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2017 Michigan High School Ethics Bowl Case Studies

The schools and growing number of student teams in the 2017 Michigan High School Ethics Bowl have the opportunity to advance the dialogue on a range of complex and important ethical issues presented in this year's cases. 

Unlike other Regional Bowls, the Michigan Bowl case studies are written by community members, all of whom are working in Michigan or have a long-standing Michigan affiliation. This year, only one of the cases is from the national bowl committee. The Michigan Bowl also has a fine editing team, including Kevin Craven,  Zoë Johnson-King and Caroline Perry from the University of Michigan Department of Philosophy Outreach Program. 

As always, each case is accompanied by some study questions to fire up the neurons and jumpstart discussions. And don't forget to take a look at the author bios and the helpful links highlighting their current work and interests. You may share some interests with the case writers. You might meet them on Bowl Day. Several of the case writers come to the Bowl  to learn about what you think and to hear your arguments about theirs as well as all the other case studies. 

  

Case 1: The Deciding Vote

You are one of nine members on the board of a local health department.

It has been discovered that your county suffers from unusually high rates of infant mortality. Although the county is facing a severe budget deficit, the state has offered additional funding to address this problem. Your board is considering two excellent proposals that would improve the infant mortality rate. Proposal A targets the highest risk group of women of childbearing age (which represents about eight percent of all women who are of childbearing age in the county). Proposal B targets all women of childbearing age in the county.

Four of the board members support Proposal A because they feel that it is the responsibility of the local health department to care for the most vulnerable members of the population with tailored interventions. They also believe that focusing on the highest risk group will have the greatest impact since county data has shown that this group is disproportionately affected by infant mortality. One of the four board members has stated, "Those with the highest disease burden should have special services." The other four board members support Proposal B because they believe that it is the responsibility of the local health department to serve the needs of all county residents equally. They feel that an intervention focused on all women of childbearing age will improve the health of everyone. One of these individuals has asserted, "A rising tide floats all boats."

Those eight board members have cast their votes with four supporting Proposal A and the other four supporting Proposal B. You are due to cast the ninth vote, which will determine which proposal is selected.

Study questions:

1. Which proposal will you choose, and why?
2. What additional information would help you to make an ethically informed decision?
3. Do you think it is morally right that a decision like this one should be made by majority vote of a nine-person panel of public health officials?
4. Suppose all pregnant women in the county already receive standard prenatal care, and the benefits whose allocation you are considering are extra benefits above and beyond the essentials. Does this additional fact change your reasoning about which way to vote? If so, how and why?

Author: Jessie Kimbrough Marshall, MD, MPH is the medical director of Washtenaw County Public Health and an adult hospital medicine physician at the University of Michigan Health System. As medical director, she provides leadership in multiple areas including the provision of medical oversight to the health department, prevention of disease and promotion of public health, and policy-setting through coordinated planning with local health systems, health care providers, residents, and other county stakeholders. As a practicing physician, she cares for patients with chronic and acute disease. Dr. Marshall has years of leadership experience with health equity initiatives, cross-cultural care training in medical education and clinical care of vulnerable populations.

Dr. Marshall attended medical school and completed residency at Wayne State University. She is a trained internal medicine and pediatric physician. She received a Master’s Degree in Public Health with a concentration on health policy and management from Harvard School of Public Health and completed a health policy fellowship at Massachusetts General Hospital, in Boston, MA. Dr. Marshall completed the General Internal Medicine Research fellowship program at Johns Hopkins University, in Baltimore, MD. 

Case 2: A Transformational Scholarship

Emma loves serving as director of the foundation’s Summer Scholar Program. Each year the program awards scholarships to talented high school women from the Midwest so they can participate in summer academic programs at selective colleges like Harvard, Brown, and Stanford. The experience often proves transformative for these students, and it is a big boost for them in the college admissions process. Emma knows this firsthand, as she grew up in a rural part of Michigan, and her own summer experience at Yale changed her path to college. Like the students the Foundation supports, Emma would not have been able to afford the program if she hadn’t received a scholarship.

Each year, the Scholar Selection Committee evaluates applications along three dimensions: academic and intellectual qualities, leadership, and transformational potential. The Foundation typically exhausts its funds long before running out of talented students, so applicants are ranked and the Board of Directors determines where the funding cut-off should be.

The “transformational potential” rating is often challenging to determine. The mission of the program is to provide exposure and support to students who otherwise would not have the financial means or mentoring support to consider these highly selective colleges. A family’s finances, whether or not a student has ever traveled out of the state or the Midwest, and if any family member has attended college – particularly an elite college – are all considerations.

Emma pulls up Tiffani Williams’ application. Tiffani has excellent grades, and her teachers rave about her ability to move class discussions in new directions with her creative ideas. There is no question she is active in her community, as she has held leadership positions in her church youth group, student council, and peer mentoring program. However, Emma is unsure how to rate Tiffani for transformational potential. There is no question that Tiffani, who has never been far from home, would have a transformational experience, but Tiffani’s older sister is an undergraduate student at Harvard. Neither of Tiffani’s parents has been to college, but her older sister would undoubtedly be a good source of support, and Tiffani is likely aware of schools like Harvard because of her sister. Still, Emma knows that Tiffani will not be able to attend a summer program without a scholarship.

