Non-action in times of catastrophe

Ivan Ermakoff's 2008 book Ruling Oneself Out: A Theory of Collective Abdications is dense, rigorous, and important. It treats two historical episodes in close detail -- the passing of Hitler’s enabling bill by the German Reichstag in the Kroll Opera House in March 1933 (“Law for the Relief of the People and of the Reich”) and the decision by the National Assembly of the French Third Republic in the Grand Casino of Vichy to transfer constitutional authority to Marshal Pétain in July 1940. These legislative actions were momentous; "the enabling bill granted Hitler the right to legally discard the constitutional framework of the Weimar Republic," and the results in France were similar for Pétain's government. In both events major political parties and groups acquiesced in the creation of authoritarian legislation that predictably led to dictatorship in their countries and repression of their own parties and groups. Given that these two events largely set the terms for the course of the twentieth century, this study is of great importance.

The central sociological category of interest to Ermakoff here is "abdication" -- essentially an active decision by a group not to continue to oppose a social or political process with which it disagrees. Events are made by the actions of the actors, individual and collective. But Ermakoff demonstrates that sometimes events are made by non-action as well -- deliberate choices by actors to cease their activity in resistance to a process of concern.

Abdication is different from surrender. It is surrender that legitimizes one’s surrender. It implies a statement of irrelevance. When the act is collective, the statement is about the group that makes the decision. The group dismisses itself. It surrenders its fate and agrees to do so, thereby justifying its subservience. This broad characterization sets the problem. Why would a group legitimize its own subservience and, in doing so, abdicate its capacity for self-preservation? (xi)

Based on a great deal of archival research as well as an apparently limitless knowledge of the secondary literature, the book sheds great light on the actions and inactions of the individual and collective actors involved in these enormously important episodes of twentieth-century history. As a result it provides a singular contribution to the theories and methods of contentious politics as well as comparative historical sociology.

The book is historical; but even more deeply, it is a sustained contribution to an actor-centered theory of collective behavior. Ermakoff wants to understand, at the level of the actors involved, what were the dynamics of decision making and action that led to abdication by experienced politicians in the face of anti-constitutional demands by Hitler and Pétain. Ermakoff believes that the obvious theories -- coercion, ideological sympathy, and the structure of existing political conflicts -- are inadequate. Instead, he proposes a dynamic theory of belief formation and decision making at the level of the actor through which the political actors arrive at the position they will adopt based on their observations and inferences of the behavior of others with regard to this choice. Individuals retain agency in their choices in momentous circumstances: "Individuals fluctuate because (1) they are concerned about the behavioral stance of those whom they define as peers and (2) they do not know where these peers stand. Individual oscillations are the seismograph of collective perceptions. Their uncertainty fluctuates with the degree of irresolution imputed to the group." Ermakoff wants to understand the dynamic processes through which individuals arrive at a decision -- to abdicate or to remain visibly and actively in opposition to the threatened action -- and how these decisions relate to judgments made by individuals about the likely actions of other actors.

Ermakoff's key theoretical concept is alignment: the idea that the individual actor is seeking to align his or her actions with those of members of a relevant group (what Ermakoff calls a "reference group"). "By alignment I mean the act of making oneself indistinguishable from others. As a collective phenomenon, alignment describes the process whereby the members of a group facing the same decision align their behavior with one another’s." For individuals within a group it is a problem of coordination in circumstances of imperfect knowledge about the intentions of other actors. And Ermakoff observes that alignment can come about through several different kinds of mechanisms (sequential alignment, local knowledge, and tacit coordination), leading to substantially different dynamics of collective behavior.

Jon Elster and other researchers in the field of contentious politics and collective action refer to this kind of situation as an "assurance game" (link): an opportunity for collective action which a significant number of affected individuals would join if they were confident that sufficient others would do so as well in order to give the action a reasonable likelihood of success.

Though Ermakoff does not directly suggest this possibility, it would appear that the kinds of decision-making processes within groups involved here are amenable to treatment using agent-based models. It would seem straightforward to model the behavior of a group of actors with different "thresholds" and different ways of gaining information about the likely behavior of other actors, and then aggregating their choices through an iterative computational process.

Much of the substance of the book goes into evaluating three common explanations of acquiescence: coercion, miscalculation, and ideological collusion. And Ermakoff argues that the only way to evaluate these hypotheses is to gain quite a bit of evidence about the basis of decision-making for many of the actors. A meso-level analysis won't distinguish the hypotheses; we need to connect the dots for individual decision-makers. Did they defer because of coercion? Because of miscalculation? Or perhaps because they were not so adamantly opposed to the fascist ideology as they professed? But significantly, Ermakoff finds that individual-level information fails to support any of these three factors as being decisive.

Part III moves from description of the cases to an effort at formulating a formal decision model that would serve to explain the processes of alignment and abdication described in the first half of the book. This part of the book has something in common with formal research in game theory and the foundations of collective action theory. Ermakoff undertakes to provide an abstract mid-level description of the processes and mechanisms through which individuals arrive at a decision about a collective action, illustrating some of the parameters and mechanisms that are central for the emergence of abdication as a coordination solution. This part of the book is a substantial addition to the literature on the theory of collective action and mobilization. It falls within the domain of theories of the mechanics of contentious politics along the lines of McAdam, Tarrow, and Tilly's Dynamics of Contention; but it differs from the treatment offered by McAdam, Tarrow, and Tilly by moving closer to the mechanics of the individual actor. The level of analysis is closer to that offered by Mancur Olsen, Russell Hardin, or Jon Elster in describing the logic of collective action.

Consider the logic of the "abdication game" that Ermakoff presents (47):

The "authoritarian challenger" is the leader who wishes to extend his powers beyond what is currently constitutionally permissible. The "target actors" are the groups and parties who have a say in modification of the constitution and legislative framework, and in this scenario these actors are assumed to have a blocking power in the legislative or constitutional process. If they remain unified in opposition the constitutional demands will be refused and either the status quo or an attempt at an unconstitutional seizure of power will occur. If they acquiesce, the authoritarian challenger will immediately undertake a transformation of the state that gives him unlimited executive power.

There is a difficult and important question that arises from reading Ermakoff's book. It is the question of our own politics in 2020. We have a president who has open contempt for law and political morality, who does not even pretend to represent all the people or to respect the rights of all of us; and who is entirely willing to call upon the darkest motivations of his followers. And we have a party of the right that has abandoned even the pretense of maintaining integrity, independent moral judgment, and a willingness to call the president to account for his misdeeds. How different is that environment from that of 1933 in Berlin? Is the current refusal of the Republican Party to honestly judge the president's behavior anything other than an act of abdication -- shameful, abject, and self-interested abdication?

It seems quite possible that the dilemmas created by authoritarian demands and less-than-determined defenders of constitutional principles will be in our future as well. This book was published in 2008, at the beginning of what appeared to be a new epoch in American politics -- more democratic, more progressive, more concerned about ordinary citizens. The topic of abdication would have been very distant from our political discourse. Today as we approach 2020, the threat of an authoritarian, anti-democratic populism has become an everyday reality for American society.

One other aspect of the book bears mention, though only loosely related to the theory of collective action and abdication that is the primary content of the book. Ermakoff's discussion of the challenges that come along with defining "events" is excellent (chapter 1). He correctly observes that an event is a nominal construct, amenable to definition and selection by different observers depending on their theoretical and political interests.

Events are nominal constructs. Their referents are bundles of actions and decisions that analysts and commentators abstract from the flow of historical time. This abstraction is based on a variety of criteria—temporal contiguity, causal density, and significance for subsequent happenings—routinely mobilized by synthetic judgments about the past. Because events are temporal constructs, their temporal boundaries can never be taken for granted. They take on different values depending on whether we derive these boundaries from the subjective statements left by contemporary actors (Bearman et al. 1999) or construct them in light of an analytical relevance criterion derived from the problem at hand (Sewell 1996, 877).

