Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Profits. Show all posts
Showing posts with label Profits. Show all posts

Saturday, June 8, 2024

A Doctor at Cigna Said Her Bosses Pressured Her to Review Patients’ Cases Too Quickly

P. Rucker and D. Armstrong
Propublica.org
Originally posted 29 APR 24

Here is an excerpt:

As ProPublica and The Capitol Forum reported last year, Cigna built a computer program that allowed its medical directors to deny certain claims in bulk. The insurer’s doctors spent an average of just 1.2 seconds on each of those cases. Cigna at the time said the review system was created to speed up approval of claims for certain routine screenings; the company later posted a rebuttal to the story. A congressional committee and the Department of Labor launched inquiries into this Cigna program. A spokesperson for Rep. Cathy McMorris Rodgers, the chair of the congressional committee, said Rodgers continues to monitor the situation after Cigna shared some details about its process. The Labor Department is still examining such practices.

One figure on Cigna’s January and February 2022 dashboards was like a productivity score; the news organizations found that this number reflects the pace at which a medical director clears cases.

Cigna said it was incorrect to call that figure on its dashboard a productivity score and said its “view on productivity is defined by a range of factors beyond elements included in a single spreadsheet.” In addition, the company told the news organizations, “The copy of the dashboard that you have is inaccurate and secondary calculations made using its contents may also be inaccurate.” The news organizations asked what was inaccurate, but the company wouldn’t elaborate.

Nevertheless, Cigna said that because the dashboard created “inadvertent confusion” the company was “reassessing its use.”


Here is my summary:

The article reports on Dr. Debby Day, who alleges that Cigna, her employer, pressured her to prioritize speed over thoroughness when reviewing patients' requests for healthcare coverage.

According to Day, managers emphasized meeting quotas and processing claims quickly, even if it meant superficially reviewing cases. Dr. Day said Cigna expected medical directors to review cases in as little as 4 minutes, which she felt was too rushed to properly evaluate them.  The pressure to deny claims quickly was nicknamed "click and close" by some employees.

Day felt this practice compromised patient care and refused to expedite reviews at the expense of quality. The article suggests this may have led to threats of termination from Cigna.

Wednesday, January 24, 2024

Salve Lucrum: The Existential Threat of Greed in US Health Care

Berwick DM.
JAMA. 2023;329(8):629–630.
doi:10.1001/jama.2023.0846

Here is an excerpt:

Particularly costly has been profiteering among insurance companies participating in the Medicare Advantage (MA) program. Originally intended to give Medicare beneficiaries the choice of access to well-managed care at lower cost, MA has mushroomed into a massive program, now about to cover more than 50% of all Medicare beneficiaries and costing far more per beneficiary than traditional Medicare ever has. By gaming Medicare risk codes and the ways in which comparative “benchmarks” are set for expected costs, MA plans have become by far the most profitable branches of large insurance companies. According to some health services research, MA will cost Medicare over $600 billion more in the next 8 years than would have been the case if the same enrollees had remained in traditional Medicare. Opinions differ about whether MA enrollees experience better care and outcomes than those in traditional Medicare, but the weight of evidence is that they do not.

Hospital pricing games are also widespread. Hospitals claim large operating losses, especially in the COVID pandemic period, but large systems sit on balance sheets with tens of billions of dollars in the bank or invested. Hospital prices for the top 37 infused cancer drugs averaged 86.2% higher per unit than in physician offices. A patient was billed $73 800 at the University of Chicago for 2 injections of Lupron depot, a treatment for prostate cancer, a drug available in the UK for $260 a dose. To drive up their own revenues, many hospitals serving wealthy populations take advantage of a federal subsidy program originally intended to reduce drug costs for people with low income.

Recent New York Times investigations have reported on nonprofit hospitals’ reducing and closing services in poor areas while opening new ones in wealthy suburbs and on their use of collection agencies for pursuing payment from patients with low income. The Massachusetts Health Policy Commission reported in 2022 that hospital prices and revenues increased during a decade at almost 4 times the rate of inflation.

Windfall profits also appear in salaries and benefits for many health care executives. Of the 10 highest paid among all corporate executives in the US in 2020, 3 were from Oak Street Health, and salary and benefits included, reportedly, $568 million for the chief executive officer (CEO). Executives in large hospital systems commonly have salaries and benefits of several million dollars a year. Some academic medical centers’ boards allow their CEO to serve for 6-figure stipends and multimillion-dollar stock options on outside company boards, including ones that supply products and services to the medical center.


