The Office Shakedown

Philanthropic pressure; malpractice pursuit.

Comments: 108

  1. My corporate employer's policy prohibit's the following uses of email:

    · Sending chain letters or mass distributions of non-business information.

    · Usage as a forum for political or religious debate.

    · Solicitation for any private business or cause.

  2. That's a smart policy. Emails like that can cause problems, and/or be a waste of people's work time.

  3. This policy was also in effect when I worked at a major Boston area university some time ago.

    But this did not stop my boss in 2008 from promoting her support for Barack Obama, putting me in an awkward position position during these thinly veiled solicitations since I was not a true believer of Mr. Obama.

    The lesson is that you can have all the policies in place, but unless an employer is committed to maintaining an ethical work environment - which in the example above, I had my doubts - cohesion, in all of its forms, will always be a part of the work environment.

  4. In the 1980's, Florida Power's corporate headquarters in St Pete FL used to strongarm employees into "giving" automatic paycheck deductions to United Way. I told my husband that it was extortionate and if I were to give to a charity, it would not be under duress and it would never be to United Way. He informed me that his manager, like all the other managers, told him they were on the hook to their superiors, and anyone not "voluntarily" contributing would suffer as a result through poor performance reviews, regardless of their merit. So he was coerced into a $600 a year donation that we could ill afford. Shortly afterward it was publicized that a United Way honcho had been blowing United Way money on hookers and booze. To this day, I won't give United Way a dime.

  5. I think you are referring to that small bunch in Arlington VA at UW National caused damage to charities in general and local UWs in particular with more bang for the buck than I can think of in virtually any other industry in the US. (OK, maybe the scrimping on good well cement offshore Louisiana by the BP and Halliburton folks competes.)

    PS. I don't remember prostitutes, just adulterous affairs, but your point stands.

  6. I agree with the Ethicist that filing a lawsuit would be really difficult. Have you thought of writing a letter to your local newspaper about your experience? If it is printed, that would satisfy your feelings of being wronged without a lot of expense and stress.

  7. The boss should not be soliciting donations to a charity on company time. She is pressuring the employees to donate to a charity they care nothing about. This is similar to the situation a few weeks ago of the man who was pressured to donate to the opera by a friend. A boss certainly holds sway over an employee's position in the company and I am sure, deliberately or not, makes decisions based on how friendly a worker is to her charity "holdups". It's not with a gun but there is definite coercion. The one good point that a former "boss from hell" had was not asking us to donate to any charities or using payroll deductions for a cause. My sister worked for a company that used payroll deductions for what it called "fair share" donations. Whose idea of a fair share? It is wrong for a company to tell employees how they should spent any portion of their pay. Charitable donations should be personal and coercion by a boss should not be tolerated and that includes cookies and other worthless items your kids are selling.

  8. "Fair Share" usually refers to the the collection of a portion of union dues from an employee who declines to join the union. The non-union worker still enjoys all benefits negotiated on his/her behalf and so by law must reimburse the union for a portion of the work they did on the employees' behalf. If that is the situation your sister is in, then it most definitely is NOT a matter of unethical charitable contribution, but the repayment of a lawful debt. If her company is really taking money without her consent for a charity, then that sounds illegal.

  9. The situation with the opera was actually quite different. Each man was supposed to be contributing an equivalent amount of money to the other's
    pet cause. One of the two discovered that the other one had not been giving
    the $10,000 a year he had promised.

  10. Your advice to the boss is fine, provided that every employee has the same opportunity to request donations from all the other employees to his or her favorite charity. The boss's status as boss is not relevant to her promoting her charity and should give her no special privileges in this regard.

  11. I am in favor of not allowing anyone to ask for money for charities in the workplace, rather than allowing everyone to do so.

  12. "The boss's status as boss is not relevant"?

    For most of us in the real world the boss's status is very "relevant".

    Do you not think for one moment that getting on the wrong side of your boss, by turning down his/her pet charity would not have direct consequences for you?

    The boss is the person that does job performance reviews, assigns work, and does the hiring and firing - in other words, the boss holds your job in the palm of his/her hand.

    Also do you also realize how foolish your idea is to let everyone in your office have an equal crack at soliciting donations for pet charities?

    Ever heard of the term a "hostile work environment"?

    You would definitely have that - a hostile work environment - when you are known as the person who has the "audacity" to turn down requests for handouts from your co-workers.

  13. Re: malpractice, post your story on reputable online forums where Google can find it; mention the hospital and the responsible people by name. Patients may not routinely research official public records, but people commonly Google their doctors. Also post your story on review sites such as Yelp.

    If you allow the hospital to write up its side and include it in your posts, your posts will gain much in credibility.

  14. " your story on reputable online forums where Google can find it; mention the hospital and the responsible people by name."

    This is a far cry from posting negative comments or complaints about a bad meal in a restaurant, a shabby hotel, or a lousy haircut.

    By making serious accusations (allegations) of malpractice against specific people and institutions on so-called "reputable" online forums might, in fact, put the writer on the receiving end of a slander and defamation lawsuit of his own.

    By writing to the various accredited agencies and medical boards who deal with these specific types of issues, the LW now has a legally-defensible record of his complaints, which can be investigated by the proper officials in those areas.

    Posting allegations and accusations (because that's what they will be construed as - no matter how "reputable" the forum may be) in an internet forum, can be attacked as "unsubstantiated claims" by the attorneys -- and that's exactly what they would be, without any definitive findings from any of those accredited agencies.

