Drug Abuse

1995 VOL 6 NO 1
Whisteblowing against the company: A case of ethical violations at a Norwegian treatment centre

Katherine van Wormer, Department of Social Work, University o, Northern Iowa, USA

Whistleblowing can be conceived of as an activity of last resort in an unusual and extreme situation. For the sojourner in a foreign country, as for the native a home, to pursue this path, the course can be down right treacherous. This article examines the phenomenon of whistleblowing, of what Glazer anc Glazer ( 1989) term 'ethical resistance'. Rarely studied in the social work literature or in schools of social work, ethical resistance is a contingency for which the public or private employee may want to be pre pared. Because without the knowledge of what whistleblowing entails - the dynamics of resistance and counter resistance - the individual may pay an unnecessary psychological toll.

My aim in this article is to filter out from the available relevant literature a framework for the social career of the whistleblower. Then I want to apply this framework to a personal situation. I want to present the reality of whistleblowing in its stunning complexity. I want to present an analysis with which every thoughtful social worker can identify. The first portion of the article places ethical resistance in a theoretical context. Attention is paid to definition of whistleblowing and then to the institutional context within which it occurs. The common role of the worker in society is discussed. In the second half I will depict my own experience as a social work supervisor at an unidentified treatment centre in eastern Norway. Implications for social workers and social work education are provided.

DEFINITION

Whistleblowing is not listed (much less defined) in the current Encyclopedia of Social Work ( 1987 ) . It is not included in small dictionaries of the English language. The Random House Dictionary ( 1966, p. 1628) lists blow the whistle on: Slang, to stop (a person, organisation, etc.) from continuing an activity.

The 1983 edition (p. 2167) comes closer:

'To blow the whistle' is defined as 'to expose the existence of mischief or wrongdoing'.

This is precise and to the point. But no mere definition can begin to capture the emotional turmoil faced by the worker torn between workplace and professional (personal) ethics. The Social Work Dictionary (Barker, 1991, p. 260), very much to its credit, contains an entry under:

whistleblowing - 'alerting those in positions of higher authority in an organization about the existence of practices that are illegal, wasteful, dangerous, or otherwise contrary to the organization's stated policies'.

I had in mind an activity somewhat more extreme, going outside the organisation, perhaps, but the inclusion of this term is an acknowledgement by the field of social work of its importance.

Terms such as whistleblowing seem to capture of themselves, in memorable vernacular, an experience that social workers would recognise in all its intricacies and even forbiddenness. Images that are generated range from 'the lone crusader' and hero, to the bitter worker bent on revenge. As a term, whistleblowing is vested in both positive and negative characteristics. The positive side is conveyed in the terse National Association of Social Work (NASW) statement 'money available for job loss due to whistleblowing'. To the degree that the company or concern is viewed as a malevolent entity, the whistleblower becomes a hero. Thus, Hollywood immortalised Karen Silkwood for her ill-fated attempt to expose conditions in a plutonium plant. Marie Ragghianti, former head of the Board of Pardons and Paroles for the State of Tennessee, rose to fame when she resisted corrupt Tennessee state politics.

The negative aspect is ingrained in the reality of breaking the company loyalty (which at treatment centres can be likened to family loyalty), of playing the spy - both working for organisational goals and against those goals at the same time. Even commentators on professional ethics cast a cold eye towards the employee who would go outside the system. In a conflict of ethics, according to Levy (1976, p.171).

'It is the agency's policies that the social worker has committed himself to.'

Levy recommends that the social worker who cannot honour the policies leave the agency. Kurzman (1983, p.108), likewise, suggests that social workers caught in an unresolvable ethical dilemma 'retain the right to leave'. (One is reminded of the 'love it or leave it' response to antiwar protesters of the 1960s.) Whistleblowing becomes, in this framework, a radical and controversial alternative. One may continue to work inside to expose the violations and ethical irregularities to the outside. Yet secrecy is necessarily required, secrecy and some degree of deception. Such ethical compromise may be regarded as an acceptable means towards achieving some higher end.