Ermakoff returns to this theme at the end of the book in chapter 11. The approach here taken towards "events" is indicative of one of the virtues of Ermakoff's book (as well as the work of many of the comparative historical sociologists who have influenced him): respect for the contingency, plasticity, and fluidity of historical processes. We have noted elsewhere (link, link, link) Andrew Abbott's insistence on the fluidity of the social world. There is some of that sensibility in Ermakoff's book as well. None of the processes and sequences that Ermakoff describes are presented as deterministic causal chains; instead, choice and contingency remain part of the story at every level.

(Levitsky and Ziblatt's How Democracies Die provides a stark companion piece for Ermakoff's historical treatment of the ascendancy of authoritarianism.)

High-reliability organizations

Charles Perrow takes a particularly negative view of the possibility of safe management of high-risk technologies in Normal Accidents: Living with High-Risk Technologies. His summary of the Three Mile Island accident is illustrative: “The system caused the accident, not the operators” (12). Perrow’s account of TMI is chiefly an account of complex and tightly-coupled system processes, and the difficulty these processes create for operators and managers when they go wrong. And he is doubtful that the industry can safely manage its nuclear plants.

It is interesting to note that systems engineer and safety expert Nancy Leveson addresses the same features of “system accidents” that Perrow addresses, but with a greater level of confidence about the possibility of creating engineering and organizational enhancements. A recent expression of her theory of technology safety is provided in Engineering a Safer World: Systems Thinking Applied to Safety (Engineering Systems) and Resilience Engineering: Concepts and Precepts.

In examining the safety of high-risk industries, our goal should be to identify some of the behavioral, organizational, and regulatory dysfunctions that increase the likelihood and severity of accidents, and to consider organizational and behavioral changes that would serve to reduce the risk and severity of accidents. This is the approach taken by a group of organizational theorists, engineers, and safety experts who explore the idea and practice of a “high reliability organization”. Scott Sagan describes the HRO approach in these terms in The Limits of Safety:

The common assumption of the high reliability theorists is not a naive belief in the ability of human beings to behave with perfect rationality, it is the much more plausible belief that organizations, properly designed and managed, can compensate for well-known human frailties and can therefore be significantly more rational and effective than can individuals. (Sagan, 16)

Sagan lists several conclusions advanced by HRO theorists, based on a small number of studies of high-risk organizational environments. Researchers have identified a set of organizational features that appear to be common among HROs:

• Leadership safety objectives: priority on avoiding altogether serious operational failures
• Organizational leaders must place high priority on safety in order to communicate this objective clearly and consistently to the rest of the organization
• The need for redundancy. Multiple and independent channels of communication, decision-making, and implementation can produce a highly reliable overall system
• Decentralization -- authority must exist in order to permit rapid and appropriate responses to dangers by individuals closest to the problems
• culture – recruit individuals who help maintain a strong organizational culture emphasizing safety and reliability
• continuity – maintain continuous operations, vigilance, and training
• organizational learning – learn from prior accidents and near-misses.
• Improve the use of simulation and imagination of failure scenarios

Here is Sagan's effort to compare Normal Accident Theory with High Reliability Organization Theory:

The genuinely important question here is whether there are indeed organizational arrangements, design principles, and behavioral practices that are consistently effective in significantly reducing the incidence and harmfulness of accidents in high-risk enterprises, or whether on the other hand, the ideal of a "High Reliability Organization" is more chimera than reality.

A respected organizational theorist who has written on high-reliability organizations and practices extensively is Karl Weick. He and Kathleen Sutcliffe attempt to draw some useable maxims for high reliability in Managing the Unexpected: Sustained Performance in a Complex World. They use several examples of real-world business failures to illustrate their central recommendations, including an in-depth case study of the Washington Mutual financial collapse in 2008.

The chief recommendations of their book come down to five maxims for enhancing reliability:

1. Pay attention to weak signals of unexpected events
2. Avoid extreme simplification
3. Pay close attention to operations
4. Maintain a commitment to resilience
5. Defer to expertise

Maxim 1 (preoccupation with failure) encourages a style of thinking -- an alertness to unusual activity or anomalous events and a commitment to learning from near-misses in the past. This alertness is both individual and organizational; individual members of the organization need to be alert to weak signals in their areas, and managers need to be receptive to hearing the "bad news" when ominous signals are reported. By paying attention to "weak signals" of possible failure, managers will have more time to design solutions to failures when they emerge.

Maxim 2 addresses the common cognitive mistake of subsuming unusual or unexpected outcomes under more common and harmless categories. Managers should be reluctant to accept simplifications. The Columbia space shuttle disaster seems to fall in this category, where senior NASA managers dismissed evidence of foam strike during lift-off by subsuming it under many earlier instances of debris strikes.

Maxim 3 addresses the organizational failure associated with distant management -- top executives who are highly "hands-off" in their knowledge and actions with regard to ongoing operations of the business. (The current Boeing story seems to illustrate this failure; even the decision to move the corporate headquarters to Chicago, very distant from the engineering and manufacturing facilities in Seattle, illustrates a hands-off attitude towards operations.) Executives who look at their work as "the big picture" rather than ensuring high-quality activity within the actual operations of the organization are likely to oversee disaster at some point.

Maxim 4 is both cognitive and organizational. "Resilience" refers to the "ability of an organization (system) to maintain or regain a dynamically stable state, which allows it to continue operations after a major mishap and/ or in the presence of a continuous stress". A resilient organization is one where process design has been carried out in order to avoid single-point failures, where resources and tools are available to address possible "off-design" failures, and where the interruption of one series of activities (electrical power) does not completely block another vital series of activities (flow of cooling water). A resilient team is one in which multiple capable individuals are ready to work together to solve problems, sometimes in novel ways, to ameliorate the consequences of unexpected failure.

Maxim 5 emphasizes the point that complex activities and processes need to be managed by teams incorporating experience, knowledge, and creativity in order to be able to confront and surmount unexpected failures. Weick and Sutcliffe give telling examples of instances where key expertise was lost at the frontline level through attrition or employee discouragement, and where senior executives substituted their judgment for the recommendations of more expert subordinates.

These maxims involve a substantial dose of cognitive practice, changing the way that employees, managers, and executives think: the importance of paying attention to signs of unexpected outcomes (pumps that repeatedly fail in a refinery), learning from near-misses, making full use of the expertise of members of the organization, .... It is also possible to see how various organizations could be evaluated in terms of their performance on these five maxims -- before a serious failure has occurred -- and could improve performance accordingly.

It is interesting to observe, however, that Weick and Sutcliffe do not highlight some factors that have been given strong priority in other treatments of high-reliability organizations: the importance of establishing a high priority for system safety in the highest management levels of the organization (which unavoidably competes with cost and profit pressures), the organizational feature of an empowered safety executive outside the scope of production and business executives in the organization, the possible benefits of a somewhat decentralized system of control, the possible benefits of redundancy, the importance of well-designed training aimed at enhancing system safety as well as personal safety, and the importance of creating a culture of honesty and compliance when it comes to safety. When mid-level managers are discouraged from bringing forward their concerns about the "signals" they perceive in their areas, this is a pre-catastrophe situation.

There is a place in the management literature for a handbook of research on high-reliability organizations; at present, such a resource does not exist.

(See also Sagan and Blanford's volume Learning from a Disaster: Improving Nuclear Safety and Security after Fukushima.)

Entertainment as a valuable thing

Quite a bit of the GDP of the United States goes into a broad category we can call "entertainment" -- television, video streaming services, books and newspapers, concerts, theatre, sports events (live and broadcast), and video games. The entertainment industry amounts to $717 billion in the US economy (link), and professional athletics adds another $73.5 billion (link). This category approaches a trillion dollars, and we haven't even taken account of the video gaming sector. US GDP is about $19.4 trillion; so entertainment in all sectors may amount to 5% or more of the total US economy.

