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Intelligent Disobedience
Doing Right When What You're Told to Do Is Wrong
By Ira Chaleff Berrett-Koehler Publishers, Inc.
Copyright © 2015 Ira Chaleff
All rights reserved.
ISBN: 978-1-62656-429-9
CHAPTER 1
The Pressure to Obey: What Would You Do?
I was teaching a class on courageous followership to a group of doctoral candidates at a Methodist university. Courageous followership is a way of being in relation to leaders. It requires giving those in leadership roles genuine support and building relationships with them that will allow those in follower roles to speak candidly when needed to prevent or correct leadership failures. It was a great class with lots of lively, engaged dialogue. During a break, one of the students came up to me and told a story that made a deep impression on me. This story happened twenty years prior to our conversation.
She had been a young nurse, fresh out of nursing school and assigned to a hospital emergency room. A cardiac patient was rushed in. After a quick assessment, the emergency room physician ordered her to administer the medication he judged the patient needed. She was stunned because she had been taught that this particular medication carried grave risks for a cardiac patient.
For a moment, put yourself in her shoes—in those days, probably uniform white shoes. This was an era when nearly all physicians were male, all nurses female, so the gender-based inequality of power was pronounced. The physician was older and more experienced, so this added to the perceived power differential. And, after all, he was a physician, with years more training than she had! Can you feel how many social forces were at work pushing her to snap to and do what she was told? Can you sense the time pressure to act one way or another with a cardiac patient's life at stake?
She confided that she did not know where the needed courage came from to speak back to this authority figure. She told the doctor that she had been taught that particular medication could be fatal in this patient's situation.
What was the doctor's response? As is so often the case with someone in authority, he bristled at the questioning of his decision and in a raised voice, with a stern glare told her, "You just do it!"
Imagine yourself in that moment. You are in an emergency room. You chose nursing as a profession to help people. You want to be a competent, caring professional. If you act against your training and administer the medication and the patient dies, how are you going to feel? How will you face the patient's family? How will you face a review board that examines actions that were taken? There is no "do-over." But what if the doctor is right and you disobey? What if your refusal to act endangers the life you are trying to save? How will you live with that? And what will be the repercussions of disobedience on your career that you have just spent several years preparing for?
There's no time to hesitate. What would you do?
Seriously, what would you do?
We don't face such obvious life and death choices like this every day, but it is just such a choice that requires us to think about our accountability for obeying or disobeying, regardless of who gave the order. And it gives us a chance to mentally rehearse what it feels like to be under great pressure from an authority figure to do something we feel may be wrong, or even very wrong. When under pressure like this, our ability to make rational or moral calculations may freeze as we are flooded with stress hormones. Our ability to think outside the two choices—obey or disobey—may shut us off from productive alternative responses. The decision to question a forcefully given order usually must be made in a situation of high emotional stress. Will that excuse the choice you make? Will that allow you to fall back on "I was just following orders"?
If you've allowed yourself to feel what this young nurse must have been feeling, you realize that you're at the point where you are going to need to take a deep breath, pump some oxygen to the brain, and quiet your fear sufficiently to make a principled decision.
So I invite you to actually do that now, to keep experiencing what she must have felt like. Take a deep breath. Take a moment. Think about alternatives to responding to the situation you suddenly find yourself in.
Now let's return to the emergency room to see what the young nurse did. This is a paraphrase of what she told me:
"I hooked up the IV bag to the patient, and I injected the medication the doctor had ordered into the bag. Then I called the doctor over and told him the medication was ready to be administered. All that was needed was to open the valve on the IV bag, but that I couldn't do it because it violated my training. He would need to open the valve himself."
Do you see how she found a stance that was neither obeying nor disobeying, but stayed true to the principles she had been taught? Most of the groups to which I tell the story at this point let out low sounds of admiration for the way this newly minted professional found the composure to hold her ground. I certainly do. I am not at all sure that I would have had the presence of mind to generate the option she chose in that intense situation. That is the value of sharing stories. They mentally rehearse us for times when we find ourselves in similar, intense situations.
What was the outcome of this story?
The nurse's requirement that the doctor himself open the valve, if he was indeed convinced that his order was correct, stopped him in his tracks. It was enough to get him to rethink the risks and the other options that were available. He changed his order to administer a different medication, which the nurse promptly did. The patient recovered fully.
