Ron’s Book Selections

***Business as a Calling: Work and the Examined Life*, by Michael Novak.**

The economic and ethical responsibility of a business is to serve others, and increase the wealth of its customers. The business world instills, and requires, the practice of a number of virtues: diligence, industriousness, prudence in risk taking, reliability, kindness to strangers (customers), and fidelity in personal relationships. Are not these the same virtues parents try to teach their children? As Michael Novak explains in Business as a Calling:

My general position on these three questions has two parts. First, business is a morally serious enterprise, in which it is possible to act either immorally or morally. Second, by its own internal logic and inherent moral drive, business requires moral conduct; and, not always, but with high probability, violations of this logic lead to personal and business disgrace. Immoral acts do occur in business. But to behave immorally is neither necessary to nor conducive to business success (Novak, 1996: 8-9).

These men [industrial barons] did more than make money; calling them “money-makers” trivializes what they accomplished. Nor does the word greed capture their state of soul. “Greed” does not explain why Andrew Carnegie gave virtually all his money away. Instead, he poured [profits] back into his firm as an investment in its future. In other words, he put it at risk. “Greed” is for the impoverished socialist imagination a term of art; its purpose is neither descriptive nor analytical. Its purpose is moral denunciation, for ideological reasons (Ibid: 75).

The Seven Internal and External Responsibilities

The moral case for capitalism needs to be made, and fortunately it has been. Nonetheless, most popular culture and institutions, from movies and television shows to research organizations and universities, villainize businesspeople and business firms, endlessly portraying them as power-hungry, stop-at-nothing-to-get-ahead, ruthless members of society. This view is pernicious, not to mention entirely out of touch with how the world works. A business, in its essence, is a moral institution because it requires moral conduct to succeed in the long run. As Novak explains:

It may help to divide these responsibilities into two different sets. The second set will easily be recognized as “ethics,” since the source of their authority comes from outside business––from religious conviction, moral traditions, humane principles, and human rights commitments.

The first set [Internal Responsibilities] consists of the moral requirements necessary for business success. One way to see that they are ethical is to ask yourself what happens when they are violated (Novak, 1996: 135).

Seven Internal Responsibilities:

1) To satisfy customers with goods and services of real value. Like other acts of freedom, launching a new business is in the beginning an act of faith; one has to trust one’s instincts and one’s vision and hope that these are well enough grounded to build success. It is the customers who, in the end, decide.

2) Make a reasonable return on the funds entrusted to the business corporation by its investors. Is it moral to lose other people’s money?

3) To create new wealth. This is no small responsibility. If the business corporation does not meet this, who else in society will?

4) To create new jobs. You cannot create employees without creating employers.

5) To defeat envy through generating upward mobility and putting empirical ground under the conviction that hard work and talent are fairly rewarded. The founders of the American republic recognized that most other republics in history had failed and that the reason they failed was envy: the envy of one faction for another, one family for another, one clan for another, or of the poor toward the rich. ...The best way to conquer this is to generate economic growth through as many diverse industries and economic initiatives as possible, so that every family has the realistic possibility of seeing its economic condition improve within the next three or four years. Poor families do not ask for paradise, but they do want to see tangible signs of improvement over time. When such horizons are open, people do not compare their condition with that of their neighbors; rather, they compare their own position today with where they hope to be in three or four years. They give no ground to envy. ...Only then can people see that hard work, goodwill, ingenuity, and talent pay off. When people lose their faith in this possibility, cynicism soon follows.

6) To promote invention, ingenuity, and in general, “progress in the arts and useful sciences” (Article I, Section 8, U.S. Constitution). All wealth comes from intellectual capital and the human mind, or caput, Latin for head. The great social matrix of such invention, discovery and ingenuity is the business corporation.

7) To diversify the interests of the republic. Crucial to preventing the tyranny of the majority. The interests of road builders are not those of canal builders, or of builders of railroads, or of airline companies. The sheer dynamism of economic invention makes far less probable the coalescing of a simple majority, which could act as a tyrant to minorities. The economic interests of some citizens are, in an important sense, at cross-purposes with the economic interests of others, and this is crucial to preventing the tyranny of a majority (Ibid: 138-45).

Seven Responsibilities from Outside Business:

To establish within the firm a sense of community and respect for the dignity of persons.
To protect the political soil of liberty.
To exemplify respect for law.
Social justice. To be good citizens of the community. Like other forms of justice and love, social justice begins at home.
To communicate often and fully with their investors, shareholders, pensioners, customers, and employees.
To contribute to making its own habitat, the surrounding society, a better place.
To protect the moral ecology of freedom (Ibid: 146-51).

***Bad Medicine: Doctors Doing Harm Since Hippocrates*, by David Wootton**

Bad Medicine is one of the most important books I have read in a long time. David Wootton is a historian at the University of York. He’s no medical profession basher, thanking modern medicine for saving his life and also proudly announcing his daughter is a doctor.

Not only is the book incredibly well written—even if, like me, you have no particular interest in the history of medicine—it is a mesmerizing look at how a supposedly scientific and evidence-based profession rejected new innovations, knowledge, and theories while stubbornly clinging to their old—and completely ineffectual, if not down right lethal—therapies.

Bad Medicine Drives Out Good Medicine

The history of medicine begins with Hippocrates in the fifth century BC. Yet until the invention of antibiotics in the 1940s doctors, in general, did their patients more harm than good. In other words, for 2400 years patients believed doctors were doing good; for 2300 years they were wrong.

From the 1st century BC to the mid-nineteenth century, the major therapy was bloodletting, performed with a special knife called a lancet. Interestingly enough, that is the title of today’s prestigious English medical journal, The Lancet. Bad ideas die hard.

The Case Against Medicine

The author makes three devastating arguments. First, if medicine is defined as the ability to cure diseases, then there was very little medicine before 1865. Prior to that—a period the author calls Hippocratic medicine—doctors relied on bloodletting, purges, cautery, and emetics, all totally ineffectual, if not positively deleterious (no matter how efficiently they were administered).

Second, effective medicine could only begin when doctors began to count and compare, such as using clinical trials.

Third, the key development that made modern medicine possible is the germ theory of disease.

We all assume that good ideas and theories will drive out bad ones, but that is not necessarily true. Historically, bad medicine drove out good medicine, as Wootton explains:

We know how to write histories of discovery and progress, but not how to write histories of stasis, of delay, of digression. We know how to write about the delight of discovery, but not about attachment to the old and resistance to the new.

The cultural obstacles, Wootton believes, are based on a somewhat counterintuitive observation: institutions have a life of their own. All actions cannot be said to be performed by individuals; some are performed by institutions. For instance, a committee may reach a decision that was nobody’s first choice.

This is especially true for institutions that are shielded from competition and hermetically sealed in orthodoxy. In a competitive market, germ theory would have been tested in a competing company, diffusing into the population much faster than it did within the institutions of the medical community. Wootton also cites Thomas Kuhn’s book, The Structure of Scientific Revolutions, wherein he distinguished between periods of “normal science” and science that takes place during periods of crisis. Germ theory was adopted because the medical profession knew it was in crisis.

Why is this Relevant to Business?

The similarities between bad medicine, the billable hour, timesheets, Frederick Taylor’s efficiency metrics, and value pricing are illustrative.

In physics the key barriers to progress are most likely theoretical. In oceanography they might be practical. What are the key barriers to progress in the professional knowledge firm?

If a supposed scientific and evidence-based profession is this slow to change, what chance do lawyers, CPAs, and other professionals have to move away from the discredited labor theory of value—the modern-day equivalent of bloodletting?