WHISTLEBLOWING IN THE CONTEXT OF SOCIAL WORK PRACTICE

A wealth of social work literature addresses ethical issues and dilemmas in social work practice (e.g. see Abramsen, 1981; Kirst-Ashman and Hull, 1993; Kurzman, 1983; Cohen, 1987; Conrad, 1988). The conflict in ethics between social worker and client or between the social worker and agency ethics is addressed only in passing by the writers Cohen (1987), Levy (1976), Reamer (1987) and Walsh (1987). Pawlak (1976) discusses organisational tinkering as a means of effecting lasting change in an organisation. The importance of 'going through channels' as opposed to using 'radical tactics' is stressed.

Whistleblowing is, in social work terminology, more than a mere slang expression, in spite of the inherent clumsiness of the term. Whistleblowing is a direct act of exposure against an individual or the agency for violation of societal ethics or law. The whistleblowing can be considered effective if the offending behaviour or practice is brought to a halt and appropriate changes are made. Typical grounds for complaint may be violations of labour laws, health violations, laws pertaining to business and delivery of services, anti-discrimination laws, and laws and rules protecting clients (e.g. confidentiality). For whistleblowing to be successful, the violation of the law or professional ethics must be concrete and provable. Then there must be official machinery for investigating the charges.

Whistleblowing by the social worker against a social work agency would probably be an exceeding Iy risky (careerwise) and unpopular act. But how about whistleblowing in the non-traditional and perhaps culturally alien setting7 Kurzman (1983) discusses the alien nature of the non human service host environment for social work practice. Potential value dilemmas, he writes, are rampant. Social work values stress human dignity and individual worth. In contrast, industry prioritises production of goods and profits (Kurzman, 1983). Clearly, potential ethical quandaries are involved. But as long as the company is honest and practices sound business ethics, the social worker should be able to maintain his or her professional integrity in the service of professional duties. The problem is where the company's violation of standards produces harm to the individual worker or consumer of services. In this situation, the social worker, as representative of the company or agency, becomes an accomplice in the wrongdoing. Here, the impetus for whistleblowing may be unleashed.

Some may be inclined to sacrifice ethical standards for personal career goals. (Most supervisors, according to Cohen (1987) pursue this self-aggrandising course.) For the way of whistleblowing is the way to loss of employment, friends (see Glazer and Glazer,1986), the opening of the door to ridicule and predictable 'How could you7' looks that can kill. More subjectively, I would place whistleblowing on a continuum somewhere between suicide and murder. I believe that the worker enters this course as an act of utter desperation, all other resources having been exhausted.

Maypole's (1986, p.33) observations on the victims of sexual harassment by superiors are relevant here. The power structure represents 'a virtual stranglehold on the careers of social workers'. Dealing

directly with a harasser in such a position requires extraordinary courage, according to Maypole. Soeken (1986), himself a therapist and psychiatric social worker, writes of his work with more than 100 men and women whose personal problems arose from their efforts to expose fraud, waste or abuse in government, business and industry. His own experience at a Public Health Service clinic, where false psychiatric examinations were used to fire whistleblowers and other 'troublemakers', was the impetus for Soeken's personal concern with providing support for those who dare to speak out and then must struggle with vindication and a host of other overwhelming problems.

NASW News (June 1990) offers a rare headline pertaining to a social worker:

Member Blows Whistle on Prescription Refills.

Kathy Leddy was fired from Hackensack Medical Center in New Jersey 2 months after she complained to the state attorney general's office that social workers were ordering prescription refills, essentially practising medicine without a licence. Leddy was granted an out of court settlement and was hired by another Medical centre in New York. The clinic was reprimanded by the New Jersey State Board of Medical Examiners and was forced to end all illegal practices. Psychology Today (Glazer and Glazer, 1986) reports the in depth interview results with 55 whistleblowers and their spouses. These were ethical resisters who risked all to reveal fraud and waste in their organisations. Coming from a variety of occupations, these individuals were motivated by feelings of professional ethics, religious values or allegiance to the community. Punishment by the corporation took many forms, for example, transfer, demotion, firing and blackmail. The 55 resisters all suffered greatly. In the end, they sought to clear their own names and salvage their reputations. Glazer and Glazer in their book The Whistleblowers ( 1989) places the cases of the 'ethical resistance' within the context of societal constraints and recrimination. When eight city welfare department supervisors submitted affidavits in the case challenging midnight bed check raids of AFDC clients, they became ethical resisters on behalf of their clients (Levi, 1991).