    We see stories every day concerning a restaurant or hotel which threatens to sue a patron for having posted an online complaint about bad and over-priced food - or a dingy room with poor housekeeping and an unfriendly staff.

    Imagine the reaction if one were to post the actual names of the hospital, doctors, nurses and staff which treated you.

  15. But do NOT post anonymously! There's far too much hate-spewing and libel going on under the guise of anonymous 'free speech.' If you name others by name, name yourself, also.

  16. Reputable online forums? What a great oxymoron.

  17. For once I agree with both situations' assessments and advice. Oh happy day! Balanced, practical, responsible and merciful.

  18. For a manager to ask subordinates to donate to a charity has hints of extortion. There is no escaping that, however well intended, however noble the charity, even if there is a personal friendship. Unless support of a particular charity was a clear condition of employment it is quite unethical for a manager to do this.

    When an employee requests donations from colleagues (not subordinates) managers must be fair, consistent, and reasonable in giving. Not too much, which might embarass those who cannot afford similar donations, or too little, which might encourage others to give little. It's a tough balancing act, you want to encourage an atmosphere of charitability and community support in the workplace but you're always walking a fine line.

    My pet peeve is when colleagues (not managers) collect money for causes that I regard as highly unworthy, the most objectionable being field-trips for their childrens' sports teams. If a team or a school or a community is genuinely deserving of charity to enable its children to participate in sport, then collecting money to be blown on buses and hotels is sinful. And if a team is not really needy, which in the case of most people whose parents have jobs they are not, then this is not charity, it is just sponging off your colleagues. If i "donate" to your child's overnight football trip, then why don't you "donate" to my "child's", ahem, backyard swimming pool construction fund? Where does this end?

  19. What if she lost the lawsuit?

    Raises the issue of certainty of claim.

    Would the decision allow the "wronged" parties, in the case above--the providers, an outlet to reconstitute their reputation.

    As I read the presentation, I wondered about the "if." The episode, if egregious, should not be an obstacle to move forward. Seek counsel and get an opinion. An obvious case of negligence will be apparent to a lawyer.

    I wonder though: damages and compensation vs. public awareness. Which one does she value more? I could not determine.

  20. Asking for donations at work is extortion. It's totally unethical. Neither the company nor it agents has the right to make assumptions about the private lives of the staff, i.e. the things they value. This includes the United Fund and its many cousins. If there's a bulletin board, it's ok to post pictures or pamphlets, but I don't want my department's % of contribution posted, either. Extortion, remember?

    Malpractice- I second the idea that both sides of the story be posted on site(s) where people typically look to find out about medical providers. It would be ethical to check in a reasonable amount of time to see if changes have been made, and the providers should be so notified. If you're not seeking remuneration, stay out of the courts, please.

  21. Re: malpractice: There really ought to be more public outing of hospitals. A colleague was recently hospitalized and was severely injured by a hospital employee during her stay.

    My colleague also wrote letters--they informed her "these events never occurred."

    Writing letters to hospital administrators, ethic committees, or professional organizations does not make anything public.

    Having said that--malpractice suits are not the appropriate response. Lawyers rarely take on hospital malpractice cases unless it tots up to over a million dollars. They will have to find medical experts willing to testify that what happened doesn't constitute a reasonable standard of care, that the person's current functioning is impaired as a direct consequence, and that the impaired functioning was directly caused due to treatment. Plus, if the person wasn't working, was retired, had grown children, wasn't supporting anyone--it's unlikely to become a case.

    So, as my lawyer advised me--write about them in your diary, vent in your blog, and get over it. And, as I advise people--if anything happens, call a cab, ignore the incoherent screams, and go home. If you're still alive in the morning, get a doctor to make a house call. It's still cheaper than being in the hospital. And safer.

  22. One reason companies do not allow such solittations is that it opens the doors to unionization efforts. Giving one employee the right to sell cookies means the others can sell their own whatevers and allows disgruntled employees the right to lobby fellow employees to unionize. Activity like this is also a drain on productivity and therefore also not in the best interest of the business.

  23. "unionization efforts ..."

    EEEWWWW! Yucky!! Evil!!

    What's next? Socialism?!

  24. Re: Malpractice lawsuit.

    If you want to change the hospital practice and not just get punishment, why not volunteer your case as an "M&M" (Morbidity and Mortality) report? This is where doctors, nurses and administrators talk about what went wrong in a case and how to correct the error in the future.

    I know my wife (who helps run M&Ms at a major teaching hospital) is always searching for doctors and patients willing to open about their experience so others can learn.

    You sound quite reasonable and this would be a positive and actionable way to improve the experience for future patients.

  25. i don't get it. The knowledgeable patient involved in a M&M might well be, er unavailable, eh?

  26. Downhill Racer, complications and poor outcomes are discussed along with deaths. I think Jack's suggestion is excellent. As someone who has lived with years of serious complications after a poor surgical outcome that resulted from easily avoidable physician error, I wish I'd participated in the hospital's M & M. I was too ill at the time and the thought never occurred to me, but in many ways it would have been a liberating act.

    Just to be able to feel helpful, proactive, and involved in some way can be important for someone who's experienced serious complications resulting from medical error. Part of what's so difficult is the sense of vulnerability, the trust betrayed. I completely understand wanting to help protect other potential patients from experiencing the very same problem.

