I just scored a sweet little contract to investigate a client accused of wrongdoing. I’ve been assured it’s nothing much, just a quick check to make sure all their current practices are on the up-and-up.  It’s going to be forward-looking; no need to dig too deep into the past, apparently. The thing is, this is all making me a little nervous.  What if I find that something really, really wrong is going on? What do I do then? I mean, I make my living off this stuff. I know I’m supposed to do a good job, but what if I say something that makes people never want to hire me again? How do I do my job in a way that keeps me employed?

Conscientious

Dear Conscientious,

Why does everybody just assume that taking on an ethics gig requires them to become a sanctimonious, industry-bashing nutball? (Ok, don’t tell me, I already know.)  Anyway, I’ll say it again: You’ve got the profession all wrong.   Being one of the good guys often means knowing how to keep the bad guys  coming back for more. It’s a delicate balance, but you can do it. Many of us have.

I’m reminded of an email that an elderly friend passed on to me and a few hundred other people, about this tribe in Africa, where apparently they have an unusual way of dealing with crime:

When someone does something hurtful and wrong, they take the person to the center of town, and the entire tribe comes and surrounds him. For two days they’ll tell the man every good thing he has ever done.

The tribe believes that every human being comes into the world as GOOD, each of us desiring safety, love, peace, happiness.

But sometimes in the pursuit of those things people make mistakes. The community sees misdeeds as a cry for help. They band together for the sake of their fellow man to hold him up, to reconnect him with his true Nature, to remind him who he really is, until he fully remembers the truth from which he’d temporarily been disconnected: “I AM GOOD.”

Think about that for a moment, and ask yourself: Doesn’t your client deserve the same? When that terrible moment comes, and you find out your benefactors have truly screwed the pooch, maybe you just need to put this in the context of your client’s inherent, abiding goodness.

As they say, you’ve got to love yourself first.  And let’s face it: Sometimes, exploiting sick people for money is just a cry for help. So consider being like those tribespeople:  Take some time to remind your clients of every good thing they have ever done in their lives; bring witnesses to tell them the same.   Sing your clients praises at every event you can put together:  Press conferences. State fair booths.  Infomercials.   And finally, do your absolute best to crush and humiliate all the sanctimonious weasels and vermin who would tell the public otherwise. But above all, bathe your clients in the warmth of that simple, homely reminder: I AM GOOD.

Face it, nobody listens to a scold. Positivity is the key. That exoneration you are about to write?  Think of it as aspirational.

And above all, remember: You are one of the good guys. Otherwise, nobody would have given you the title. Sleep well.

You’re welcome,

The Ethicator.

Dear Ethicator,

I am a hard-working, dedicated researcher at one of our country’s top pharmaceutical labs. We’re working on a promising new antidepressant and we’re pretty excited. You didn’t hear this from me, but the side effects profile is pretty sweet: Euphoria, bursts of extreme productivity, extraordinary sexual prowess and a diminished need for sleep. Plus, we haven’t had an adverse event in nearly three weeks. This could be big.

As far as I can see, we’ve only got one thing to worry about: Big Ethics. I know we’re supposed to get these people involved at some point, but seriously: Can’t we just get some momentum going before the buzzkill brigade heads onto the cable news shows and tells everybody they’re all better off lazy, impotent and miserable? I’d rather just skip them altogether. Or maybe I could just hire one to make the others go away? What do you think?

Conflicted

Dear Conflicted,

Do you need an ethicist? You bet your ass you need an ethicist. Did you seriously think you were just going to waltz in with some wonder drug and not give any of my people a taste?

Besides:  You’ve got ethics all wrong. Questioning the value of your drug is not even remotely within the scope of our mandate.  We’re here to stimulate discussion and frame the issues; the rest is up to you.  If your ethicists are hurting your bottom line, well, you are talking to the wrong ethicists.  An experienced pro will know what to ask.  Check these out:

• Is it ethical to deny people your drug, once we know how awesome it is?
• Are we harming the public by requiring this drug undergo more testing, instead of just saying “fuck it” and putting it right in the water supply?
• What should our moral stance be toward the idiots and crazies who refuse to take your drug?  Is it wrong to post their home phone numbers online, or did these people give up their right to privacy the moment they started jeopardizing public health?

See what I mean? This is where our profession starts showing practical value.  Kick a little up to the right ethicist, and you’ll start hearing all the good questions, the type that get people crashing down pharmacy doors.

All I’m saying is: I’m on your side. It sounds to me  like you’ve got a kick-ass drug on your hands, and it would really be a shame, hypothetically speaking, if anything happened to it. An ethicist can help you navigate those waters.

