Ethics Specialist Named Dean of Harvard Business School

A sign of the times? Who knows. But Nitin Nohria is one of the prime faculty movers behind the “MBA Oath,” and he both talks the talk and walks the walk. Click here for more.

Here are two excerpts from an interview with Bloomberg BusinessWeek:

What does it mean to take on this role after the global economic crisis?
Business itself is at an inflection point. Society’s trust in business has certainly been shaken. As a result, some of society’s trust in business education has been shaken as well. My hope at Harvard Business School is to restore that trust in business and business education. What we have to ask ourselves as business leaders and as a school is what can we do to restore this trust that has been lost so widely. I believe this trust can be repaired.

What’s the common thread running through the current raft of business scandals?
Not all of this is about ethics. It’s a broader thing. There’s something about the way that we began to run business that made the pursuit of short-term profit maximization more important than creating long-term sustainable businesses.

I guess I’d take slight exception to that last answer. Sacrificing short-term profit maximization in favor of systemic stability and sustainability is an ethical issue. It’s also — and let’s pray business leaders figure this out sometime soon — good for their bottom line.

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Was LeBron unethical?

Bob Stone, blogging over at bleacherreport.com, thinks so:

The very foundation of ethics is the ability to imagine yourself in others??? circumstances. It???s the Golden Rule. James owed the Cav fans a gentle let-down. Instead he left his loyal fans to suffer for two days waiting for the decision, then 27 minutes more, then BAM! Ugly. And unethical.

Unethical? Or just a jerk?

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When Did Cheating Become An Epidemic?

New New York Times discussion:

For as long as exams and term papers have existed, cheating has been a temptation. But with Web technology, it’s never been easier. College professors and high school teachers are engaged in an escalating war with students over cutting and pasting articles from the Internet, sharing answers on homework assignments and even texting answers during exams. The arms race is now joined between Web sites offering free papers to download and sophisticated software that can detect plagiarism instantly.

Is this apparent increase in cheating a matter of shifting morals in this new generation or something else? Are students defining cheating differently than in past decades?

Click here for the home page and to join the discussion.

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The power of apology

Good piece about Lee Taft in today’s Dallas Morning News. Lee is a skilled advocate for the transformational potential of aplogies.

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A big week for the Maguire Center, 21-25 September

Early in the week, we are co-sponsoring the Tate-Willson Lectures with the Graduate Program in Religious Studies. Nigel Biggar – Regius Professor of Moral and Pastoral Theology and director of the McDonald Centre for Theology, Ethics, and Public Life at the University of Oxford – will discuss “Behaving in Public: Christian Ethics in a Polyglot Secularity” in TWO LECTURES on Sept. 22 in 106 Prothro Hall. The first is at 11:30 a.m. (“Between Distinctiveness and Consensus”) and the second lecture is at 7:00 p.m. (“Behaving in a Polyglot Public”). Both lectures are free and open to the public. For more information, contact the Graduate Program in Religious Studies Office, 214-768-2432.

We are co-sponsoring two events in conjunction with the campus-wide observance of the 200th anniversary of Charles Darwin’s birth, along with the Biology Department, the Meadows School (and the Division of Cinema-Television), and the Dedman School of Law. Read all about it over here.

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Public health ethics

An article in today’s Dallas Morning News about H1N1 influenza did a pretty good job of covering the bases: vaccination (and vaccine safety and availability), prevention, and the possible effect of a pandemic on the ability of health providers to care for large numbers of flu sufferers. This part of the story caught my eye:

Last spring, news stories popped up about airlines pulling sick passengers from planes as a precaution against spreading the H1N1 virus. We could well see repeats of this scenario: ushers asking sick people to leave the theater, bus drivers yanking people out of their seats and depositing them onto the street.

These enforcement tactics are unethical, according to Carlo, who also is an expert in the esoteric realm of public health ethics. He said that removing symptomatic people from public places is discriminatory. For every sneezing and coughing person in a public place, there may be another contagious person who shows no symptoms at all but is just as dangerous as the sneezing person.

Carlo’s opinion is based on research in which flu patients report that they were never around anyone who appeared to be sick before they themselves got sick.