  27. Doesn't the doctor have to agree to the M&M? Not sure this would work, in reality, if the doctor and hospital in the LW's case do not think or do not want to admit they are at fault.

  28. There seems to be an option here that takes away the pressure on the employee and if used shows the supervisor has only altruistic motives. The supervisor can send an email explaining why the charity is important to her and provide a link where people can donate. The charities have an option to make the donation anonymous and the supervisor should request that this option be chosen.

    Sometimes a friend will ask me for a donation, and even though the charity may not mean anything to me, if it is important to them I am happy to help out. This might be the case at work. The anonymous giving satisfies everyone's goals and no one can be hurt professionally or personally if they don't give (except in the special case that everyone who does give leaves their name)

  29. I am offended even if a friend approaches me for a donation to a certain cause. It's the same as passing out your business cards and chatting up people as prospective clients at you dinner party. Crass.

  30. "Sometimes a friend will ask me for a donation, and even though the charity may not mean anything to me, if it is important to them I am happy to help out."

    I occasionally am solicited for a donation to a health charity by one or another of my neighbors. I have grave reservations about contributing to these organizations because I have investigated a number of them (and these include really MAJOR health charities) and found that far too much of their income goes to salaries and the expenses of fund raising and far too little goes to further research in the disease or treatment of those affected.

    I generally refer my neighbors to good sources of information about the finances of these charities, but I suspect they are not at all interested.

  31. I strongly disagree about the malpractice lawsuit. I speak from experience, though I can't share the details here (hint, hint). Who would know about medical mistreatment if patients and their advocates didn't speak up or bring lawsuits? Why should an injured person not want to help others avoid such treatment in the future?

    If our court systems are overwhelmed, we can stop prosecuting and jailing people for minor drug offenses and broken car blinkers. Serious injury at the hands of the people we trust to heal us is important and should be punished.

  32. I doubt that most people who sue their doctors for malpractice are doing so
    in order to further the greater good.

  33. "Here’s what your boss should do: She should write an e-mail to everyone on staff that says, 'This is a charity I care about, and here’s why.' She should then outline its benefits and explain how people can contribute through a channel that will not involve her in any way whatsoever."

    No, the boss shouldn't do that either. The boss should keep her personal pet causes out of the office, the same as politics, religion, etc. It is not fair for her to pressure her employees in this manner regardless of how noble her motives. Even if the donation channel is independent of her, employees will still feel there is an expectation to respond, and at the very least it will create resentment in some employees. It does not belong in the workplace.

  34. I agree 100%. The Ethicist got it right until that last paragraph. She should keep her philanthropic philosophy to herself and let employees do the same. If an individual employee were to ask, privately, for her opinion, that would be different. But a mass e-mail is a terrible idea.Silence really is golden sometimes.

  35. I worked in an office where people felt free to post political cartoons or jokes around the office. I always felt it was inappropriate, even though most of the people working there were of similar political persuasion and were not offended by the jokes. I felt it was potentially discomfiting to anyone of a differing political persuasion (political affiliation was NOT one of the criteria for working there). Eventually, I became the boss and I took all the political cartoons down. (They were mainly pro-Obama; I am pro-Obama too, but I didn't think our office should look like an Obama campaign outpost.)

    I feel this is similar. No matter how innocuous the cause, even if the cause is "saving cute kittens," it isn't going to appeal to everyone and there will be somebody who is not sympathetic to it. (Or who is just annoyed because it distracts from work.) It will create resentments that will interfere with the purpose of the workplace.

  36. If I walked into a place of business—lawyers, doctors, accountant, dry cleaner, you name it— with the intent of doing business and was faced with signs lauding George Bush and "patriotism" I would walk out.

  37. I went for a consultation with a doctor whose waiting room had only 2 types of magazines: gun magazines and extremely conservative ones. This was a woman's health center, no less! When he looked at my x-rays on a computer, there was nothing else on the counter except for a daily calendar that had a scathing anti-Obama "fact" of the day. I have never before seen a doctor's office with such biased material. It was appalling. I didn't go back.

  38. My husband stopped going to a particular barbershop because the barber couldn't shut up about his political views. When we walk by the place nowadays, I enjoy thinking about how the guy would react if he were to arrive at work one morning to find a "Flush Rush!" bumper sticker attached to the front door! (I won't actually do it, of course.)

  39. I was a partner in a Wall Street firm. We were required to give at least one percent of our gross income every year to charity. But it was the charity of our choice and there was no pressure to give to a senior partner's favorite. But at Bear Stearns Ace Greenberg was a known large contributor to UJA. Many of the executives there also gave to UJA. Was it out of respect or fear of Ace? My impression was a little of both.

  40. I remember a lot of one-offs that weren't even eligible for the charity tax deduction getting done by Bear Stearns partners. I think it is a little different situation. Remember for most of its life, especially its life under Ace, the Bear really was a partnership. The idea was that partners should have a certain degree of community interest and involvement. My sense is that the UJA option was there for those who weren't going to be terribly original on their own, sort of a safe harbor. Full disclosure: my firm happily cleared much institutional equity business through Bear from 1987 through 1998, I had friends there in other departments as well.