Emma is wrestling with whether to give one of the few remaining scholarships to Tiffani or to reserve the funds for another student with less exposure to these types of colleges – even though none of the remaining applicants has academic and leadership credentials as outstanding as Tiffani’s. In one sense, Tiffani seems to deserve the funding more. One the other hand, she also seems to need it less.

Study questions:

1. What should Emma do, and why?
2. To what extent should Emma’s decision be guided by the stated mission of the organization? How should this consideration affect her choice, if at all?
3. How should “transformational potential” be measured? Should it be a measure only of the increase in exposure and support a student would receive through the scholarship, or should it also take into account how the student would likely take advantage of those additional opportunities?

Author: S. Caroline Kerr is Chief Executive Officer of the Joyce Ivy Foundation, a non-profit organization that supports the academic advancement and leadership development of talented young women from the Midwest. Through its Summer Scholars program, the Joyce Ivy Foundation gives scholarships to female high school students to participate in pre-college academic programs at partner colleges, such as Harvard, Yale, Brown, and Stanford. Previously, Caroline worked in undergraduate admissions, and as a college counselor and educational consultant. She grew up in Ann Arbor, and is a graduate of Dartmouth College, where she currently serves on the Board of Trustees, and the Harvard Graduate School of Education.

Case 3: Intellectual Property 

The scientific method is a process that uses observation to learn about the world. To answer a question of interest, a scientist forms a hypothesis--an educated guess--and then conducts experiments to test the hypothesis. Based on the data gathered, the scientist draws conclusions that may or may not support the initial hypothesis.

There is fierce competition among scientists for research funding grants, publications in high-ranked journals, and invitations to speak at conferences and scientific meetings. Research projects with compelling questions and results receive great attention from the scientific community, and this attention advances researchers’ careers.

Professors conduct their research within research groups. The head of the research group, the Principal Investigator (PI), hires undergraduates, graduate students, and postdoctoral fellows to work on projects relevant to the PI’s field of expertise. During weekly meetings, group members share ideas, data, and information about the progress of their respective projects. Although the competitive nature of professional science often pits researchers against one another, members of research groups must collaborate, sharing their ideas and results with their colleagues. This contradiction may give rise to conflict.

In a large university, a research group in the Medical School meets once per week. Group members include Jay (the PI), Sarah (a fourth-year doctoral student), David (a first-year doctoral student), and Lisa (a postdoctoral fellow). Since Sarah joined the program four years ago, she has been working on the same project without much success. Her hypotheses have not been confirmed by the experiments she has conducted, and the lack of promising results and absence of fresh ideas have slowed her progress. David, the new student, joined the group at the beginning of the academic year with great enthusiasm and strong motivation. As the newest member in the group, he usually spends meetings listening to progress reports from other group members, sometimes asking questions. He does not have a project yet.          

During this week’s meeting, Sarah again shares her frustration with negative experimental results and says that she does not have an alternative hypothesis or experiment to develop. Jay, the PI, suggests they meet later to brainstorm other projects. However, after the group meeting, David thinks of a novel way to test Sarah’s hypothesis. He stays late at the lab that night planning the experiment. Following several months of work, David is able to answer the question that Sarah has been struggling to answer for four years. He meets with Jay and presents the results. Jay is excited, and the two men begin drafting a joint paper for publication.

Study questions:

1. Should Sarah be included in this project? Why or why not? If she should be included, in what capacity should she be included?
2. What counts as a person’s intellectual property? If Jay and David publish the paper without including Sarah, have they violated Sarah’s intellectual property rights? What further information might you need to answer this question?
3. David is a first-year graduate student, while Jay is a professor whose responsibilities include mentoring students. How do these different roles affect David’s and Jay’s various obligations, particularly their obligations toward Sarah?

Author: Galit Levi Dunietz, MPH, PhD, is a Research Fellow in the Neurology Department of the University of Michigan. Her current research focuses on sleep health among at-risk populations across the lifespan. Dr. Dunietz obtained an MPH from the University of Michigan and a PhD in Epidemiology from Michigan State University. 

Case 4: Academic Integrity

You're in your second semester at a prestigious Midwestern university with rigorous academic standards.  You and three classmates have been assigned a group project that will count for 75% of your course grade.  You think that's a little harsh and have made comments to your fellow teammates about how unfair you think the weight of the assignment is for a first-year course.  You've already taken on an academically challenging course load, in spite of concerns stated by your academic advisor.  You feel that this assignment unjustly increases an already heavy burden.

The situation is complicated by the fact that you have just been invited to join a popular and high profile campus organization — one that will fill your time with meetings and other public obligations.  None of your teammates has been asked to join any campus organizations, so they can't possibly understand the pressures you are feeling.  Then there's your roommate who keeps impossible hours, making it difficult to work or study in your room.