Levi recommends blowing the whistle in situations where administrative agencies persist in violating the law or in enforcing bad law. As a result of courageous efforts in this case, the bad law was ruled unconstitutional.

A FRAMEWORK FOR THE STAGE OF ETHICAL RESISTANCE

I have drawn from the literature on whistleblowing seven recognised stages of resistance. The primary source is Glazer and Glazer ( 1989) whose study reveals the psychological complexity and ultimate frustration in 'going public'. Patti( 1974) and Pawlak ( 1916) provide secondary material on the reality of coming forward.

I will utilise the following framework for stages to present my transition from company advocate to spy to betrayer of trust. The basic stages of whistleblowing are the following:

• beginnings of distress; work through channels;
• professional 'ideology' and mixed loyalty;
• transition stage: from advocate to spy;
• power of personal belief system;
• company retaliation;
• allies in the struggle;
• remaking one's life.

.*

'

Beginnings of distress; work through channels

A social work educator and former alcoholism counsellor, I was recruited to Norway to teach the Minnesota Model to Norwegian counsellors. Translators would help me as necessary. The treatment centre was private and one of the few in the country to subscribe to the disease model. I was to lecture to clients on the 'Twelve Steps of Recovery' and on alcoholism as a disease. Public relations work would be an impor tant part of my work, I would meet influential persons from all over Norway and Sweden. The work was fascinating. The fine Family Week programme was exemplary of the outstanding treatment work that was done at the treatment centre. My American colleague was outstanding as programme director and therapist. Observers came from all over Norway to watch, even, alas, reporters.

Structurally, the treatment centre was organised along the lines of what Max Weber called the charismatic style of leadership. All major decisions were made 'on the third floor'. Decisions at lower levels could be overturned upon a whim. The director-owner was a recovering alcoholic but one without the expected AA (Alcoholic Anonymous) involvement and ethical code. Predictably, he was engaged in a more or less continual power struggle with the programme director. Although one made business interests primary, the other stressed treatment and professionalism. It was indicated to me that company loyalty was the road to personal advancement and professional survival. Delighted to be working in Norway and with the kind of 'royal treatment' accorded to me in the early days, I had few complaints. I remember thinking that the programme director was too professional and even rigid in his approach.

Pawlak's ( 1976, p. 3 79) theory of escalation is relevant here. The essential point of this strategy is that the protester should not begin by engaging in the most radical and abrasive strategy. . . The protester's etiquette and failure to go through channels (can) become the bone of contention, and the protester the object of protest. Both my American colleague and I went through channels. Our request was for trainee therapists with at least 6 months of sobriety. The high rate of relapse for the newly sober staff seemed an unnecessary impairment to the professionalism of the centre.

Professional ideology and mixed loyalty

Patti ( 1974) discusses the how and when of internal advocacy. Internal advocacy is defined as working for change from a subordinate position within an agency. The decision, according to Patti, whether or not to engage in internal advocacy will be influenced by the urgency and magnitude of the problem faced, the worker's personal inclination and, above all, the agency climate. The barriers that impede this kind of practice are considerable: job risks, patterns of job mobility and uncertain legitimacy of the position taken (Patti, 1974).

Passionately, furiously, my American colleague advocated internally. Many memorable staff meetings took place. The director then made some abrupt lower level staff changes. Bringing on board his ex bodyguard and confidant, he 'let go' the programme director's translator and right-hand man. My colleague now found much to complain about: first there was the ex bodyguard's very recent sobriety. Then there was the director's public involvement with a much younger recent ex-client. Mean while the ex-bodyguard moved in with the much older assistant director. In the midst of the chaos, my colleague returned to America. He died of a stroke shortly thereafter.