My summary and warnings are here:

Greed is not good, especially in healthcare. This article outlines the concerning issue of greed pervading the US healthcare system. It argues that prioritizing profit over patient well-being has become widespread, impacting everything from drug companies to hospitals. The author contends that this greed is detrimental to both patients and the healthcare system as a whole. To address this, the article proposes solutions like fostering greater transparency and accountability, along with reevaluating how healthcare is financed.

Tuesday, February 7, 2023

UnitedHealthcare Tried to Deny Coverage to a Chronically Ill Patient. He Fought Back, Exposing the Insurer’s Inner Workings.

By D. Armstron, R. Rucker, & M. Miller
ProPublica.org
Originally published 2 FEB 23

Here is an excerpt:

Insurers have wide discretion in crafting what is covered by their policies, beyond some basic services mandated by federal and state law. They often deny claims for services that they deem not “medically necessary.”

When United refused to pay for McNaughton's treatment for that reason, his family did something unusual. They fought back with a lawsuit, which uncovered a trove of materials, including internal emails and tape-recorded exchanges among company employees. Those records offer an extraordinary behind-the-scenes look at how one of America's leading health care insurers relentlessly fought to reduce spending on care, even as its profits rose to record levels.

As United reviewed McNaughton’s treatment, he and his family were often in the dark about what was happening or their rights. Meanwhile, United employees misrepresented critical findings and ignored warnings from doctors about the risks of altering McNaughton’s drug plan.

At one point, court records show, United inaccurately reported to Penn State and the family that McNaughton’s doctor had agreed to lower the doses of his medication. Another time, a doctor paid by United concluded that denying payments for McNaughton’s treatment could put his health at risk, but the company buried his report and did not consider its findings. The insurer did, however, consider a report submitted by a company doctor who rubber-stamped the recommendation of a United nurse to reject paying for the treatment.

United declined to answer specific questions about the case, even after McNaughton signed a release provided by the insurer to allow it to discuss details of his interactions with the company. United noted that it ultimately paid for all of McNaughton’s treatments. In a written response, United spokesperson Maria Gordon Shydlo wrote that the company’s guiding concern was McNaughton’s well-being.

“Mr. McNaughton’s treatment involves medication dosages that far exceed FDA guidelines,” the statement said. “In cases like this, we review treatment plans based on current clinical guidelines to help ensure patient safety.”

But the records reviewed by ProPublica show that United had another, equally urgent goal in dealing with McNaughton. In emails, officials calculated what McNaughton was costing them to keep his crippling disease at bay and how much they would save if they forced him to undergo a cheaper treatment that had already failed him. As the family pressed the company to back down, first through Penn State and then through a lawsuit, the United officials handling the case bristled.

Thursday, January 16, 2020

Ethics In AI: Why Values For Data Matter

Ethics in AIMarc Teerlink
forbes.com
Originally posted 18 Dec 19

Here is an excerpt:

Data Is an Asset, and It Must Have Values

Already, 22% of U.S. companies have attributed part of their profits to AI and advanced cases of (AI infused) predictive analytics.

According to a recent study SAP conducted in conjunction with the Economist’s Intelligent Unit, organizations doing the most with machine learning have experienced 43% more growth on average versus those who aren’t using AI and ML at all — or not using AI well.

One of their secrets: They treat data as an asset. The same way organizations treat inventory, fleet, and manufacturing assets.

They start with clear data governance with executive ownership and accountability (for a concrete example of how this looks, here are some principles and governance models that we at SAP apply in our daily work).

So, do treat data as an asset, because, no matter how powerful the algorithm, poor training data will limit the effectiveness of Artificial Intelligence and Predictive Analytics.

The info is here.

Wednesday, November 20, 2019

The ‘cancer growing in cancer medicine’: pharma money paid to doctors

Money and medicineVinay Prasad
statnews.com
Originally posted October 30, 2019

Here is an excerpt:

The fundamental problem is that, as a profession, cancer physicians are not interested in addressing conflict of interest. Too many people in prominent positions benefit from the current lax policies. Disclosure is not the solution —ending these payments is.

I want to be clear: I’m all for doctors interacting with and working with the pharmaceutical and device industries. I have lectured at major pharmaceutical companies, but without accepting money, travel expenses, or meals. Researchers should be free to work with pharmaceutical companies on trials, but there is no legitimate reason why a well-paid physician needs to take personal payments, gifts, meals, or travel expenses from the pharmaceutical industry. That practice must end.