As the weeks pass, you are putting more and more time into the work of the campus organization and have been absent or underprepared for meetings with your teammates to discuss the project.  Shortly before the deadline and in a panic, you volunteer to gather the parts of the project from your teammates, add your portion, edit appropriately, and turn in the entire thing on behalf of your team.  There is one problem: you haven't yet written a single word of your portion.

Desperate and in a rush, you use portions of a paper you wrote last semester. This paper earned an A, so it seems like a good choice. You tweak the old paper, bury its parts within the text from your teammates’ papers, and turn the project in.

Unfortunately, the professor discovers your tactic and calls the four of you before an academic integrity board.  Your teammates have no clue about what's happening, and you pretend to be ignorant as well. 

Study questions:

1. Were you right to feel that the weight of the assignment was unfair? If so, does this have any bearing on how you ought to handle the project?
2. What ethical obligations do you have toward your teammates? Are these obligations affected by the fact that they have fewer responsibilities outside of coursework than you do?
3. Once your actions have been revealed by the professor, are you obligated to inform your teammates of your actions prior to the academic integrity meeting?
4. If the paper you submitted is your own original work, although from a different class, is that cheating, or isn't it?

Author: Clinical Associate Professor Emerita Pat Van Volkinburg, served a total of 32 years with the University of Michigan School of Kinesiology. For more than 16 years, Professor Van Volkinburg also served in various administrative positions, with the last five years as the Assistant Dean and then Associate Dean for Academic Programs.  One of her duties was to chair the Academic Integrity Committee.  She served in that capacity for more than 25 years for both graduate and undergraduate cases. Additionally, Professor Van Volkinburg created two new academic majors in the School and several non-academic programs within Kinesiology and across the greater campus.

In addition to teaching and advising undergraduate students, Professor Van Volkinburg was active at the state and national level on committees that wrote and addressed state and national policy related to pedagogy. Professor Van Volkinburg was selected by Kinesiology students three times for her teaching excellence and twice at the state level for her dedication to teaching and for service.

Case 5:  Dubious Donations

One part of the federal Health Insurance Portability and Accountability Act (HIPAA) states that health care providers may not discuss any patient with anyone without the patient’s permission, if the patient is 18 years old or older. Parents or guardians of younger patients have access to their medical records and are permitted to discuss these records with medical personnel.

Dr. John Sauk is an internationally respected gastroenterologist and professor of medicine at a major university hospital. One day Dr. Sauk gets a call from the development office of the university, asking if he can see an elderly woman that afternoon. The woman is going to meet with the university’s development director that day to continue discussing a generous eight-figure donation. Despite his busy schedule, Dr. Sauk agrees to make time.

Dr. Sauk sees that the woman is in her early eighties. As well as conducting a physical exam, he spends a significant amount of time talking to her about her physical history, her diet, and her living conditions. He obtains her online medical records as well. He identifies a lower bowel irritation which can easily be treated with a well-tolerated drug and some dietary changes. Otherwise, the elderly woman seems to be in reasonably good health.

However, throughout his conversations with her, Dr. Sauk notices that the elderly woman shows significant signs of dementia. He also sees in her records that there are some comments from other physicians who have treated her in the past, suggesting that they, too, had seen signs of dementia. But there is no indication in her records that the woman has identified anyone to act on her behalf in making medical decisions for her. 

This leaves Dr. Sauk in an uncomfortable position regarding the elderly woman’s discussions at the development office. He does not know whether the development director is unaware of the mental state of the patient, or is aware and is continuing discussions with her about making a donation regardless. To protect the patient (and the university), he could call the development office and warn them. But this would require violating the HIPAA privacy rules. According to these guidelines, Dr. Sauk cannot even let the patient’s family know that he has seen her.

Study questions:

1 What is the point of regulations guaranteeing the privacy of an adult’s medical records? Does this rationale for medical privacy apply in the present case? If it does not apply, does that mean that Dr. Sauk should make an exception?
2. If Dr. Sauk does nothing, is he putting the university at risk? What are his professional responsibilities, both as a doctor and as an employee of the university?
3. Under what conditions, if any, do we lose the right to choose what to do with our own money?

Author: David Herzig is a private consultant to the biotechnology and pharmaceutical industries. Dr. Herzig is the former Vice President of Drug and Scientific Development at Parke-Davis. He has been a champion of the local arts community and has served on several arts organization Boards, including the University Musical Society and the Ann Arbor Symphony

Case 6: Scrubs

Many nurses and young doctors in training wear their scrubs to and from work. Some do this because it saves time, while others think it looks cool; the practice has been popularized by television programs like "Scrubs" and "Grey’s Anatomy." Physicians sometimes wear scrubs for television appearances to lend an air of authenticity to the advice they give to viewers and to studio audiences.

Despite the popularity of the practice, most hospitals prohibit their employees from wearing their scrubs outside of work, except in extraordinary circumstances. Cleanliness is extremely important in medical environments, and scrubs that have recently been worn outside may put patients at risk.  This wouldn’t be a problem if medical professionals reliably changed into clean scrubs before work, but evidence suggests that they don’t always do this.

