"The system doesn't work for us; still we pay
If the system doesn't work for us, we should take it back."
Those lyrics are from a song released last year by British proto-punk Mick Jones, originally lead guitarist and singer for The Clash, more recently for Carbon/Silicon. Now well into his fifties, Jones is pumping out his left-wing "power to the people" themes to great guitar riffs.
Here in New Brunswick, there's at least a couple of systems we need to take back and make work for us. Unfortunately, it's taken tragedy before someone notices, and formal inquiries before someone does something.
First is the tragedy of Ashley Smith. The horrors of mental illness can be bad enough, but the horrors of the system we created to deal with people like her can be worse. The facts of the case are well known - a teenaged girl who killed herself after several years of incarceration, solitary confinement, pepper spray, Tasers, the routine of strip-searches and shackles, and 501 institutional charges.
Five hundred and one? After the first couple of hundred, wouldn't someone say, "Hey, guys, I don't think this is working"? Punishment is defined as a consequence that reduces the probability of a behaviour reoccurring. This system clearly wasn't having its intended effect on her behaviour.
Stanford psychologist Philip Zimbardo first gained fame in the scientific community for the Stanford Prison Experiment (SPE) in 1971. The SPE randomly assigned student subjects to be guards or prisoners in a mock prison. The study was terminated only six days into the 14 day experiment because of the abuse the guards were heaping on the prisoners. The SPE became standard reading in introductory psychology books, with Zimbardo joining Stanley Milgram, who studied obedience, and Solomon Asch, who studied conformity, as the three scientists who most frequently shock students with data suggesting people in groups don't always behave in ways congruent with their personal values. It also led to Zimbardo being an expert witness at the trial of an American military guard who abused prisoners at Abu Ghraib.
Zimbardo's recent book, The Lucifer Effect, summarizes his studies into the idea that it's not a few bad apples that cause these problems, but bad barrels we put good apples into. The bad barrels, in other words, are the systems we've created. We can't blame what happened to Ashley Smith on four guards at the Grand Valley Institution, feel good about ourselves for addressing the problem, and move on. The report by Bernard Richard, the province's Child and Youth Advocate, sets out specific recommendations and "broad themes" about how we need to change the system.
A word about the guards is warranted. I've been to the New Brunswick Youth Centre in Miramichi, seen first hand the corrections officers at work, and had the opportunity to speak to some of them about what they do. They're professionals working with a theoretical approach (that of the therapeutic community, much like the Portage adolescent treatment centre at Cassidy Lake) who certainly aren't there to torment children. The system's not working for them either, and needs to be fixed.
The other system being called into question is how we monitor our doctors and hold them accountable for their decisions. The inquiry into pathologist Raj Menon's inability to read an x-ray with accuracy and consistency is disturbing for everyone, and simply pathetic for those whose illnesses have advanced needlessly because of his incompetence.
More disturbing and pathetic, however, are the details emerging from the inquiry that indict a system that would not only allow him to practise so poorly for so long, but prevent anyone from doing anything about it. Glancing at the headlines in the last couple of weeks pretty much tells it all: "Menon too busy for quality control,-Menon refused to have pathology reports reviewed,-pathology services check halted in 1998,-hospital bylaws have no teeth,-bylaws prevented Menon from being fired,-protecting doctors at all costs."
This isn't simply a story about a "bad apple" doctor, it's a story about a system that's a "bad barrel" that needs to be fixed.
World affairs Gwynne Dyer once used the principle of inertia to explain why we don't do anything when confronted with problems on a systemic level: when the mass of people and institutions is large, the effort it takes to move them must also be large.
Bernard Richard's report and the information coming from the Menon inquiry are giving the system a starting push. Let's not stop there.
17 June 2008
The Lucifer Effect: How Good People Turn Evil by Philip Zimbardo is in our bookstore.
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