It is interesting to take a look at the Bureau of Labor Statistics American Time Use Survey (link) to get an empirical idea of how Americans of varying ages spend their time each day. Table 8A breaks down "time spent in primary activities for the civilian population 18 years and over". Out of a 24-hour day, personal care activities and sleeping amount to 18 hours per day; organizational, civic, and religious activities amount to .27 hours per day; and leisure and sports activities amount to 4.12 hours per day. Work takes 3.94 hours per day (on average; 4.96 hours for men and 3.07 hours for women). (These are averages over a population, which explains the relatively low number of hours spent working.)

Both these observations demonstrate that millions of people value entertainment: they pay for it and the spend their time engaging with it. So entertainment is plainly valued in the lives of most people. But we can still ask a more fundamental question: what is the good of entertainment? Should society be organized in such a way as to facilitate the ability of people to find and consume sources of entertainment? Is more entertainment better than less?

There are a few simple answers to the question.

First, people often want to be entertained and choose to be entertained, and it is a basic principle of liberalism that it is good for people to exercise their liberty by doing what they want to do. (Liberty principle)

Second, people take pleasure in being entertained, pleasure is an important component of happiness, and happiness is a good thing. Therefore entertainment is a good thing, and people should be in a position to be entertained. (Happiness principle)

Third, sometimes "entertainment" is developmental and fulfilling of human capabilities for imagination, empathy, and ethical reasoning. By watching Citizen Kane or reading The Fire Next Time, people gain new insights into their own lives and the lives of others; they extend their capacity for empathy; and they enrichen their ability to think about complex social and moral topics. Martha Nussbaum makes this point in her discussions of the value of literature in Poetic Justice: The Literary Imagination and Public Life and Cultivating Humanity: A Classical Defense of Reform in Liberal Education. Nussbaum's views are discussed by Heather McRobie in OpenDemocracy (link). These outcomes too seem intrinsically valuable by the individuals who experience them. This view of the potential value of "entertainment" converges with the capabilities approach to human wellbeing. (Human development principle)

But, of course, not all forms of entertainment are uplifting in an intellectual or moral sense. Six seasons of The Sopranos probably didn't result in much intellectual or moral uplift for the millions of viewers who enjoyed the series, and an earlier generation's interest in Gunsmoke, Bonanza, and Car 54 was probably equally unrewarded. So what about "pure entertainment", without moral, intellectual, or aesthetic redeeming value? What about Tetris, Solitaire, Grand Theft Auto, or the Madden NFL franchise? What about Downton Abbey?

J. S. Mill, far-sighted media critic that he was, distinguished between higher and lower pleasures, and argued that the former are inherently preferable to any agent who has experienced both over the latter. His reasoning is based on his view that human beings have higher faculties and lower faculties; the higher pleasures exercise the higher faculties; and anyone who has experienced both will prefer the higher pleasures. Here are a few lines from Utilitarianism.

Now, it is an unquestionable fact that the way of life that employs the higher faculties is strongly preferred to the way of life that caters only to the lower ones· by people who are equally acquainted with both and equally capable of appreciating and enjoying both. Few human creatures would agree to be changed into any of the lower animals in return for a promise of the fullest allowance of animal pleasures; no intelligent human being would consent to be a fool, no educated person would prefer to be an ignoramus, no person of feeling and conscience would rather be selfish and base, even if they were convinced that the fool, the dunce or the rascal is better satisfied with his life than they are with theirs. . . . If they ever think they would, it is only in cases of unhappiness so extreme that to escape from it they would exchange their situation for almost any other, however undesirable they may think the other to be. Someone with higher faculties requires more to make him happy, is probably capable of more acute suffering, and is certainly vulnerable to suffering at more points, than someone of an inferior type; but in spite of these drawbacks he can’t ever really wish to sink into what he feels to be a lower grade of existence. .... It is better to be a human being dissatisfied than a pig satisfied; better to be Socrates dissatisfied than a fool satisfied. And if the fool, or the pig, are of a different opinion, it is because they only know their own side of the question. The other party to the comparison knows both sides. (14)

This position is based on Mill's idea that people who have experienced both kinds of pleasures will choose the higher (demanding, challenging, aesthetically and morally complex) pleasures over the lower pleasures. But this view seems to be largely refuted by the current entertainment industry; the audience for bad television certainly includes a proportionate share of Mill's counterparts today (college professors, literary critics, journalists, and pundits). Plainly, there are many millions of people who have indeed experienced both higher and lower pleasures, and continue to enjoy both.

So Mill did not have a very good psychological theory of "entertainment", even if he had a good aspirational philosophy of living. I doubt that Netflix would want JS Mill to serve as programming chief for its upcoming seasons.

There is probably a nugget of truth in the idea that the challenge and complexity of an activity is a dimension of its continuing appeal to the individuals who engage in the activity. Perhaps Go masters and chess masters take greater satisfaction in their games than do checkers players and aficionados of tic-tac-toe, and people who love literature may take more satisfaction from a novel by Boris Pasternak than Nora Roberts because of the relative complexity, unpredictability, and nuance of Pasternak's love story. But it is clear that pleasure in entertainment derives from more than this: humor, suspense, nostalgia, complicated plots, character development, amazing special effects, depictions of human emotions, violence, plots that speak to one's own experience, and so on indefinitely. Why these elements produce pleasure, however, is still unclear.

Perhaps we need to go back to ancient Greek philosophers in our quest for the sources of pleasure in "entertainment". Is Aristotle right that we enjoy tragedy because of the catharsis it provides, and comedy, because of the physical pleasure we take in laughter? Does Epicurus have anything to tell us about why we enjoy watching Breaking Bad and Blazing Saddles? Can the Stoics shed light on why Santa Claus Conquers the Martians (1964) and Heaven's Gate (1980) were so very unpopular with the movie audience? Does Plato have anything to say about whether Waiting for Godot is really entertaining, and whether people can take pleasure in viewing it?

Why do regulatory organizations fail?

Why is Charles Perrow a pessimist about government regulation?

Perrow is a leading researcher in the sociology of organizations, and he is a singular expert on accidents and failures. Several of his books are classics in their field -- Normal Accidents: Living with High-Risk Technologies, The Next Catastrophe: Reducing Our Vulnerabilities to Natural, Industrial, and Terrorist Disasters, Organizing America: Wealth, Power, and the Origins of Corporate Capitalism. So why is he so gloomy about the ability of governmental organizations to protect the public from large failures and disasters of various kinds -- hurricanes, floods, chemical plant fires, software failures, terrorism? He is not a relentless critic of organizations such as the EPA, the Department of Justice, or the Food and Drug Administration, but his assessment of their capacity for success is dismal.

We should not expect too much of organizations, but the DHS is extreme in its dysfunctions. As with all organizations, the DHS has been used by its masters and outsiders for purposes that are beyond its mandate, and the usage of the DHS has been extreme. One major user of the DHS is Congress. While Congress is the arm of the government that is closest to the people, it is also the one that is most influenced by corporations and local interest groups that do not have the interests of the larger community in mind. (The Next Catastrophe, kl 205)

I don't think that Perrow's views derive from the general skeptical view that organizations never succeed in accomplishing the functions we assign to them -- hospitals, police departments, labor unions, universities, public health departments. And in fact his important book Complex Organizations: A Critical Essay provided a constructive description of the field of organizational studies when it appeared in 1972 and was updated in 2014 (link).)

Instead, there seem to be particular reasons why large governmental organizations designed to protect the public are likely to fail, in Perrow's assessment. It is organizations that are designed to regulate risky activities and those that are charged to create prudent longterm plans for the future that seem particularly vulnerable, in his account. So what are those reasons for failure in these kinds of organizations?