Several months later, five trainee therapists decided to blow the whistle to the press. Their concern was with the sexual harassment to which they had been subjected, the kidnapping of clients into treatment and the lack of pay for trainees. These workers were simultaneously fired. I was now the programme director, in fact, if not in pay. With the ex-bodyguard I ran the treatment for alcoholics and their families. Over time, the ex-bodyguard and I became friends. It was then that he confessed to me that he had threatened the late programme director. This happened at the airport; the American seemed to be in a state of confusion as he boarded the plane. As he had been 'under orders' frorn the director, the ex bodyguard blamed the director and was no longer loyal to him.

Increasingly, for guidance I looked to professional ideology. Researching the social work code of ethics over and over, I pored over the part about one's professional responsibility to one's colleagues and to the community. My mind began to race forward with possibilities and intrigue.

Transition stage: from advocate to spy

As Glazer and Glazer ( 1989) suggest, workers who stay clean and refuse to compromise their values (such as the policeman, Frank Serpico) are in the best position to challenge professional malpractice. Nevertheless, merely to work for an unethical organisation, to represent the organisation publicly, and to recruit and train staff, each is in itself a degree of professional compromise. Of all the employees of the treatment centre, except for the accountant, I was the only one with professional credibility. In marketing this fact was stressed, 'a treatment director with a PhD, American expertise provided'. The discrepancy between my public performance, the smiling representative of the agency, and the private turmoil was growing. As I received secret 'phone calls from those 'on the outside', I began to feel like a spy. 'Some day I will write an article on all of this,' I told myself.

Glazer and Glazer ( 1989) do not describe the transition stage, the time when the disillusioned worker goes through the motions of loyalty to the paying institution while his or her true loyalties are elsewhere. The feeling of being an imposter can be overwhelming. Goffman ( 1959) captures the essence of this ambivalence in his description of the gay person masquerading as straight in straight company. I was masquerading as loyal in endless paranoid staff meetings concerning the growing number of enemies both inside and outside. Numerous court cases were pending.

The power of a personal belief system

The belief system for ethical resisters is regarded by Glazer and Glazer ( 1989 ) as paramount. In situations of deceit, colleague support is hard to come by. Workers have vested interests in believing in their places of work; managers exploit such feelings and label dissenters as trouble makers. To stand alone against such forces, the individual is bolstered by a strong professional and/or personal belief system and by support of local activist groups. My decision to join the Norwegian Social Work Union was a logical way to acquire a sense of belonging and community.

During the year that followed I trained many newly sober clients to do the therapy. The director no longer paid trainees, they were instructed to apply for sick pay for alcoholism and to live on this. Turnover was extremely high: about four trainees per month was average. The editor of Sosionomen, the Norwegian social work journal, called to request an article. The issue was to be the need for regulation of alcoholism treatment centres. The article was professionally translated into Norwegian.

Company retaliation

Glazer and Glazer ( 1989) devote a chapter to a detailed analysis of management's response to the whistleblowing. According to the Glazers:

'The resister's lack of gratitude and the resultant threat to the organization's line of command required a firm response' Glazer and Glazer(1989,p. 133)

Few resisters, in the sample of 55 studied, were prepared for the gravity of their fate. But as the Glazere are careful to point out, the revenge may be under taken not for personal reasons, but rather as part of a rational and planned process of breaking the resister and his or her credibility. False accusations (or true ones), dismissal from the job and barring the whistleblower from getting other jobs are the most common forms of retaliation fostered upon ethical resisters.

'They feel humiliated and emasculated by a process that leaves them powerless, frightened and facing an unpredictable future'

Glazer and Glazer (1989,p. 155)

When my article 'The need for regulation' (van Wormer, 1990) hit the press, I was in the process of negotiating the return air fare for myself and my family. All negotiations came to an abrupt end. I had several hours to clear everything out of my desk an/ office. My salary and holiday money were confiscated. And what a shock when I got to read in the local paper that police charges would be filed for 'underslag' - embezzlement!

