctor empathizes with their plight.

‘“When there is increased empathy by the doctor, patients are more likely to report they are satisfied with their care, and they are more likely to adhere to recommendations of physicians,” Dr. Gudzune said. “There is evidence to show that after visits with more empathy, patients have improved clinical outcomes, so patients with diabetes have better blood sugar control or cholesterol is better controlled.”’

Continue reading

Professionism 101: What Not To Do At Your Desk

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A confused commenter who wanted to take the side of that potty-mouthed TV broadcaster fired for making his first words on the job “…fucking shit” has argued that A. J. Clemente should be re-hired because “it could happen to anyone.” Wrong. It could not “happen to anyone,” I explained to her, because civil professionals don’t say “fucking shit” in public or on the job. A.J. is further displaying his cluelessness and gray matter deficit by trying to exploit his 15 minutes of infamy, appearing on Letterman and thus bidding to be known forever as “the guy who said ‘fucking shit’ in his first seconds on TV.”  Why would he think this is the way to start anew and make potential employers believe in his professionalism? Is he bidding to be a reality show cast member?

Who is advising this poor guy? Politicians, like Texas governor Rick Perry, go on shows like Letterman after a well-publicized gaffe to show they are good sports and that they understand that they messed up, but these are celebrities who are already famous for the mistake. For them,the  tactic is designed to remove the sting by laughing along with everyone else. For an unknown like Clemente to do this is self-destructive: it makes far more people aware of the embarrassing incident, it looks like he is exploiting his incompetence, and suggests that he doesn’t understand how serious his conduct was. Letterman doesn’t care if A.J. wrecks his future on the show; Dave just wants some cheap laughs. Not only is A.J. not professional or bright, he apparently has no friends or family members who are, either.

Well, enough of A. J. He has offered a vivid example of one kind of career-killing job conduct, and Salary.com has some more, in a feature it calls “Crimes in the Cubicle.” The list by Heather Dugan suggests 15 varieties of conduct to eschew at one’s desk, and it is all about professionalism, as well as etiquette, civility, decorm, dignity, office demeanor, respect for others…ethics, in short. It is a good collection: send the link to the young man or woman of your acquaintance who is starting their first office job. Or send it to A. J. Clemente.

Perhaps he should start here.

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Source and Graphic: Salary.com

“The Ortiz Standard,” With An Ethics Note To High Appointed Officials: If You Can’t Say Something Responsible And Intelligent, Please Shut Up!

Gee, thanks, guys. Fuck.

Gee, thanks, guys. Fuck.

Apparently April is officially “Let’s Make The U.S. Permanently Vulgar and Uncivil Month.”

We’ve had a University of Maryland sorority lovely ream out her charges with a rant that would, in the words of Henry Higgins, “make a sailor blush.” Kmart launched a potty-minded commercial based entirely on the hilarious similarity between the phrase “ship my pants” and “shit my pants,” including two happy seniors boasting how they “shipped our pants.” In Bismarck, North Dakota, a local station’s brand new anchor man’s very first words to the audience were “…fucking shit!” because he didn’t know his mic was live.  And, of course, given the honor of representing his team during the Boston Red Sox’s pre-game ceremony honoring the heroes of the past week in their terror-besieged city, slugger David Ortiz told 35,000+ spectators, including many children, and a large TV audience, also including young children, watching the event, “This is our fucking city!” He was then unanimously praised for his passion.

Not to be left out of this full-throated endorsement of public incivility and locker room banter as the new normal, FCC Chairman Julius Genachowski sent out a tweet for those wondering how Ortiz’s outburst would be received by the FCC, which has previously threatened fines of networks that didn’t take sufficient precautions against live obscenities. He wrote,

“David Ortiz spoke from the heart at today’s Red Sox game. I stand with Big Papi and the people of Boston – Julius.” Continue reading

Unethical Quote Of The Week: Boston Red Sox Star David “Big Papi” Ortiz

“This is our fucking city!”

—Boston Red Sox designated hitter and icon David Ortiz, aka “Big Papi”, representing the team in a pre-game ceremony at Fenway Park honoring Boston in the wake of the past week’s violence, heroism and travails.

"Big Potty-Mouth"

“Big Potty-Mouth”

I love you, David, and you got us past the Yankees in 2004, but your choice of words  was classless, crude and unnecessary.

There were children in that crowd and watching on TV, as I was. You are a role model, and locker room language belongs in the locker room, not in public events. Your obviously calculated incivility moves the culture one more step away from public manners and toward obscenity as standard expression.

I’m disappointed in you, and you also embarrassed your sorority sisters at Delta Gamma.

The Dilemma of the Oblivious Questioner

"Where was I? Oh, right...so what you were saying about client perjury reminds me of a trial in the Boer War...well, it wasn't a trial exactly; that was what Churchill's cousin called it---wait, not Churchill's cousin...the other guy, the one who was such a good canasta player. Nobody plays canasta any more..."