FEMA is faulted, for example, because of its failure to adequately plan for and provide emergency relief to the people of New Orleans and other parts of the Gulf region from the effects of Hurricane Katrina. Poor planning, incompetent executives at the top, politicized directions coming from the White House, poor coordination across sub-units, and poor internal controls eventually resulted in a historic failure. These are fairly routine organizational failures that could happen within the United Parcel Service corporate headquarters as easily as Washington.

The Nuclear Regulatory Commission is faulted for its oversight of safety in nuclear plants, including Three Mile Island, Davis-Besse, and Shoreham. Key organizational faults include regulatory capture by owners and the nuclear industry, excessive dependence on specific key legislators, commissioners who are politically beholden, and insufficient personnel to carry out intensive inspection regimes.

Perrow's key ideas about failures in the industrial systems themselves seem not to be central in his negative assessment of government regulatory organizations. The features of "complex systems" and "tightly coupled processes" that are so central to his theory of normal accidents in industrial systems like nuclear power plants play only incidental roles in his analysis of regulatory failure. Agencies are neither complex nor tightly coupled in the way a petroleum processing plant is. In fact, an outside observer might hypothesize that a somewhat more tightly coupled system in the NRC or the EPA (a more direct connection among the scientists, engineering experts, inspectors, and commissioners) might actually improve performance.

Instead, his analysis of regulatory failure depends on a different set of axes: interests, influence, and power. Regulatory agencies fail, in Perrow's accounts, when their top administrators have bureaucratic interests and dependencies that diverge from the mission of safety, when powerful outsiders and owners have the capacity to influence rules, policies, and implementation, and when political and economic power is deployed to protect the interests of powerful actors. (All these defects are apparent in Trump administration appointments to federal agencies with regulatory responsibilities.)

Interestingly, these factors have also played a central role in his sociological thinking about the emergence of the twentieth-century corporation; he views corporations as vehicles for the concentration of power:

Our economic organizations -- business and industry -- concentrate wealth and power; socialize employees and customers alike to meet their needs; and pass off to the rest of society the cost of their pollution, crowding, accidents, and encouragement of destructive life styles. In the vaunted "free market" economy of the United States, regulation of business and industry to prevent or mitigate this market failure is relatively ineffective, as compared to that enacted by other industrialized countries. (Organizing America, 1-2)

So the primary foundation of Perrow's assessment of the linked of organizational failure when it comes to government regulation derives from the role that economic and political power plays in deforming the operations of major government organizations to serve the interests of the powerful. Regulatory agencies are "captured" by the powerful industries they are supposed to oversee, whether through influence on the executive branch or through merciless lobbying of the legislative branch. Commissioners are often very sympathetic to the business needs of the sector they regulate, and strive to avoid "undue regulatory burden".

This leads us to a fascinating question: is there a powerful constituency for safety that could be a counterweight to corporate power and a bulwark for honest, scientifically guided regulatory regimes? Is a more level playing field between economic interests and the public's interests in effective safety regulation possible?

We may want to invoke the public at large, and it is true that public opinion sometimes effectively demands government intervention for safety. But the public is generally limited in several important ways. Only a small set of issues manage to become salient for the public. Further, issues only remain salient for a limited period of time. And the salience of an issue is often geographically and demographically bounded. There was intense opposition to the Shoreham nuclear plant siting decision on Long Island, but the public in Chicago and Dallas did not mobilize around the issue. Sometimes vocal public opinion prevails, but much more common is the scenario where public interest wanes and profit-motivated corporate interests persists. (Pepper Culpepper lays out the logic of salience and unequal power between a diffuse public and a concentrated corporate interest in Quiet Politics and Business Power: Corporate Control in Europe and Japan.)

Other pertinent voices for safety are public interest organizations -- the Union of Concerned Scientists, Friends of the Earth, Bulletin of Atomic Scientists. Organizations like these have succeeded in creating a national base of support, they have drawn resources in support of their efforts, and they have a greater organizational capacity to persist over an extended period of time. (In another field of advocacy, organizations like Anti-Defamation League and the Southern Poverty Law Center have succeeded in maintaining organizational focus on the dangers of hate-based movements.) So public interest organizations sometimes have the capacity and staying power to advocate for stronger regulation.

Investigative journalism and a free press are also highly relevant in exposing regulatory failures and enhancing performance of safety organizations. The New York Times and Washington Post coverage of the FAA's role in certification of the 737 Max will almost certainly lead to improvements in this area of aircraft safety. (Significantly, when I made this statement concerning the link between industrial safety in China and a free press, I was told that "this is a sensitive subject in China.")

(These examples are drawn from the national level of government. Sometimes local government -- e.g. police departments and zoning boards -- are captured as well, when organized crime "firms" and land developers are able to distort regulations and enforcement in their favor. But it may be that organizations at this level of government are a bit more visible to their publics, and therefore somewhat less likely to bend to the dictates of powerful local interests. Jessica Troundstine addresses these kinds of issues in Political Monopolies in American Cities: The Rise and Fall of Bosses and Reformers (link).

The second primitive accumulation

One of the more memorable parts of Capital is Marx's description of the “so-called primitive accumulation of capital” — the historical process where rural people were dispossessed of access to land and forced into industrial employment in cities like Birmingham and Manchester (link). It seems as though we’ve seen another kind of primitive accumulation in the past thirty years — the ruin of well-paid manufacturing jobs based on unionized labor, the disappearance of local retail stores, the extinction of bookstores and locally owned hardware stores, all of which offered a large number of satisfying jobs. We’ve seen a new set of bad choices for displaced workers — McDonald’s servers, Walmart greeters, and Amazon fulfillment workers. And this structural economic change threatens to create a permanent under-class of workers earning just enough to get by.

So what is the future of work and class in advanced economies? Scott Shane's major investigative story in the New York Times describing Amazon's operations in Baltimore (link) makes for sobering reading on this question. The story describes work conditions in an Amazon fulfillment center in Baltimore that documents the intensity, pressure, and stress created for Amazon workers by Amazon's system of work control. This system depends on real-time monitoring of worker performance, with automatic firings coming to workers who fall short on speed and accuracy after two warnings. Other outlets have highlighted the health and safety problems created by the Amazon system, including this piece on worker safety in the Atlantic by Will Evans; link. It is a nightmarish description of a work environment, and hundreds of thousands of workers are employed under these conditions.

Imagine the difference you would experience as a worker in the hardware store mentioned in the New York Times story (driven out of business by online competition) and as a worker in an Amazon fulfillment center. In the hardware store you provide value to the business and the customers; you have social interaction with your fellow workers, your boss, and the customers; you work in a human-scale enterprise that actually cares whether you live or die, whether you are sick or well; and to a reasonable degree you have a degree of self-direction in your work. Your expertise in home improvement, tools, and materials is valuable to the customers, which brings them back for the next project, and it is valuable to you as well. You have the satisfaction of having knowledge and skills that make a difference in other people’s lives. In the fulfillment center your every move is digitally monitored over the course of your 10-hour shift, and if you fall short in productivity or quality after two warnings, you are fired. You have no meaningful relationships with fellow workers — how can you, with the digital quotas you must fulfill every minute, every hour, every day? And you have no — literally no — satisfaction and fulfillment as a human being in your work. The only value of the work is the $15 per hour that you are paid; and yet it is not enough to support you or your family (about $30,000 per year). As technology writer Amy Webb of the Future Today Institute is quoted in the Times article, [It’s not that we may be replaced by robots,] “it’s that we’ve been relegated to robot status.”

What kind of company is that? It is hard to avoid the idea that it is the purest expression that we have ever seen of the ideal type of a capitalist enterprise: devoted to growth, cost avoidance, process efficiency, use of technology, labor control, rational management, and strategic and tactical reasoning based solely on business growth and profit-maximizing calculations. It is a Leviathan that neither Hobbes nor Marx could really have visualized. And social wellbeing — of workers, of communities, of country, of the global future — appears to have no role whatsoever in these calculations. The only affirmative values expressed by the company are “serving the consumer” and being a super-efficient business entity.