Suppose you see a physician or nurse in scrubs eating at a McDonald’s outside the hospital.  How do you respond? On the one hand, it seems inappropriate to accost them on the spot — you don’t know what their circumstances are and therefore don’t know for sure whether they are behaving irresponsibly. On the other hand, if they are behaving irresponsibly, shouldn’t someone do something? How would you feel if you saw them the next day, coming out of surgery in the same scrubs they wore to McDonald’s, to tell you how your friend’s surgery went?

Study questions:

1. How should society respond to small misbehaviors that erode the public’s trust in institutions like hospitals, police departments, or the government?
2. Your knowledge of the circumstances of the physician or nurse eating at McDonald’s is very limited. What bearing does this have on what you ought to do in this situation?
3. Do we ever have a responsibility to get involved in situations where we suspect — but don’t know — that wrongdoing is occurring? If so, under what circumstances do we have such a responsibility, and under what circumstances do we not?

Author: David A. Bloom is currently chair of the Department of Urology at the University of Michigan Medical School. Dr. Bloom joined the University of Michigan faculty in 1984. He received the Jack Lapides endowed professorship in urology in 2002 and served as associate dean for faculty affairs of the medical school from 2000-2007. Dr. Bloom has published more than 160 papers and 68 book chapters, and has served on the editorial boards of several urology journals, including the Journal of Pediatric Urology and the British Journal of Urology. He has held offices in 26 professional societies, among them as president of the American Association of Genitourinary Surgeons. 

Before coming to Michigan, Dr. Bloom was a staff urologist at the Walter Reed Army Medical Center in Washington, DC.  In 1983, at the time of his discharge from the U.S. Army and upon leaving Walter Reed, he had been promoted to Lt. Colonel and had been appointed chief of pediatric urology. He earned his medical degree from the State University of New York at Buffalo; served dual residencies in surgery and urology at UCLA; and completed a fellowship in pediatric urology at the Institute of Urology of the University of London. 

Case 7: Humane Conditions in Prisons

Anders Behring Breivik, a Norwegian far-right terrorist, killed eight people by detonating a van bomb in Oslo and then shot dead sixty-nine participants in a youth summer camp on the island of Utøya in 2011. A year later, he was sentenced to the maximum penalty in Norway, which was twenty-one years preventive detention, including at least a minimum of ten years of incarceration.

In 2016, he sued the Norwegian Correctional Service over his solitary confinement and conditions of confinement. He claimed that the restriction of access to other people, including fellow inmates, healthcare workers, chaplains, and family members, is a form of torture. While he has an electric typewriter and an X-box, he claims the cold temperature requires layers of clothing to stay warm and that guards interfere with his daily routine.  He demands easier communication with the outside world, a PlayStation3 with “more suitable games,” a room with better decoration and a view, as well as “access to a sofa and a bigger gym.”

The court found in his favor that his conditions violated Article 3 of the European Convention on Human Rights. Article 3 reads, “No one shall be subjected to torture or to inhuman or degrading treatment or punishment.”

Study questions:

1. How comfortable should prison conditions be?
2. What does the word “inhumane” mean, and who gets to decide?
3. Does this issue matter according to the offense; that is, should “humane” conditions be required regardless of whether the reason for imprisonment was marijuana sale, theft, child abuse, murder, or embezzlement? 
4. Should society imprison anyone? If so, why? What are the costs and benefits of incarceration?

Author: David A. Bloom is currently chair of the Department of Urology at the University of Michigan Medical School. Dr. Bloom joined the University of Michigan faculty in 1984. He received the Jack Lapides endowed professorship in urology in 2002 and served as associate dean for faculty affairs of the medical school from 2000-2007. Dr. Bloom has published more than 160 papers and 68 book chapters, and has served on the editorial boards of several urology journals, including the Journal of Pediatric Urology and the British Journal of Urology. He has held offices in 26 professional societies, among them as president of the American Association of Genitourinary Surgeons. 

Before coming to Michigan, Dr. Bloom was a staff urologist at the Walter Reed Army Medical Center in Washington, DC.  In 1983, at the time of his discharge from the U.S. Army and upon leaving Walter Reed, he had been promoted to Lt. Colonel and had been appointed chief of pediatric urology. He earned his medical degree from the State University of New York at Buffalo; served dual residencies in surgery and urology at UCLA; and completed a fellowship in pediatric urology at the Institute of Urology of the University College, London

Case 8: Persons with Disabilities in Institutions

In many countries all over the world parents of children with disabilities are encouraged, and in some cases more or less required, to renounce guardianship of their children and send them to be housed at state-run institutions (or less frequently in private institutions). Once a child is institutionalized, it is very difficult or even impossible for the child to leave. The child’s legal authority to make decisions for himself or herself is revoked. Once a person is declared legally incompetent, it is almost impossible to have legal capacity restored, even in adulthood.