Conflict of interest is the cancer growing in cancer medicine. It poisons the field. It leads us to celebrate marginal drugs as if they were game-changers. It leads experts to ignore or downplay flaws and deficits in cancer clinical trials. It keeps doctors silent about the crushing price of cancer medicines. It is rampant in guidelines that lead to off-label prescribing and that mandate payment. It is surely a calculated maneuver by the industry to increase their profits.

The info is here.

Wednesday, November 6, 2019

Insurance companies aren’t doctors. So why do we keep letting them practice medicine?

(iStock) (Minerva Studio/iStock)William E. Bennett Jr.
The Washington Post
Originally posted October 22, 2019

Here are two excerpts:

Here’s the thing: After a few minutes of pleasant chat with a doctor or pharmacist working for the insurance company, they almost always approve coverage and give me an approval number. There’s almost never a back-and-forth discussion; it’s just me saying a few key words to make sure the denial is reversed.

Because it ends up with the desired outcome, you might think this is reasonable. It’s not. On most occasions the “peer” reviewer is unqualified to make an assessment about the specific services.

They usually have minimal or incorrect information about the patient.

Not one has examined or spoken with the patient, as I have.

None of them have a long-term relationship with the patient and family, as I have.

The insurance company will say this system makes sure patients get the right medications. It doesn’t. It exists so that many patients will fail to get the medications they need.

(cut)

This is a system that saves insurance companies money by reflexively denying medical care that has been determined necessary by a physician.

And it should come as no surprise that denials have a disproportionate effect on vulnerable patient populations, such as sexual-minority youths and cancer patients.

We can do better. If physicians order too many expensive tests or drugs, there are better ways to improve their performance and practice, such as quality-improvement initiatives through electronic medical records.

When an insurance company reflexively denies care and then makes it difficult to appeal that denial, it is making health-care decisions for patients.

The info is here.

Tuesday, November 20, 2018

How tech employees are pushing Silicon Valley to put ethics before profit

Alexia Fernández Campbell
vox.com
Originally published October 18, 2018

The chorus of tech workers demanding American tech companies put ethics before profit is growing louder.

In recent days, employees at Google and Microsoft have been pressuring company executives to drop bids for a $10 billion contract to provide cloud computing services to the Department of Defense.

As part of the contract, known as JEDI, engineers would build cloud storage for military data; there are few public details about what else it would entail. But one thing is clear: The project would involve using artificial intelligence to make the US military a lot deadlier.

“This program is truly about increasing the lethality of our department and providing the best resources to our men and women in uniform,” John Gibson, chief management officer at the Defense Department, said at a March industry event about JEDI.

Thousands of Google employees reportedly pressured the company to drop its bid for the project, and many had said they would refuse to work on it. They pointed out that such work may violate the company’s new ethics policy on the use of artificial intelligence. Google has pledged not to use AI to make “weapons or other technologies whose principal purpose or implementation is to cause or directly facilitate injury to people,” a policy company employees had pushed for.

The info is here.

Wednesday, November 7, 2018

Hospitals are fed up with drug companies, so they’re starting their own

Carolyn Johnson
The Washington Post
Originally posted September 6, 2018

A group of major American hospitals, battered by price spikes on old drugs and long-lasting shortages of critical medicines, has launched a mission-driven, not-for-profit generic drug company, Civica Rx, to take some control over the drug supply.

Backed by seven large health systems and three philanthropic groups, the new venture will be led by an industry insider who refuses to draw a salary. The company will focus initially on establishing price transparency and stable supplies for 14 generic drugs used in hospitals, without pressure from shareholders to issue dividends or push a stock price higher.

“We’re trying to do the right thing — create a first-of-its-kind societal asset with one mission: to make sure essential generic medicines are affordable and available to everyone,” said Dan Liljenquist, chair of Civica Rx and chief strategy officer at Intermountain Healthcare in Utah.

The consortium, which includes health systems such as the Mayo Clinic and HCA Healthcare, collectively represents about 500 hospitals. Liljenquist said that the initial governing members have already committed $100 million to the effort. The business model will ultimately rely on the long-term contracts that member health care organizations agree to — a commitment to buy a fixed portion of their drug volume from Civica.

The info is here.

Thursday, October 11, 2018

Pharma exec had 'moral requirement' to raise price 400%

Wayne Drash
CNN.com
Originally published September 12, 2018

 A pharmaceutical company executive defended his company's recent 400% drug price increase, telling the Financial Times that his company had a "moral requirement to sell the product at the highest price." The head of the US Food and Drug Administration blasted the executive in a response on Twitter.

