60 Minutes and the Opioid Crisis

While catching up on chores around my apartment Sunday Evening ‘60 minutes’ came on CBS and I found the topic to be quite engaging.  The 27-minute segment produced by 60 minutes and The Washington Post is presented below, if you are interested in watching it, and focuses on the opioid crisis; specifically, how congress and the drug industry may have exasperated the issue.

The report hinges around Joe Rannazzsi, a whistleblower, who ran the Drug Enforcement Agency’s Office of Diversion Control. This division is responsible for monitoring, investigating, and regulating the pharmaceutical industry. As Rannazzsi alleges, the drug industry, paid lobbyist, and congress colluded to not curtail the developing opioid crisis, but rather “provide the rocket fuel for a crisis that… has claimed 200,000 lives.”

Article:/Video https://www.cbsnews.com/news/ex-dea-agent-opioid-crisis-fueled-by-drug-industry-and-congress/

I would recommend reading the article and/or watching the video to get the entirety of the story. In brief, Mr. Rannazzisi accuses: 1) drug distributors knowingly pumping unjustifiable quantities of opioid drugs into communities ravished by addiction, 2) drug companies using their power and clout to push back on federal investigations and regulations, 3) drug companies perpetuating the revolving door where top DEA attorneys are bought out and end up working for the same companies they were originally prosecuting, and 4) congress, at the recommendations of lobbyist and former drug company associates, removed the DEA’s power to legally go after wholesale distributors.

The reality is all of these actions, and more that Mr. Rabbazzisi and others exposured during the interview, are worth discussing within an ethical context.

Should drug distribution companies be solely worried about profits or should they take their users general welfare into account?

Should companies be allowed to lobby their corporate interests or buyout politicians?

Should DEA attorneys with intimate knowledge of the methods used to prosecute be allowed to be bought out to protect those same organizations?

Should individuals with conflicts of interest (drug company attorneys, for instance) be allowed to pursue public office and change legislation for personal (or corporate) gain?

Personally, I feel that I find most of the above to be unethical (I feel, regardless of how achievable it is, that those in the health field should care about people’s health and wellbeing, politicians should be less inclined to legislate based on powerful lobbyists, attorneys shouldn’t be bought out and flip sides, and certainly that conflicts of interests should be considered with any public service position) but I am more interested in how others view this case. Thoughts?

 

As always thanks for reading,

Matt

[Ethics] Should You Bring Some Home for Dinner?

I think one of the major things we have not touched on in this class (and in life) is how our personal ethics interplay with our families. We have discussed our professional and ethical obligation to speak up in the face of injustices, at nosism. If water utility A poisons their users with high lead, as an employee/engineer we would (should) feel obligated to put our career on the line to protect the public’s health. We understand, simple. Admittedly hard to do, but still simple to understand.

We have discussed developing our person code of ethics, adhering to them, and trusting them. If we feel something is wrong, we should act to rectify it. However, we commonly relate these situations to businesses, corporations, summer jobs, a shuttle launch, etc. In these situations, it is you and your ethical code vs a manager, a business practice, a co-worker, or maybe even a friend.

The question I have is, do the same rules apply if you are at home? Do you still apply your code of ethics when it is you vs a family member? Whether it be a parent, sibling, or child? And regardless of if you do apply the same code, should you?

I think the largest difference is that we feel that we owe something to our family members, and through this connection I feel it is easy to blur the ethical line even more.

Think back to our discussion on the valet job, and taking money from the owners share to increase the tip jar and each of the valet’s take home pay. One of the largest justifications for turning your co-workers in was ‘I do not owe them anything, I want to stay true to myself and why would I cover up for people I barely know?’, but what if it wasn’t some random strangers. What if your brother or sister was the ring leader? What if he or she had done you a favor by getting you the job in the first place, and only then did you realize what was going on. Would everyone who turned in their coworkers when they didn’t know them do the same if it was their own blood? I personally don’t think everyone would.

Another situation (the one that got my thinking about this in the first place) goes back to my home town, and the recent death of someone I grew up with to a heroin overdose.

We were not close, I was a few years older, and I will keep my opinions about her and the situation largely to myself; though I will say the media’s portrayal may not be entire consistent with my own opinions of the deceased. Regardless, addiction is a terrible thing, but not entirely the point of this example.

For those interested in a back story, here is a link to the media’s take (video and a write up in the article): http://wamu.org/story/17/10/10/drug-cop-daughter-opioids-one-familys-story-addiction/

In brief, a police officer who worked for multiple years on a Narcotics Task Force was faced with a daughter addicted to heroin, among other illegal substances. For a man who was adamant about “doing God’s work” by fervently arresting and “target[ing] everyone with any connection to the drug trade: supplies, dealers, and addicts” his position on drugs both personally and professional could not be more clear. The question I pose goes back to the blurred lines that family can create. It is obvious (whether right or wrong – since addiction likely needs more treatment than just arrests) that Mr. Simmers felt arresting dealers and users was what he should do professionally (and ethically), but yet he doesn’t apply the same reasoning to his own kin, should he? Should he, since he thought it was the best course of action, have arrested his daughter for possession of illegal drugs? Professionally? Ethically?