What was going on here? Was this an incompetent doctor? Probably not. Just as we put ourselves in the nurse's shoes, we need to put ourselves in the doctor's shoes. He may have been doing his residency at the hospital, a requirement for all physicians. Hospital residencies are infamous for the brutally long hours they require, particularly in the period this occurred. It could be that he was sleep deprived and that his own mental processes were operating at a reduced level. Emergency rooms can be particularly hectic places where the patient load suddenly spikes as several ambulances arrive at once, or violently ill patients begin retching or having seizures in the waiting area. Maybe the doctor himself had a touch of illness he was working over.
None of these conjectures are to excuse bad decisions; they are offered to humanize the authority figure. Whether a doctor, factory manager, fast-food supervisor, school principal, financial executive, or athletic coach, sometimes those in authority are not at their best, yet the responsibilities of their position require them to act. We must be able to see them as both having legitimate authority and human frailty, and at times be prepared to question them, correct them, or even disobey them. Because we can't say "we were just following orders."
Remember that nurse. There is one great role model, whatever your profession.
A few initial lessons we can glean from our engagement with this story:
1. The need for Intelligent Disobedience can arise suddenly and demand a high order of poise to respond appropriately within the compressed time the situation demands.
2. We must give our own perceptions, training, and values equal validity to the perspectives of those in authority when weighing the right course of action.
3. There are often options other than "obey" or "disobey" that can lead to better outcomes.
4. If we take a deep breath and pause to think, we may be able to offer alternative creative responses that satisfy the authority and better meet the need of the situation.
CHAPTER 2
Obedience and Disobedience: When Is Which Right?
"If a man can only obey and not disobey, he is a slave; if he can only disobey and not obey, he is a rebel; he acts out of anger, disappointment, resentment, yet not in the name of a conviction or a principle."
Erich Fromm
To understand appropriate obedience and disobedience, let's reconsider the scenario in the previous chapter.
We saw the nurse resist what she thought to be a destructive order. Her skillful resistance caused the physician to reflect on his own reasoning and to take a different, presumably safer course. The patient recovered and the story had a happy ending. We know, however, that it could have played out differently.
Was it the success of the patient outcome that made this an act of Intelligent Disobedience as opposed to outright insubordination? Or were there intrinsic factors that made it Intelligent Disobedience, regardless of the outcome? To answer this we need to examine our concepts of obedience and disobedience.
Most cultures have a bias that obedience is good and disobedience is bad. If you doubt that, read the same sentence in reverse: Most cultures have a bias that disobedience is good and obedience is bad. That doesn't make sense to us because it isn't true. Why is that?
All human society must be organized around certain rules. How will we live together? How will we defend ourselves against hostile forces? How will we make decisions that affect the community? How will we respond to those who don't follow the rules the community has developed?
To Obey or Not to Obey
We recognize that to enjoy the many benefits of community and organization requires a degree of voluntary, and at times involuntary, obedience to the norms. This is the default position in society. It has been observed that there are three components to appropriate obedience:
1. The system we are part of is reasonably fair and functioning.
2. The authority figure setting the rule or giving the order is legitimate and reasonably competent.
3. The order itself is reasonably constructive.
I am inserting the term reasonably into these conditions because we are dealing with imperfect human systems and human beings. In many situations, "reasonably so" is the realistic standard. In a few situations, such as the safety of nuclear power plants, the standard must be higher.
In the nurse's case, the first two conditions were present. The third was not. If all three had been present, then obedience was the appropriate default response, not because she had been given an order but because it was an order that appeared correct and did not violate her own knowledge of the situation.
The nurse didn't consciously ask herself if the system was fair; that was to her a given. Nor did she have reason to question the second component. It was presumed the doctor was a real doctor, with appropriate training and credentials. The third component, however, triggered an alarm: based on the information she had, the order, if executed, could be harmful, maybe deadly.
The Simplest Test
This is the simplest test, and often the most practical test, for Intelligent Disobedience: based on the information we have and the context in which the order is given, if obeying is likely to produce more harm than good, disobeying is the right move, at least until we have further clarified the situation and the order.
Why is that so hard to do? We are wired to obey. It is an evolutionary adaptation for allowing the growth of complex human organization and society. A general summary of works by developmental social psychologists such as Jean Piaget and Lawrence Kohlberg tell us that although our tendency to obey is strong, our reasons for obeying evolve as we grow:
At first we obey because our parents say to: "authority is always right."