What is most worrisome about the Amazon employment philosophy is its single-minded focus on “worker efficiency” at every level, using strict monitoring techniques and quotas to enforce efficient work. And the ability to monitor is increased asymptotically by the use of technology — sensors, cameras, and software that monitor the worker’s every movement. It is the apotheosis of F.W. Taylor’s theories from the 1900s of “scientific management” and time-motion studies. Fundamentally Taylor regarded the worker as a machine-like component of the manufacturing process, whose motions needed to be specified and monitored so as to bring about the most efficient possible process. And, as commentators of many ideological stripes have observed, this is a fundamentally dehumanizing view of labor and the worker. This seems to be precisely the ideal model adopted by Amazon, not only in its fulfillment centers but its delivery drivers, its professional staff, and every other segment of the workforce Amazon can capture.

Business and technology historian David Hounshell presciently noticed the resurgence of Taylorism in a 1988 Harvard Business Review article on “modern manufacturing”; link. (This was well before the advent of online business and technology-based mega-companies.) Here are a few relevant paragraphs from his piece:

Rather than seeing workers as assets to be nurtured and developed, manufacturing companies have often viewed them as objects to be manipulated or as burdens to be borne. And the science of manufacturing has taken its toll. Where workers were not deskilled through extreme divisions of labor, they were often displaced by machinery. For many companies, the ideal factory has been — and continues to be — a totally automated, workerless facility. 

Now in the wake of the eroding competitive position of U.S. manufacturing companies, is it time for an end to Taylor’s management tradition? The books answer in the affirmative, calling for the institution of a less mechanistic, less authoritarian, less functionally divided approach to manufacturing. Dynamic Manufacturing focuses explicitly on repudiating Taylorism, which it takes to be a system of “command and control.” American Business: A Two-Minute Warning is written in a more popular vein, but characterizes U.S. manufacturing methods and the underlying mind-set of manufacturing managers in unmistakably similar ways. Taylorism is the villain and the anachronism. 

Predictably, both books arrive at their diagnoses and prescriptions through their respective evaluations of the “Japanese miracle.” Whereas U.S. manufacturing is rigid and hierarchical, Japanese manufacturing is flexible, agile, organic, and holistic. In the new competitive environment — which favors the company that can continually generate new, high-quality products — the Japanese are more responsive. They will continue to dominate until U.S. manufacturers develop manufacturing units that are, in Hayes, Wheelwright, and Clark’s words, “dynamic learning organizations.” Their book is intended as a primer. (link)

Plainly the more positive ideas associated with positive human resources theory about worker motivation, knowledge, and creativity play no role in Amazon’s thinking about the workplace. And this implies a grim future for work — not only in this company, but in many others who emulate the workplace model pioneered by Amazon.

The abuses of the first fifty years of industrial capitalism eventually came to an end through a powerful union movement. Workers in railroads, textiles, steel, and the automobile industry eventually succeeded in creating union organizations that were able to effectively represent their interests in the workplace. So where is the Amazon worker’s ability to resist? The New York Times story (link) makes it clear that individual workers have almost no ability to influence Amazon’s practices. They can choose not to work for Amazon, but they can’t join a union, because Amazon has effectively resisted unionization. And in places like Baltimore and other cities where Amazon is hiring, the other job choices are even worse (even lower paid, if they exist at all). Amazon makes a great deal of money on their work, and it manages its great initiatives based on their Chaplin-esque speed of completion (one-day delivery). But there is very little ability to change the workplace towards a more human-scale one, and a workplace where the worker’s positive human capacities find fulfillment. An Amazon fulfillment center is anything but that when it comes to the lives of the workers who make it run.

Is there a better philosophy that Amazon might adopt for its work environments? Yes. It is a framework that places worker wellbeing at the same level as efficiency, “1-day delivery” and profitability. It is an approach that gives greater flexibility to shop-floor-level workers, and relaxes to some degree the ever-rising quotas for piece work per minute. It is an approach that sets workplace expectations in a way that fully considers the safety, stress, and health of the workers. It is an approach that embodies genuine respect and concern for its workers — not as public relations initiative, but as a guiding philosophy of the workplace.

There is a hard question and a harder question posed by this idea, however. Is there any reason to think that Amazon will ever evolve in this more humane direction? And harder, is there any reason to think that any large modern corporation can embody these values? Based on the current behavior of Amazon as a company, from top to bottom, the answer to the first question is “no, not unless workers gain real power in the workplace through unionization or some other form of representation in production decisions.” And to the second question, a qualified yes: “yes, a more humane workplace is possible, if there is broad involvement in business decisions by workers as well as shareholders and top executives.” But this too requires a resurgence of some form of organized labor — which our politics of the past 20 years have discouraged at every turn.

Or to quote Oliver Goldsmith in The Deserted Village (1770):

Ill fares the land, to hastening ills a prey,
Where wealth accumulates, and men decay.
Princes and lords may flourish, or may fade;
A breath can make them, as a breath has made:
But a bold peasantry, their country’s pride,
When once destroy’d, can never be supplied.

So where did the dispossessed wind up in nineteenth century Britain? Here is how Engels described the social consequences of this "primitive accumulation" for the working people of Britain in his book, The Condition of the Working Class in England:

It is only when [the observer] has visited the slums of this great city that it dawns upon him that the inhabitants of modern London have had to sacrifice so much that is best in human nature in order to create those wonders of civilisation with which their city teems. The vast majority of Londoners have had to let so many of their potential creative faculties lie dormant, stunted and unused in order that a small, closely-knit group of their fellow citizens could develop to the full the qualities with which nature has endowed them. (30)

This passage, written in 1845, could with minor changes of detail describe the situation of Amazon workers today. "The vast majority ... have had to let so many of their potential creative faculties lie dormant, stunted and unused in order that a small, closely-knit group of their fellow citizens could develop to the full the qualities with which nature has endowed them."

And what about income and standard of living? The graph of median US income by quintile above in constant 2018 dollars tells a very stark story. Since 1967 only the top quintile of household income has demonstrated significant growth (in a timeframe of more than fifty years); and the top 5% of households shows the greatest increase of any group. 80% of US households are barely better off today than they were in 1967; whereas the top 5% of households have increased their incomes by almost 250% in real terms. This has a very clear, unmistakeable implication: that working people, including service workers, industrial workers, and most professionals have received a declining share of the economic product of the nation. Amazon warehouse workers fall in the 2nd-lowest quintile (poorest 21-40%). (It would be very interesting to have a time series of Amazon's wage bill for blue-collar and white-collar wages excluding top management as a fraction of company revenues and net revenues since 2005.)

Here is a relevant post on the possibilities created for a more fair industrial society by the institution of worker-owned enterprises (link), and here is a post on the European system of workers councils (link), a system that gives workers greater input into decisions about operations and work conditions on the shop floor.

Organizations as open systems

Key to understanding the "ontology of government" is the empirical and theoretical challenge of understanding how organizations work. The activities of government encompass organizations across a wide range of scales, from the local office of the Department of Motor Vehicles (40 employees) to the Department of Defense (861,000 civilian employees). Having the best understanding possible of how organizations work and fail is crucial to understanding the workings of government.

I have given substantial attention to the theory of strategic action fields as a basis for understanding organizations in previous posts (link, link). The basic idea in that approach is that organizations are a bit like social movements, with active coalition-building, conflicting goals, and strategic jockeying making up much of the substantive behavior of the organization. It is significant that organizational theory as a field has moved in this direction in the past fifteen years or so as well. A good example is Scott and Davis, Organizations and Organizing: Rational, Natural and Open System Perspectives (2007). Their book is intended as a "state of the art" textbook in the field of organizational studies. And the title expresses some of the shifts that have taken place in the field since the work of March, Simon, and Perrow (link, link). The word "organizing" in the title signals the idea that organizations are no longer looked at as static structures within which actors carry out well defined roles; but are instead dynamic processes in which active efforts by leaders, managers, and employees define goals and strategies and work to carry them out. And the "open system" phrase highlights the point that organizations always exist and function within a broader environment -- political constraints, economic forces, public opinion, technological innovation, other organizations, and today climate change and environmental disaster.