These institutions are known to be places where human rights violations occur. Organizations such as Human Rights Watch, Disability Rights International, and the Mental Disability Advocacy Center have monitored such institutions and documented gross misconduct, including neglect, abuse, and violence. Women and girls with disabilities find themselves in especially vulnerable conditions, as watchdog organizations have reported numerous instances of abuse, including sexual assault.  In some cases state authorities have even acknowledged these violations, and they have made efforts to improve monitoring and to prosecute perpetrators.

One solution that has been implemented in several countries is the sterilization of girls and women with disabilities. This practice is intended to avoid unwanted pregnancies from rape, but it has been decried by human rights organizations. Especially troubling is the existence of documented cases of sterilization without informed consent. In response, authorities argue that the laws and customs of the state necessitate these extreme measures. In some countries abortion is illegal, and they don’t want women to be forced to carry children conceived through rape.

One recent case in India received international attention when a young woman with intellectual disabilities, who had become pregnant as a result of rape, challenged a ruling which would have forced her to have an abortion. In court, the state argued in favor of abortion since the young woman was regarded as legally incompetent and therefore incapable of providing for the child, due not only to her intellectual disability but also to the fact that she resided in an institution. Her lawyers argued that she firmly expressed the desire to keep the baby even though it was conceived as a result of rape. 

Study questions:

1. What obligations does society have to people with intellectual disabilities? What is the relationship between the obligation to protect persons from harm, and their right to personal autonomy?
2. Is a declaration of legal incompetence ever justified? If so, under what circumstances? 
3. Is it ethically permissible to encourage or require sterilization or abortion as a way of protecting vulnerable women from sexual assault and unwanted pregnancy?
4. How do you think the judge should rule?

Author: Michael Szporluk has been working in the international relief and development field for more than two decades. He has worked in Serbia, Bosnia and Macedonia for local and international organizations on a range of development and dialogue projects, and led the European Centre for Minority Issues’ Policy Dialogue Initiative in Macedonia. Michael spent four years as a research officer and analyst in the Office of the Prosecution at the International Criminal Tribunal for the former Yugoslavia. For the past eight years, he has focused on advocacy for the universal rights of persons with disabilities across the world. His most recent publication is a strategic plan, commissioned by the city of Portland, Oregon, to increase employment as well as access opportunities of persons with disabilities. Michael grew up in Ann Arbor and is a graduate of the John F. Kennedy School of Goverment at Harvard University with a Master's Degree in Public Policy.    

Case 9: Informed Consent

The social media site Facebook is used by over a billion people all over the world for a variety of purposes. Facebook operates a research branch that conducts studies on its users, investigating everything from responses to different types of advertisements, to those stories people are more likely to read, to whether or not predictions can be made about someone’s behavior from their posts on Facebook.

In 2014, Facebook and collaborators at Cornell University published a study in Proceedings of the National Academy of Sciences. This study tested whether exposure to positive and negative emotions led people to change their own posting behavior — for example, whether exposure to positive emotional content led people to post more positive pictures, statements, etc. This study was conducted by removing positive posts in the news feeds of one group of people and removing negative posts in the news feeds of another group. In total, 689,003 people’s Facebook pages were manipulated as part of this experiment (Kramer et al., 2014).

This experiment was conducted without informing any of the subjects before or after it was conducted. That is, the researchers did not get informed consent from their subjects. Informed consent is one of several ethical principles that guide scientific research conducted on humans. Most generally, the requirement of informed consent mandates that people must be informed of potential risks of participation in a given study before they agree to participate. In some cases, not all of the details of the experiment are given to potential subjects, as full disclosure may bias the data. But even in these cases, participants are informed of potential negative outcomes before giving their consent, and often they are given the full details of the study after it is completed. Neither of these measures was taken in the Facebook study. In addition, every academic institution that conducts studies on human subjects has an Institutional Review Board (IRB) that determines what the potential harm participants could suffer and what information must be given to potential participants both before and after the study is conducted. 

In their paper, the authors state, “[The study] was consistent with Facebook’s Data Use Policy, to which all users agree prior to creating an account on Facebook, constituting informed consent for this research.” They also stated that “[b]ecause this experiment was conducted by Facebook, Inc. for internal purposes, the Cornell University IRB [Institutional Review Board] determined that the project did not fall under Cornell’s Human Research Protection Program.”

The study was met with an overwhelming outcry from the scientific community, who argued that the absence of informed consent violated fundamental and well-established best practices of human research. These practices are laid out in the “Common Rule,” a set of regulations provided by the U.S. Department of Health and Human Services. The journal that published the study, Proceedings of the National Academy of Sciences, claimed that, as a private company, Facebook was “under no obligation to conform to the provisions of the Common Rule when it collected the data used by the authors, and the Common Rule does not preclude their use of the data. Based on the information provided by the authors, PNAS editors deemed it appropriate to publish the paper. It is nevertheless a matter of concern that the collection of the data by Facebook may have involved practices that were not fully consistent with the principles of obtaining informed consent and allowing participants to opt out.”

