Friday, December 17, 2010

Ends and Means, Means and Ends

Especially at this time of year, when people are so crazed by the spirit of love and charity that they will get into fistfights over parking spaces at the shopping mall, it's important to review some ethics basics.

For instance: Do the ends ever justify the means?

I don't like to say, "Never". Mostly because whenever I say I'd "never do X", within approximately 30 seconds I'm doing X. Always for the best of reasons, of course.

So I'll just answer my question with a little wriggle-room: Almost never.

Here's a great example from today's New York Times:

As Abby Goodnough writes in her article, "On its face, it seemed reasonable enough: a bone marrow registry sending recruiters to malls, ballparks and other busy sites to enlist potential donors."

What a worthy enterprise! Who could argue against having more people sign up to help those suffering from formerly-incurable diseases?

The devil, as they say, is in the details.

If you were a young man, hanging out at the mall with some friends, would you be more likely to respond positively to a request to "be a hero" if those words were said to you by a paunchy middle-aged guy in floods, or by a pretty young model in a short skirt and high heels?

I thought so.

You could argue that this was smart marketing (assuming there were some attractive young men in the model pool too, preferably not in short skirts and heels).

But models aren't free, of course. The donor registry, Caitlin Raymond International, apparently hired them at a cost of about $60,000 per week, according to Goodnough's article.

The registry is a nonprofit subsidiary of UMass Memorial Medical Center in Worcester, MA. An estimated 185,000 potential donors were recruited in New England.

The hospital "said Thursday that it had stopped seeking donors in New Hampshire and using models altogether."

Why no New Hampshire donors? Because the registry's practices are being investigated by the New Hampshire state attorney general's office. The AG is interested, not just because of questionable marketing tactics, but also because of extremely questionable billing procedures: those who agreed to the DNA cheek swab were not told that their insurance companies would be billed for the test, to the tune of $4,300 each.

Goodnough notes that "New Hampshire passed a law in 2006 requiring insurers to pay for tissue-typing tests for potential bone marrow donors. But at the time, ... proponents told lawmakers that each test would cost $100 or less." Oops. All of a sudden, we understand why New Hampshire seemed like such a good recruiting arena, don't we?

There's no question that more of us should learn about donation -- of blood, of marrow, of organs -- and that more of us should donate all of these.

But: isn't there a more transparent way of getting information out than by hiring sweet-talking high-heeled models, and by hoping no one will notice that the insurers are being billed, big-time?

Did the hospital really have that little confidence in the worth of the work it was doing that it needed to resort to these kind of tactics?

When this many people are being enlisted, do the tests really cost $4,300 a shot, and if so, how could New Hampshire legislators have been given a figure almost 98% lower?

Not to mention: don't you think there was a better use for $60,000 per week?