In the end he didn’t, as I doubt most people would. I think it highlights a unique point that people generally work on developing their personal code of ethics, applying it to their professional work place, and (seemingly) throwing it out in their family lives. This begs the questions, should ethics stop when you clock out, or should you bring ethics home with dinner?

[Should?] Do the Ends Justify the Means?

 

 

For me, one of the biggest ethical pitfalls is the idea that if the end justifies the means then the original action is acceptable regardless of it ethical intent.

I think back to our class discussion on altering scientific data to create a new drug. When the scenario was presented with the drug curing a terrible disease and benefiting numerous people, a good number of our classmates said the action was ethical. When the same scenario resulted in a drug causing deadly side effects, many of the same people said it was unethical. This is a prime example about why ethics cannot, and should not, be a results based principal.

Think of the scientist in the moment, he/she does not know how his/her action will play out and he/she is trying to decide to alter their data. Is the action of adding/subtracting data to a study that is supposed to uphold scientific standards ethical? I think the answer is extremely simple, no. Full stop. If you believe it is ethical, I would maybe suggest you consider a different line of work. Not only does falsifying a dataset undermine that individual’s work, but it undermines the cumulative trust we (as a society) place in science.

With that in mind, regardless of how the result turned out, the original action was unethical. You cure cancer? Awesome, you have an extraordinarily great unethical act that will likely be heralded as the greatest advancement in modern medicine, but it was still unethical. You manage to create the plot to ‘I Am Legend’ by turning humanity into ultra-predatory mutants? Terrible, you have an extraordinarily awful unethical act that will likely be heralded as the worst modern medicine has to offer, and in the same vein was unethical from the start. The reality is these cases can and should be judged by their original ethical intent and their subsequent result separately, and the later should never be used to justify the former.

Louis CK, a comedian, has what I think is a pretty dark-but-funny bit called “of course, but maybe” where he essentially provides a commonly held thought, but contrasts it will a ‘funny’ alternative. I think his ‘of course, but maybe’ on slavery highlights my point that ethics cannot be results dependent (but throughout history is).

For those interested in the joke https://www.youtube.com/watch?v=UVTXFsHYLKA. Beware, the content is dark, and uses adult language. I also do not condone slavery.

The point is, a lot of great things can be (and have been throughout history) accomplished when you disregard an entire group of people’s rights, and ‘throw human death and suffering at it until it is finished.” Do the great accomplishments of slavery make it any less despicable?

If Nazi Germany had cured cancer, or heart disease through their unthinkable experiments during the holocaust, does that make the holocaust ethically or morally acceptable?

I understand that these scenarios are extreme; I think they should be as they serve the purpose of distinguishing the difference between a result and the action that leads to it. At the same time, by considering the ethical implications of ones actions instead of the result that it may or may not lead to, it might be easier to identify smaller ethical pitfalls in your (or my) own life., and may serve to prevent them from becoming larger.

I’d be happy to hear if anyone has a different perspective, or an example to add!

As always thanks for reading,

Matt

PS: for more from Louis CK’s ‘Of Course, but maybe’…

Why do(n’t) people cheat?

When I think of ethical conduct, at least in an academic setting, academic dishonesty or cheating is the crux that commonly comes to mind. Though it is a relatively mundane topic, and rather cliché, I feel that (as a student) it is still worth discussing.

I admit that I may (or may not) have a different view on cheating than most. For much of my life, I honestly do not understand cheating, or deeply understand why people engage in it. I do not mean that I have a transcendent ideology or am too naive to understand that people do cheat, but rather I do not understand what it would take to make me cheat (again).

One of the first and last times I cheated was in 2nd grade. I was young, and struggled mightily with spelling, a problem I still have today. I remember feeling pressure to do well, and not understanding, at least at the time, why I had such a difficult time spelling the word basket or country. To the 2nd grade me cheating seemed to make sense. I could write the words down, and just copy them over. Simple. Easy. What could go wrong? Well, apparently looking into your desk for a prolonged period of time every 5 seconds is a bit obvious. (As a substitute teacher, and a GTA I can also attest that high school students and college students are just as obvious with their methods…)

To summarize what happened next… I got caught, I got in trouble, I cried, and I felt embarrassed. Looking back, I feel that I was just as embarrassed for feeling the need to cheat as I was actually getting caught. Roughly one year later I was tested and diagnosed with dyslexia and 15 years later I am still terrible at spelling. How did cheating help me? Short answer: It didn’t, and was never going to.