And remember: You asked me first. We both know what that means.

You’re welcome,

The Ethicator

A NY Times Magazine reader writes:

At my office, we were feeling a nagging concern about a candidate we were strongly considering for a position. So we decided to call someone at a company the person had listed on the résumé but had not provided a reference for. Wow, did we get earful on the person (not in a good way)! But then we weren’t sure if it was ethical to use this information in assessing the person. Of course, it was awfully hard to forget. We ultimately didn’t hire the person.
– NAME WITHHELD, OAKLAND

The Ethicator responds:
Dear Oakland: I fully understand the need to vet an employee thoroughly.  And who can trust references?  They all lie anyway.  The more they want to get rid of an employee, the better the reference they’ll provide.  But still, you shouldn’t limit yourself to asking other employers. They can lie, too.  You need to start probing all your prospective employees’ friends and distant acquaintances.  Thanks to social media, you can do this easily and under cover of anonymity.  An example:  A while back, while I was vetting an employee, I got suspicious of his references, so I just set up a fake twitter account, posted his name and address to twitter and the comments section of several newspapers, and asked if anybody knew him. Sure enough, my fears were confirmed. “Fuck that guy!  He’s a racist and a child molester!” said one.  “Dumb fuck”, said another.  So just to confirm we were talking about the same person, I sent out his address and social security number, and what do you know, I heard even worse things. Total douche, apparently.  Which goes to show:  You can never be too careful.

Another reader writes:

We are planning a trip to Orlando to take my son to Disney World for Memorial Day weekend. Everything was booked, and then the Trayvon Martin case happened. We are quite angry  . . . .  Are we obligated to cancel our trip? Our son very much wants to go, but even if we lose a lot of money, I feel that ethically we shouldn’t be spending our tourist dollars in Florida.
– NAME WITHHELD

The Ethicator responds:
You are reluctant to spend your money where you believe evil is taking place; I totally get that.  I’ve felt the same way from time to time.  For example, a short time ago I took my kids to the Mall of America.  The Mall is in Minnesota, a state which, as you are aware, continues to devote a portion of its budget to evil, plagiarizing pharmascolds.  I kept thinking to myself:  Is it not immoral for me to spend my tourist dollars in this state?  I solved the issue by going anyway, but refusing to spend any money, sleeping outside and foraging food  from the local dumpsters.  My kids considered it the most miserable experience of their lives.  They have flatly refused ever to go again, and have told all their friends how much they hate Minnesota.  Problem solved.  Do the same, and you can fulfil your son’s wishes while teaching him a powerful moral lesson

My mom and I argue whenever we head to the mall or go grocery shopping. I think it’s fine to duck into Sephora and try on some makeup, even though it is out of my price range. Similarly, it’s fine to grab a free sample at Trader Joe’s or a food store, even if I have no intention of buying it. My mom happily takes free samples, but won’t try on makeup with me. Is there a difference? Is either ethical?
– NAME WITHHELD

The Ethicator responds:
You should not feel guilty at all.  There is absolutely nothing wrong with making free samples a part of your everyday routine.  I do this all the time at liquor stores, in particular, where free samples can make for a pretty entertaining evening out if you’re willing to hop from store to store.  Also, pharmacies can be great for free samples, especially if you know how to get behind the counter when the pharmacist is not looking.  I try the samples, then I get to write about them and tell other people.  Win-win.

Dear Ethicator,

A while back I got a spam email inviting me to be on the editorial board of a new journal.  I had never heard of it, but I was coming up for tenure, so I said yes and added it to my CV.

Last week, I finally got around to checking the Internet and found your “journal.”  Is this some kind of joke?  You said the journal was peer-reviewed and had the highest impact factor in its class.  But as far as I can tell, you spend all your time insulting your brother.  Am I supposed to have heard of this guy?  You give out terrible advice, and you whore yourself to private industry at every opportunity.  I am a strong advocate of civil discourse, and I am embarrassed to be associated with this.  Plus, I have tenure now.  So my question is: how do I get off?

Sincerely,

Regretful

Dear Regretful,

I’m sorry. I missed the part where you thanked me for saving your academic career. I’m sure you intended to start with that, because that’s the only thing any decent person could say under these circumstances. Your name is now associated with one of the three most widely cited websites in the history of the bioethics field. You have a lifetime meal ticket that can’t be revoked, as long as nobody catches you in the faculty lounge with your pants around your ankles. That’s my gift to you. You’re welcome; use it well.

