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InReview – Issue 29

Leadership by Rudolph W. Giuliani; New York, Merimax Books, 2002; xvii, 407 pp.

Rudy Giuliani was mayor of New York City from 1993 to 2001. He founded the consulting firm Giuliani Partners in 2002. Giuliani started writing this book in early 2001. The shape and structure of the book had been largely developed before the fateful day of terrorist attacks, September 11, 2001. His theories of leadership were put to the ultimate test as he was called on to manage New York City through the toughest period of its history. Two full chapters are devoted to these events, and illustrations from these events are spread throughout the book. Reading these first-hand accounts is both exciting and painful — but they make the book.

Giuliani has strong views on the subject of leadership and shares them in great detail. The central theme is “sweat the small stuff” — illustrated with detailed accounts of events throughout the book. This detail makes the book a bit ponderous in places but it surely underscores his view that the details matter.

One of the best chapters is entitled “Underpromise and Overdeliver.” Here he lays out a philosophy of promising less than he thinks he can deliver and then delivering more. I wonder if this has carried over to his consulting business.

As in most books of this type, there is the question of how fairly the accomplishments of the mayor are presented, and how much credit is given to those who worked for him. For example, he discusses learning about the “broken windows” theory (fix a broken window, clean up graffiti, stop the small crimes so that larger things don’t happen) from Professor Kelling shortly after coming to office in 1992. He proceeds to apply this in multiple areas throughout the book, claiming credit for the huge decline in crime statistics in the city as well as other innovative applications.

In The Tipping Point by Malcolm Gladwell we see a different picture. Gladwell suggests the David Gunn and William Bratton started applying this theory to the transit system of New York City between 1984 and 1990. The contribution of Giuliani in this area came in appointing Bratton as head of the police department in 1994, and Bratton brought it over from the transit system to the police department.

I am not qualified to say whose version is correct, but these different accounts raise questions. Small point? Perhaps. But it makes you wonder if this is a pattern.

In general, this is a good book that holds the interest and offers insight. Concerns and the sometimes ponderous pace aside, this book offers leadership insight that is valuable.

Reviewed by Al Erisman

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Trust: The Social Virtues and The Creation of Prosperity by Francis Fukuyama; New York, Free Press, 1995; xv, 457 pp.

Francis Fukuyama is a senior social scientist at the Rand Corporation and one of America’s most highly-regarded intellectuals. Trust: The Social Virtues and the Creation of Prosperity was published in 1995 just as the technology-powered “new economy” was dramatically heating up. Trust was regarded as one of the most important business books of the mid-Nineties and its message is as timely today as the day it appeared.

Trust is a massive, densely-argued and illustrated, study in economic and social history. Fukuyama argues that economic prosperity and business success cannot be adequately explained by abundance of natural resources, brilliance of intellect, or the presence of good laws and institutions. Nor is capitalist success attributable solely to the operations of rational, self-interest in free market environments (the Neo-Classical argument).

Rather, business success and economic prosperity require (also) a culture of trust and a capacity for what Fukuyama calls “spontaneous sociability.” While most economic enterprise begins in families, it is often then limited by an incapacity to develop trusting relationships beyond the family. France, China, and southern Italy are examples of such “low trust” societies. Between family enterprise and the centralized state apparatus there is a lack of viable intermediate institutions. Germany, Japan, and the United State exemplify “high-trust” societies and, despite profound differences on many levels, they have in common a history of economic expansion and success.

Without trust, relationships, if they occur, are guarded and encumbered by legalistic contracts and processes. These additional “transaction costs” prevent flexibility and rapid growth. Relationships depend on trust. Trust depends on a culture of shared values, a shared language of good and evil.

There is not one unique pathway to trust. Japan and Germany have their own stories. In America, Fukuyama argues that the history of voluntary societies, especially the various Protestant sects and churches, was the grounding of a widespread receptivity to the practice of joining together with non-family others, on the basis of shared values, to build something important.

Fukuyama, however, saw clouds on the horizon even in the mid-90s. The rapid increase in both lawyers and prisoners in America, and the breakdown of families and voluntary community associations signaled a decline in trust. Could Internet technologies facilitate new forms of spontaneous sociability and trust, Fukuyama asks? Maybe so, but probably not. In the end, Fukuyama provides no answers and no recommendations but his case is thoroughly made. No shared values, no trust; no trust, no business. It’s up to us to figure out how to enrich trust in our time and place.

Reviewed by David Gill

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The Ethical Process: An Approach to Disagreements and Controversial Issues by Marvin T. Brown; Upper Saddle River, NJ, Prentice-Hall, 2003; viii, 88 pp.

Marvin Brown teaches business ethics at the University of San Francisco and has consulted for various organizations. He recently designed an ethics training program for the California State Automobile Association. In addition to The Ethical Process he is author of a longer study, Working Ethics (Jossey-Bass, 1990).

