Otolaryngology- Head and Neck Surgery JULY 1997 VOLUME 117 NUMBER 1 NEEL DISTINGUISHED RESEARCH LECTURER Clarity of judgment society addicted to during amoral times in a codified law MARIANNE M. JENNINGS, JD, Tempe, Arizona Amid the public and media outcries about ethics, there is a continuing theme. The universal theme in the reaction to ethical scandals is the expression of sur- prise. How could this cheating scandal have permeated the U.S. Naval Academy? How did the activities of a trader go on for so long without another employee objecting or reporting him or her to a supervisor? How did this product go on the market when there was prior knowledge of a problem with its safety? The surprise relates to the magnitude of the lack of judgment among the participants in these ethical scandals. Why would Orange Cotmty Treasurer Robert Citron .risk so much money on a stock market bet? Why would Mike Espy, a cabinet member with strong credentials, accept a free flight from Tyson Foods, a company regalated by the Department of Agriculture he headed? Why did officers try to conceal the Navy Tailhook scandal? The surprise and outrage should not come so easily. These are times of grayness, Times of rationalization. Times that no longer permit declarations of right and wrong. Murder isn't murder if the person you killed From the Lincoln Center for Applied Ethics, College of Business, Arizona State University. Presented at the Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery,Washington,D,C., Sept. 29-Oct. 2, 1996. Reprint requests: Marianne M. Jennings, College of Business, Arizona State University, RO. Box 873706, Tempe, AZ 85287- 3706, OtolaryngolHead Neck Surg 1997;117:1-6. Copyright @ 1997 by the AmericanAcademyof Otolaryngology- Head and Neck SurgeryFoundation, Inc. 0194-5998/97/$5.00 + 0 23/1/81514 made your life difficult. And there is no such thing as criminal conduct for those who had a trying child- hood. Slowly there has been an evolution from a society grounded in religious values to one that remains detached and amoral. There is an addiction to positive or codified law. Codified law is the sole determinant of our standards of behavior. If there is not a specific pro- hibition against conduct, it is appropriate. And even when a prohibition does exist, any violation or sanction must be tempered with a consideration of mitigating factors. The addiction to codified law and individual rights at the expense of the whole leaves us with a col- lective lack of wisdom and judgment. How scandals happen is not the question. The more appropriate ques- tion is are we too late to stop the cycle that most assuredly will continue without a refocus on basic va!- ues? There can be a restoration of values that is the key to curbing our addiction to law and increasing the power of wisdom and judgment in the resolution of one of our most challenging issues: the delivery, structure, and pricing of medical care. Before that restoration of values can take place, it is important to examine certain assumptions about the status of society and health care today, for it will be these assumptions that will drive the value structure. ASSUMPTIONS MADE FOR THE REINTRODUCTION OF CLARITY OF JUDGMENT Assumption One: Society is Addicted to Positive or Codified Law Gone are the days when manners were the standards of behavior and it was sufficient to label conduct inap- propriate because it "wasn't right." Six-year-old