Doctors and the Deadly Anti-Snitch Reflex

Everybody, or almost everybody, hates to report friends and colleagues for misconduct. This is the anti-snitch reflex, a strongly programmed response from childhood. Telling authorities about the misconduct of others sets off internal alarms that have been installed by parents and peer groups, ensuring that we feel terrible if we “tattletale.” This is betrayal, a violation of loyalty, and most of all, a breach of the Golden Rule: we’d never want anyone to snitch on us.

For professionals, however, this reflex is false, mistaken and even deadly. The duty to report dishonest public employees, crooked cops, unethical lawyers, conflicted accountants, self-dealing business executives, fraudulent researchers and others in the workplace—even if they are colleagues and friends—trumps childhood codes, personal loyalty and general discomfort. There is nothing noble or admirable about allowing innocent people to entrust their life and livelihood with untrustworthy professionals. Nevertheless, a disturbing large proportion of all professionals can’t bring themselves to do the right thing when it comes to the core ethical duty of stopping workplace dishonesty, incompetence or corruption when it involves a colleague.

A recent survey of doctors is not comforting, but it confirms the problem. Continue reading →

Provocative Links for Ethical Weekend Reading

Here is a diverse selection of five ethics-related posts from cyberspace for your weekend reading pleasure:

  • Christopher Hitchens analyzes, critiques and updates the Ten Commandments—and does an excellent job of all three, here.
  • Finally, a former Bush Justice Department official takes aim at the Republican attacks on the so-called “Al Qaeda Seven,” a despicable moniker apparently invented by Mary Cheney. There really is no debate here: the suggestion that attorneys who previously represented accused terrorists cannot be trusted to work in Justice is legally, ethically and logically ignorant. Still, it is good to have a Republican lawyer say so.

Ethics Trainwreck in Kermit, Texas

In the tiny west Texas town of Kermit, just north of Mexico, an ethics train wreck is underway that may have long-term consequences far beyond the Lone Star State.

Anne Mitchell, a nurse with an impeccable record, became disturbed at the conduct of a physician at the Winkler County hospital where she worked. After unsuccessfully attempting to get hospital administrators to deal with what she believed was a matter of patient endangerment, she sent an anonymous complaint to the Texas Medical Board. This was a classic whistle-blower situation, protected by law and encouraged by the ethics code governing nurses. Unless she trumped up her accusations for a personal vendetta, she did exactly what the medical profession says she has an obligation to do, a responsible act of medical system self-policing that all too few nurses are willing to follow. Continue reading →

Ethics Heroes: “Pharmed Out”

A group of 100 medical ethicists, physicians and others calling themselves Pharmed Out have written the head of the National Institutes of Health and requested that the NIH fund studies examining the effect financial and industrial conflicts of interest have on medical research. Continue reading →