Organizations themselves exist only as a complex set of social processes, some of which reproduce existing modes of behavior and others that serve to challenge, undermine, contradict, and transform current routines. Individual actors are constrained by, make use of, and modify existing structures. (20)

Most analysts have conceived of organizations as social structures created by individuals to support the collaborative pursuit of specified goals. Given this conception, all organizations confront a number of common problems: all must define (and redefine) their objectives; all must induce participants to contribute services; all must control and coordinate these contributions; resources must be garnered from the environment and products or services dispensed; participants must be selected, trained, and replaced; and some sort of working accommodation with the neighbors must be achieved. (23)

Scott and Davis analyze the field of organizational studies in several dimensions: sector (for-profit, public, non-profit), levels of analysis (social psychological level, organizational level, ecological level), and theoretical perspective. They emphasize several key "ontological" elements that any theory of organizations needs to address: the environment in which an organization functions; the strategy and goals of the organization and its powerful actors; the features of work and technology chosen by the organization; the features of formal organization that have been codified (human resources, job design, organizational structure); the elements of "informal organization" that exist in the entity (culture, social networks); and the people of the organization.

They describe three theoretical frameworks through which organizational theories have attempted to approach the empirical analysis of organizations. First, the rational framework:

Organizations are collectivities oriented to the pursuit of relatively specific goals. They are "purposeful" in the sense that the activities and interactions of participants are coordinated to achieve specified goals..... Organizations are collectivities that exhibit a relatively high degree of formalization. The cooperation among participants is "conscious" and "deliberate"; the structure of relations is made explicit. (38)

From the rational system perspective, organizations are instruments designed to attain specified goals. How blunt or fine an instrument they are depends on many factors that are summarized by the concept of rationality of structure. The term rationality in this context is used in the narrow sense of technical or functional rationality (Mannheim, 1950 trans.: 53) and refers to the extent to which a series of actions is organized in such a way as to lead to predetermined goals with maximum efficiency. (45)

Here is a description of the natural-systems framework:

Organizations are collectivities whose participants are pursuing multiple interests, both disparate and common, but who recognize the value of perpetuating the organization as an important resource. The natural system view emphasizes the common attributes that organizations share with all social collectivities. (39)

Organizational goals and their relation to the behavior of participants are much more problematic for the natural than the rational system theorist. This is largely because natural system analysts pay more attention to behavior and hence worry more about the complex interconnections between the normative and the behavioral structures of organizations. Two general themes characterize their views of organizational goals. First, there is frequently a disparity between the stated and the “real” goals pursued by organizations—between the professed or official goals that are announced and the actual or operative goals that can be observed to govern the activities of participants. Second, natural system analysts emphasize that even when the stated goals are actually being pursued, they are never the only goals governing participants’ behavior. They point out that all organizations must pursue support or “maintenance” goals in addition to their output goals (Gross, 1968; Perrow, 1970:135). No organization can devote its full resources to producing products or services; each must expend energies maintaining itself. (67)

And the "open-system" definition:

From the open system perspective, environments shape, support, and infiltrate organizations. Connections with "external" elements can be more critical than those among "internal" components; indeed, for many functions the distinction between organization and environment is revealed to be shifting, ambiguous, and arbitrary.... Organizations are congeries of interdependent flows and activities linking shifting coalitions of participants embedded in wider material-resource and institutional environments.  (40)

(Note that the natural-system and "open-system" definitions are very consistent with the strategic-action-field approach.)

Here is a useful table provided by Scott and Davis to illustrate the three approaches to organizational studies:

An important characteristic of recent organizational theory has to do with the way that theorists think about the actors within organizations. Instead of looking at individual behavior within an organization as being fundamentally rational and goal-directed, primarily responsive to incentives and punishments, organizational theorists have come to pay more attention to the non-rational components of organizational behavior -- values, cultural affinities, cognitive frameworks and expectations.

This emphasis on culture and mental frameworks leads to another important shift of emphasis in next-generation ideas about organizations, involving an emphasis on informal practices, norms, and behaviors that exist within organizations. Rather than looking at an organization as a rational structure implementing mission and strategy, contemporary organization theory confirms the idea that informal practices, norms, and cultural expectations are ineliminable parts of organizational behavior. Here is a good description of the concept of culture provided by Scott and Davis in the context of organizations:

Culture describes the pattern of values, beliefs, and expectations more or less shared by the organization’s members. Schein (1992) analyzes culture in terms of underlying assumptions about the organization’s relationship to its environment (that is, what business are we in, and why); the nature of reality and truth (how do we decide which interpretations of information and events are correct, and how do we make decisions); the nature of human nature (are people basically lazy or industrious, fixed or malleable); the nature of human activity (what are the “right” things to do, and what is the best way to influence human action); and the nature of human relationships (should people relate as competitors or cooperators, individualists or collaborators). These components hang together as a more-or-less coherent theory that guides the organization’s more formalized policies and strategies. Of course, the extent to which these elements are “shared” or even coherent within a culture is likely to be highly contentious (see Martin, 2002)—there can be subcultures and even countercultures within an organization. (33)

Also of interest is Scott's earlier book Institutions and Organizations: Ideas, Interests, and Identities, which first appeared in 1995 and is now in its 4th edition (2014). Scott looks at organizations as a particular kind of institution, with differentiating characteristics but commonalities as well. The IBM Corporation is an organization; the practice of youth soccer in the United States is an institution; but both have features in common. In some contexts, however, he appears to distinguish between institutions and organizations, with institutions constituting the larger normative, regulative, and opportunity-creating environment within which organizations emerge.

Scott opens with a series of crucial questions about organizations -- questions for which we need answers if we want to know how organizations work, what confers stability upon them, and why and how they change. Out of a long list of questions, these seem particularly important for our purposes here: "How are we to regard behavior in organizational settings? Does it reflect the pursuit of rational interests and the exercise of conscious choice, or is it primarily shaped by conventions, routines, and habits?" "Why do individuals and organizations conform to institutions? Is it because they are rewarded for doing so, because they believe they are morally obligated to obey, or because they can conceive of no other way of behaving?" "Why is the behavior of organizational participants often observed to depart from the formal rules and stated goals of the organization?" "Do control systems function only when they are associated with incentives ... or are other processes sometimes at work?" "How do differences in cultural beliefs shape the nature and operation of organizations?" (Introduction).

Scott and Davis's work is of particular interest here because it supports analysis of a key question I've pursued over the past year: how does government work, and what ontological assumptions do we need to make in order to better understand the successes and failures of government action? What I have called organizational dysfunction in earlier posts (link, link) finds a very comfortable home in the theoretical spaces created by the intellectual frameworks of organizational studies described by Scott and Davis.

Personalized power at the local level

How does government work? We often understand this question as one involving the institutions and actors within the Federal government. But there is a different zone of government and politics that is also very important in public life in the United States, the practical politics and exercise of power at the state and local levels.

Here is an earlier post that addresses some of these issues as well; link. There I present three scenarios for how our democracy works: the ideal case, the "not-so-ideal" case, and the "nightmare" case.

The Nightmare Scenario Elected officials have no sincere adherence to the public good; they pursue their own private and political interests through all the powers available to them. Elected officials are sometimes overtly corruptible, accepting significant gifts in exchange for official performance. Elected officials are intimidated by the power of private interests (corporations) to fund electoral opposition to their re-election. Regulatory agencies are dominated by the industries they regulate; independent commissioners are forced out of office; and regulations are toothless when it comes to environmental protection, wilderness protection, health and safety in the workplace, and food safety. Lobbyists for special interests and corporations have almost unrestricted access to legislators and regulators, and are generally able to achieve their goals.

