Rehab

Amy Winehouse’s chart-topping, Grammy-winning song “Rehab” is an old-fashioned piece of rock-and-roll defiance:

It’s also a statement about drugs in the workplace, and a very impacting one when the workplace is a concert hall and the worker standing up in front singing is collapsing under the weight of abuse, falling out of her clothes, tripping across the stage, forgetting the lyrics. Winehouse’s picture is all over the Internet with cocaine dabbing her nose. She’s been filmed inhaling crack. When people notice that her arms are laced with cuts, she explains that she knives herself during withdrawals as a distraction from the aching need for another drink or shot or whatever. Still, she sings that she’s not going to “go, go, go,” and everyone out in the crowd sings it right along with her.

Where’s the line? Does it get crossed when she finally gets to the point where she can’t walk out on stage? Or will the line get drawn when people stop paying money to watch her sing and the profits dry up? Or maybe there is no line, maybe she means what she sings and there won’t be any stopping. And no matter where the line is, who decides? Is it her equally distraught, on-and-off husband? Her manager, her record label, her fans? No one at all except Amy Winehouse?

Sooner or later her story is going to end badly, but the questions will keep getting asked because drugs lace so deeply through professional lives. In most offices the boost comes from coffee, Red Bull, antidepression pills, or the prescription amphetamine Ritalin (which, to complete the ladder, is used to cut cocaine). Then there are the relaxers, the cigarettes, the gin tonic, the Valium. In between, there’s a broad and colorful spectrum of chemicals that help people go to work, do their work, and get away from work. Some athletes—or just guys wanting to fill out a suit—are using steroids. Others respond to the stress of the workday with high blood pressure or similar, and there are drugs for that too.

The ethics of drugs at work starts with a straightforward question, and then divides into two areas of debate. The question is “What counts as a drug?” The two areas of debate are the following:

1. What should happen when a worker wants to use drugs or alcohol, and that goes against an employer’s policy and wishes?
2. What should happen when the organization doesn’t intervene in a worker’s drug use, or actually encourages it because the organization benefits from the use?

What Is a Drug?

The technical definition of a drug is a substance affecting the structure or function of the body or of one’s consciousness. When discussed in business ethics, only a slice of the broad category is applicable. The subject here isn’t diabetes medications and similar doctor-prescribed substances; the dosing under consideration is recreational drugs and those substances taken to improve performance temporarily, but that don’t seem medically necessary and that may not be medically desirable, especially because they cause negative effects further down the line. Steroids are an easy example.

In the area of business ethics and drugs, it can be stated that, loosely, a drugIn the area of business ethics, a substance providing a temporary and artificially desirable state, one followed by a reversal to a level below the original condition. means a substance providing a temporary and artificially desirable state, one followed by a comedown or a reversal to a level below the original condition. Under this definition, the reason a Red Bull is a drug and, say, taking a nap isn’t is that while both provide some good working hours, Red Bull eventually leaves you even more tired than when you started. It comes with a letdown not affecting those who choose a nap. Something similar, but over a longer term, happens to those who use cigarettes to tighten their concentration. For many, nicotine works; it helps get work done. Later, however, when you try to kick the habit, it’ll be hard to concentrate on anything at all for months. What, finally, makes a drug a drug is that in essence it’s something that lets you borrow against the future.

A Brief History of Drugs (with Lessons That Could Be Applied to Sex)

One warning should be inserted before any ethical consideration of drugs, sex, and similar themes in the workplace: both the legal rules as well as social attitudes are subject to change over time. The fact that rules can change doesn’t mean they will or should, but simple prudence demands that anyone trying to form a justifiable position in any particular ethical situation should be aware of how significantly society’s broad view of the subject can transform in relatively short periods.

The way we think about almost everything evolves, but the case of attitudes toward alcohol, marijuana, and similar substances go beyond gradual developing: they can turn so abruptly that they fall into the category of social paradigm shiftsAn abrupt change in a social attitude.. The word paradigm (from the Greek word paradeigma) could be translated as “pattern.” Think of it as a pattern of thought or a pattern of processing things. More than an attitude, a paradigm is a worldview, an almost instinctual way of seeing and understanding experience. A paradigm shift is a change in the way we perceive things as we try to understand them.

As an abstract example, you’ve seen three-dimensional boxes drawn on paper with just a set of twelve lines. You look, and one face seems to be in front and the other behind. But when you blink, the box seems to have shifted and reversed: now the front is the back and the back is front. Called a Necker Cube, this experience of certain things in the world that make perfect sense even when seen in opposed ways is analogous to a social paradigm shift. In both cases, something is out there, and all of a sudden we see it in an entirely different but equally true way. Another, more human example, of a paradigmatic shift has been lived by all of us when as boys and girls we passed through puberty. Suddenly, and almost inexplicably, the way most of us saw members of the opposite sex was different. As it happens, this adolescent shift is based on biological transformations, but the cause can be anything. What’s important is that fundamental views modify very quickly, and over the course of the 1980s in America, fundamental views about drugs in the workplace modified significantly and fast.