“Hence, asymptomatic transmission is used to explain this,” he said. “It’s really unfair to take enforcement action against people who have symptoms and leave the others alone. It’s unethical.”

I am not sure I get the logic of this. Just because there are infected people out there who are asymptomatic and therefore unknown to us, we can’t deal with the infected people who are symptomatic and therefore identifiable? Is that how we deal with TB? If the reason we isolate TB patients, even though there are others with TB who are asymptomatic and unknown to us, is because the threat to public health is greater than appears to be the case with H1N1 influenza, then fine, that’s a distinction I understand, but it’s not the argument being made by the health department.

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Kidney Donations–Some New Ideas

Tom Mayo and I have already posted some thoughts about organ donation in the US and elsewhere on this blog. I’ve just read two interesting recent articles about the problem with regard to kidney transplants in the US. Currently some 80,000 people are on a waiting list for kidneys, and they generally receive dialysis while they wait. About 16,000 people receive transplants each year. Many come from cadavers, although they tend not to be as useful. (My post from November 2, 2008 was concerned with agreements by living people to donate their organs after their death.) About 4000 people on the list die each year for lack of a suitable kidney to transplant. Both articles focus on donations of one kidney by a living donor, which is now much less of a hardship, thanks to new technology.

Virginia Postrel has written an excellent article in The Atlantic about this issue.

http://www.theatlantic.com/doc/200907u/kidney-donation

She writes with very understandable passion:

With 300 million people in the United States, the numbers shouldn’t be so daunting. Eighty thousand people wouldn’t even fill the Rose Bowl. Surely we could find enough kidney donors to end the list. But solving that problem demands creativity, daring, and, above all, a sense of urgency—a radical break with the fatalism fostered by dialysis culture. Kidney patients ought to command the kind of outrage that demanded a cure for AIDS. The list doesn’t have to exist. It is a result not of medical necessity or economic constraints but of public ignorance, conscious policy, and complacent institutions. Too many people are suffering unnecessarily.

Postrel explains an ingenious new system, the National Kidney Registry, that creates chains of unmatched donors and potential recipients that should be able to increase the number of transplants, given the current supply of willing donors. (She understands the economics behind such a system, having once helped to write the excellent “Economic Scene” column in The New York Times.) This system supplements the main organization overseeing the transplant of kidneys in the US, the United Network for Organ Sharing, which administers the waiting list. But Postrel thinks a system that pays donors is the best way to enlarge the donor pool. She is aware of the ethical objections to this, and gives a very intelligent response to them. I should mention that Postrel herself gave one of her kidneys to an unrelated acquaintance of hers.

There is another interesting article in a recent New Yorker.

http://www.newyorker.com/reporting/2009/07/27/090727fa_fact_macfarquhar

(There is unfortunately only an abstract of the article on the site.) The author, Lisa MacFarquhar, focuses on another organization that is trying to increase the number of donors. It operates a website where potential recipients post descriptions and pictures of themselves, and invites people to donate a kidney to one of them. So in this system individuals can pick a particular person to give a kidney to, though they may choose not to have their identity revealed to the recipient. I found this other new system to be strange and unsettling, somewhat like the old TV show, Queen for a Day. On the other hand, MacFarquhar does a nice job of explaining the motivation of people who are prepared to give a kidney to a complete stranger. (Apparently doctors for a long time regarded such radical altruism with great suspicion.)

Both articles describe how certain creative outsiders have tried to supplement the authorized system for matching donors and recipients of kidneys. Of course, the professionals who run that system deserve tremendous praise for saving as many lives as they do, and for fairly carrying out a morally difficult task. But it seems that everyone who understands that system feels that Postrel’s sense of urgency is legitimate, since thousands of Americans a year are needlessly dying.

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Public Responsibility & Ethics

Perkins Theology School’s Dean Bill Lawrence had an absolutely outstanding commentary on KERA-FM this week. You can hear it here (MP3).

Dean Lawrence’s timely message concerned those who “ensmall” their spheres of responsibility and accountability vs. those who enlarge them. By defining down those things for which we feel any responsibility, anything outside that circle becomes “someone else’s problem.” Whether it’s the cold chicken entree served by a flight attendant (“I serve ’em; someone else cooks them” (or doesn’t)), or Gov. Mark Sanford‘s ensmalling of his public and private obligations to the citizens of South Carolina and his family, if you can define your spheres of responsibility and accountability narrowly enough, lots of hard things become someone else’s problem.