Study questions:

1. Was it ethically permissible for the Facebook and Cornell researchers to conduct this experiment in the way they did? Was it permissible for PNAS to publish the results?
2. Does Facebook users’ agreeing to Facebook’s terms of service mean they gave informed consent to participate in this research?
3. What does a private company like Facebook owe to its users, many of whom use Facebook to have private conversations and to share personal information?

Author: Carrie Ferrario, PhD, is a Neuroscientist and Professor at the University of Michigan Medical School, where she studies the effects of obesity and drug addiction on the brain. She grew up in New Jersey and has lived in Ann Arbor since 2001. In addition to conducting lab-based research, Dr. Ferrario teaches a wide range of students at UM, from freshmen undergraduates to students in the medical school.   

Case 10: Conflicting Interests

You are a county commissioner, elected to represent your local community. You’re one of nine commissioners on the county board. Most of you are in the same political party, and you have worked together for several years.

One day, Commissioner Jones asks if he can talk to you privately about something that’s on his mind. Commissioner Jones is a friend of yours. He’s very charming, is a compelling speaker, and cares about many of the same issues that are important to you. He is also married to a state legislator, who’s a powerful ally in your political party. In fact, Jones has many strong family, social, and political connections. These connections will be important to you if you decide to seek higher political office. You’d need their support.

You agree to meet with him. At the beginning of the meeting, Jones asks for the discussion to remain confidential, and you agree. He then tells you that he’s interested in applying for a high-paying job within the county. The job has been vacant for several months. The person responsible for hiring – the county administrator – is supervised by the county board of commissioners. This means that, in his current position as a commissioner, Jones is the boss of the person who’ll make the hire for the job that Jones wants.

Jones really wants this job, and thinks he’d be great at it. But he doesn’t want to tell anyone about his interest publicly, because he’s also running for re-election this year. Currently, it’s unlikely that he’ll face any opposition. However, that might change if people know he’s applying for this county job. He would have to resign as commissioner if he got the job.

Jones tells you that he’s worried about the timing of this decision. He wants to make sure that he either gets re-elected or gets the county job. If he resigns, the county board is responsible for appointing someone to fill his seat until the election. He tells you that he’s been talking to people who might be interested in replacing him on the county board. None of this is known to the public, and Jones wants to keep it that way.

You feel uncomfortable because you see that this is a clear conflict of interest for him. You also are disturbed because he’s trying to manipulate the system to his advantage, out of public view. But he’s your friend and political ally. If you insist that he resign, you might alienate him and hurt your own political future.

The county board meets publicly in a week. In the meantime, you need to decide what to do.

Study questions:

1. At next week’s meeting, what statement, if any, should you make about this situation?
2. What is your responsibility to your constituents as an elected public official? What your responsibility to Jones as a friend? Which responsibility takes precedence?
3. What are some concrete actions that you can take to help prevent this type of situation from happening in the future? For example, some communities have “revolving door” laws that prevent elected officials from seeking employment until at least a year after they leave office.

Author: Mary Morgan is founder and executive director of The CivCity Initiative, a nonpartisan nonprofit that’s fighting civic apathy. She is former publisher of The Ann Arbor Chronicle, an online news site focused on covering local government.

Case 11:  Shady Plumbing

You are a project manager for an up-and-coming custom builder and renovator in Michigan. You are working on an upstairs master bath remodel that includes a huge clawfoot tub and custom tile shower installation.

While removing the old tile and subfloor to install the necessary plumbing for your project, you discover that there has been some improper plumbing done in the building’s upstairs laundry unit. The current owners have informed you that they have lived there only a short time, and they have stated that everything seems to be working fine. So the improper plumbing was presumably done either by the previous owner or by a contractor that they hired.

The work you are doing will not come into contact with this previous work. So, if you say nothing, you will not be responsible for any issues that arise as a result of these past errors. But it looks as though they could create problems in the future that would cost the building’s current owners a lot of money to fix.

You cannot contact the homeowners, as they are out of the country on holiday. This means that it would be difficult to get approval for extra work. You could stop work on the project until the homeowners return and then discuss the situation with them, but they deliberately timed the renovations and their holiday to minimize inconvenience for themselves. Moreover, you are already on an extremely tight schedule. To stop and wait or to try to correct the improper plumbing at your own expense would put you behind, and the delay would likely upset the next customer on your schedule.

Study questions:

1. What is your responsibility to these homeowners?
2. Once someone has signed a contract, do they ever still have a duty to do more than the contract specifies? If so, then what are these duties, and when do they apply?
3. Does the fact that you are the manager of this project, as opposed to a lower-level employee, make a difference to what you should do? If so, why?

Author: Bill Burroughs is a Project Manager with William Charles Custom Homes in Saline, Michigan. Prior to his career with Charles Custom Homes, Bill has worked in real estate, mortgage banking and investment. One of his crowning achievements is appearing in an episode of the DIY Networks Man Caves, Fireman’s Pub in Parsippany, New Jersey. 

Case 12:  Pacemaker

The pacemaker has become a critical medical device extending the life of millions of cardiac patients.  Implanted in the chest of the patient, it provides an electrical signal that paces the heartbeat, compensating for failures in the patient’s neurological system. 