  41. The prohibition on collecting money at the office for charity should extend to selling merchandise for school fundraisers. At least if the envelope gets passed around for the charity, your donation (or lack of a donation) is anonymous. But when you don't place an order for little Brandy's candy/wrapping paper/candles/raffle tickets, it is obvious to the boss that you're not willing to contribute.

  42. Oh God yes - that's the WORST.

  43. Girl Scout cookies! It was a simpler age, and no one ever admitted to my father that they didn't want any Girl Scout cookies.

  44. I've seen it work in cases where employees would put the order forms in the break room, and anyone who wanted to sign up, could do so. I never ordered anything from my workmates (or my workmates' kids), and no one came to me to ask why. That's different from going cube to cube soliciting orders.

    That same organization encouraged us to give to the United Way, but we weren't made to feel bad if we didn't do so.

    Sometimes, it's just a matter of deciding how much you're willing to give, and sticking to it, even if someone tries to make you feel guilty.

    A woman at a different job accused me of "hating children" when I said I didn't want to order something her daughter was selling. That was way out of line, and I told her that line wasn't going to work on me.

  45. United Way is truly a problem. That another physician on the hospital's medical staff was tracking which colleagues donated and which didn't, and sending the latter group personal letters requesting donations, is.... (I won't say it in mixed company.)

  46. Anonymous: Before you get wound up in an ethical knot, you should get some legal advice. You may not even have a viable case. First, you can't just assume that liability is a slam-dunk. Although I don't know the standards in NJ, in my state, to get past a medical malpractice tribunal on the liability issue (required here before the litigation can proceed past the inital complaint), a plaintiff has to hire an expert to review the records and give an opinion. Most lawyers want the expert opinion before they even file suit. Second, even if there is clear liability, if the damages (anticipated amount of settlement or verdict) are not significant, the case may not be worth pursuing, either for the cleint or the lawyer. Litigating a medical malpractice claim is costly and the expenses of suit would be deducted from what the plaintiff gets. Finally, lawyers take these cases on a contingency fee basis, so the damages would have be be large enough to warrant the number of hours a lawyer puts into into the case. So do some homework first.

  47. A friend of mine was totally butchered in a cancer operation. When he called a lawyer about suing, he was told that unless he's going to die because of their malfeasance, it wasn't worth it to pursue it in court.

  48. If the employer elects to promote a charity of her own, shouldn't all employees be invited to also enlist support for their charities? Absent reciprocity, the transaction remains lopsided.

  49. Absent reciprocity? The issue is one of power. Given the lopsided power of the work-place, one of the most undemocratic of all institutions in a nation that touts democracy at the drop of a hat, there is no reciprocity because there is no level playing field. Managers have authority over workers which does not flow both ways. Now if the work place was a democracy, as in the highly successful Mondragon Corporations, this would not be a power issue.

  50. Your suggestion intensifies the pressure on all the employees to donate money to others' charities.

  51. Did you try discussing the situation with the provost or other official, mikenh? Academia can be such a minefield of subtle coercion, if the people in charge don't foster a healthy working environment.

  52. Some bosses even ask to borrow money, now what?!

  53. Learn how to say "no" so people will realize you mean business, without being unduly harsh.

  54. Concerning the second letter and our anonymous friend's "ethical" dilemma....a word of advise is in order...

    Never ask for legal advise from a "ethics" columnist.

    And for our "ethicist"...

    Please do a better job in vetting the letters that you choose to publish.

    Because it seems to me that if a person actually "suffered" at the hands of a doctor or hospital the last thing on such a person's mind would be to risk tossing away just recompense in order to make a public "statement."

  55. Excellent point! Ethics and legality are frequently at odds. What is legal, as slavery and the notorious Dred Scott Decision showed us, is not necessarily right or ethical.

  56. There is a difference between 'suffering' and harm, injury or disability. Suffering can be temporary. Suffering as a result of incompetence or negligence is not trivial. A monetary award, especially to one who who may be financially comfortable, will not undo the suffering. The writer seems motivated to prevent the suffering of others in the future. Seems altruistic to me.

  57. Research financial reports before giving. Too many charities are just tear-jerk bait scams that feed their directors HUGE Salaries while spending a ridiculously token tiny amount on their "cause".

  58. They got us once with that "feed the children" scam which certainly did more to harm the children when we found out only 12 cents of every dollar actually went to the kids. Now no cents of every dollar goes to any of them.

  59. There is a feeding charity where very little of the money is spent to feed people because most of it is used on organizational staff. The multiplier for this organization is that they solicit non-cash donations of food from major corporations. They are very effective.

  60. Malpractice suit settlements require SECRECY, You cannot disclose any information to the pubic.
    So--suing the hospital/doctors will not accomplish your goal.

  61. No, you are wrong about that. Malpractice settlements do not REQUIRE secrecy. However, litigants are often told that if they want the settlement, they are required to sign a non-disclosure agreement. But it is not written into the law that this must be done.

  62. I worked in a corporation that had de facto mandatory United Way. including mid level supervisors who went desk to desk to collect the envelopes (later the monitoring was electronic, even worse). But the final straw for me was the day after bonuses were awarded, when a new CEO sent an email with percentage suggested contributions to the company PAC, which distributed funds in accordance with the views of sr mgmt and not those of the majority of employees.

    One should never underestimate the power of direct supervisors. I had one who expected attendance at post work drinking sessions, with one's entire family at his wife's Christmas party, and at random group outings such as concerts. Failure to partake of these "freebies" with enthusiasm was bad for one's prospects.