With the permission of Sosionornen I will cite the whistleblowing portion of that article. This portion chronicles the depth of my professional compromise

'Professionals who work for an organization which is allowed to engage in questionable practices become necessarily implicated in the carrying out of those practices. Compromise becomes an essential form of survival in the profit-oriented treatment institution. The social worker will try to work within the system to change the system and then one day, in anger and desperation will turn to the outside

'I have survived at this treatment center because as a foreigner [unable to speak Norwegian] I have really had no option. Also, I thought I could have some influence. I have survived by uttering feeble protests, manipulating the situation where possible, but mainly by "turning a deaf ear". I have turned a deaf ear to some of the following practices in which I was directly or indirectly involved:

• Placing recent ex-clients on night watch duty; this entailed distribution of sedative medications.
• Training recent ex-clients to do therapy before they were ready, encouraging them to receive their money illegally from the government.
• The firing of the entire treatment staff (except for the director's ex-bodyguard) for disloyalty to the director.
• Pressing clients to proclaim their illnesses publicly to the press.
• Pulling clients out of treatment to perform duties "for the home."
• Getting clients drunk, then "kidnapping" them to treatment.
• Violation of health laws pertaining to rights of non-smokers.
• Former clients turned out of aftercare programs for disloyalty.
• Sexual harassment (sex press) of clients and staff.' van Wormer ( 1990)

The aftermath of the article made the point better than the article itself - regulation by the state was necessary to protect whistleblowers as well as the ordinary workers and clients.

ALLIES IN THE STRUGGLE

Key support systems are crucial to sustain one's strength in the face of the psychological blows that are dealt out. The presence of peer support is viewed by Patti ( 1974) as one of the most important requirements in successful advocacy. Through expressive support, the resister can maintain his or her morale and perspective. The Glazers ( 1989) graphically describe the whistleblower's quest for vindication during the final stage of resistance. Three basic goals are delineated:

1. To have an external body officially declare that the charges are true.

2. To have one's name cleared through public confirmation.

3. To recover what was taken away during the retaliation period.

The Norwegian Social Work Union, through their attorney, have given me their full support. As of this writing an appropriate settlement has been reached. The union journal has devoted a great deal of effort to the fight for regulation. And, reportedly, in fact, the Norwegian government is now preparing to take a stand to remedy the present desperate situation. The Norwegian social work journal, Sosionomen, has devoted three follow-up issues to developments of the case and to supporting testimonials from victims of sexual harassment and of other professional conduct at the treatment centre.

REMAKING ONE'S LIFE

Glazer and Glazer quote one of their interviewees in the aftermath of retaliation:

'As a whistleblower you will experience every emotion known to mankind . . . Be prepared for old friends to suddenly become distant. Be prepared to change your type of job and life style. Be prepared to wait years for blind justice to prevail.' b

Glazer and Glazer (1989, p. 237)

I feel lucky that I arrived when I did and that I had the professional tools and connections to do what I did. The sadness that haunts me is that when I left, nobody waved good-bye. Nothing in graduate school prepares us, nothing in the professional journals informs us. To be willing to blow the whistle you have to be willing to be despised. Not to be seen as sick, angry, merely, but as a traitor. Still, you do it because you have to. And because it feels good. And because it can be one of the most thrilling and meaningful things a social worker can ever do.

CONCLUSION

Whistleblowing may take many forms. It can be an impulsive, 'I couldn't care less' act of utter frustration or a carefully and secretly plotted revelation as in the case history presented here. The individual may stand alone (and fall alone) or there may be dynamic group backing by a union with full legal and monetary support. And what is the end-result of all this resistance ? There can be a compensatory monetary settlement (as reported in NASW News, 1990) or the company may be shut down (both outcomes are extremely rare). More simply, the truth may be revealed to the general public (through the mass media perhaps). In all probability, however, nothing significant will happen at all. The would-be whistleblower will be silenced, his orher professionalism stifled along with the intended message. The various dictionary definitions, accordingly, fail to do justice to the complexity and difficulty of the act: whistleblowing, as conceptualised in this article, is 'going public' against your company or agency, against your people; it is finding a way when there is no way; it is finding a way to be heard. I blew the whistle. And I was discredited. I like to think that I blew the whistle not as an American or a female, but as a social worker schooled in the tradition of Addams and Perlman and the conscience of the profession to believe that it matters. Because it matters, I did what I did and in the way that I did it. But I also must admit - and no article or book will mention this - I did it because it was fun.

Katherine van Wormer, Department of Social Work, University of Northern Iowa, Cedar Falls, Iowa, USA.

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