Currently, pacemakers are powered by batteries.  The average life of a pacemaker battery is approximately five to fifteen years. Technology permits monitoring the battery and estimating when the pacemaker has less than ninety days of battery life remaining.  This permits the scheduling of an operation to replace the pacing mechanism before the patient is in crisis.  The operation is fairly simple and involves relatively little risk.

Martha and Mike are Aunt Jean’s niece and nephew and her only living relatives.  They have a loving relationship.  Aunt Jean has an estate of several million dollars, having been a successful business owner who said she wanted to live to one hundred.  Her estate plan provides that all of her assets are to be split equally between Martha and Mike.  Aunt Jean is now ninety-five, having had a pacemaker implanted when she was ninety.  At that time, she still lived independently and managed her own affairs. In the last two years, however, her physical and mental health have declined dramatically.  She can no longer manage her personal affairs, including her medications. About eighteen months ago, she moved into an assisted living facility. She is pleasant to everyone, but sometimes fails to recognize Martha.  Physically, she is incontinent. She can, with effort, walk with a walker.

Aunt Jean’s cardiologist has determined that her pacemaker needs to be replaced.

Some years ago, Aunt Jean signed a healthcare power of attorney designating Martha and Mike as her advocates in the event she would be unable to make decisions for herself.  As per the terms of the document, Aunt Jean’s physicians have determined that she is unable to participate in determining the course of her health care. 

Aunt Jean’s medical team has asked Mike and Martha how to proceed.  The surgery is regarded as relatively low risk and replacement should allow the new pacemaker to operate for another five or more years.  Without the surgery, the pacemaker will cease operation in about seventy-five to ninety days, with the result that Aunt Jean would likely die within days.  Her death would be very peaceful.

Study questions:

1. What should Martha and Mike tell Aunt Jean’s medical team? Would the answer be different if she had said she never wanted to live to one hundred? What if she had never indicated a preference either way?
2. Suppose Aunt Jean had severe dementia, such that she no longer recognized Martha and Mike; could not participate in coherent conversation; and spent her days slumped over her wheelchair. How would that change the moral dimensions of the decision? 
3. Suppose instead that Aunt Jean has arrived at this point without a pacemaker, but now needs one. The operation is relatively simple and is performed under local anaesthetic. Should Martha and Mike consent to the surgery?

Optional background reading:

1. http://newoldage.blogs.nytimes.com/2014/01/29/a-decision-deferred-turnin...

2. http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodi...

3. http://newoldage.blogs.nytimes.com/2012/06/07/a-heart-quandary/?_r=0

Author: William L. Ball is a retired automotive executive who spent most his career in public policy.  In retirement, he consults on issues regarding connected vehicle technology.  He serves on the board of a large, non-profit provider of aging services in Michigan.  He volunteers as a mediator with the Dispute Resolution Center (DRC) in Ann Arbor and has participated on DRC’s team for the A2Ethics Big Ethical Question Slam.  He holds a BChemE and J.D. from the University of Minnesota and an MBA from Stanford University.

Case 13: Athlete Dissent and the National Anthem

On August 14th, 2016, Colin Kaepernick, the backup quarterback for the San Francisco 49ers, sat on the bench during the National Anthem in a show of protest. His actions weren't noticed by the general public or the media until the 49ers' third game of the pre-season on August 27th. After this game, Kaepernick was questioned for over eighteeen minutes about his decision to sit.[1] Kaepernick told reporters that he would not “show pride in a flag for a country that oppresses Black people and people of color.”  He spoke out about police violence toward minorities and the killing of unarmed Black Americans, saying, “This isn't for publicity or anything like that. This is for people that don't have a voice."

It is customary at sporting events to play the National Anthem prior to the start of the event, and for those in attendance and participating in the game to stand to attention. But there is no law or written policy requiring anyone to oblige. 

The NFL issued a statement stating that players are encouraged, but not required, to stand during the National Anthem.  The San Francisco 49ers also released a statement: "In respecting such American principles as freedom of religion and freedom of expression, we recognize the right of an individual to choose to participate, or not, in our celebration of the National Anthem." By and large, head coaches in the NFL have expressed guarded acceptance of Kaepernick’s protest.[2]

However, Kaepernick has been openly ridiculed by many in the media, especially on social media, for his “show of disrespect and selfishness.”[3] Critics argued that he makes too much money to speak on this matter; that he is imposing his personal views on his fans; and that ultimately he is paid to play football, not to protest. ESPN commentator and NFL Hall of Fame member Mike Ditka even suggested that Kaepernick “get the hell out of the country” if he doesn’t like it.[4] Kaepernick’s most prominent detractors are white males.

Many members of the U.S. military have criticized Kaepernick for protesting during the National Anthem, finding it disrespectful. But others have argued that the reason they choose to fight for their country is to defend the very freedom of expression that Kaepernick is exercising. Kaepernick's supporters also argue that the relationship between the National Anthem and the U.S. military has been overemphasized, with not enough emphasis placed on civilians who also fight for human rights - including many athletic heroes such as Jackie Robinson, Roberto Clemente, John Carlos, Tommie Smith, and Muhammad Ali.