  63. Mandatory contributions to a PAC are illegal. But this writer raises the tough issue of how much pressure constitutes "mandatory". This is one of my major problems with how PACs work in practice.

  64. Corporate sponsored giving to a PAC or the United Way is part of the culture of the organization you joined. Companies are permitted to establish whatever legal internal practices they believe are beneficial to the company. If you don't like giving to the PAC or the United Way, don't. But, your nonparticipation in a company sponsored program may hurt you. Many companies institute dress codes which cost employees money and dictate how they must appear at work. If you don't dress the way the company wants it may hurt you. In the end you join a sort of club when you accept employment from a company. That club can change the rules and you may not like it, but short of quitting or pushing for governance (company policy) to prohibit the actions you don't think appropriate within a private company, you have no choice but to accept the culture or accept the consequences.

  65. I agree that no supervisor should solicit for a favorite charity, or even a redistributor like the United Way. However, some charities design their solicitations to take advantage of employees. In this case, for example, will the supervisor will some prize or some status for the amount of she or he solicits? For another example, one major charity has an annual athletic event, and encourages companies to enter teams, each of whose members are asked to solicit donations from their own friends and families. Not only is there no privacy about how much a person donates, there is the added pressure to compete for most outside contributions.

    One remedy: Just say NO! Tell your supervisor that your respect the charity (if that's a lie, it's for a good cause), but you are not contributing for personal reasons that you would prefer not to disclose, and you hope that your diligent efforts on behalf of the company are not undervalued because of your decision not to contribute. Hopefully, the dept. head will behave ethically in response.

  66. Do not wager a positive outcome for your next performance and salary upgrade review upon that supposition.

  67. "Your boss should write an e-mail to everyone on staff that says, “This is a charity I care about, and here’s why.” She should then . . . explain how people can contribute through a channel that will not involve her in any way whatsoever."

    I guess the Ethicist is unclear on the concept of "conflict of interest". Any such request from a boss to their employees takes the character of an order, since no one knows for sure whether the boss has some method they plan to use to figure out who donated and who didn't.

    The solution is to keep non-work-related requests from being requested by people in work situations where they are in power over those they are making the requests to.

    This question isn't remotely worth the real estate that its answer took up.

  68. The comments I've read have focused on the boss. Broaden the picture. Have an annual giving campaign (as we do at my home institution) that showcases a large number of charities (in our case a very large number). The practice instills giving, allows personal choice to flourish, and cuts off this kind of implicit pressure.

  69. I'm sorry but strongly urging employees to give up a portion of their promised compensation should in almost no circumstances be the function of the organization that is paying the salary. You refer to a "home institution" and are in Nashville. Is your "home institution" church affiliated? In that case I might be inclined to cut you some slack. Particularly if the annual giving campaign is managed so that line supervisors have no idea which of their employees (or their colleagues or bosses) are giving how much to whom.

  70. @carol:

    For reasons that should be obvious, if the employer or the charity is church-affiliated, the employer should absolutely NOT be soliciting contributions.

  71. Regarding the malpractice issue, consider the possibility that the writer suffered a negative outcome through no fault of the medical caregivers. If we assume that is not the case, there are patient safety experts (perhaps even within the hospital where the writer stayed) who are very interested in reports of such events as they inform patient safety efforts. Nor would I discourage bringing a med mal claim: while it can be a significant investment of time and energy, one can obtain recompense. More important to the writer's stated goals, a determination adverse to a doctor is required to be reported to a national database that can be used for vetting medical competence.

  72. Not every mistake is malpractice. People err (in fact, proof of this lies in the fact that few people can correctly pronounce the word "err"). I was in a wonderful hospital recently and managed to contract a rare infection that later re-hospitalized me for over a week with ten days more home-care. They still do not know what infected me. But hey, hospitals are full of sick people and disease. Things happen. Should I sue?
    The renowned lawyer Louis Nizer wrote an illuminating chapter on malpractice and negligence in his classic memoir My Life In Court which everyone should read.

  73. "But hey, hospitals are full of sick people and disease. Things happen. Should I sue?"

    Maybe. Does the hospital have a program of continual hygeine among the staff? Are there hand sanitizers at the doors to every room? Does staff, both medical and support (janitors and maintenance) use them? Does the hospital have a history of contracting or passing along "rare infections," or an historically higher statistical drift in an untoward direction? These elements are becoming well-known state-of-the-art metrics for patient care.

    I'm an engineer, I understand that "what can go wrong will go wrong." If the system does not accommodate amelioration of the risk, "fault" may be the reason.

  74. I would like to respond to your remarks on "err". Until a few years ago, I would have agreed with your comment on "err", as part of my college years, where I avidly absorbed ivory tower learning of all disciplines. Then someone called me on it, and I learned that for years I had been wrong, or had just been too strict.

    In your area of the country, as well as others, and in some areas of the UK, "err" is usually pronounced, at least by well-educated people, to rhyme with "brother", whether one actually pronounces the "r" or not. In other areas of these countries, the word is pronounced to rhyme with "air". Both are considered correct, except for Received Pronunciation in England, which is a thing unto itself.

    The difference has to do with whether one's pronunciation is rhotic or non-rhotic, an esoteric study that goes back centuries. It, however is an interesting if you go in for that sort of thing.