This is the nightmare scenario if one cares about democracy, because it implies that the apparatus of government is essentially controlled by private interests rather than the common good and the broad interests of society as a whole. It isn't "pluralism", because there are many important social interests not represented in this system in any meaningful way: poor people, non-unionized workers, people without health insurance, inner-city youth, the environment, people exposed to toxic waste, ...

 If anything, personal networks of power and influence appear to be of even greater importance at this level of government than at the Federal level.

So how does personal power work at the local level? Power within a democracy is gained and wielded through a variety of means: holding office within an important institution, marshaling support from a political party, possessing a network of powerful supporters in business, labor, and advocacy groups; securing access to significant sources of political funding; and other mechanisms we can think of. Mayors, governors, and county executives have powers of appointment to reward or punish their supporters and competitors; they have the ability to influence purchasing and other economic levers of the municipality; and they have favors to trade with legislators.

Essentially the question to consider here is how power is acquired, exercised, and maintained by a few powerful leaders in state, county, and city, and what are the barely-visible lines through which these power relations are implemented and maintained. This used to be called "machine politics," but as Jessica Trounstine demonstrates in Political Monopolies in American Cities: The Rise and Fall of Bosses and Reformers, the phenomenon is broader than Tammany Hall and the mayor-boss politics of the nineteenth century through Mayor Daly's reign in Chicago. The term Trounstine prefers is "political monopolies":

I argue that it is not whether a government is machine or reform that determines its propensity to represent the people, but rather its success at stacking the deck in its favor. When political coalitions successfully limit the probability that they will be defeated over the long term -- when they eliminate effective competition -- they achieve a political monopoly. In these circumstances the governing coalition gains the freedom to be responsive to a narrow segment of the electorate at the expense of the broader community. (KL 140)

What are the levers of influence available to a politician in state and local government that permit some executives to achieve monopoly power? How do mayors, county executives, and political party leaders exercise power over the decisions that are to be made? Once they have executive power they are able to reward friends and punish enemies through appointments to desirable jobs, through favorable access to government contracts (corrupt behavior!), through the power of their Rolodexes (their networks of relationships with other powerful people), through their influence on political party decision-making, through the power of some of their allies (labor unions, business associations, corporations), and through their ability to influence the flow of campaign funding. They have favors to dispense and they have punishments they can dole out.

Consider Southeast Michigan as an interesting example. Michigan's largest counties have a history of longterm "monopoly" leadership. Wayne County was led for 15 years by Ed McNamara and Oakland County was led by L. Brooks Patterson, and both men wielded a great deal of power in their offices during their tenure. Neither was seriously challenged by strong competing candidates, and Patterson died in office at the age of 80. Some of the levers of power in Wayne County came to light during a corruption investigation in 2011. Below are links to several 2011 stories in MLive on the details of this controversy involving the Wayne County Executive and the Airport Authority Board.

Labor unions have a great deal of influence on the internal politics of the Democratic Party in Michigan. Dudley Buffa's Union Power and American Democracy: The UAW and the Democratic Party, 1972-83 describes this set of political realities through the 1980s. Buffa shows that the UAW had extraordinary influence in the Democratic Party into the 1980s, and even with the decline of the size and influence of organized labor, it still has virtually veto power on important Democratic Party decisions today.

As noted in many places in Understanding Society, corporations have a great deal of power in political decision-making in the United States. Corporate influence is wielded through effective lobbying, political and political action contributions, and the "social capital" of networks of powerful individuals. (Just consider the influence of Boeing on the actions of the FAA or the influence of the nuclear industry on the actions of the NRC.) G. William Domhoff (Who Rules America? Challenges to Corporate and Class Dominance) provided a classic treatment of the influence of corporate and business elites in the sphere of political power in the United States. He has also created a very useful website dedicated to helping other researchers discover the networks of power in other settings (link). Senator Sheldon Whitehouse and Melanie Wachtell Stinnett provide a more contemporary overview of the power that businesses have in American politics in Captured: The Corporate Infiltration of American Democracy.

When I speak of corporate power in politics, let me be very clear: I do not mean just the activities of the incorporated entities themselves. The billionaire owners of corporations are often actively engaged in battle to expand the influence of the corporations that give them their power and their wealth. Front groups and lobbying groups are often the ground troops when corporate powers don’t want to get their own hands dirty or when they want to institutionalize their influence. So-called philanthropic foundations are often the proxies for billionaire families who want influence and who launch these tools. (kl 214)

Contributors to Corporations and American Democracy provide extensive understanding of the legal and political history through which corporations came to have such extensive legal rights in the United States.

Business executives too have a great deal of influence on the Michigan legislature. Here is a Crain's Detroit Business assessment of the top influencers in Lansing, "Michigan's top power players as Lansing insiders see them — and how they wield that influence" (link). Top influencers in the business community, according to the Crain's article, include Dan Gilbert, chairman of Quicken Loans Inc., Daniel Loepp, president and CEO of Blue Cross Blue Shield of Michigan, Rich Studley, CEO of Michigan Chamber of Commerce, Patti Poppe, CEO of Consumers Energy Co., and Mary Barra, CEO of General Motors Co. Most of these individuals are members of the state's leading business organization, Business Leaders for Michigan (link). Collectively and individually these business leaders have a great deal of influence on the elected officials of the state.

Finally, elected officials themselves sometimes act in direct self-interest, either electoral or financial, and corruption is a recurring issue in local and state government in many states. Detroit's mayor Kwame Kilpatrick, a string of Illinois governors, and other elected officials throughout the country were all convicted of corrupt actions leading to personal gain (link).

These kinds of influence and actions underline the extensive and anti-democratic role that a range of political actors play within the decision-making and rule-setting of local government: monopoly-holding political executives, political party officials, big business and propertied interests, labor unions, and special advocacy groups. It would be interesting to put together a scorecard of issues of interest to business, labor, unions, and environmental groups, and see how often each constituency prevails. It is suggestive about the relative power of these various actors that the two issues of the greatest interest to the business community in Michigan in recent years, repeal of the Michigan Business Tax and passage of "Freedom to Work" legislation, were both successful. (Here is an earlier post on the business tax reform issue in Michigan; link.)

Data for case study about networks of influence in SE Michigan

Jeff Wattrick, November 2, 2011. "This didn't start with Turkia Mullin: The inter-connected web of Wayne County politics from Ed McNamara to Renee Axt", MLive (link)
___________, November 4, 2011: "Wayne County Executive Bob Ficano replaces top officials, vows to end 'business as usual'", MLive (link)
___________, November 7, 2011: "Renee Axt resigns as Chair of Wayne County Airport Authority", MLive (link)
___________, November 8, 2011: "Almost half of Wayne County voters say Executive Bob Ficano should resign", MLive (link)
Jim Schaefer and John Wisely. November 15, 2011. "Wayne Co. lawyer who quit is back". Detroit Free Press. (link)
David Sands. November 15, 2011. "Wayne County Corruption Probe Gathers Speed, Turkia Mullin To Testify", Huffington Post (link)

Detroit had its own nationally visible political corruption scandal when Mayor Kwame Kilpatrick was charged with multiple counts of racketeering and corruption, for which he was eventually convicted. Stephen Yaccino, October 10, 2013. "Kwame M. Kilpatrick, Former Detroit Mayor, Sentenced to 28 Years in Corruption Case", New York Times (link).

The internal machinations of Michigan's political parties with respect to choosing candidates for office reflect the power of major "influencers". Here is a piece about the choice of candidate for the office of secretary of state in the Democratic Party in 2002: Jack Lessenberry. March 30, 2002. "Austin has uphill fight in Michigan secretary of state race", Toledo Blade (link).