Then we obey because we become aware of the social rewards and penalties for obeying and disobeying: gold stars for the former, after-school detention for the latter.
Later we obey because we realize the need for society to have the predictability that rules and laws bring: confidence that everyone at the four-way stop sign will wait their turn.
Ultimately, if our moral development isn't stunted, we obey because we realize the intrinsic value of the rule or order in the context in which it applies.
In the nurse's situation, she in fact was obeying, but not the ill-conceived order. She was obeying a higher set of values that had grown up with her developmentally: values of placing human life and safety above her own fear of reprisal; of adhering to her hard-won training; of maintaining professionalism in a crisis situation. She discerned that the order was not correct, given the context and its potential for causing more harm than good. Whether consciously or instinctively, she chose to obey the higher level values, which directed her to take a stand.
Are there higher level values we all share as a guide for the choices we make? It does not appear life is so simple. A brief examination of history shows how dramatically values can change in a culture over the short space of a few generations. We can see the variation there is in the weight given to similar values in different cultures or even among different families. Values that we hold dearly conflict with other values we hold and may shift in importance as we change or the realities around us change.
Despite this, there are some values worth standing up for, regardless of shifting cultural mores. We may conceive of these values as inherent in life, as emanating from a higher source, as a rational way to live, or as aspirations for the people we wish to become. Regardless, there is an inner sense of values to which we can refer when faced with difficult choices. This is sometimes referred to as an inner voice. However that inner voice has come to be, if we recognize and honor that voice, it becomes the internal balance to the social pressures exerted upon us.
The Value of Obedience
Still, as we have seen, obedience is our default mode. Is this good?
Obedience is not itself good or bad. It is the context in which it occurs that gives it positive or negative value. Obedience can even be a malicious act. How? The person receiving the order knows that implementing it will have adverse consequences but implements it anyway because it will make the authority who issued the order look bad and be publicly discredited for issuing it. Leaders, beware of creating an environment in which you insist on unwavering obedience!
If obedience is not itself good or bad, neither is disobedience. Let's imagine that this particular nurse had issues with authority figures. Many people do. If she remained developmentally unaware of these issues, she might respond to the physician's order not based on reason but from an unconscious need to assert her independence.
I once sat in a dentist's chair having a cavity prepared for a filling. Each time the dentist drilled and thought the tooth had been prepared, his dental assistant would check and tell him it wasn't good enough. The first time or two this could seem like a healthy collaboration on their part. After the fifth time, it was evident there was a power struggle occurring. The result was the enamel in my tooth was drilled too thin and broke, requiring more extensive repair of the tooth.
The last thing a physician needs in an emergency room is a nurse acting out unresolved authority issues. The correct default stance in that context is prompt, accurate obedience to legitimate authority issuing appropriate professional orders.
Although we often rail against authority, there is a great benefit to systems in which it is clear who has the authority to establish rules and issue orders: it avoids endless conflict between competing ideas. There are always different goals that can be pursued and different ways of pursuing them. If each individual insists on his or her preference, or each faction on theirs, the result is paralysis, or worse, internal warfare. In healthy systems, dialogue is encouraged to inform the best possible decision. But once all voices have been heard and a decision is made by those with the authority to make it, if no core values are being violated, supporting that decision is the correct mode.
Let me underline this point by referring back to the inspiration for this story, the trusted guide dog whose core value is keeping the human in its care safe. We will examine the training that equips it to do this in a later chapter. For the moment, keep in mind that the young dog is first socialized to obey the rules and commands it needs to know. Only when the dog is socialized is it taught the equally critical skills of Intelligent Disobedience.
Deciding Whether to Obey
There are underlying rules operating in any group that enable its members to reach decisions as situations arise that require making choices. There are likely two related rule sets, or what we might call social algorithms, running at once in the guide dog or in the human being about how to respond to a command or order. The first is the algorithm of obedience:
* I am receiving a rule or order from a legitimate source, not from a random direction.
* I understand the rule or order, what its goal is and what is expected of me in achieving that goal.
* The order is good, or at least neutral in terms of the impact it will have.
* Because no serious harm will result from implementing the order and no core value is being violated, I will obey the order.
This is the dominant algorithm that we use most of the time. If we didn't, life would deteriorate into endless conflict.
(Continues...)
Excerpted from Intelligent Disobedience by Ira Chaleff. Copyright © 2015 Ira Chaleff. Excerpted by permission of Berrett-Koehler Publishers, Inc..
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