Dr. Otis Brawley is one of the good guys. He is a distinguished oncologist with all the professional awards and certificates that a physician could possibly want. He has written more than 200 scientific articles and his brave and insightful book How We Do Harm: A Doctor Breaks Ranks About Being Sick in America led us at Ethics Unwrapped to reach out to him once upon a time in an ultimately unsuccessful attempt to partner to create a video on medical ethics. Dr. Brawley has been honored for his post-Katrina work in New Orleans with the Public Health Service.
Dr. Brawley recently faced a difficult ethical dilemma. He was the Chief Medical and Scientific Officer and Executive Vice President of the American Cancer Society from 2007 until November 2018. One of the ACS’s most important goals over the course of its century-long existence has been to raise funds for all-important cancer research. However, its fund-raising efforts in recent years have fallen on comparative hard times.
To fill the void, ACS marketers developed “corporate partnerships” with organizations such as the Tilted Kilt, a chain of sports pubs that feature scantily clad “Kilt Girls” (think Hooters Girls in plaid). Another partner is Long John Silver’s, a fast-food chain that sells mostly less-than-healthy (but really yummy) fried foods. And, finally, ACS partnered with Herbalife, an organization that sells controversial products in questionable ways and has a very checkered history with regulators. For Dr. Brawley, ACS’s association with these firms created a level of discomfort that led him to resign.
This dilemma faces many charities and non-profits. The Susan G. Komen Foundation has been criticized for partnering with KFC and the American Medical Association for agreeing to endorse medical products made by Sunbeam in exchange for donations. On the one hand, charities and other nonprofits usually are seeking to do good work—to help cure cancer, to feed the poor, or (in a case close to home) to make videos to improve people’s moral decision making. Accomplishing these good works requires money, which is often in short supply. The ACS’s Chief Marketing Officer has been quoted as saying: “Our intent with all of our partnerships is to generate as much revenue as we can to achieve our mission.”
Needing funding, organizations such as ACS (and Ethics Unwrapped) seek donors and sponsors, but sometimes they come with demands and occasionally with baggage. An individual donor with a questionable public persona may be willing to write a big check, but want his or her name on the door. A corporation may need to improve its public image and seek to do so by being associated with a good cause like the ACS. While the Tilted Kilt, Long John Silver’s, and Herbalife might not be ideal partners for an anti-cancer crusade, the marketing director for Long John Silvers has said: “Cancer is a disease that has touched all of our lives and it does not discriminate based on who you are or where you work. Frankly, we are disappointed people are offended by any organizations supporting efforts toward finding a cure.”
Who is right here? Was Dr. Brawley right to choose to resign after a decade-long role at ACS? Or was he too sensitive to appearances? Should he, like the ACS CMO, have been more “practical” in light of the ACS’s need to fund research that prompted creation of these corporate partnerships?
Let’s say you’re the chair of the drama department at a private school that can no longer afford a drama department. Disgraced actor Kevin Spacey decides that it is time to rehabilitate his public image and offers a $10 million donation if you rename your drama program after him. You wish to be too proud to accept this donation. But your department may not exist if you don’t. How proud can you afford to be? Would John Stuart Mill laud of you if you made that decision? Or might he say: “Pride goeth before a fall”? When the very life of your program is on the line and all the benefits it generates for student or others is up in the air, does it truly make sense to raise moral objections to the background of a potential donor?
On the other hand, would you want to be known as the Stephen Paddock Department of Drama if the Las Vegas mass shooter had left $10 million to your program in his will on the condition that you change the name of your department? Where should a charity properly draw the line? How odious must the potential donor be before a charity should refuse a program-saving gift?
And what standards should apply here? Should a red deontological line be drawn in the sand, or is this solely a utilitarian calculation? If it is only about consequences, how should a charity weigh the benefit of saving a program’s existence now against the long-term damage the program might suffer from being identified with a sexual predator or a mass murderer or maybe just a company whose products are difficult to square with the charity’s mission?
There are no obviously correct answers to these questions, but the leaders of every nonprofit and charity that relies on donations, corporate partnerships, advisory councils and the like should consider them right now and make some decisions. It is difficult to act ethically on the fly and if behavioral ethics teaches us anything, it is that it will be difficult to ignore the decision makers’ short term interests when it is time to actually decide. They should watch our Concepts Unwrapped video on the self-serving bias. And as they make the decisions, they should also watch our In It to Win video on rationalizations.
Ethics Unwrapped video on the self-serving bias: https://ethicsunwrapped.utexas.edu/video/self-serving-bias.
Ethics Unwrapped video on rationalizations: https://ethicsunwrapped.utexas.edu/video/jack-rationalizations.
Otis Brawley, How We Do Harm: A Doctor Breaks Ranks About Being Sick in America (2011).
Paul Goldberg, Otis Brawley to Leave American Cancer Society as It Pursues “Open-for-Business” Strategy,” The Cancer Letter, Nov. 9, 2018.
Mark Hrywna, “Top Doc at ACS Steps Down,” The Nonprofit Times, Nov. 8, 2018.
Sheila Kaplan, “American Cancer Society Executive Quits Over Corporate Partnerships,” New York Times, Nov. 6, 2018.
Gary T. Rosenthal, “Otis Brawley, Face of ACS, to Step Down as Chief Medical Officer,” Medpage Today, Nov. 6, 2018.