I cannot say for sure if my 2nd grade mishap shaped how I view cheating, or if it was random events over the next few years, but by the time I got to high school I no longer saw the benefit of cheating. I think this can be, more or less, traced back to how I view learning. I don’t care about my grades as much as I care about understanding the information. If I would ever fail an exam I would be more disappointed in not understanding the material than getting the ‘F’. Honestly, I would rather get a ‘C’ grade and know that I understand an ‘A’ worth of the material than get an ‘A’ with the comprehension of a ‘C’.  Admittedly, I will argue for my grades, and do care about them, but more so when they do not directly represent my knowledge of a topic. My point is, I value understanding more than the grade.

This little shift in perspective, I think, makes it easier for me not to cheat. By valuing the process more than the result I have found that the result is almost always guaranteed. If you strive to understand all the material given to you (not crammed for an exam just to regurgitate it and forget it) odds are your exam will reflect a higher level of understanding, making the need for simple shortcuts superfluous. If I want an honest barometer of my work, then how would putting someone else’s work down tells me anything of value? How did cheating on my spelling test in 2nd grade help me understand that my difficulty spelling has more to do with how I perceive and view words than my intelligence? The short answer is that it doesn’t, didn’t, and never would. Cheating doesn’t provide any real benefit, but a short term payoff and the placebo that you actually understand.

I recognize that there is immense pressure on each one of us to ‘do well’, and that sometimes cheating seems like a life line. However, in a profession where our mistakes directly impact people’s health admitting what you do not know is sometimes more valuable than what you do know. I believe that some of this world’s biggest issues can be attributed to powerful people unwilling to acknowledge their own deficiencies. I believe cheating, or other unethical activities, slowly begin to blur the lines between actual and perceived understanding as well as right or wrong.

Why do agencies bathe in blood? – A Press Conference Reflection

As an exercise for our Graduate Engineering Ethics class, we recently conducted a mock press conference related to the Washington DC Lead Water Poising Disaster where each student played a role as a member from the major agencies involved. I was assigned the EPA, and for several days leading into the Mock Press Conference, I was struggling to decide how I wanted to approach the conference. On the one hand, I personally felt obligated to be as transparent as possible, but I somewhat felt that this would go against what I thought the EPA would actually do.

For a few days I went back and forth between what I thought I would personally do (tell as much of the truth as I could, knowing what I would have known at the time) and what I thought the EPA’s action would be (withhold information and deflect blame onto other agencies). During this internal debate, I was somewhat surprised by how strongly I felt that I knew the EPA would not be entirely honest in their account of the events. This could potentially be contributed to hindsight, knowing that the EPA did not handle this event particularly well, or maybe it is just human nature to deflect blame instead of take accountability. Regardless, I decided to be as true to myself as possible by being transparent and forthright with my statements and explanation of the events. I also wanted to see what would happen if an agency admitted outright that they made mistakes and were trying to rectify them as quickly as possible. After deciding on my course of action, reviewing the materials given to me, and formulating my talking points, I went into the press conference feeling relatively at ease. Granted it wasn’t my actual career on the line, but even if it was I didn’t see the benefits of deceit.

My opening remarks admitted wrong doing and poor oversight, acknowledged pain and suffering, but reiterated that the EPA was fundamentally created to serve the public and that ‘we’ would do our best to better realize this goal through our actions. After these remarks, I felt that the panelists interviewing us (interrogating might be a better word) were visibly accepting of my apology and surprised; they seemed to turn their probing questions (which I image would have been directed toward me), and scorn toward the agencies who were less honest with the presentation of their actions.

By admitting that I was (at least in some part) to blame, I seemed to provide vindication to the interviewers while those who lied were ‘attacked’ as if their lies were personal attacks on those asking the questions. This back and forth forced those who lied to stick to their guns, so to speak, perpetuating the lie-probing question-lie interaction that seemed to develop. Down the road, having these statements on record would force future discourse into similar molds.

This then raises the question, why, when given the opportunity, do agencies feel the need to attempt to deceive the public? The only reasonable explanation I can see is that individuals do not want to personally sacrifice their job or that the organization does not want to be tied to their mistakes. Though I understand the need for self-preservation, this necessity, in my opinion, should not transcend an engineer’s requirement to safely provide services to the public.

Organizationally, I fail to see how admitting mistakes is a better look than perpetuating dishonestly until they are publically found out. Instead of the handful of errors they originally committed, you are left with numerous instances where the organization is irrefutably wrong.