“Where was I? Oh, right…so what you were saying about client perjury reminds me of a trial in the Boer War…well, it wasn’t a trial exactly; that was what Churchill’s cousin called it—wait, not Churchill’s cousin…the other guy…no, it was a girl, I misspoke… the one who was such a good canasta player. Nobody plays canasta any more…”

I launched a new legal ethics seminar today. This is always nerve-wracking, because it has to last exactly three hours, has to cover the topics I’ve included in the printed materials, and the programs are interactive, meaning that the degree of attendee participation is unpredictable. After I’ve done a program a couple of times, I usually have a good idea about which segments prompt a lot discussion and which don’t, so I can time my own comments accordingly. The first time, however, it is pure guesswork.

This one, a country-music themed program, was going to be tight, but was close to schedule until an elderly lawyer burdened with various medical paraphernalia raised his hand. I called on him by reflex, and then realized that he was the same attendee who had blathered on earlier in the program, telling an irrelevant and pointless anecdote that ate up five minutes. Sure enough, the second he got his hands on the mic he was off again, this time making an obscure and convoluted comparison between what I had been discussing and Japanese war crime trials, but it was even worse. He went on tangents; he forgot names; he backtracked; he never made any coherent point. Some people got up and left. It was easily a ten minute filibuster, and permanently killed any chance I had of covering all my material. He finally reached the end, never making clear what the story had to do with anything. I went on to the next segment.

Now I wonder if I handled the situation properly and made the right ethical call, which was to tolerate his clueless intrusion and not embarrass him by cutting him off. Continue reading

Now THIS Is Incivility!

DormRoom1950sThe Delta Gamma sorority chapter at the University of Maryland has received some unwelcome publicity as a result of a leaked e-mail from one of the sorority’s executive board members, reprimanding the Gammas’ for not sufficiently participating in Greek Week activities with their “matchup” fraternity, Sigma Nu. The admonition was delivered in a vulgar, threatening and verbally violent rant containing, among its over 800 words, 4 stupids, 3 variations of ass–, as in “ass-wipe” and “ass-hat,” 5 shits, 2 cocks, 2 sucks, 3 goddamns, and no less than 42 variations of fuck. Gawker, which received the text of the rant, mercifully did not release the young woman’s name when it posted the thing, which is as it should be. No reason to destroy her reputation now. The odds are she’ll do it herself eventually.

I’ll post the whole message at the end, to spare your having to go to Gawker, but here are some brief observations: Continue reading

Now THAT’S Unethical…But Funny! And Weirdly Satisfying…

Attack of the Fridge

Danny the Fridge stalks his prey…

[UPDATE: This story was, it now turns up, just another hoax. Fred Phelps doesn’t even have a son. I hate web hoaxes, whether I’m sucked in by them or not. But I’m cutting this one a little dispensation, because I needed a good laugh, and this sure provided it. ]

I am awash in shame. Since early this morning I have been bursting into uncontrollable laughter at another human being’s pain, as he was subjected to an experience of unimaginable existential and surreal horror. It is schadenfreude beyond question, not unethical in itself—feelings are not unethical—but taking joy in the misfortune of others is not a sound foundation for ethical conduct.

I’m not going to rationalize this: I should feel sympathy for the victim. Nonetheless, and even though he was attacked without provocation, and for exercising his First Amendment rights, there are some unusual mitigating circumstances:

  • The victim was David Phelps, son of Fred Phelps of Westboro Baptist Church infamy.
  • He was ranting on during a radio interview in a mobile studio, and had just said, “God hates fags.”
  • Suddenly, a 500 pound naked man known as “Billy the Fridge” burst out of a bathroom roaring, “Leviathan! Leviathan!” (see, now I’m laughing again: I’m a horrible person…) and..
  • …proceeded to sit on Phelps, saying, “Who’s your Daddy now, Davey?”
  • An eye-witness later claimed that he saw Phelps being pursued down the street outside the mobile studio by a naked fat man.

That last part was the one that got me. There, see, I’m laughing again.

We have been puzzling about what to do about the Westboro Baptist Church and its disgusting ritual of shouting anti-gay epithets at the funerals of fallen U.S. soldiers, and I admit that having a 500 pound naked fat man sit on him never occurred to me. I can’t condone it; it is assault and battery, and both a crime and a tort. Nor is it ever ethical, if you are a 500 pound fat man, to chase someone down a street. Indeed, it is arguably not even ethical to be a 500 pound naked fat man, at least in public. It is certainly wrong for any of us to sanction such behavior by cheering it on, or doing anything to encourage other naked obese people to ambush, sit on and pursue members of the Westboro Baptist Church.

Just wrong.

And now I’m laughing again.

I’m so ashamed.

