Tuesday, April 2, 2019

The Indian Health Service and One of its Problem Doctors (1992-2018)

Case
 
     Dr. Weber started his career by working for the Indian Health Service in an Oklahoma hospital,where he was a pediatrician. In 1992, Dr. Weber moved to the Blackfeet Indian Reservation (Dow, 1). Once settled in he started to dedicate his time to youth outreach. However, some hospital staff became concerned when a couch was moved into Weber's area of the hospital and it was found out that young boys would visit him after hours without other adults and when the rest of the hospital staff had gone home for the day. This sort of behavior continued for years until there was an incident where a young boy was found to be sleeping over Dr. Weber's home and his father punched him in the face. Dr. Weber would be removed as a result.
Dr. Weber
     After leaving, Dr. Weber transferred to the Pine Ridge Reservation in South Dakota. Within months of being transferred, more complaints started to begin. At Pine Ridge Reservation, a boy named Paul gave the first firsthand account, where he alleged waking up drunk to Dr. Weber on top of him (Martin). Tribal police don't have jurisdiction over non Indians, so the allegation was passed onto federal police that never looked into it. Years later when Paul was older during November 2006, he and some friends were drunk and went to Dr. Weber's for money. He was beat up by the group badly and was rushed to the hospital, but he refused to talk about it to anyone, causing many of his coworkers to be very suspicious (Martin).
     Angered by the inaction of the agency, another doctor named Dr. Butterbrodt took it into his own hands to investigate. He would end up having an argument over the care of a patient with Dr. Weber and said some brash comments to Dr. Weber. Several weeks later he was transferred to North Dakota. This experience taught him why people were afraid to say anything (Martin). Dr. Butterbrodt would convince the Sioux Nation to look into Dr. Weber, which led them to Paul, one of the boys abused by Dr. Weber and the one who beat him up. With the information uncovered, the Tribal Justice Department brought the information to the U.S. Justice Department. In 2018, Dr. Weber would be brought to trial (Weaver, 2). After hearing witness testimony and the other evidence provided by the Justice Department, a jury convicted Dr. Weber of multiple accounts of pedophilia (Democracy, 1). Since this happened, IHS has launched an independent investigation about the extent of Dr. Weber's conduct.

Dr. Butterbrodt
Stakeholders

     Patrick Stanley Weber is the doctor who sexually abused boys and Dr. Butterbrodt who put his career on the line to stop Dr. Weber. Co-workers of Dr. Weber, many who stayed silent. Reservation communities and patients of Dr. Weber like Paul, who were sexually assaulted by Dr. Weber.

Individualism

     Using the Individualist Theory, the goal is to maximize profits for the owners, so long as it's legal (Salazar, 17-18). It's very clear that sexually abusing children is illegal, however, because the IHS is a government department, its goal isn't to maximize profits such as a business. Government departments are paid for by the taxpayers, so in the case of the IHS, its organizational goal should be to maximize the use of taxpayer funds or provide the best possible healthcare service. In regards to IHS fulfilling this goal, they not only failed at meeting it, but also failed to even deliver a product being healthcare. Using taxpayer funds for the salary for a sub-par pediatrician does not maximize the potential use of taxpayer dollars. The IHS also violated Individualism by failing in even delivering a product, because young boys were harmed, not helped by Dr. Weber.

Paul, around the age he was assaulted
Utilitarianism

     Using the Utilitarian perspective, one would look at both Dr. Weber's behavior and the actions of the Indian Health Service as unethical. If happiness is the only thing of value in Utilitarianism, then causing pain violates this theory (Salazar, 19-20). Regardless of if Dr. Weber created happiness by lessoning his patients' pain, the pain caused to his victims is arguably the worst kind of pain, trauma. The pain of his victims is so great that it can cause fully grown hardened criminals such as Paul to break down crying just thinking about it years after it happened. His victims have to live with this humiliating pain for the rest of their lives, which completely violates everything Utilitarianism stands for. The IHS"s leniency and culture is why the organization violated Utilitarianism. By not taking allegations against Dr. Weber seriously, the agency showed that they do not care for the happiness or safety of patients. Employees who stayed silent showed that they don't care for the happiness of patients as well. Not taking allegations of pedophilia seriously, because he's a doctor and does show up to work each day isn't a good enough reason. To reiterate the pain Dr. Weber caused outweighs any happiness he created as a healthcare provider, resulting in happiness not being maximized.
Paul, around the age he testified in court

Kantianism

     For Kantianism, a business's job is to inform customers of all the necessary information that will allow them to make a rational decision. The decision to tell the truth needs to be because you believe that it is the right thing to do, not because you will gain something from it. At all levels of the IHS, one would find that Kantianism had been violated. To start, other faculty members were afraid to say anything to superiors about Dr. Weber. The supervisors also violated Kantianism, because concerning allegations against Dr. Weber did make it to superiors and the responses to them were to transfer Dr. Weber or transfer the person who made the allegations and not inform the reservation communities about why their new doctor was there. In the case of Dr. Weber, there are two ways that he violated Kantianism. He should have informed patients of any desires to them inappropriately and not started doing it without saying anything to them. Dr. Weber also violates the Formula for Humanity by using the boys as a means (Salazar, 21-22). The boys were used as a means by Dr. Weber to fill his twisted desire to perform sexual acts with young boys. For these reasons Dr. Weber and most of the IHS violated Kantianism.