Nirmal Mulye, founder and president of Nostrum Pharmaceuticals, commented in a story Tuesday about the decision to raise the price of an antibiotic mixture called nitrofurantoin from about $500 per bottle to more than $2,300. The drug is listed by the World Health Organization as an "essential" medicine for lower urinary tract infections.

"I think it is a moral requirement to make money when you can," Mulye told the Financial Times, "to sell the product for the highest price."

The info is here.

Friday, September 7, 2018

23andMe's Pharma Deals Have Been the Plan All Along

Megan Molteni
www.wired.com
Originally posted August 3, 2018

Here is an excerpt:

So last week’s announcement that one of the world’s biggest drugmakers, GlaxoSmithKline, is gaining exclusive rights to mine 23andMe’s customer data for drug targets should come as no surprise. (Neither should GSK’s $300 million investment in the company). 23andMe has been sharing insights gleaned from consented customer data with GSK and at least six other pharmaceutical and biotechnology firms for the past three and a half years. And offering access to customer information in the service of science has been 23andMe’s business plan all along, as WIRED noted when it first began covering the company more than a decade ago.

But some customers were still surprised and angry, unaware of what they had already signed (and spat) away. GSK will receive the same kind of data pharma partners have generally received—summary level statistics that 23andMe scientists gather from analyses on de-identified, aggregate customer information—though it will have four years of exclusive rights to run analyses to discover new drug targets. Supporting this kind of translational work is why some customers signed up in the first place. But it’s clear the days of blind trust in the optimistic altruism of technology companies are coming to a close.

“I think we’re just operating now in a much more untrusting environment,” says Megan Allyse, a health policy researcher at the Mayo Clinic who studies emerging genetic technologies. “It’s no longer enough for companies to promise to make people healthy through the power of big data.”

The info is here.

Wednesday, August 8, 2018

Health Insurers Are Vacuuming Up Details About You — And It Could Raise Your Rates

Marshall Allen
ProPublica.org
Originally posted July 17, 2018

Here are two excerpts:

With little public scrutiny, the health insurance industry has joined forces with data brokers to vacuum up personal details about hundreds of millions of Americans, including, odds are, many readers of this story. The companies are tracking your race, education level, TV habits, marital status, net worth. They’re collecting what you post on social media, whether you’re behind on your bills, what you order online. Then they feed this information into complicated computer algorithms that spit out predictions about how much your health care could cost them.

(cut)

At a time when every week brings a new privacy scandal and worries abound about the misuse of personal information, patient advocates and privacy scholars say the insurance industry’s data gathering runs counter to its touted, and federally required, allegiance to patients’ medical privacy. The Health Insurance Portability and Accountability Act, or HIPAA, only protects medical information.

“We have a health privacy machine that’s in crisis,” said Frank Pasquale, a professor at the University of Maryland Carey School of Law who specializes in issues related to machine learning and algorithms. “We have a law that only covers one source of health information. They are rapidly developing another source.”

The information is here.

Friday, February 23, 2018

Apple vs. Ivanka Trump: Competing ethics collide in China

Erika Kinetz
Associated Press
Originally published January 25, 2018

Here is an excerpt:

Ivanka Trump's company, meanwhile, has called supply chain integrity a "top priority," but maintains that suppliers are the responsibility of its licensees — companies it contracts with to manufacture tons of Ivanka Trump handbags, shoes and clothes. The brand doesn't publish the identities of its manufacturers. In fact, its supply chains have only grown more opaque since the First Daughter took on her White House role, the Associated Press showed last year.

"That mode of thinking is the dominant mode of thinking," said Seth Gurgel, who has worked on Chinese legal and labor rights issues for more than a decade. "They'd be a textbook company that would want to hide behind licensee protections."

Big brands with dedicated suppliers tend to be more invested in workplace conditions than smaller brands like Ivanka Trump's. But the political and ethical calculus surrounding Ivanka Trump's name — and her namesake brand, which she still owns but no longer closely manages — shifted radically when she became an adviser to her father in the White House.

"If Ivanka could be pressured or convinced to become a global leader or speak out about abuses in the apparel industry, she could be a huge ally for labor NGOs and worker groups around the world," Gurgel said.

The article is here.

