The Business Ethics Blog

Arthur Caplan (a very prominent U.S. bioethicist) has a good column on breast cancer genetic test over at MSNBC: Breast cancer gene tests — not worth the price?

Fear of breast cancer has created a tempting market for companies to sell genetic testing directly to consumers. The disease kills 40,000 people a year in the U.S., with an estimated 212,920 new cases diagnosed in 2007, according to the Mayo Clinic.

It’s no wonder women would want a reliable gauge of their risk. However, American women should be aware that genetic tests for breast cancer are more hype than real hope.

At least two companies, now — Myriad and deCODE Genetics — are offering genetic tests that they claim can, at very least, help women assess their risk for breast cancer. But according to Caplan (and many other commentators) the value of these tests (which cost thousands of dollars) is very much in doubt.

According to Caplan,

Of the more than 200,000 new breast cancer cases, only about 20,000 seem to be connected to the BRCA1 and BRCA2 genes — the genes most closely linked to the inherited form of the disease that Myriad’s test can detect. For women without a family history of the disease, perhaps 1 percent would benefit from the test.

Note that if a product that costs, say, $2,000 is useful only 1% of the time, that means from a social point of view each useful test effectively costs $200,000. Or, it means spending $2,000 on something that has a 1% chance of telling you something useful (though note that the info won’t prevent or cure cancer). So, from a consumer point of view or a social point of view, the tests are pretty ridiculous. Caveat emptor, to say the least!

Caplan’s prescription is more regulation, and that very likely is a good idea. Genetic technologies just aren’t the kinds of products you can expect consumers to understand well, and such serious information asymmetries constitute a classic case for regulation. In such cases, regulation is actually required to promote the goals of a free market (i.e., mutually advantageous, wefare-enhancing exchanges).

What about the ethics of selling a not-very-useful test, or a not-very-useful product more generally? (Note that I’m talking about ethics, not law. It’s mostly legal to sell not-very-useful products. There’s no law against selling Tarot cards or holy water or books on the healing power of crystals. Of course, those things don’t typically cost thousands of dollars.) But the analogy is of course an unfair one. Genetic testing is rooted in science, and even if it’s not as useful as the marketing would have us believe, it’s a far cry from the wares hawked by self-proclaimed psychics, mediums, and faith-healers. Yet in both cases, someone is selling something that is highly unlikely to prove useful, and it is highly unlikely that buyers will know that in advance. There are certainly other products, the objective value of which is pretty unclear but the sale of which is not considered unethical. Will buying a Corvette win you the respect of your snooty neighbours? Probably not. Will wearing Axe deodorant really make you a hit with the ladies? Not likely. But then, reasonable people (even without a PhD in psychology or biochemistry) know that, or would if they stopped to think for just a second or two. The value of such products — their ability to deliver what consumers want from them — is suspect, to say the least.

One thing that helps make genetic testing a reasonable product is the fact that potential consumers can’t (for now?) order the test directly. According to deCODE’s press release, for example: “deCODE BreastCancer™ is a DNA-based reference laboratory test performed using a simple blood sample or cheek swab, ordered by physicians on behalf of their patients.” [emphasis added] This means that women interested in the breast cancer gene test have to go through their physician, who (maybe!) understands the limits of the test well enough to advise her on it. Other companies are offering other genetic tests “direct-to-consumer,” and those are more problematic. But even a test that has to go through a physician is open to question. For starters, many physicians are not well trained in genetics, and others will simply be swept along by a patient’s zeal and agree to order the test, regardless of its appropriateness. The net result is that these companies are walking a very fine line, by advertising directly to consumers an expensive, hard-to-understand product that is useful to few but taps into a fear shared by many.

Yesterday I blogged briefly about a story on monkey waiters in Japan. I made a few tongue-in-cheek comments about the likely ethical issues, but I got email asking what I really think about this story, from an ethical point of view.

I don’t see any problem with the monkey waiters. The gentle version is that the monkeys seem (based on too little evidence, admittedly) to be happy & well cared for. They’re not being abused in any noticeable way (and they “labour” in full public view, where abuse would be noticed). I’m guessing they’re happier than 99% of captive monkeys (they’re not caged, and they’re engaging in considerable social interaction, getting healthy treats, etc.), and perhaps happier (certainly safer) than most wild monkeys.

The harsher line of argumentation is that all of the above is really just aesthetics, not ethics; animals are outside the moral realm entirely. Ethics is a human cultural construct to help us get along together. That leaves animals mostly beyond its limits. To the extent that you could argue for reciprocal good treatment for animals capable of reciprocity, the situation described in the story seems pretty mutual. I realize there is a lot more to be said here, but that is basically my take on the relation of ethics to animals. (Please note that this argument is not an argument against kind & sympathetic treatment of animals. Far from it. It’s just a technical point about the extent of the social mechanism we call “ethics.”)