Virtue Theory

     There are four characteristics in Virtue Theory. These characteristics are courage, honesty, temperance and justice (Salazar, 23). Courage means risk taking and standing up for what you believe in. The IHS took the risk of keeping Dr. Weber on their staff regardless of the allegations against him. However, they didn't keep him for the right reasons. Dr. Weber filled a position that was needed, he wasn't kept, because allegations weren't credible, he was kept to meet the status quo. Honesty is to be truthful with employees, customers and other companies. The IHS wasn't honest with reservation communities about Dr. Weber's history and Dr. Weber wasn't honest with young boys about his true intentions. The IHS as an organization had a culture that allowed for employees to lie about what was going on. The third virtues trait is temperance, which is having reasonable expectations and desires. Expectations for the care of Native Americans. The care that some young boys received from Dr. Weber was well below what should be reasonable. In the case of Dr. Weber's victims, they were harmed more than helped. The IHS seemed to not care much about what any of their doctors have done as long as they came to work. The final of the virtuous aspects is justice, which encompasses hard work, quality and fairness. Quality is something that Dr. Weber doesn't have, because he is a convicted pedophile, As for fairness, it doesn't seem to be demonstrated by the IHS. The department rarely punished anyone for conduct including Dr. Weber and when Dr. Butterbrodt complained about him, he was punished and transferred to another facility. For these reasons, fairness as well as the other virtuous qualities are not represented by the IHS or Dr. Weber.

Justified Ethics Evaluation

     To me, what was done by Dr. Weber and the IHS was nothing but abhorrent. I can't fathom why any organization would even consider keeping Dr. Weber on the payroll when there have been multiple allegations against him and multiple investigations into whether he was a pedophile. I really think that the U.S. should have opened an extensive investigation into how many employees of the IHS had serious allegations of misconduct. Sexual assault is one of the worst things that can be done to someone, because the victim has to live on with the humiliation and it effects the development of that person. It should never be tolerated by any organization. My opinion of the IHS is that over the career of Dr. Weber they didn't care for the safety of their patients, otherwise they would have done something about Dr. Weber.

Action Plan

     The action plan will be broken down into two parts, how the IHS should change its policies as a government agency and what the U.S. government should do to get better doctors. In Dr. Weber's case, he was only transferred when the complaints against him were extensive at the Blackfeet Indian Reservation. Allegations of misconduct should be taken seriously against any employee. If the allegations have merit to them, it should be a policy to have an investigator from outside the IHS to investigate, because internal investigations against Dr. Weber found nothing wrong. Independent investigators would hopefully remove most of the corruption that happened in the IHS's investigations of its employees. Many IHS employees were afraid of being punished for not speaking up about Dr. Weber. Employees should be trained that speaking up about misconduct is the right thing to do and that they will not be punished for doing so.
     The second part of the action plan is getting better doctors for the IHS. To me, opening medical schools near the reservations would be one way to get higher quality doctors. The schools could have lower tuition rates and work with the reservations, so that medical students would be able to get first hand experience providing health care for the reservations. The government could also provide student loan forgiveness for doctors who are willing to work for the IHS for three years after graduating. This would make it so that the IHS wouldn't be desperate for doctors and not have to tolerate problem doctors that do commit misconduct or have a bad record. There needs to be a lot that the IHS will have to do in order to earn the trust of the reservation and improve their image. If the U.S. government implemented my action plan, I would guarantee that it would improve the IHS. My action plan would cost the government more money, but I believe it would be the right thing to do in order to make it up to the reservation communities. If something isn't done, other Dr. Weber's may be able to get away wit their crimes.

By E. Garete

Citations

"Agency Overview." About IHS, www.ihs.gov/aboutihs/overview/.Decades." Democracy Now!, 15 Feb.                                  2019, www.democracynow.org/2019/2/15/headlines/us indian health service faces probe after pedophile doctor                  allowed to keep working for decades.
 
Democracy Now! "U.S. Indian health Service Faces Probe After Pedophile Doctor Allowed to Keep Working for 

Dow Jones & Company, www.wsj.com/video/series/wsj-frontline/predator-on-the-reservation-a-documentary-film-by-         frontline-and-wsj/7DA882E8-5139-4948-AA922455E94386EE?mod=article_inline.

"HHS to Review Indian Health Service After Revelations of Pedophile Doctor." PBS, Public Broadcasting Service,               www.pbs.org/wgbh/frontline/article/hhs-to-review-indian-health-service-after-revelations-on-pedophile-doctor/.

Martin, Nick. "Pedophile Doctor Preyed on Native Children for Years While the Feds Turned a  Blind Eye." Splinter,             Splinternews.com, 8 Feb. 2019, splinternews.com/pedophile-doctor-preyed-on-native-children-for-years-wh-                     1832474363. "'Predator on the Reservation': A Documentary Film by Frontline and WSJ." The Wall Street Journal.

Salazar, Heather. "The Business Ethics Case Manual." 2 Apr. 2019

Weaver, Christopher, and Dan Frosch. "HHS to Review Indian Health Service After Revelations on Pedophile Doctor."        The Wall Street Journal, Dow Jones & Company, 13 Feb. 2019, www.wsj.com/articles/hhs-to-review-indian-health-          service-after-revelations-on-pedophile-doctor-11550091301.






     

   






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