How do you get on my editorial board? It’s easy: Say yes, give me your name, and – this is the hard part – shut the fuck up.  Seriously, put a sock in it.  Stay quiet, no matter what I say or do. Remember: this job is about loyalty, nothing more.  It may seem unsettling at times — in fact, there will be days when you wonder if I am a batshit crazy, self-destructive psychopath — but you’ve got to remember there’s a method to my madness, and if you stick with me, you’ll go places.

You want out now?  Look:  What you don’t realize is that you’ve already boarded this crazy train whether you like it or not.  I’ve been writing this shit for a year and a half — where’ve you been?  Sorry, too late. Your best hope at this point is to stick it out with the man who got you here.  And in case you didn’t notice, I blog and tweet like a motherfucker.  You want to cut me loose in public, hoss, go right ahead.

Your loving mentor,

The Ethicator

Dear Ethicator,

You are my personal hero and role model. Just thought I’d get that out there right at the start, just in case it might influence your answer.

I am writing you because I have a problem. Like you, I am a world-renowned bioethicist and digital pioneer. Recently, I was asked to perform an ethics review of a highly reputable, scientifically driven, offshore stem cell clinic. There’s only one problem. A few people have died after getting the injections. Not that it’s their fault or anything; these things happen. In fact, I suspect this clinic might hire me full-time at some point in the future. My question: when I clear them of wrongdoing, would it be impolite to ask for an “honorarium”? How much do you think would be appropriate?

Your Willing Disciple

Dear Willing Disciple,

No, sir, you are the hero.  You have taken leave from your cushy, well-paid university job to make a difference in the world.  While the rest of us sit and pontificate, you are out there getting your hands dirty, 24/7, keeping the life-saving innovators on the up-and-up.  Sure, some jealous colleagues will raise an eyebrow or two, but remember:  You are one of the good guys.  Otherwise, nobody would have given you the title.

Should you get an honorarium?  That is a tricky question, one that requires a bit of fact-finding, consultation and a thorough study.  You need an independent investigator, someone outside of both Big Ethics and Big Industry, an established ethicist who is not corrupted by the prejudices and petty jealousies of the university scene.  Until very recently, there were no such people in the field, but thanks to some of my own pioneering work on the Internet, a number of new possibilities have opened up.  For more details, feel free to contact me individually.

With good wishes,

The Ethicator

No doubt many of you will see in this the hand of a jealous sibling, or the petty vindictiveness of a powerful, pharma-bashing NGO. Of course,  it’s not for me to say whether that assessment is bang-on, or whether it confirms what we really all should have known from the beginning.

What I can do is thank you all for your support, congratulate this year’s winners, and appeal for calm amidst your crushing disappointment.   I know you are all angry right now, but please, keep your demonstrations respectful and nonviolent.  We are not like them.  Remember the words of Jesus:  What does not kill us, only makes us stronger.

I will be fine.  There are more accolades to garner, more contest forms to fill out, more battles to win.  Soldier on, my friends; you are all heroes, each and every day of your lives.

The Ethicator

Got a moral issue you just can’t solve?  Send your questions to the Ethicator: info@whitecoatblackhat.com

Ethicists are an integral part of the healthcare field, making a profound difference and positively affecting individuals and improving quality of life across America. It takes an exceptional person to do what you do, as I can attest to from my years of clinical healthcare experience.

So there you have it.  The only barrier is the $290 admission fee, but since there are hundreds of you out there, the cost per person should be peanuts.

No doubt, Carl Elliott and his raging band of anti-pharma thugs will try to scuttle this, just as he has always tried to squash my academic freedom at every turn; but this is your chance to beat the odds, fight back, and score that rare victory for Freedom.

The application deadline is this Friday, June 10.  You can get the details here.

My name:  The Ethicator
My organization:  White Coat, Black Hat website
My title:  CEO and Proprietor (pro-bono)

You are all heroes.  Thank you.

Got a moral issue you just can’t solve?  Send your questions to the Ethicator: info@whitecoatblackhat.com

Dear Ethicator,

I recently encountered a problem with coercion.

Someone I know of from the ethics world tried to manipulate people into nominating him for an honor. It seems that this person is trying to make his mark in the ethics world and does blatant self-promotion, sometimes at the expense of others. He decided that he should be nominated for an award given by a prestigious group from Big Pharma. He embarked on a campaign of wheedling, flattery and pleading to try to manipulate his readers into nominating him for this award. I and others were besieged by e-mails. All the same, begging to be nominated. Some of the e-mails were sent in the early hours of the morning. Not only was he obsessed with this idea, he was trying to drive us crazy, apparently hoping that his barrage tactics would force up to nominate him.

I was torn. This ethics geek seems to be dedicated, though sometimes his opinions are skewed. I really wanted to nominate someone who would merit the honor, like the world famous Carl Elliott. Or even the unemployed Randy Cohen. But, in the end, I caved in and nominated the dweeb. I was just too worn out by the endless e-mails.