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p.s. for a philosophical exploration of the extent to which at least some animals could be part of the “social contract,” see this essay I co-wrote: Beastly Contractarianism? A Contractarian Analysis of the Possibility of Animal Rights.

And now, on the lighter side of business ethics… Monkey waiters. Yes, monkey waiters. This would make a great first case-study in a spoof ‘textbook’ on business ethics.

Pictured: The amazing monkey waiters that serve tables in a Japanese restaurant

A Japanese restaurant has changed the face of customer service by employing two monkeys to help with the table service.

The Kayabukiya tavern, a traditional ‘sake house’ north of Tokyo has employed a pair of uniformed Japanese macaque called Yat-chan and Fuku-chan to serve patrons.

Twelve-year-old Yat-chan is the crowd-pleaser as he moves quickly between tables taking customer drink orders.

So, what would be the burning issue, here?
Denying jobs to low-skilled humans by “outsourcing” to another species?
Forced animal labour?
Imposition of a dress code, contrary to the standards of the species?
Or, as some would have it, fostering the beginnings of the Great Monkey Uprising?

Laugh all you want. You know someone, somewhere, thinks there really is an ethical issue here.

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Thanks to my pal Andrew Potter for the link.

Here’s an intriguing piece. Blogger/columnist Violet Blue interviews advertising expert & blogger Steve Hall for the San Francisco Chronicle. The topic is sex in advertising, and in particular whether, as the old saying goes, sex sells.

Sex Doesn’t Sell: Violet Blue says that if you think “sex sells” then you’re not paying attention.

The whole thing is worth reading, but the normative question comes right at the end:

VB: Should there be more sex in advertising?

SH: Yes and no. Yes, in the sense that sex is normal. It should not be taboo. It should be a normal part of everyone’s life and so therefore should be represented as such in advertising. No, because it’s just too easy and makes for too much bad advertising. And the sexual content in a sexually-laced ad can overshadow the product being promoted and therefore make it even more difficult to remember what the ad was actually promoting.

I’m currently spending the fall as a Visiting Fellow at Duke University’s wonderful Kenan Institute for Ethics.

One of the many interesting projects here at Kenan is an online evaluation tool called Measure Up, “an online assessment tool to help you understand the strengths and weaknesses of your organization’s ethical culture.”

The Measure Up instrument is, of course, just a very brief, thought provoking start at assessing an organization’s ethical culture (the Kenan folks are interested to work with organizations to provide fuller assessments). But it’s worth noting the value inherent in simply working one’s way through the questions the instrument asks. The process is probably just as valuable as the outcome. It’s worth something simply to sit down and think through questions like, “Do leaders at my organization genuinely encourage input?” and “Does my organization genuinely take the concerns of outside stakeholders into account when making decisions?”

What’s a personalized genetic blueprint worth? Yesterday the NY Times (and everyone else!) ran a story gushing about how a new-ish company called Complete Genomics is about to start offering to map an individual’s entire genome for the bargain-basement price of $5,000. Five grand isn’t pocket change for most of us, but being able to get a complete genetic blueprint for the price of a used car is pretty cool, given that the very first complete human genome ever was published just last year.

Less clear, of course, is just what you’ll get for that price — after all, a printout listing the 3 billion or so base-pairs (the fundamental units making up the DNA molecule) that make up my genome doesn’t exactly foretell my future or tell me how to live my life. The raw data has to be interpreted, and in many cases (since the function of various genes, and the relation between some genes & diseases) is unclear, the process of interpretation is itself fraught with danger.

So, how does a company responsibly advertise a product, the health benefits of which are so poorly understood even by experts?

At least some personalized genetics companies promise other kinds of benefits. One of the most prominent “personalized genetics” companies, 23andMe, has just issued this press release, announcing:

a world-wide effort to assemble the largest cohort of women whose lives have been impacted by breast cancer and to build an infrastructure, based on genetics, that will accelerate consumer-based research of the disease.

One of the most significant benefits offered by 23andMe’s breast cancer project is the opportunity to be part of a community of women sharing similar experiences. Well, that’s the hope. But of course unlike most social networks (such as Facebook and MySpace), 23andMe’s social network isn’t free (in fact it’s now available at the new, reduced price of $399). Stay tuned. Advertising the benefits — and making clear the distinction between medical benefits on one hand and psycho-social benefits, on the other — is going to pose ethical challenges for companies advertising personalized genetics over the coming years.

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For comments from a different angle, see the posting over at the Research Ethics Blog.