This describes a lot of what’s going on in the debate over health care reform right now. “I’ve got mine. The 47 million uninsured are someone else’s problem, not mine.”

This is a middle-class fantasy to a large extent. Your insurance company makes money by collecting premiums and denying claims. It’s that simple. Hundreds of thousands, if not millions, of your fellow citizens have learned the hard way that medical costs can drive to the brink of financial ruin even those with “good” insurance policies. Medical costs are the number one cause for personal bankruptcies in America, and no small number of bankruptcy petitioners thought their insurance was up to the task, only to find out otherwise, with catastrophic financial consequences. Even the Wall Street Journal seems to get it: health care crises don’t happen only to “them.”

Apart from the fantasy, though, there is the matter of ethics and public responsibility. Half of those uninsured are children. Most of the uninsured live in working households, but their employers don’t provide insurance and they are priced out of the market for individual health insurance. Nearly 90 million were without insurance at some time during 2007 and 2008. They live in our communities. Their kids go to our schools. Our employment-based, market-oriented “system” for financing and delivering health care goods and services isn’t working for the benefit of nearly one-third of the country (by any conservative measure, and the number is almost certainly much, much higher). When does it become “our problem” and not just “their problem”?

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Explaining Morality Religiously

The Op-Ed page of the New York Times again has a challenging discussion of morality. The well-known atheist Sam Harris expresses some reservations about President Obama’s nomination of Francis Collins as Director of the National Institutes of Health.

http://www.nytimes.com/2009/07/27/opinion/27harris.html?ref=opinion

Harris recognizes Collins’ important scientific accomplishments. But he quotes some statements by Collins about religion and morality that trouble him (and me). Collins is well-known for claiming that religion and science are compatible. He accepts current accounts of cosmology and evolution, but also accepts evangelical Christianity. He is quoted as follows:

“After evolution had prepared a sufficiently advanced ‘house’ (the human brain), God gifted humanity with the knowledge of good and evil (the moral law), with free will, and with an immortal soul….

We humans used our free will to break the moral law, leading to our estrangement from God. For Christians, Jesus is the solution to that estrangement….

If the moral law is just a side effect of evolution, then there is no such thing as good or evil. It’s all an illusion. We’ve been hoodwinked. Are any of us, especially the strong atheists, really prepared to live our lives within that worldview?”

As Harris sees it, Collins’ religious views as such do not present an obstacle to his appointment. But he asks whether someone who holds these views is suited to oversee the enormous research budgets that the Institutes control.

As someone who believes that our understanding of human nature can be derived from neuroscience, psychology, cognitive science and behavioral economics, among others, I am troubled by Dr. Collins’s line of thinking. I also believe it would seriously undercut fields like neuroscience and our growing understanding of the human mind. If we must look to religion to explain our moral sense, what should we make of the deficits of moral reasoning associated with conditions like frontal lobe syndrome and psychopathy? Are these disorders best addressed by theology?

Good questions! Furthermore, I would note, it’s not just new disciplines like neuroscience that can help us to understand moral and immoral behavior. Political science, sociology, law and economics can, too. Turning elsewhere in today’s Times, and moving down from the cosmic scale, we find an enlightening treatment of a venerable moral question, namely, why are New Jersey politicians so corrupt?

http://www.nytimes.com/2009/07/27/nyregion/27jersey.html?ref=nyregion

Here are some of the things that are mentioned.

A decade-long building boom has flooded towns with millions of development dollars, as well as wealthy businessmen eager to secure sewer permits and zoning waivers. The Democratic Party firmly dominates local politics, turning most elections into sleepy coronations. The state’s news organizations, once vigorous watchdogs, have been decimated by a deep industry downturn.

Add to all that the fact that New Jersey is divided into hundreds of tiny fiefdoms, where part-time elected officials without much education and with small salaries wield considerable power, and the heady mix of arrogance, control and promised payoffs dissolves the will of even the most determined reformer….

Academics say that the state’s history of decentralized, small-bore government is to blame. There are 566 municipalities, many with paltry budgets and skeletal staff, whose leaders arrive in government with little training and salaries of less than $15,000 a year.