    As for the rest of your comment, I totally agree. Doctors are only human, as all we all. It was not until the twentieth century that they started saving more people than they killed. I read that in a book somewhere. I hope readers will forgive me for not citing my source. It had something to do with plagues.

  75. On charity giving in the workplace: I have worked in organizations where giving to United Way was almost mandatory. It was the goal to have 100% contribution. Usually this is larger organizations where the boss is on the "board" and wants to show that his/her company is a 100% giver. The pressure is unbelievable. I believe that when a person goes to work for a company there is an unwritten agreement, you do this work and I will pay you this amount. No where is there an addendum that says "and you contribute to this charity so I will look good". My solution, give a dollar and continue to support the charities that I prefer.

  76. The only exception is if you actually work for a United Way agency, as my mother did. Part of the job is setting an example, otherwise seen as proving that the people who work there value the cause.

    By the way, she taught me not to give to exactly the kind of charity that the supervisor was soliciting for, those that only help children. Her take (based on much observation) was that nearly everyone has a soft spot for children, if you are a more sophisticated donor you will understand that by helping those who are not such attractive beneficiaries you will balance the field That is part of what United Way at its best is about. Your local UW may or may not measure up. Personally for many years I almost exclusively have given to small organizations with clearly defined purposes of leftwing orientation or directly to political campaigns.

  77. I have also worked in organizations where contributions to United Way have been solicited and felt pressured to donate. In one case employees were encouraged to give through payroll deductions. In spite of all the good the United Way may do, I resent this tactic and have never understood why this organization is allowed direct access to a company's employees.

  78. I had this experience years ago, working for a large law firm that wanted to show 100% participation. I refused to give to United Way, stating that I preferred to give money to charities I knew and could give directly to. The pressure to give was unreal. The office manager kept calling me, asking why did I not want to participate, could I participate on even a low level, etc. It was infuriating and I stuck to my guns. Ruined their 100% participation rate. Boo hoo.

  79. Be prepared to ask for a donation to the charity of your choice, envelope in hand. If everybody on the office did that the boss might see the light.

  80. To the Employee: Employer extortion, as intangible and noble as it is and seems, is simply a manner of bullying with the omnipresent aura of anxiety whirring around and inside of the employees. Given the SCOTUS ruling that corporations are people too executives are now empowered to mimic their political idols by being unethical and at times, immoral as well. Acting like corporate Juntas in the office (that PAC demand) is truly an egregious vulgarity in every (lack of) respect.

    And the Survivor: You should thank the powers that be you are still alive and well. More than 100,000 unfortunate folks die every year from just such accidents known as a statistic hospitals and medical personnel would rather we didn't: iatrogenic deaths. Life is short, make your point. move on, and keep living.

  81. United Way usually involves religious organizations I can not support. Even though you can supposedly direct your money away from them, they still get a percentage of the total, so your designation is meaningless. I routinely refused to donate. When pressured with the 100% argument I told the solicitor they could put in any amount they wanted in my name and I would not complain.

    My Captain in the Coast Guard wanted 100% participation in the savings bond allotment program and I didn't want to participate. I showed him the actual cost to me even if I cashed them as soon as possible. He reimbursed me the cost out of his own pocket so he could have his 100%. (Full disclosure - I was not a career officer.)

  82. A non-work related request from an employer, supervisor, or anyone in a position of authority is extortion.

  83. I once worked at a major Seattle healthcare provider. Once a month, employees were allowed a "casual Friday," but only if they donated $5.00 to a cause chosen by the company. That manipulation was just one reason I found a new job.

  84. Your report to the state medical board should bring about an investigation of the doctor and result in proper posting on that doc's online listing on the state medical board website of prior malpractice if found to be care outside of what is provided by colleagues in the same field and situation. There are a few other conditions that must be met for malpractice. Unfortunately, most informed consent forms signed for procedures and other medical care include rare outcomes know to exist, often stated " to include death". Your other alternative is googling doc's name and sites to rate that doctor pop up.

  85. We have a company-wide email announcement list on which people post things like My daughter is selling Girl Scout cookies. If you are interested in buying some, stop by my office or call... or I am walking in the Cure for X Disease, if anyone cares to make a pledge contact me....I have tickets to event X that I can't use...the announcements are company wide and impersonal, any response has to be made to the individual.

    And we can opt out of receiving emails from the list if we want. Works well for us.

  86. "Here’s what your boss should do: She should write an e-mail to everyone on staff that says, 'This is a charity I care about, and here’s why.'"

    No, no and no! First of all, she is still using her position of power to promote a cause and not-so-subtly hint to employees that they *should* make a donation to the cause. Second of all, I highly doubt that all employees are entitled to write such an email (thank goodness). Why should she be allowed to do so, if everyone else is not?

    Bottom line: keep your charities and your politics to yourself. The moment a boss "suggests" donating to a cause, there is coercion, however subtle.

  87. "But if every person who felt wronged pursued a lawsuit on principle, the court system would collapse."

    The court system is near collapse now: not enough funds, courtrooms, judges; and nobody can afford a lawyer, even us lawyers. Consequently, even if you did negotiate all that, dockets are so full, your day in court would be years away.

    I used to think this was accidental, but now I believe the American system of civil justice is purposefully designed to deny access to all but the rich. Otherwise, we would expand and fully fund our courts and apply downward pressure on legal fees and guarantee that the average guy has equal access to the courts.