In 1981, an American military jet crashed while trying to land on the USS Nimitz, an aircraft carrier. Numerous crew members were killed. Subsequent tests showed some were high on marijuana. That worrisome result—along with the suspicion that drugs may have contributed to the accident—provoked testing of soldiers across the armed services. Positive results were startlingly high. Quickly, zero-tolerance policies were imposed within the military. Soon, the restrictions spread to the civilian side of the federal government. By 1988, the Drug-Free Workplace Act had been promulgated; it required that most companies doing business with the government certify that they maintained a drug-free workplace. More, federal contractors were asked to publish a policy explicitly prohibiting the use and distribution of unlawful drugs at work, and also institute a drug awareness program emphasizing the potential dangers of substance abuse. Soon, even businesses not engaged with the government were customarily advertising themselves as drug-free workplaces.

None of this seems remarkable now, but it would have seemed so in 1976 when then-presidential candidate Jimmy Carter campaigned in favor of decriminalizing marijuana use and his leading expert on illicit drugs believed that cocaine wasn’t a serious public health threat. At the time, Dr. Robert DuPont was head of the National Institute of Drug Abuse, and he too supported marijuana decriminalization (though he later changed his mind after learning that thirteen-year-olds in suburban neighborhoods like his own were passing around joints at their birthday parties). While tolerance dominated political attitudes toward drugs, the media was busy glamorizing them, especially cocaine. A widely read article informed Americans that “among hostesses in the smart sets of Los Angeles and New York, a little cocaine, like Dom Perignon and Beluga caviar, is now de rigueur at dinners. Some partygivers pass it around along with the canapés on silver trays…the user experiences a feeling of potency, of confidence, of energy.”“Thirty Years of America’s Drug War: A Chronology,” PBS, Frontline, accessed June 1, 2011, http://www.pbs.org/wgbh/pages/frontline/shows/drugs/cron/.

It seems like that must have been a long time ago. It’s not, though—only a few decades. And there’s no reason to believe we won’t see similar shifting in the coming years; we just don’t know what will change and which way it’ll go. Regardless, the lesson for business ethics is simple and applies whether the subject is drugs or sexual advances or whatever in the workplace. It’s that the broadly accepted rules and social attitudes should be handled—and relied on—with care.

What’s Wrong with Drugs at Work?

The most commonly discussed issue in the area of drugs and work involves the organization’s interest in promoting and enforcing a drug-free workplace. Of course space is made for coffee. It’s true that the drink can leave people irritable and aggressive, but the effects are mild and since almost everyone uses it, there’s not much to do by way of dissuasion anyway. And pushing into the slightly stronger stuff, most organizations accept the occasional wine and beer shindig in the office corridors on Friday afternoons to loosen the atmosphere a bit. For the most part, however, companies want their workers straight for two reasons: productivity and safety.

A study published in the Journal of the American Medical Association (JAMA) asserted that postal workers testing positive for illegal drugs (typically marijuana and similar) were significantly more likely to be fired, injured, disciplined, or absent than their nonusing peers.Craig Zwerling, James Ryan, and Endel John Orav, “The Efficacy of Preemployment Drug Screening for Marijuana and Cocaine in Predicting Employment Outcome,” Journal of the American Medical Association 264, no. 20 (1990): 2639–643, doi:10.1001/jama.1990.03450200047029. Study quoted in William Shaw, Moral Issues in Business, 10th ed. (Belmont: Thomson Higher Education, 2007), 335. If that study accurately represents reality, then companies stand on firm ground when arguing that because they have a right to expect a full day’s good work for a full day’s pay, they can demand that employees be drug free. If they’re not, the argument goes, the statistics indicate that they’re less productive. And if they’re absent, then their coworkers who count on them being there may end up being less productive also. Drug use, finally, becomes an ethical breach of the duty to fidelity. It violates the responsibility employees have to honor their commitments to employers.

Moving in a slightly different direction, all public companies hold responsibilities to their shareholders. They include, in most cases, the obligation to make a profit—and to make as large a profit as possible within the parameters of normal business practice. That obligation may well go unfulfilled, however, if a workplace is not drug free. Because companies frequently pay health insurance premiums for their employees, workplace injuries climbing in number and severity resulting from drug use ultimately add to the firm’s operating costs. And these subtract from the annual profit.