The Ethical Process, has gone into a third edition for good reason. It is a very insightful little one-volume ethics education, especially for business and technology leaders who may have never studied the field. The Ethical Process is not a comprehensive approach to values and ethics but rather a focus on ethical discussion and decision-making in the face of controversy. Brown’s “ethical process” teaches us to put our disagreements boldly on the table, listen to each other more carefully, explore the reasons and assumptions behind our different positions, and look for ways of modifying our proposals to be more inclusive of each other’s insights and, thus, stronger.

Workbooks and manuals are often not the most exciting reading but here is a hundred page workbook that at least somebody in every organization should buy and study. I have read hundreds of books on business ethics. This one is a keeper

Reviewed by David Gill

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Medical Information Web Resources

“If a child were not declared alive until three days after birth,” wrote Nobel Laureate David Watson in the May 1973 issue of AMA Prism, “then all parents could be allowed the choice … the doctor could allow the child to die if the parents so choose and save a lot of misery and suffering.” This famous statement by one of the co-discoverers of DNA illustrates in the extreme the sometimes chilling moral dimensions posed by human genetics. With April 2003 marking the 50th anniversary of the discovery of DNA by Watson and Crick, the National Human Genome Research Institute (NHGRI)(a branch of the National Institutes of Health) publishes a landmark study describing the future of the field of genomics, and the role the NHGRI and other government agencies will play in enabling that future. Information on this study is available on this site, as well as a variety of resources on policy and ethics in genetic research including privacy and legal issues, health issues, social, cultural and religious issues, and a host of others. Government and social policy, ethics and law related to human genetics are all topics that demand our attention. Without our responsible input, our genetic future may be determined by persons with views like Watson’s. Scary thought. The practice of medicine has changed dramatically in the U.S. over the last several decades. With rising costs and declining physician availability, many patients are taking greater responsibility for their own treatment, turning to so-called Complementary and Alternative Medicine (CAM). This places uninformed patients at risk for trusting charlatan practitioners who may end up doing more harm than healing. Moreover, leading edge genetic technologies such as cloning are opening up new therapeutic possibilities while creating new moral dilemmas. Here are three web sites that may be of help in this context.

edited by Gerard Beenen

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www.Quackwatch.com

Quackwatch is a non-profit organization founded by retired psychiatrist Stephen Barrett. Perhaps the most popular site of its kind, Quackwatch.com is a resource to help keep patients informed regarding questionable medical practices and personalities, particularly ones that may be considered as “alternatives” to conventional medicine. There are five sister sites to Quackwatch, with home page links, which provide similar resources for Chiropractic, Dentistry, Homeopathy, Multi-Level Marketing (e.g., vitamin selling schemes), Nutrition, and general health fraud. Although Quackwatch may be one of the most comprehensive places to go on the web for critiques on CAM practices, it does have two main shortcomings. First, the site architecture is clunky and difficult to navigate. There are plenty of well-documented resources on spurious medical practices and products, but you’ll need to hunt quite a bit for them. For example, the home page alone has several hundred links, and a search function that is a lot harder to use than Google. The second shortcoming is the content on the site favors negative criticism of CAM approaches and personalities (hence the name, “Quackwatch”), rather than providing a balanced approach. Nonetheless, if you are considering an alternative medical procedures or interventions, Quackwatch.com is a great place to start your research.

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NATIONAL INSTITUTES OF HEALTH
www.nih.gov/sigs/bioethics/

This is a tightly organized site that points you to a sufficiently comprehensive, though less than exhaustive, set of resources on bioethics. The site has six main sections: Bioethics and the NIH, Other Federal Resources, General Resources, Specific Topics, and Organizations of Interest. The Specific Topics section is perhaps the most comprehensive part of the site, containing useful links regarding issues, policies and guidelines on research ethics, genetics, and medicine and health. Think of this site as an annotated bibliography that guides you to resources available on various topics of interest around bioethics. It doesn’t answer a lot of questions; it just leads you to where you might find answers.

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NATIONAL HUMAN GENOME RESEARCH INSTITUTE
www.genome.gov/PolicyEthics/

“If a child were not declared alive until three days after birth,” wrote Nobel Laureate David Watson in the May 1973 issue of AMA Prism, “then all parents could be allowed the choice … the doctor could allow the child to die if the parents so choose and save a lot of misery and suffering.” This famous statement by one of the co-discoverers of DNA illustrates in the extreme the sometimes chilling moral dimensions posed by human genetics. With April 2003 marking the 50th anniversary of the discovery of DNA by Watson and Crick, the National Human Genome Research Institute (NHGRI)(a branch of the National Institutes of Health) publishes a landmark study describing the future of the field of genomics, and the role the NHGRI and other government agencies will play in enabling that future. Information on this study is available on this site, as well as a variety of resources on policy and ethics in genetic research including privacy and legal issues, health issues, social, cultural and religious issues, and a host of others. Government and social policy, ethics and law related to human genetics are all topics that demand our attention. Without our responsible input, our genetic future may be determined by persons with views like Watson’s. Scary thought.

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