Saturday, June 17, 2017

Taking Single-Payer Seriously

Dave Kamper
Jacobin Magazine
Originally published May 28, 2017

Here is an excerpt:

Medicare for All wouldn’t just scrap Obamacare — it would uproot the entire industry. It would be a huge efficiency savings. But it would also be devastating in the short term for hundreds of thousands of working people whose only crime was getting a job at an insurance company, and the hundreds of thousands more who work as billing specialists for clinics and hospitals (the number of medical assistants shot up 44 percent between 2011 and 2016). Yes, the CEO of United Health Group made $101 million in 2011. But few of the 230,000 other people working for the company saw money like that.

Bernie Sanders’s recently announced Medicare for All plan asserts that we “need a health care system that significantly reduces overhead, administrative costs, and complexity,” and projects that his plan would save $6 trillion over ten years.

The article is here.

Saturday, June 10, 2017

Feds probing psychiatric hospitals for locking in patients to boost profits

Beth Mole
Ars Technica
Originally published May 24, 2017

At least three US federal agencies are now investigating Universal Health Services over allegations that its psychiatric hospitals keep patients longer than needed in order to milk insurance companies, Buzzfeed News reports.

According to several sources, the UHS' chain of psychiatric facilities—the largest in the country—will delay patients' discharge dates until the day insurance coverage runs out, regardless of the need of the patient. Because the hospitals are reimbursed per day, the practice extracts the maximum amount of money from insurance companies. It also can be devastating to patients, who are needlessly kept from returning to their jobs and families. To cover up the scheme, medical notes are sometimes altered and doctors come up with excuses, such as medication changes, sources allege. Employees say they repeatedly hear the phrase: “don’t leave days on the table.”

The Department of Health and Human Services has been investigating UHS for several years, as Buzzfeed has previously reported. UHS, a $12 billion company, gets a third of its revenue from government insurance providers. In 2013, HHS issued subpoenas to 10 UHS psychiatric hospitals.

But now it seems the Department of Defense and the FBI have also gotten involved.

The article is here.

Sunday, May 28, 2017

CRISPR Makes it Clear: US Needs a Biology Strategy, FAST

Amy Webb
Wired
Originally published

Here is an excerpt:

Crispr can be used to engineer agricultural products like wheat, rice, and animals to withstand the effects of climate change. Seeds can be engineered to produce far greater yields in tiny spaces, while animals can be edited to create triple their usual muscle mass. This could dramatically change global agricultural trade and cause widespread geopolitical destabilization. Or, with advance planning, this technology could help the US forge new alliances.

How comfortable do you feel knowing that there is no group coordinating a national biology strategy in the US, and that a single for-profit company holds a critical mass of intellectual property rights to the future of genomic editing?

While I admire Zheng’s undeniable smarts and creativity, for-profit companies don’t have a mandate to balance the tension between commercial interests and what’s good for humanity; there is no mechanism to ensure that they’ll put our longer-term best interests first.

The article is here.

Tuesday, February 7, 2017

Business Leaders Get an ‘F’ in Ethics, Yet Again

Bruce Weinstein
Fortune
Updated: Jan 09, 2016 

Here is an excerpt:

Business ethics can be improved

Public perception is malleable, so there is no reason why business executives have to remain stuck in the bottom of the Gallup poll. I propose the following four strategies for businesses that want to be regarded as honest and trustworthy:

Publicize your values. It never ceases to amaze me how few businesses list their company’s values and ethical commitments on their websites. This is the first Call to Action that I give businesses that hire me as a consultant: put your organization’s mission statement, code of ethics, and core values on the home page where they can be readily accessed.

Hire for character. The values and ethical standards you post on your website don’t mean anything if they’re not embodied by your employees. You understandably devote a lot of energy, time, and resources to hiring people who are knowledgeable and skilled. Isn’t it at least as important to hire people who are consistently honest, accountable, loyal, and fair—that is, men and women of high character?

Fire for character. Just as it’s crucial to bring high-character people into your organization, so too is it to get rid of those who don’t share your organization’s values. No matter how much the senior vice president of marketing knows about his or her field, if he or she has played fast and loose with the truth or hasn’t honored commitments to clients, why keep him or her on the payroll?

Reward excellence. I recently spoke at a Fortune 100 company on the day when five employees who embodied the company’s values were flown in to receive a prestigious award and a handsome bonus. One young man had found a $15,000 diamond ring in his store’s parking lot and had gone to considerable lengths to track down the owner. Imagine how the customer felt when her ring was returned. And imagine the positive word-of-mouth she gave the company.

