Ethical disasters

Many examples of technical disasters have been provided in Understanding Society, along with efforts to understand the systemic dysfunctions that contributed to their occurrence. Frequently those dysfunctions fall within the business organizations that manage large, complex technology systems, and often enough those dysfunctions derive from the imperatives of profit-maximization and cost avoidance. Andrew Hopkins' account of the business decisions contributing to the explosion of the ESSO gas plant in Longford, Australia illustrates this dynamic in Lessons from Longford: The ESSO Gas Plant Explosion. The withdrawal of engineering experts from the plant to a remote corporate headquarters was a cost-saving move that, according to Hopkins, contributed to the eventual disaster.

A topic we have not addressed in detail is the occurrence of ethical disasters -- terrible outcomes that are the result of deliberate choices by decision-makers within an organization that are, upon inspection, clearly and profoundly unethical and immoral. The collapse of Enron is probably one such disaster; the Bernie Madoff scandal is another. But it seems increasingly likely that Purdue Pharma and the Sackler family's business leadership of the corporation represent another major example. Recent reporting by ProPublica, the Atlantic, and the New York Times relies on documents collected in the course of litigation against Purdue Pharma and members of the Sackler family in Massachusetts and New York. (Here are the unredacted court documents on which much of this reporting depends; link.) These documents make it hard to avoid the ethical conclusion that the Sackler family actively participated in business strategies for their company Purdue Pharma that treated the OxyContin addiction epidemic as an expanding business opportunity. And this seems to be a huge ethical breach.

This set of issues is currently unresolved by the courts, so it rests with the legal system to resolve the facts and the issues of legal culpability. But as citizens we all have the ability to read the documents and make our own decisions about the ethical status of decisions and strategies made by the family and the corporation over the course of this disaster. The point here is simply to ask these key questions: how should we think about the ethical status of decisions and strategies of owners and managers that lead to terrible harms, and harms that could reasonably have been anticipated? How should a company or a set of owners respond to a catastrophe in which several hundred thousand people have died, and which was facilitated in part by deliberate marketing efforts by the company and the owners? How should the company have adjusted its business when it became apparent that its product was creating addiction and widespread death?

First, here are a few details from the current reporting about the case. Here are a few paragraphs from the ProPublica story (January 30, 2019):

Not content with billions of dollars in profits from the potent painkiller OxyContin, its maker explored expanding into an “attractive market” fueled by the drug’s popularity — treatment of opioid addiction, according to previously secret passages in a court document filed by the state of Massachusetts. 

In internal correspondence beginning in 2014, Purdue Pharma executives discussed how the sale of opioids and the treatment of opioid addiction are “naturally linked” and that the company should expand across “the pain and addiction spectrum,” according to redacted sections of the lawsuit by the Massachusetts attorney general. A member of the billionaire Sackler family, which founded and controls the privately held company, joined in those discussions and urged staff in an email to give “immediate attention” to this business opportunity, the complaint alleges. (ProPublica 1/30/2019; link)

The NYT story reproduces a diagram included in the New York court filings that illustrates the company's business strategy of "Project Tango" -- the idea that the company could make money both from sales of its pain medication and from sales of treatments for the addiction it caused.

Further, according to the reporting provided by the NYT and ProPublica, members of the Sackler family used their positions on the Purdue Pharma board to press for more aggressive business exploitation of the opportunities described here:

In 2009, two years after the federal guilty plea, Mortimer D.A. Sackler, a board member, demanded to know why the company wasn't selling more opioids, email traffic cited by Massachusetts prosecutors showed. In 2011, as states looked for ways to curb opioid prescriptions, family members peppered the sales staff with questions about how to expand the market for the drugs.... The family's statement said they were just acting as responsible board members, raising questions about "business issues that were highly relevant to doctors and patients. (NYT 4/1/2019; link)

From the 1/30/2019 ProPublica story, and based on more court documents:

Citing extensive emails and internal company documents, the redacted sections allege that Purdue and the Sackler family went to extreme lengths to boost OxyContin sales and burnish the drug’s reputation in the face of increased regulation and growing public awareness of its addictive nature. Concerns about doctors improperly prescribing the drug, and patients becoming addicted, were swept aside in an aggressive effort to drive OxyContin sales ever higher, the complaint alleges. (link)

And ProPublica underlines the fact that prosecutors believe that family members have personal responsibility for the management of the corporation:

The redacted paragraphs leave little doubt about the dominant role of the Sackler family in Purdue’s management. The five Purdue directors who are not Sacklers always voted with the family, according to the complaint. The family-controlled board approves everything from the number of sales staff to be hired to details of their bonus incentives, which have been tied to sales volume, the complaint says. In May 2017, when longtime employee Craig Landau was seeking to become Purdue’s chief executive, he wrote that the board acted as “de-facto CEO.” He was named CEO a few weeks later. (link)

The courts will resolve the question of legal culpability. The question here is one of the ethical standards that should govern the actions and strategies of owners and managers. Here are several simple ethical observations that seem relevant to this case.

First, it is obvious that pain medication is a good thing when used appropriately under the supervision of expert and well-informed physicians. Pain management enhances quality of life for people experiencing pain.

Second, addiction is plainly a bad thing, and it is worse when it leads to predictable death or disability for its victims. A company has a duty of concern for the quality of life of human beings affected by its product, and this extends to a duty to take all possible precautions to minimize the likelihood that human beings will be harmed by the product.

Third, given that the risks of addiction that were known about this product, the company has a moral obligation to treat its relations with physicians and other health providers as occasions of accurate and truthful education about the product, not opportunities for persuasion, inducement, and marketing. Rather than a sales force of representatives whose incomes are determined by the quantity of the product they sell, the company has a moral obligation to train and incentivize its representatives to function as honest educators providing full information about the risks as well as the benefits of the product. And, of course, it has an obligation not to immerse itself in the dynamics of "conflict of interest" discussed elsewhere (link) -- this means there should be no incentives provided to the physicians who agree to prescribe the product.

Fourth, it might be argued that the profits generated by the business of a given pharmaceutical product should be used proportionally to ameliorate the unavoidable harms it creates. Rather than making billions in profits from the sale of the product, and then additional hundreds of millions on products that offset the addictions and illness created by dissemination of the product (this was the plan advanced as "Project Tango"), the company and its owners should hold themselves accountable for the harms created by their product. (That is, the social and human costs of addiction should not be treated as "externalities" or even additional sources of profit for the company.)

Finally, there is an important question at a more individual scale. How should we think about super-rich owners of a company who seem to lose sight entirely of the human tragedies created by their company's product and simply demand more profits, more timely distribution of the profits, and more control of the management decisions of the company? These are individual human beings, and surely they have a responsibility to think rigorously about their own moral responsibilities. The documents released in these court proceedings seem to display an amazing blindness to moral responsibility on the part of some of these owners.

(There are other important cases illustrating the clash between moral responsibility, corporate profits, and corporate decision-making, having to do with the likelihood of collaboration between American companies, their German and Polish subsidiaries, and the Nazi regime during World War II. Edwin Black argues in IBM and the Holocaust: The Strategic Alliance Between Nazi Germany and America's Most Powerful Corporation-Expanded Edition that the US-based computer company provided important support for Germany's extermination strategy. Here is a 2002 piece from the Guardian on the update of Black's book providing more documentary evidence for this claim; link. And here is a piece from the Washington Post on American car companies in Nazi Germany; link. )

(Stephen Arbogast's Resisting Corporate Corruption: Cases in Practical Ethics From Enron Through The Financial Crisis is an interesting source on corporate ethics.)