Electronic Health Records and medical mistakes

Electronic Health Record systems (EHRs) have been broadly implemented by hospitals and health systems around the country as a way of increasing the accuracy, availability, and timeliness of patient health status and treatment information. (These systems are also sometimes called "Digital Medical Records" (DMRs).) They are generally regarded as an important forward step in improving the quality of healthcare. Here is a description of the advantages of Electronic Health Record systems, according to Athena Health:

The advantages of electronic health records in the clinical setting are numerous and important. In the 2012 edition of the Physician Sentiment IndexTM, published by athenahealth and Sermo, 81% of physicians said they believe EHRs improve access to clinical data. More than two-thirds said an EHR can actually improve patient care.

The use of an electronic health records system offers these clinical advantages:

• No bulky paper records to store, manage and retrieve
• Easier access to clinical data
• The ability to establish and maintain effective clinical workflows
• Fewer medical errors, improved patient safety and stronger support for clinical decision-making
• Easier participation in Meaningful Use, Patient-Centered Medical Home (PCMH) and other quality programs, with electronic prompts ensuring that required data is recorded at the point of care
• The ability to gather and analyze patient data that enables outreach to discreet populations
• The opportunity to interact seamlessly with affiliated hospitals, clinics, labs and pharmacies

Considering all the advantages of electronic health records, and the rapidly growing electronic interconnectedness of the health care world, even if EHRs had not been mandated by health care reform, their development and eventual ubiquity in the health care industry was inevitable.

And yet, like any software system, EHR systems are capable of creating new errors; and some of those errors can be harmful to patients.

Nancy Leveson is an important expert on software system safety who has written extensively on the challenges of writing highly reliable software in safety-critical applications. Here are a few apt observations from her book Safeware: System Safety and Computers (1995).

Although it might seem that automation would decrease the risk of operator error, the truth is that automation does not remove people from systems -- it merely moves them to maintenance and repair functions and to higher-level supervisory control and decision making. The effects of human decisions and actions can then be extremely serious. At the same time, the increased system complexity makes the decision-making process more difficult. (10)

The increased pace of change lessens opportunity to learn from experience. Small-scale and relatively nonhazardous systems can evolve gradually by trial and error. But learning by trial and error is not possible for many modern products and processes because the pace of change is too fast and the penalties of failure are too great. Design and operating procedures must be right the first time when there is potential for a major fire, explosion, or release of toxic materials. (12)

(To the last statement we might add "or harm to hospital patients through incorrect prescriptions or failed transmission of lab results".)

The safety implications of computers exercising direct control over potentially dangerous processes are obvious. Less obvious are the dangers when ... software generated data is used to make safety-critical decisions, ... software is used in design analysis, ... safety-critical data (such as blood bank data) is stored in computer databases. The FDA has received reports of software errors in medical instruments that led to mixing up patient names and data, as well as reports of incorrect outputs from laboratory and diagnostic instruments (such as patient monitors, electrocardiogram analyzers, and imaging devices". (23)

Automatic control systems [like aircraft autopilots] are designed to cope with the immediate effects of a deviation in the process -- they are feedback loops that attempt to maintain a constant system state, and as such, they mask the occurrence of a problem in its early stages. An operator will be aware of such problems only if adequate information to detect them is provided. That such information is often not provided may be the result of the different mental models of the designers and experienced operators, or it may merely reflect financial pressures on designers due to the cost of providing operators with independent information. (117)

One of the cases examined in detail in Safeware is the Therac-25 radiation-therapy device, which due to a minor software flaw in the treatment-entry plan module began seriously injuring patients with excessive doses of radiation in 1985-87 (515 ff.). It had operated without incident thousands of times before the first accident.

So Leveson gives ample reason to be cautious about the safety implications of DMRs and the "fault pathways" through which their normal functioning might harm patients. What has been the experience so far, now that the healthcare industry has witnessed widespread adoption of DMR systems?

Two specific issues involving EHR errors affecting patient care have been identified in the past several years. The first is in the area of errors in the administration of prescription drugs, and the second is in the area of the handling and routing of medical test results. Both errors have the potential for harming the patient.

Jennifer Bresnick (link) summarizes the results of a report by the Pennsylvania Patient Safety Authority concerning medication errors caused by DMR systems. Medication errors (wrong medication, wrong dose, wrong patient, wrong frequency) can occur at several stages of the clinical process, including prescribing, transcribing, dispensing, and administration. The digital medical record is intended to dramatically reduce all these sources of error, the Pennsylvania study shows that the DMR can also contribute to errors at each of these stages.

While EHRs and other technologies are intended to reduce errors and improve the safe, standardized, and well-documented delivery of care, some stakeholders believe that digital tools can simply serve to swap one set of mistakes for another. Poor implementation and lackluster user training can leave patients just as vulnerable to medication errors as they were when providers used paper charts, commented Staley Lawes, PharmD, BCPS, Patient Safety Analyst, and Matthew Grissinger, RPh, FISMP, FASCP, Manager of Medication Safety Analysis in the brief. (link)

Part of the blame, according to the Pennsylvania report, belongs to the design of the user interface:

For this reason, it is important to design a system with an intuitive user interface to minimize the risk for human error. Users should be able to easily enter and retrieve data and share information with other healthcare professionals.  When systems are designed without these considerations in mind, patients are subject to undue risk. (link)

The report contains several specific design standards that would improve the safety of the DMR system:

The interaction between clinician and software is a key component that is to be taken into consideration when trying to improve the safety of health IT,” the report says. “Incident reports can provide valuable information about the types of HIT-related issues that can cause patient harm, and ongoing HIT system surveillance can help in developing medication safety interventions. (link)

It is clear that ongoing health IT system surveillance and remedial interventions are needed. Efforts to improve health IT safety should include attention to software interoperability, usability, and workflow. The relationship between clinician and software includes complex interactions that must be considered to optimize health IT’s contribution to medication safety.

Yackel and Embi (link) treat the problem of test result management errors in "Unintended errors with EHR-based result management: a case series". Here is their abstract:

Test result management is an integral aspect of quality clinical care and a crucial part of the ambulatory medicine workflow. Correct and timely communication of results to a provider is the necessary first step in ambulatory result management and has been identified as a weakness in many paper-based systems. While electronic health records (EHRs) hold promise for improving the reliability of result management, the complexities involved make this a challenging task. Experience with test result management is reported, four new categories of result management errors identified are outlined, and solutions developed during a 2-year deployment of a commercial EHR are described. Recommendations for improving test result management with EHRs are then given.

They identify test management errors at four stages of the clinical process:

• results not correctly communicated to provider;
• results communicated but never received or reviewed by the provider;
• results reviewed, but appropriate action not recommended by provider;
• appropriate recommendation made by provider, but action not carried out.

They make several key recommendations for improving the performance of DMR systems in managing test results: Develop fault-tolerant systems that automatically report delivery failures; use robust testing to find rare errors that occur both within and between systems; implement tracking mechanisms for critical tests, such as cancer screening and diagnostics; and deliver results directly to patients.

These are just two types of errors that can arise in digital medical record management systems. It is evident that the designers and implementers of DMRs need to take the systems-safety approach described by Nancy Leveson and implement comprehensive safety failure analysis, both in terms of "safety case analysis" (discovery of failure scenarios) and after-event investigation to identify the source of the failure in the software and its human interface.

These examples are not intended to suggest that DMRs are hazardous and should be avoided. On the contrary, the consolidation and convenient presentation of patient information for the provider is clearly an important step forward. But it is crucial that designers and implementers keep safety at the center of their attention, and to have a healthy respect for the ways in which automated systems can incorporate incorrect assumptions, can produce unintended interactions among components, and can be presented in such a confusing way to the human provider that patient care is harmed.

(Here is a case of treatment involving several different errors conveyed through the digital medical record system that involved attaching biopsy and test results to the wrong patient, leading to the wrong treatment for the patient. It is interesting to read because it reflects some of the complexity identified by Leveson in other system failures.)