  88. I totally agreed with your office shakedown answer and would like to expand its reach to include the intrusive and abusive corporate wide "charity" pushes that intimidate many employees on a monthly or yearly basis. It goes something like this. In letter, email or meeting employees are told that the company is going to be a pons or of this or tha charity's run, capital campaign or wants to be the highest donating company ever to the charity upon whose board the CEO, president or manager sits and you my dear employes are going to be given and "opportunity" to help, give back or reach out or many be "lean in". Then the "fun" begins. Teams are assembled and the completion begins full force. Shaming, cajoling and outright threats are often part of these "charity" initiatives taking time and money from many employes who are barely making ends meet. It is ridiculous. If millionaires want to give to charity they should do so and leave their employes out of it the same way they are happy to leave their employes out of sharing the wealth!

  89. What I did once for a charity I support, that charity was having a fundraiser show and I offered to buy everyone the admission ticket. This was my way of supporting the charity by getting more audience in, and if somebody donates money it would be bonus. A few people took the offer, enjoyed the show and came back satisfied having spent a nice evening with their family.

  90. Or you could view a civil law suit as a means to ensure that the complaints are more likely to be followed through on by a bureaucracy that may, or may not, be as conscientious as it should be.

  91. Actually, people do often research hospitals and doctors before pursuing treatment. Still, there must be alternatives to a lawsuit, such as review sites.

  92. I, too, used to work at a (formerly) Very Big NYC Company that had mandatory United Way contributions. We're talking desk to desk collections, online contributions, special STICKERS to show that you had contributed (to be attached to your employee ID to get free coffee refills at the cafeteria).

    We were also encouraged to contribute a set percentage of our annual salary; if we did so, we actually get as much as 2 extra days off.

    The daily coercion was unbearable; even when the company was going through massive layoffs we were still pressured to give and give and give.

    This was even after United Way was shown up to be massively corrupt and wasteful in its management.

    Pressure to give at the workplace is never ethical.

  93. I had a boss who went from person to person, leaving the 'sign-up sheets' to buy things her school-age daughter was selling, from candy to wrapping paper to cards. It was awful, and while I didn't want to cave to what I perceived to be an unethical practice and pressure, I was well aware that never buying anything (none were things that I liked or wanted), it would shape her view of me. My agency also sponsored an annual 'campaign' for contributions to a statewide fund-raising movement. While I could always fins a charity to which I was willing to donate, I suspected -- and later learned by witnessing a discussion of the list -- that both departmental and individual contributions were scrutinized by executive management.

  94. The ethicist is entirely wrong about whether or not a person should punish an entity on behalf of society. It is every person's role to do so although every person can choose to act or not, as they see fit.

    As to the charitable question...having been in the military and corporate society....the boss doesn't ask for donations because the boss is not entitled to take compensation away from subordinates.
    However the boss can support a charitable cause by recruiting volunteers and letting them importune the employees. The boss cannot take official or direct notice of who does or doesn't donate. Often the volunteers create pride pieces (paper ornaments) to give to the employees who donate or contribute to display. As do most other charitable organizations who gather money in the work environment. There are just different levels of sponsorship. Some are high level, some initiated at a local level. Mostly these aren't religiously organized charities although some for providing holiday gifts for children are. Fundraising in organizations raises big money.

  95. To add to the individual struggling with the issue of their Medical problem, join the club. Malpractice is yours alone but there are many activist groups that are about patient safety and advocacy.. Those you join and work with but your individual problem is yours alone. I too did all the "right" things to avoid filing suit, and then when I did I did so per se to remain in control and prove that this was not about money. The minute you get Attorneys involved it becomes about the punitive damages aka their pockets. There are many books on the Medical Industry and their malfeasance. Read them and then make a decision to do what best serves YOU.

  96. I once worked at a social service agency which received a portion of its funding from United Way. Every year, our Executive Director would hold a meeting where he would urge 100% staff donation participation... and every year, we would fall short because I refused to donate to United Way - preferring instead to give to the charities I chose.

    The pressure was unbelievable.

  97. I had a similar experience while working for a non-profit social service agency. It rubbed me the wrong way. After all, the employees of the non profit made low wages and devoted their lives to providing charity to the needy through direct service. To expect an additional financial contribution made to the United Way seemed over the top and intrusive.

  98. I have had a similar request fordonations, but not from my boss -- from my temple!

    The temple president sent out to all temple members a list entitled "Count Your Blessings." The list consisted of things we should be thankful for, with a suggested monetary amount for an extra donation to the temple (above and beyond the annual required dues payment). For example (and these are actual examples from the list):

    1) Do you own a cat or a dog? Give an extra 50 cents to the temple for each animal.
    My take: I really meant to make a contribution to the shelter where I got my cat.

    2) Do you have a son or daughter who was a bar or bat mitzvah at the temple?
    Give $18.00 per kid.

    My take: But religious school tuition was double in the years leading up to the bat mitzvahs. So didn't I already pay for this?

    3) Do you have a circle of friends? Give $5.00 per friend.

    4) Do you own a refrigerator? Two bucks.

    5) Do you have health insurance? $10.00 seems an apt amount.

    Nowhere in the letter does it say God will think I'm a bad person if I don't cough up extra money for the temple because I can keep my food cold, and I am not friendless, petless, or in the hospital, but it's IMPLIED.