The stakes rise as occupations become more prone to accidents affecting those outside the company or organization. While a walking mailman probably can’t do too much damage to others no matter how many swigs he takes from his hip flask, a crane operator, a school bus driver, an airplane pilot, a technician at a nuclear power plant, all these kinds of posts demand that employers take aggressive steps to ensure workers are well suited to carry out their duties. If they’re impaired and make mistakes, there’s no telling who or how many may suffer. What’s certain is that lawyers will chase to the scene of any accident fitting those characteristics. As the punitive lawsuits pile up, the catastrophic accident caused by drug use will probably turn out to be a financial disaster for the company. It will also be an ethical nightmare. Assuming the drug use causing the accident was preventable—a more scrupulous and sternly applied policy would’ve cleaned out the workplace and so avoided the accident—all the major ethical theories produce condemnation:

• The duty to avoid harming others is broken.
• The utilitarian imperative to serve the general welfare is breached.
• The right to individual freedom of the accident’s victims gets jeopardized or destroyed.

Summarizing, the following concerns lead to policies within most organizations—as well as concrete actions—aiming to control how employees treat their mind and bodies:

• Drugged employees can be less productive.
• Employees using drugs can cause others to be less productive.
• Medical insurance and other costs elevate as drug use rises.
• Risks to third parties increase with drug use.

Against these powerful arguments in favor of limiting or eliminating drugs in the workplace, individuals naturally chafe at demands made by their employer that go beyond specific job tasks. Many of them figure that they’re paid to do a job, and as long as they’re doing it, the boss ought to leave them alone. While it’s clear that the Amy Winehouse situation is an extreme one, it’s also quite typical in terms of its basic structure. On one side, the people writing her paycheck want her getting to the workplace on time and then performing well. They want her remembering the lyrics and they’d prefer that she not fall off the stage. She, on the other hand, wants to enjoy her leisure time as she pleases, and she’d prefer that others just leave her to do her work in the way she sees fit.

Drug Tests: Actions by the Organization to Stop Drug Use

From the management’s side, a number of actions may be taken to diminish drug use in the workplace. Most are noncontroversial. Just like cigarette boxes come with dire warnings, so too company policy handbooks and employee bulletin boards are used to underline the potentially negative effects of use and abuse. More positively, drug-free lifestyles may be encouraged through an organizational culture stressing healthy choices. Special bonuses may be given to those who quit smoking (or certain privileges may be denied to those who don’t). Possibly, a gym membership will be included with a standard contract. Biking to work may be encouraged (the advertising agency Crispin Porter Bogusky has a bike repair shop right in its offices). More incentives could be added but, in general, steps organizations take to encourage physically healthy lives receive little resistance and do, at least indirectly, discourage substance abuse.

With increasing frequency, intrusive steps are also being taken to separate drugs from work. Drugs testsA chemical analysis to determine whether an individual has used drugs. are the most notable. Over the course of the last decade, scientific advances have made these probes easier to administer and less expensive to apply. That, combined with hardening attitudes about drugs in society and at work, has led to increasingly frequent testing. The checks are applied to filter new employees and also (though less frequently) to guarantee the condition of those already on the payroll.

This testing is a controversial practice both legally and ethically. There is agreement on one point: no one can be forced to take a drug test. At least with respect to work-related activities (as opposed to police-related events including drunk driving), any employee is always free to say no, to quit, and leave. Within the business world, all drug testing must be consensual. Informed consentWith respect to drug testing, a decision to accept possible testing after making a careful and deliberative judgment. is an employee agreeing to undergo a drug test (or a series of them, or at least be open to possible testing) only after fully understanding the reason the organization is asking for the test, what is being tested for, and knowing—fully—the extent to which he or she may refuse. Beyond simply having information, informed consent also implies deliberation. In a complicated situation, few are able to make good decisions instantly; typically, sleeping on a question or something similar is necessary for an individual to feel as though he or she may consent to a test in a confident and informed way. Finally, consent must be voluntary in the sense that those agreeing to it understand what pressures are operating to encourage one or another decision. Naturally, people are going to feel a variety of tugs and pulls (from peers, from a union or civil rights organization, from management) to make a certain decision. For the decisions to be voluntary, those pressures must be understood and accounted for. Basically, informed consent means those subjected to the test can’t be railroaded.

In some fields, refusal to submit may lead to termination (commercial airline pilot). In others where an employer has no health-connected reason to seek a test, and no reason to suspect that drug use or abuse is occurring, the employee should know that refusal can be an option, both legally and ethically.