Some politicians hold two elected offices at once—allowed under state law—which makes them “really susceptible to corruption because they have a powerful role at two levels of government,” said Christopher J. Christie, the former United States attorney who has indicted a parade of New Jersey officials and who is now the Republican candidate for governor.

Secrecy prevails, sometimes for lack of resources, shielding the graft.

“You can’t even get a copy of the municipal budget online in many of these towns,” said Ingrid W. Reed, the director of the New Jersey Project at the Eagleton Institute of Politics at Rutgers University. “That structure does not exist.”

In that environment, she said, ethics is often the first casualty.

These factors, of course, don’t completely explain any individual politician’s wrongdoing because, thankfully, not every official in New Jersey takes bribes. But thoughtful study suggests that they have an influence on the occurrence of serious misbehavior. There is always something inexplicable and mysterious about any very marked act of wickedness or virtue, but the way forward, I think, is to work on the assumption that human behavior can be explained scientifically. This doesn’t mean that “there is no such thing as good or evil”. Part of what it means is we can get a better understanding of the causes of good and evil, which will enable us to change their relative proportions. Like Harris, I would like to know that the Director of the National Institutes of Health, among others, shares these beliefs.

Postscript:
Here are the letters the Times published today (7/28/09) in response to Harris:

http://www.nytimes.com/2009/07/29/opinion/l29collins.html?ref=opinion

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Peter Singer on the Value of Life

Yesterday’s New York Times Magazine had an article by the eminent utilitarian philosopher Peter Singer with the provocative title, “Why We Must Ration Health Care”:

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html?ref=magazine

It is partly a defense of the idea of a national health insurance program, but it also discusses the idea of ‘rationing’ health care. Singer is brave enough to endorse this, so long as it is carried out according to utilitarian principles. He carefully explains what these are, and the sense in which they put a price on a human life (and on states of affairs like being cured of quadriplegia). Singer is not only a brilliant and powerful thinker, he is one of our discipline’s most effective writers. I highly recommend his article.

The only point I’d add is this. Singer explains nicely how economists have developed a way to quantify the badness of having a certain condition (like quadriplegia)–which, of course, also measures the goodness of avoiding it or curing it.

Health care does more than save lives: it also reduces pain and suffering. How can we compare saving a person’s life with, say, making it possible for someone who was confined to bed to return to an active life? We can elicit people’s values on that…One common method is to describe medical conditions to people—let’s say being a quadriplegic—and tell them that they can choose between 10 years in that condition or some smaller number of years without it. If most would prefer, say, 10 years as a quadriplegic to 4 years of nondisabled life, but would choose 6 years of nondisabled life over 10 with quadriplegia, but have difficulty deciding between 5 years of nondisabled life or 10 years with quadriplegia, then they are, in effect, assessing life with quadriplegia as half as good as nondisabled life. (These are hypothetical figures, chosen to keep the math simple, and not based on any actual surveys.) If that judgment represents a rough average across the population, we might conclude that restoring to nondisabled life two people who would otherwise be quadriplegics is equivalent in value to saving the life of one person, provided the life expectancies of all involved are similar.

This is the basis of the quality-adjusted life-year, or QALY, a unit designed to enable us to compare the benefits achieved by different forms of health care. The QALY has been used by economists working in health care for more than 30 years to compare the cost-effectiveness of a wide variety of medical procedures and, in some countries, as part of the process of deciding which medical treatments will be paid for with public money.

I have read one psychologist (Daniel Gilbert, in Stumbling on Happiness)) who mentions something that might give us some pause in utilizing this method. He refers to some research which shows that when people who do not have a certain condition (like quadriplegia) are asked to say how unhappy they would be if they did have it, they tend to give more negative answers than do the people who actually have it. In other words, non-quadriplegics tend to think that quadriplegia is worse than quadriplegics themselves do. (Gilbert uses this finding to support his general claim that people are not good in imagining how happy they will be in the future.) Perhaps if what Singer is proposing to do takes account of both perspectives then the values we arrive at will not be biased in the way that Gilbert warns us about. But, in any case, I find Singer to be very convincing when he argues that some such calculation needs to be a part of any morally defensible public health insurance program.

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