    I found that letter to be highly unethical -- as well as unintentionally humorous.

    Anyone else out there get a letter like that from their house of worship? As the late George Carlin said, "God is all powerful, omnipotent, and almighty. But he just can't handle money -- he always wants a little more.

  99. I give to charities aware that administration and fund raising are part of the racket, but no boss/employer should front for the "poor" at a time when non-profits pay salaries higher than those being solicited.

  100. Here's a tricky one: I have an illness, and a cousin of mine participates in fundraising for the nation's largest charity that helps with this illness. He dedicates his pledge drive to me! I do feel compelled to contribute when he sends around his annual pledge form, and I appreciate his efforts, but I don't like the charity and never give to it otherwise.

  101. I love the Ethicist, but I think his ruling is too narrow here. Is it ethical for any coworker to directly ask for a charity donation? Even if the person asking weren't my boss, I would still feel put-upon and compelled to donate to preserve good relations with co-workers -- almost all of whom affect my ability to to do my job well, and thus my earning potential.

  102. IT'S WRONG

    Because no matter how noble the cause, one is being pressured due to the relationship. Even among friends, unless you know that they share for sure that they share a particular concern for a charity... Again, don't due to your desire to please.

    I was a professor at a college and a member of the faculty was a nun. She asked for a contributions for a cause I didn't share with her. But, I did make a contribution.

  103. The malpractice question is incorrect. with respect to being noticed. If one complains to the state board, an investigation is mandatory and the board if they decide to take action, will result in public notice that is both reported to the NPDB (National Practitioner Database), as well as a public record that nowadays is readily available via public web search to anyone who chooses to look. This has much more meaning than a malpractice payout, which can happen to great doctors who happened to be in the vicinity of malpractice, or as a risk mitigation and economic decision to avoid the cost and risk of a trial. Presumably the writer would not just be suing the hospital but would be suing individual physicians. And the writer should know that her attorney would not be amused at forcing a trial in the face of an offer of settlement, which I understand carries certain legal risks as well as economic for the attorney, who is generally working on a contingent basis. Be sure the attorney knows these parameters up front, in which case they may decline the case for that reason alone (as well as inferring they have a client who may be difficult to work with).

  104. Every company has employees who are quick to claim entitlements about what their company should do for them, above and beyond a paycheck. Such as health insurance, paid leave, FMLA, holiday recognition, free soda etc. Many companies rightfully understand that they should be giving something back to their communities, and wish to model this for their staff, who are often young, and at times quite selfish about giving anything back.

    Companies that make it easy to give, via payroll deduction to United Way, a United Arts Fund or other umbrella organization are doing a service. It should not be a strong arming as described by the writer and a number of commenters, but it is appropriate. For those employees to give via the workplace or give meaningfully on their own, kudos to them. For those who use indignation to hide their selfishness, shame on them. We pay so little taxes relative to society's needs, that those who are making above living wages, which likely includes many Times readers, can easily afford something. Employers make it easier for those inclined, and some match employee donations to eligible 501C3 non-profits. But getting employee skin in the game is a good thing and encouraging but not forcing giving back is admirable.

  105. I worked for a national home improvment retailer as a cashier. For 2 months every year it was mandatory that i had to ask every customer to donate $1.00, $5.00, $10.00 shamrock for Jerrys Kids, and then ask them initial this and it would be taped to the wall. Only cashiers had to solicit from customers, and each store maintained daily totals on what dollar amount each cashier solicited. Each store within the region was put into competition with each other and the winning manager received a very fine dinner for their efforts. I worked for this charity for 4 years and finally called the state labor dept to ask why i was forced to solicit contributions on employers behalf when i personally would prefer a different charity, i was told it was an implied condition of my employment. Every year we would see a picture of the corp ceo giving a huge check to jerrys kids and receive kudos for his corporate giving. We cashiers were never mentioned. We all hated to solicit from customers and it was always detrimental for the cashiers moral to see only management received recognition

  106. I work for a federal agency. First, let me say that all holiday parties or celebrations (retirements, etc.)of any kind are paid for by those who choose to attend. No one in a supervisory or managerial position is allowed to organize or collect money for any event. No one is ever approached personally regarding attending these events, and there's no pressure to attend. An email is sent out with the time, place, cost, etc, with the name of the person collecting for the event. No one is allowed to sell anything (Girl Scout cookies, school fundraising items,etc) or solicit any funds for any cause at the workplace.I'm verymuch in favor of this. I've worked at other places where you were constantly bombarded with requests to buy things, sponsor particiapnts in fundraising walks, etc.There is a CFC (charity contributions via payroll deduction) campaign every year. A non-supervisory/management employee serves as point person. This person (I've done this) simply distributes materials regarding the participating charities and instructions regarding how to arrange for payroll deductions via an online process. No one is ever approached personally. No one in the agency knows who does or doesn't contribute. This also works very well.

  107. Report her activities to HR anonymously.

    You'll be found out, she'll be promoted, you'll be expelled.

    There is never a good solution to this. Give minimally, and tell her you can't afford more because you save your charitable donations for (name your cause here) to aid a friend/family member who has (name disease here.)

  108. My old boss would post a signup sheet on his door to collect for a children's charity road race. He kept a running tally each year of who sponsored him and for how much. disgusting to use a worthwhile charity to shake down your direct reports.

    It really lowered him in my estimation, even though as you note, his intentions were good.