From the autoblog:

Ford announced today a new technology called MyKey that will be standard on the 2010 Focus Coupe and quickly spread to the rest of the Blue Oval’s lineup. MyKey can do three basic things: allow parents to limit a vehicle’s top speed to 80 mph and/or the stereo’s volume up to 44% of its max, and set a sustaining chime if the seatbelts aren’t being used. Clearly targeted towards worry wart parents, the MyKey system is meant to keep teens safe despite their protestation that a system like this curtails their kiddy freedoms. Ford did some polling and found that 67% of teens didn’t like the idea, though that number fell to 36% if the MyKey system led to parents letting the kids use the car more.

The product has engendered a surprising amount of debate — mostly criticism — in the comment sections of various blogs. Most of the comments (see here and here, for example) criticize the product for promoting invasive parenting, or say things like ‘there’s no way this will keep kids 100% safe.’ Yeah, well duh! No product is ever designed to produce 100% safety. That would be impossible, and it’s (therefore) a silly criticism.

As for the criticism that this kind of product permits/encourages invasive parenting, consider 2 points:
1) as “big brother” products go, this one is pretty mild. No actual surveillance (e.g., no electronic reporting back to Mom & Dad on Jr’s driving habits) and nothing covert — there’s no aspect of parental surveillance or control that is hidden from these young drivers. So it is totally unlike, e.g., computer software that covertly monitors & reports on kids’ web-surfing habits.
2) If invasive parenting is ever justified, monitoring and restricting teen driving habits has got to be pretty high on the “allowable” list, given the evidence about the quality of judgment exercised by young drivers, and the potential consequences — e.g., death to your kid and their friends. We’re not talking about preventing Jr from seeing naked people online, here. As “nanny” products go, this one seems an ethical winner.

What do you think?

The John Templeton Foundation has placed online this outstanding symposium on the question, “Does the free market corrode moral character?” The answers take the form of short, readable essays by a dozen or so very sharp minds (including philosopher Michael Walzer, economist Tyler Cowen, and even chess-champ-turned speaker & activist Gary Kasparov). A few of the respondents answer with a resounding “No!”, while a couple answer with a half-hearted “Yes, sort of.” Perhaps not surprisingly, a lot of the answers amount to a balanced, “Yes and no,” or “It depends,” or “Yes, but free markets are still better than the alternative(s).” I’ve read about half of the answers, and all so far are excellent.

It’s worth noting (and several of the essays hint at this) that the question is ambiguous. Just what do you mean by “the free market?” Do you really just mean free markets per se in all their manifestations? Or do you mean the kind of free market dominated by the modern, widely-held, professionally managed corporation? Do you mean Russian free markets, or Swiss free markets? Or do you mean (as many people seem to when they refer to the ‘free market’) 21st Century globalization? It seems likely that whatever moral effects we observe — whether positive or negative, and whether outweighed or not by other effects — are going to find their source not just in the basic practice of free (voluntary) exchange, but in the particular mechanisms, conventions, and institutions through which trade is carried out. As with any complicated system, the key to getting the most (socially) out of the free market is to figure out which risks must be accepted, which can be mitigated, and which can be eliminated, and at what cost.
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Note: I’ve fixed the previously-broken link above. Thanks, Will!
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Relevant Books:
Moral Markets: The Critical Role of Values in the Economy edited by Paul J. Zak (with a forward by Michael C Jensen) [Thanks to Jim for correcting me on authorship here!]
Moral Basis of the Market Economy by Brian Griffiths
Morals and Markets: An Evolutionary Account of the Modern World by Daniel Friedman

A new series of ads from Mitchum deodorant (made by Revlon) range from sophomoric to sexist to, well, promoting/condoning behaviour that could range from invasion of privacy to sexual exploitation. See the image above (click on it to see a larger version).
Clearly, what goes on between 2 consenting adults and their favourite photographic equipment is up to them; violating the terms of that consent is not cool, nor is condoning or promoting such behaviour as a sign of manliness.

(Hat tip to the gang at Feministing.)

I’m curious to know what business ethics-related blogs you read, other than mine.

This blog has been running for nearly 3 years, which is a pretty long time; quite a few other business ethics-ish blogs have come & gone. Back in the day, I used to know pretty much all of the relevant, related blogs. Now I’m pretty sure I’ve lost track.

So if you know of any I should know about, please use the Comment function below to let me know of any blogs you know about — ones worth knowing about, in areas like:

• business ethics;
• corporate social responsibility;
• sustainability;
• corporate governance;
• etc

Please give the name and URL of the blog you suggest. If its relevance isn’t obvious from its title, please give a bit of explanation.
Yes, if you’re a blogger feel free to suggest your own blog (as long as it’s relevant).
I’ll do a posting next week summarizing the results.