Did I do the right thing?

Thanks.

MT

Dear MT,

I can see why you were torn.  A bold, fresh face bursts onto the ethics scene, skyrockets to fame, and forces you to confront your conscience. You think to yourself:  Shouldn’t such courage and grace be rewarded in some way?  Who else is more deserving? And seriously, isn’t filling out that little nomination form the least you can do?

Still, you realize your move will be controversial. There are so many safer nominees out there: People who have been flaunting themselves in the media for years, people who would no doubt want to bully you into nominating them instead.  In fact, who knows what the consequences will be for you, once this self-promoting narcissist learns you’ve passed him over for a more deserving candidate?  You face all these questions and still, you vote your conscience.  Good for you.

You did the right thing.  Sleep well.

The Ethicator

Got a moral question you just can’t solve?  Send it to the Ethicator: info@whitecoatblackhat.com

Dear Ethicator,

I am thinking about jumping on the bandwagon and nominating you for the PharmaVoice 100. With the deadline (May 1) fast approaching, I must confess that I still have some reservations about you as a candidate. Don’t get me wrong:  I think you’re brilliant and all, but at times, your attacks on your brother seem, well,  a little personal. Is it really ethical for you to set up a website attacking your brother on a daily basis? Help me out here.

Sincerely,

Queasy

Dear Queasy,

I am deeply dismayed that you would threaten my academic freedom by posing a question like this.  As most of my readers know, the White Coat, Black Hat website is not meant as an indictment of any particular individual. Instead, it’s intended as a forum attempt to address, as a matter of policy, the problem  of cheapskate fuckers who steal their brother’s ideas and turn them into hate-speech infested polemics against hardworking pharma patriots.

The issue raises lot of  questions that merit further study.  For example: Is it appropriate for a so-called bioethicist to exploit his brother’s goodwill and force him to work for free? Are others in the field obliged to speak out in defense of the victimized younger brother? I’m just putting the question out there; nothing personal.  Also, if the brother decides to go online with his concerns and suddenly becomes an online viral sensation, well, what then? Is the plagiarizing fucker expected to take it like a grown-up, or is he entitled to whine like a baby and maybe sue? It’s a question of professionalism and academic integrity, for which some high-level discussions may be necessary.

I hope this clears matters up for you. Remember: 5 more days until the PharmaVoice 100 deadline!

The Ethicator

Got a moral question you just can’t solve?  Send it to the Ethicator: info@whitecoatblackhat.com

I don't deserve it, but if you insist.

I have just gotten word that there is a movement afoot among you, my loyal following, to nominate a certain columnist to the PharmaVoice 100, PharmaVoice magazine’s annual list of the 100 most inspiring pharmaceutical industry leaders.  I am deeply, deeply humbled.

Now, there is something you must understand about my work as a bioethicist.  It’s not about the awards, not about the fame; it never was.  It’s about justice, it’s about service.  It’s about speaking truth to power, and maximizing  your ROI in the process.  It’s about being that lonely voice in the wilderness, a piercing laser of Truth trained squarely on the cornea of humanity:  Standing, like Patrick Henry at the barricades of Fort Sumter, shouting “Here I stand; I can do no other!”

Also, it is about bringing down that piece of shit book my brother Carl wrote.

So really, I don’t know if I deserve this award, but far be it from me to stand in the way of a spontaneous grassroots movement.  You can find the application form, as well as the nomination criteria, on the PharmaVoice website.  The deadline for nominations is midnight, May 1.  Also, in case you need it:

My name:  The Ethicator
My organization:  White Coat, Black Hat website
My title:  CEO and Proprietor (pro-bono)

God bless you all.

The Ethicator

Dear Mr. The Ethicator,

I’m a graduate student at a large public research university that is facing severe budget cuts. While our TA-ships and other teaching gigs could never have been considered plum jobs, these days the university is thinking ever more creatively about new ways to squeeze extra work out of us. And not only this: the fate of our graduate program and our department is very much up in the air, as the university looks for ways to cut costs by closing programs and merging departments. No one knows exactly what’s coming, but it doesn’t look pretty.

The ethically murky area is this: every year, we recruit a group of new graduate students, flying them in from all around the country, and everyone pitches in to try to convince them to join our department. We did this again this year, but without exactly playing up (or mentioning) the real uncertainty about the future of the institution. Did we sell them a bill of goods? Either way, we knew it would hurt the department not to admit grad students for the coming year. In fact, if none of them were to join the department, it would likely be even easier for the university to shut us down.