Some other athletes have started to join Kaepernick in protest. One of the first was Megan Rapinoe, an Olympic Gold Medal-winning soccer player. However, after Rapinoe first chose to kneel in solidarity with Kaepernick, the Washington Spirit (a franchise of the National Women's Soccer League) altered its pre-game ceremony, playing the National Anthem while teams were still in their locker rooms so that Rapinoe wouldn't get the chance to kneel again. [5]

In November 2015, a report commissioned by two Arizona Senators found that the Department of Defense had spent over $53m for patriotic displays at sporting events between 2012 and 2015.[6] However, according to this report, the Department of Defense “cannot accurately account for how many contracts it has awarded or how much has been spent.”

Study questions:

1. Do athletes have the right to protest while in uniform?
2. Is sitting down during the National Anthem disrespectful? If so, why?
3. If a person has a platform they can use to reach a wide audience, does that platform provide them with a stronger obligation to advocate around certain issues than they would otherwise have?
4. Kaepernick’s protest is about contemporary race relations in the USA. Would things be different if it was about something else?

[1] https://www.youtube.com/watch?v=ka0446tibig

[2]http://www.chicagotribune.com/sports/football/ct-nfl-coaches-colin-kaepe...

[3]http://nation.foxnews.com/2016/09/11/musings-average-joe-nfl-coward-kaep...

[4]http://www.complex.com/sports/2016/09/mike-ditka-tells-colin-kaepernick-...

[5] http://edition.cnn.com/2016/09/08/sport/megan-rapinoe-washington-spirit-...

[6] http://www.sbnation.com/2015/11/4/9670302/nfl-paid-patriotism-troops-mca...

Author: Robert Haddad lives in New Jersey and is a 1998 Sport Management and Communications department graduate from the School of Kinesiology at the University of Michigan, where he was also the Chair of the Alumni Society from 2012-2015.  He currently works in business development for SocialFlow, a social media technology company that creates publishing software for publishers and media companies (like The New York Times, BBC and Wall Street Journal) to improve and centralize distribution of their content to platforms such as Facebook and Twitter.  Prior to his current career, Robert spent 16 years at Major League Baseball Productions as a Director of Documentaries and head of their field production department. He won an Emmy Award for his involvement on the Showtime series, "The Franchise: A Season with the San Francisco Giants" in 2011 and directed seven consecutive World Series Films from 2008-2014.  

Case 14: Armed Police

Lately many people have been paying attention to the use of lethal force by police. Many people think that police violence is excessive, and studies show that it disproportionately affects Black people.[1] As a result, police departments across the United States have started implementing training programs to address police violence and the related issue of systemic racism. However, some people believe that training programs are not enough to address these issues. They think that in addition to training police more effectively, police departments should take away many of their guns.

On one hand, some people believe that a world in which police officers do not carry guns (or a world in which most police officers do not carry guns most of the time) would be better overall than a world in which they do. They think that when police are armed, they are more likely to use excessive violence, especially against Black people. Granted, if police did not carry guns, there might be some cases in which they were less able to prevent violence than they are now. But there would also be many cases in which they were less able to cause violence than they are now, and the hope is that the good effects of disarming police would outweigh the bad. Indeed, in countries such as Iceland, Ireland, Britain, New Zealand, and Norway, most police officers do not carry guns, and the results seem to be positive.[2]

On the other hand, many people believe that a world in which police officers carry guns is better than a world in which they do not. They think that police officers need guns to perform their duty – to protect citizens from the threat of dangerous criminals who intend to harm them. They also think that police officers need guns to protect themselves. After all, we are asking them to do a dangerous job. How can we ask them to serve and protect and then take away their means for doing so safely? Especially since, as Police Academy trainer Richard Fairburn points out, if some police officers are not armed, then others might have to risk their lives to save them.[3] Indeed, even in places like the United Kingdom, people regularly debate whether or not to arm more officers whenever an officer dies on duty or whenever a terrorist attack takes place.[4] Gun violence and terrorism are here to stay, and police need to be armed so that they can be prepared to confront any threat that might appear.

Study questions:

1. Given that police officers already have risky jobs, is it morally permissible to make them even riskier for the sake of improving public safety overall?
2. How, if at all, would things be different if police violence did not disproportionately impact Black people?
3. How, if at all, would things be different if the general public had less access to guns as well?

 

[1] http://www.nytimes.com/2016/07/08/us/study-supports-suspicion-that-polic...

[2] https://www.washingtonpost.com/news/worldviews/wp/2015/02/18/5-countries...

[3] https://www.policeone.com/police-products/firearms/articles/1716565-Why-...

[4] http://www.huffingtonpost.com/robert-koehler/should-the-police-be-arme_b...

 

Author: Written by the 2016-17 National High School Ethics Bowl Regional Case Set Committee Members.