Wednesday, December 2, 2015

Volkswagen and the Future of Honesty

By Peter Singer
Project Syndicate
Originally posted October 7, 2015

Here is an excerpt:

Then came the revelations that Volkswagen installed software on 11 million diesel cars that reduced emissions of nitrogen oxides only when the cars were undergoing emissions tests, enabling them to pass, even though in normal use their emissions levels greatly exceeded permitted levels. In the wake of the ensuing scandal, the New York Times invited experts to comment on whether “the pervasiveness of cheating” has made moral behavior passé. The newspaper published their responses under the heading: “Is Honesty for Suckers?”

Cynics would say that nothing has changed in the last 40 years, and nothing will change, because in business, all talk of ethics is intended only to camouflage the ultimate aim: profit maximization. Yet Volkswagen’s cheating is odd, because, even – or especially – by the standard of profit maximization, it was an extraordinarily reckless gamble. Anyone at Volkswagen who knew what the software was doing should have been able to predict the company was likely to lose.

The entire article is here.

Monday, November 2, 2015

Many Antidepressant Studies Found Tainted by Pharma Company Influence

By Roni Jacobson
Scientific American
Originally published October 21, 2015

Here is an excerpt:

Almost 80 percent of meta-analyses in the review had some sort of industry tie, either through sponsorship, which the authors defined as direct industry funding of the study, or conflicts of interest, defined as any situation in which one or more authors were either industry employees or independent researchers receiving any type of industry support (including speaking fees and research grants). Especially troubling, the study showed about 7 percent of researchers had undisclosed conflicts of interest. “There’s a certain pecking order of papers,” says Erick Turner, a professor of psychiatry at Oregon Health & Science University who was not associated with the research. “Meta-analyses are at the top of the evidence pyramid.” Turner was “very concerned” by the results but did not find them surprising. “Industry influence is just massive. What’s really new is the level of attention people are now paying to it.”

The researchers considered all meta-analyses of randomized controlled trials for all approved antidepressants including selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, atypical antidepressants, monoamine oxidase inhibitors and others published between 2007 and March 2014.

The entire article is here.

Thursday, August 15, 2013

Increase in Urine Testing Raises Ethical Questions

By BARRY MEIER
The New York Times
Published: August 1, 2013

As doctors try to ensure their patients do not abuse prescription drugs, they are relying more and more on sophisticated urine-screening tests to learn which drugs patients are taking and — just as important — which ones they’re not.

The result has been a boom in profits for diagnostic testing laboratories that offer the tests. In 2013, sales at such companies are expected to reach $2 billion, up from $800 million in 1990, according to the Frost & Sullivan consulting firm.

The growing use of urine tests has mirrored the rise in prescriptions for narcotic painkillers, or opioids. But the tests, like earlier efforts to monitor opioid prescribing, have led to a host of vexing questions about what doctors should do with the information they obtain, about the accuracy of urine screens and about whether some companies and doctors are financially exploiting the testing boom.

The entire story is here.

Sunday, April 7, 2013

What is the Value of Ethics Education?

Are Universities Successfully Teaching Ethics to Business Students?

By Steven Mintz
Ethics Sage Blog
Originally published on February 12, 2013

Last week I read an article on the failure of ethics education of business students to change the dynamic in the business world where the pursuit of self-interests trumps all else. We certainly have been through a decade or so of glaring unethical business practices at companies such as Enron and WorldCom, Bernie Madoff’s insider-trading scandal, and the financial meltdown of 2008-2010 from which we still have not recovered.

As a professor who teaches ethics I was struck by the reasoning given for the failure of ethics education. Some claim ethics is taught only in a separate course rather than integrated throughout the curriculum creating a perception in the minds of students that ethics is only important tangentially rather than as an integral part of business practice. I agree with this perspective but realize, having been an academic administrator for many years, the problem lies in not being able to get faculty from various business disciplines on board to incorporate ethics into their individual courses. Some feel unequipped to do so; others do not believe we should be “preaching” to college students.

I did some research on how ethics is taught to business students and their perspectives on business responsibilities and found some interesting results. Surveys conducted by the Aspen Institute, a think tank, show that about 60% of new M.B.A. students’ view maximizing shareholder value as the primary responsibility of a company; that number rises to 69% by the time they reach the program's midpoint.

There is nothing wrong with maximizing shareholder value – it is a basic tenet of capitalism. The problem lies when that is the only driver of corporate behavior to the exclusion of broader stakeholder approaches that would include customers, suppliers, and employees in the mix. Though maximizing shareholder returns isn't a bad goal in itself, focusing on that at the expense of societal interests can lead corporate decision-makers down the road of greed. By maximizing shareholder value, bonuses increase and stock options are worth more.

The entire blog is here.