Yours,

Reluctant Pitchman

Dear Reluctant Pitchman,

I’m sorry.  I’m having trouble getting past the part of letter where you tell me your department brings in a whole load of young, healthy research subjects every year, and all you do with them is make them grade papers.  Are you serious? What kind of business model is this?

I know you academics aren’t known for your business smarts, but seriously, do you realize how much bigger your ROI would be if you got a project manager for hire?  Better yet, find somebody testing an ADHD drug.  That way, you’ll get pocket money, party medicine, AND some super-efficient graders who never get bored.  That, my friend, is what we call a win-win. I would also consult with experts at https://www.avensure.com/ to ensure you’re compliant with national laws.

Look: I can tell you’re one of the good guys, just doing your best to look out for the peeps. Good for you. But remember what the airlines say:  When that oxygen mask drops, you put it on yourself first.  Then you help the next guy.  Or, maybe you don’t, because there’s only so much oxygen on the plane and the other guy would probably hog it.

You’re welcome,

The Ethicator

Got a moral question you just can’t solve?  Send it to the Ethicator: info@whitecoatblackhat.com

Hello Ethicator –

I am an ethics graduate student myself, but find to be stuck in a sticky ethical situation. I am currently a Teacher’s Assistant (TA) for an upper level undergraduate course. The semester is almost over, and the department I am working for is offering a TA award. The way it works is to have students nominate you, and get the professors to co-nominate. From what I can tell, the profs I am TAing for would have no problem co-nominating me, however it must be the students who initiate it.

I would greatly appreciate getting this award, not only because there is a monetary and certificate component, but also I believe Idid a grea t job at TAing this semester. I spent more hours than allocated meeting with students, giving thorough feedback on midterm reviews, and guidance throughout the whole semester regarding presentations and the final paper (on top of all this, I myself am a full time student with a heavy course load!)

The profs have announced the award through the online course system, though I don’t know how often students actually check it. It’s also a bit of a runaround and somewhat inconvenient:  printing, filling out, signing, scanning, emailing/faxing…

Because of this, I feel the need to remind the students, yet I find myself torn as to whether I should make an announcement on the last day of class or via email asking to be nominated- what do you think? How should I go about this? Does this sound like I am campaigning myself? My internal ‘yuck’ factor is kicking in – but I am concerned if I don’t remind or persist for it by the students, I may not luck out. How do I work the system ethically?

Thoughts?

Ethically Perturbed TA.

Dear Ethically Perturbed TA,

Yuck factor? Walk it off. This is just the first of many compromises you’ll make in the ethics racket. This job ain’t for sissies.

Here’s what you should tell your students: The nomination process is difficult and lengthy, but it’s a small price to pay for what they are likely to receive for nominating you. The payoffs for them could be material, such as free drinks or prescription meds; or they could be something less tangible, such as the knowledge that you will be in a much better state of mind when you grade their final papers .

Unseemly? Not at all. Remember: You are not bribing; you are incentivizing.

Also, one final word: You have competitors for this award, and they’ll need to be dealt with. I`ll leave the details to you.

Keep building your brand,

The Ethicator

Why not just say it?

Dear Ethicator,

Your inferior counterpart at the New York Times recently told a reader that it was perfectly ok for her to write his or her own letter of recommendation for law school and then have a former professor sign it.  I’m thinking of doing this myself, but still, I’m not sure what I think of her advice. Does it sound fishy to you?

By the way, I’m disappointed Ariel Kaminer was chosen for that job; it should have been you.

Sincerely,

Need a Second Opinion

Dear Second Opinion,

Whoa!  Not so fast there.  I have no beef with Ariel Kaminer; we’re both professionals, both trying to make the world a better place. Unlike other ethicists you might know, I do not get my kicks running down my colleagues in the profession (or stealing their ideas, or exploiting their labor, for example).

And besides, she is right.  If you think about it, this is all about building your brand with your target audience.  And who is better positioned to do this than you? Face it, your supervisor is dead weight; most academics wouldn’t know a good sales pitch if it bit them on the ass. Write that recommendation yourself, and you’ll know you’ve struck the right tone.  And remember:  it’s not lying if you really believe it.  If you can honestly say you are on your way to a Nobel Prize, feel free to point that out.

Job recommendations are just one of several kinds of notes you’re better off writing yourself, and letting someone else sign.  Some other examples I’d recommend include:

• Award nominations
• Promotion letters
• Book reviews
• Medical prescriptions

Uncomfortable? Sure. But unethical? No way. Now go get ’em. You’re welcome.

The Ethicator

Send your questions to the Ethicator: info@whitecoatblackhat.com