Ronald Schouten, MD, JD

The never-ending news cycle has taken the spotlight off of Penn State, for which the folks of Happy Valley are no doubt grateful. Our attention has been diverted by events that occupy positions on opposite ends of the spectrum of human behavior: the horror of the Aurora, Colorado shootings and the inspiring accomplishments of Olympic athletes. Released on July 12, 2012, the report of the Special Investigative Counsel (the Freeh Report), found fault with Penn State’s board, it’s leadership, and its culture of football. Ten days later, it was pushed from the headlines by a new disaster. Moving on is normal in this age of 24-hour news, and generally healthy. In doing so too quickly, we risk missing an opportunity to learn from Penn State and avoid sharing its fate.

There is a natural tendency to distance ourselves from the offense and the offender when we learn of some terrible misdeed by another person or organization. We, after all, would never do anything like that. The difficult truth revealed by the Freeh report is that many of the missteps and misdeeds were the result of mistakes of perception and analysis that individuals and organizations engage in every day. If we are to avoid the fate of Penn State, we should pay attention to the basic lessons from this and similar disasters. These include:

1. Good people, and good organizations, can do some very bad things. Without getting bogged down in philosophical discourse over the meaning of “good” and “evil,” let’s agree that sexual abuse of children, lawyers stealing from clients, doctors using their positions to sexually abuse patients or commit insurance fraud, and corporate misdeeds that range from falsifying expenses to insider trading are bad things. Sadly, they occur with some degree of regularity, often when the perpetrators are associated with otherwise honest, ethical institutions that serve the public. We ignore this fact at our peril.

2. We tend to believe that people like us or with whom we are associated are inherently good and incapable of doing bad things. Sure, they may make mistakes, but they could never do anything truly evil. It is this bias that leads the family members of murderers to deny that their loved ones could ever do such a thing, the devout to deny that their religious leaders could ever engage in sexual abuse or consort with prostitutes, psychoanalytic institutes to blame allegations of sexual misconduct on the fantasies of patients, and organizations to chalk up excessive expense account claims and false billing to arithmetic errors. This tendency to believe the best about those with whom we are associated is a positive thing, until it blinds us to reality. The best solution to this lies in accepting that this benign and hopeful way of viewing the world is natural, and is a potentially dangerous source of bias in our analysis of events.

3. There are truly bad people among us. While virtually everyone tells a lie or makes a less-than-accurate tax calculation from time to time, we know when we have done it, and we feel appropriate remorse. Not so for people who lie along the psychopathy spectrum, from those we refer to as “almost” or subsyndromal psychopaths to those who would qualify as full-blown psychopaths. ( They are risk takers, remorseless, lack empathy, con and manipulate, are skilled liars, and are indifferent to right and wrong. Their sole goal is self-satisfaction, regardless of the cost to others. And they exist in our organizations, in part because some of these psychopathic traits confer competitive advantage in the workplace. Among their skills is the ability to take advantage of the better natures of those around them to pursue their ends and escape detection. Protection lies in being aware and paying attention when we encounter a colleague who exhibits the traits described above. Evil should always be part of the differential diagnosis.

4. Self-preservation is a powerful impulse. Wrongdoers prioritize their individual survival and will often deny, minimize, or outright lie about their offenses, both when first accused and in an ongoing effort to avoid punishment. Combined with our benign view of our associates, self-preservation can lead organizations to follow the initial “Not one of ours” response with further denial, minimization, concealment, or outright lies about what has occurred. The self-preservation reflex will not, and should not, go away. Organizations that wish to avoid disasters of Penn State proportions will recognize this reflex for what it is, and figure its impact into their responses to adverse events.

5. There is risk in deferring to a “higher authority.” Faced with allegations of wrongdoing within an organization, there is a natural inclination to defer investigation and decisions to others who have more formal authority or expertise to address such problems. But the criminal justice system is a blunt and imprecise tool for addressing individual and organizational misconduct. The fact that a district attorney chooses not to prosecute or even that a jury fails to convict, does not mean that nothing happened. Prosecutors decline to pursue cases when proof beyond a reasonable doubt is unlikely, even when there is evidence of wrongdoing. The district attorney declined to prosecute Jerry Sandusky in 1998, although it was known that he had showered with an 11-year-old boy and hugged him while doing so. Sandusky even acknowledged doing this with other children in the past. In a disastrous mistake of logic, university officials concluded that the matter had been adequately investigated and there was no reason for concern, given the lack of prosecution. While we may have the greatest criminal justice system in the world, it is designed to protect the rights of defendants, not the welfare of your organization. So don't count on it to do so.

6. Euphemisms, second only to fear of speaking truth to power, can be our worst enemies. Our training in polite society, our deference to and fear of offending authority, and our desire to avoid giving offense, too often lead us to pull our verbal punches when it is time to deliver bad news. Perhaps the Penn State scandal would have been more limited had Mike McQueary felt capable in 2001 of telling Joe Paterno that he saw Jerry Sandusky anally raping a boy or in 2000 a janitor had not been so fearful of losing his job that he declined to report seeing Sandusky performing oral sex on another child. How do we avoid falling into this trap that is created by both fear and reverence for those higher up the organizational ladder? Create an atmosphere in which people know that coming forward is expected and respected, and call it whatever it really is, whether theft, fraud, lying, or rape.

7. “He must be sick” is not a valid default position. When we find something truly amiss in our families, our organizations, or any group with which are associated, there is a reflexive tendency to assume that there must be some medical condition or life circumstance that explains and at least partially excuses the behavior. After all, for “one of us” to have done something so awful, they must be “sick.” Sometimes that’s true. But the bottom line is that regardless of the motivation or any mitigating circumstances, the offensive behavior occurred. The organization needs to focus on and respond to that behavior and the harm it has caused. Just because we can explain something, does not excuse it.

8. It’s not all about us. As individuals and organizations, we are naturally self-centered. We worry first and foremost about the wellbeing of ourselves and our own, and when a disaster like Penn State strikes, we see ourselves and our organizations as the victims. It is that tendency that led to one of the more damning findings of the Freeh report, of the “total and consistent disregard by the most senior leaders at Penn State for the safety and welfare of Sandusky’s child victims.”

Awareness of these perceptual tendencies and analytic biases is no guarantee that we will not find ourselves in a similar situation, but it will decrease the risk. And with a disaster of this proportion, even decreasing the risk is a very worthwhile goal.

About the Authors

Ronald Schouten, M.D., J.D.

Ronald Schouten, M.D., J.D., is an associate professor of psychiatry at Harvard Medical School and director of the Law & Psychiatry Service at Massachusetts General Hospital.

Jim Silver

Jim Silver, J.D., is a criminal defense attorney and former prosecutor.

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