Agencies actively withholding information forces experts to aggressively push issues and fervently call out the agency’s wrong doings in public forums. I imagine, to the layman, this looks as if there are significant disagreements between the experts and the agencies that represent them, and likely leads to public distrust. Personally, when public opinion can sometimes be finicky, I would hate to see a national loss of respect for an important agency (such as the EPA) through the deliberate actions of our own field. However, if agencies are not willing to police themselves, and admit when they inevitably make a mistake, then there is no alternative but for experts to provide aggressive oversight regardless of the overarching ramifications on public opinion.

It is my opinion that due to the impact these agencies have, they will inevitably falter and proverbially get blood on their hands; however, I think it is better to clean your hands, then bathe in it.

 

Engineering: A Gradual Departure from Ethics(?)

Where are we going? As a civilization? As a person? As a profession?

As a third year graduate student in Civil and Environmental Engineering (CEE) most nights I can honestly say I do not know where I am heading for food after work, so if you are looking for a life altering answer from someone who has figured it out I will likely disappoint.

The reality is these questions, though extremely difficult to actually answer, are often spinning around my head, and if you are reading this I am assuming yours as well. If you haven’t, take a moment and consider… Where are we going?

The first question you must answer is who (or what) is we?

For myself, this we is often fluid and frequently changes based on context or my perspective. Sometimes it encapsulates my own life or the lives of my closet relationships, other times it is our Country as a whole, but for the purpose of this initial blog it is the Engineering profession as I have humbly experienced it.

The second question to answer is what direction is this we headed? Positive? Negative? Backward? Forward? Aimlessly?  

To begin to answer this, I feel that it is best to start from where I came from. My broad connection to engineering and the sciences is the culmination of personal hardship, both physically and emotionally, but is not entirely relevant to this topic. The main take away is that I pursued CEE to make a positive and lasting impact on the communities around me. From talking with most of my colleagues, their stories were often different, but their motivations for joining the field were the same. I obviously do not know everyone and their motivations, but I doubt anyone ever became an engineer with the intention to unethically do their job. Nonetheless, history is tarnish with unethical engineering practice and the devastation these practices left behind, whether it be: The Challenger Disaster, Bhopal, Flint Michigan, or a yet to be discovered incident that is happening right now.

 The sad reality is that not all engineers are motivated strictly by their ethical conduct.  Engineers are human and can make mistakes when internal and external forces act on them. Most have personal and family considerations and some have industrial pressures that don’t perfectly align with ethical best practices. Altogether, engineers can find themselves in situations where good ethical conduct is not always rewarding, and sometimes comes with personal sacrifice. It is in these instances where I potentially see a departure from ethical behaviors in our profession’s future.

As a part time High School substitute teacher, and a full time believer in giving back through teaching, I have found myself talking on numerous Science Technology Engineering and Mathematics (STEM) panels with the goal of introducing High School students to the world of engineering. What I have found, with disheartening regularity, is feigned interest in (what I view are) the fundamental merits of engineering and some co-panelists who resort to talking salaries to generate interest.

Whether it can be contributed to the nativity of youth or not, having prospective engineers primarily motivated by financial compensation (in my opinion) is not conducive to fostering good ethical practice and the longevity of our profession. In the toughest of situations, where one must choose between their livelihood or their ethical center, individuals motivated principally by wealth will likely contribute to the ethical departure of engineering.

In the modern world where much of society is devoted to consumerism, how does a well-paying profession attract an ethically upstanding work force? Feel free to add it to the growing list of questions that I only have ideas, not answers.

I believe it starts with the general view of what the profession is. If people view CEE as a paycheck it will attract people for far difference reasons than if they see it as a fulfillment of their civic duty; much the same as if a prospective police officer enrolls at a police academy driven to serve his or her community or gather unrestrained power. In this instance it is up to the current profession to market the career as one of civil service and not just financial security.

Furthermore, attracting ethically aware individuals is only a start, and the greater engineering curriculum should place a larger emphasis on ethic conduct that goes beyond the adherence to various honor codes designed to limit academic fraud. Engineering ethics should be engrained in the decision making process similarly to the mathematical rigors associated with physics, calculus,  chemistry and others.

Admittedly, I do not think good ethical practice can be taught, as the fundamental application is still user dependent. However, I feel that through the exposure to ethically challenging situations and introspective thought people will be more likely to enact a positive ethical response when faced with a similar scenario in the real world while potentially promoting self-initiated ethical development.

In the end, having more ethically cognizant engineers with a willingness to act in the face of adversity may begin to counteract a gradual ethical departure and continually root engineering in the “highest principals of ethical conduct” [1].

Thank you for reading and sharing your thoughts!

-Matt

 



Attached are links to the

NSPE Code of Ethics: https://www.nspe.org/resources/ethics/code-ethics [1]

ASCE Code of Ethics: http://www.asce.org/code-of-ethics/


Imagine references in order of appearance

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