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Pointer: Fark

Facts andGraphic: The Daily Mail

Unethical Quote of the Month: Alexandra Pelosi

“I don’t ask for permission. I think anytime you have to ask for permission your project is doomed.”

—-Alexandra Pelosi, political documentary film-maker (and daughter of you-know-who), speaking about her embrace of the unethical philosophy, “It’s easier to ask for forgiveness than to get permission,” or in her version, “It’s better to beg for forgiveness than to ask for permission.” Pelosi employed a bait-and switch ruse to made former New Jersey Governor Jim McGreavey the subject of her latest documentary.

Mother taught her well...

Mother taught her well…

If Pelosi is correct, then she is in an inherently unethical profession, and shameless about it. If Pelosi is correct, then all documentary film-makers are indistinguishable from other manipulative deceivers like Sasha Baron Cohen, James O’Keefe, Michael Moore, and her. She is not correct, however. There are many celebrated, honest, straightforward documentary makers who get proper permission from subjects before they put them on camera, respecting their autonomy and privacy and engaging with them fairly. The fact that Pelosi sees no need for this tells us all we need to know about her documentaries.  She believes that the ends justify the means, so she can’t be trusted. She will employ chicanery, deception, and lies in order to make a commercially viable film, which will be worth approximately as much, from a documentation standpoint, as her word: nothing.

The context of Pelosi’s smug endorsement of deception as her SOP was the description of how she filmed McGreavey in his new life since resigning as governor and announcing that he was gay. Pelosi persuaded McGreevey to let her follow him around, but not to make a documentary, which McGreevey’s partner, Mark O’Donnell, opposed. Pelosi told Politico, “I don’t think he thought I was making a movie. I think he thought I was just hanging around.” Then, after the documentary was completed, Pelosi says she told her unwitting and deceived star,  “You have a choice. You can support the bigger picture of what the movie is trying to say, which is about the theme of redemption and second acts, or you can not sign a release and this film will go to waste.” McGreevey should have said, of course, “Go to hell. You lied to me. You won’t have my release, and if you show it to anyone, I’ll sue you right back to living in your mother’s house.” Pelosi, however, as master con artist must, chose her victim well. Though “he was not happy,” McGreevey signed the release. Continue reading

Justin Bieber’s Tardiness: Calling Card Of The Unprofessional Jerk

Professional on the right, arrogant jerk on the left. Also, anyone next to Cary Grant looks like a troll...

Professional on the left, arrogant jerk on the right. Bonus: Anyone next to Cary Grant looks like a troll…

There is still some confusion how late pop sensation Justin Bieber was for a recent London concert. It may have been as much as two hours, and it may have been only 40 minutes. The ethical verdict on the conduct is the same, however: rude, disrespectful, irresponsible, unfair and arrogant…and inexcusable.

The tardiness is especially inexcusable because the singer didn’t even offer a plausible excuse or one that might prompt some sympathy. He was not kidnapped by terrorists, abducted by aliens, or cornered by a rampaging T-Rex from Isla Sorna. He wasn’t late because he single-handedly rescued a runaway school bus full of kids, or defused a ticking bomb in the London Tube. Justin Bieber was late because he’s an unprofessional jerk who knew that his fans would wait for him until he got there, and so he chose to to get drunk, or get laid, or sleep in, or play Words With Friends with Alec Baldwin, or whatever other selfish conduct suited him rather than meet his obligations as a performer. This is the Star Syndrome in its most obvious and obnoxious form. Continue reading

“House of Cards” Ethics: Zoe’s Unethical Tweet And The Right To Talk To Just One Person

house_of_cards

At the risk of stirring up the incorrigible defenders of the vigilante Applebee’s waitress, I must again point out that using social media to make a private indiscretion a public disgrace is terrible, grossly unethical conduct that threatens our freedom, trust,privacy and quality of life. The fact that the practice is gaining acceptance as something to be feared and expected is a frightening cultural development, and we are all obligated to do what we can to condemn it and eradicate it before it becomes a toxic social norm.

The Netflix political drama “House of Cards” provided a perfect example of what is wrong with this despicable trend in its fourth episode.  Zoe Barnes, the ambitious, unethical reporter in league with Kevin Spacey’s deliciously diabolical House Majority Whip, has brought her newspaper’s editor to the point of apoplexy in a confrontation in his office.  Already considering leaving for greener pastures, the reporter goads her sputtering boss into calling her a misogynistic epithet that she senses is just on the tip of his tongue. “Go ahead,” she taunts. “Say it.”

“You’re a cunt,” he finally replies. Zoe whips out her smart phone and tweets this exchange to her thousands of followers. “Call me whatever you want, “she sneers, “but remember, these days, when you’re talking to one person, you’re talking to a thousand.”

Wrong—not unless the person you’re talking to is unethical, vindictive, has rejected the social conventions of private conversation and is consigning the Golden Rule to the cultural trash heap. Continue reading