Legality and Types of Drug Tests

Legally, the question about the employee’s right to say no to testing is a moving target. Currently, the federal government and most states allow drug screening as part of the hiring process and generally allow tests on existing employees as a condition for continued employment if there’s reasonable ground for suspicion of use. Grounds for suspicion include slurring words, acting disoriented, seeming unfocused, and similar. Most college students have a pretty good idea. Some states, including Minnesota, allow tests to be performed on random employees even without cause for suspicion. In this case, advance notice is required of the random test process.

As for the kinds of tests that are applied, urine is common. Obviously, bosses sniffing alcohol on the breath is a functioning, though unscientific, check. Saliva can be analyzed. Because traces of drugs remain detectable in hair for much longer than urine (about three months versus three days) and because it’s easy to clip a few strands, this type of drug test is not uncommon.

Ethics of Drug Tests

Ethically, justifications for drug tests rest on the legitimate reasons organizations have for wanting to weed out users from the workforce: drugged employees can be less productive, and cause others to be less productive, and use may raise operating costs as well as pose risks to third parties. The linchpin argument is that these concerns give organizations a right—and also a responsibility—to do all they can to create drug-free workplaces. Tests serve that obligation. Because they’re a reasonable way to keep worker performance up, operating costs down, and everyone as safe as possible, employers have a responsibility to apply them.

Critics of drug testing also muster strong arguments. Most rest on convictions relating to individual dignity and rights. Putting their argument into the largest perspective, it’s simply a fact that if, as a society, we decided to rid ourselves of all cocaine use, we could do that in a week. We’d only need to legislate that every single citizen would visit a government office every single morning and pee in a cup. Positive results would trigger an automatic jail sentence. Cocaine—along with its accompanying problems—would disappear in little more time than it takes to broadcast a just-say-no TV ad.

No one advocates this truly zero-tolerance enforcement strategy, however. The central reason no one proposes total testing is that basic convictions concerning human rights provide two direct forms of protection. First, our intrinsic dignity as individuals guarantees some measure of privacyThe right to be left alone by others.. Privacy is the right to be left alone by others, to conceal ourselves from their prying eyes. What we do inside our own homes and with our own time is our—and no one else’s—business.

This right to a dignified space for me stands on its own, but also extends as the right to define my own unique identity for myself. If everything we think and do is seen by others (imagine your life filmed and broadcast on TV twenty-four hours a day), then we no longer have a self. All our energy and time would get devoted to presenting an image and appearance for others. Privacy is the space each of us needs to create ourselves as who we are. Drug testing finally, insofar as it intrudes on our private reality, also intrudes on the right each of us has to be ourselves.

The right to privacy can be construed slightly differently in terms of humiliation and exposure. Being forced to pee in a cup is embarrassing; it’s being treated like a farm animal. On this front, the right to privacy is the guarantee that certain private things like that won’t intersect with anyone else unless we make that decision ourselves. The other articulation, exposure, is especially pertinent today. In an electronic world, personal information about ourselves, once it’s tapped into a computer, can end up anywhere at any time. In the end, who knows who’s going to get their hands on our lab results? Or when? Because it could be anyone into the indefinite future, there’s an element of invasive exposure in many drug-testing procedures.

The same fundamental rights that protect privacy also guarantee freedomThe right to pursue our own happiness in the ways we as individuals determine.—the right to pursue our own happiness in the ways we as individuals determine. Of course this right gets suspended the second our drug use ruins someone else’s freedom by injuring them in a car wreck, but until then, drug tests are going to appear as a violation of fundamental liberty. According to this argument, the reason we’re out in the economic world to begin with, the reason we’re going to work and earning money, is precisely to allow us to pursue our happiness in the ways we choose (by providing shelter, some drinks on Friday night, the occasional gift for the ones we love, opportunities for our children, and similar). If, finally, the reason we go to work is to have and express our freedom, and the first thing we do when we get to work is accept the imposition of a drug test designed to find out exactly what we were smoking Friday night, then the entire point of going to work in the first place is undermined.

Besides the privacy and freedom arguments against drug testing, there’s also a slippery slope concern. A slippery slopeThe idea that once you start doing something, it’ll be difficult to stop doing more and more of it. is the idea that once you start doing something, it’ll be difficult to stop doing more and more of it. Start with the proposal that random drug testing will be performed in a workplace once a month on one employee, and the sample will be tested only for some hard drug, say, heroin. For most people in most offices, that doesn’t sound very threatening, and even though it may be a violation of basic rights, some will be tempted to simply accept the measure because, really, it’s not that big a deal, not worth a fight. So the program is implemented. A few months later, the proposal comes down to test not one, but two employees every month. Again, not a big deal and no one objects. Then the test gets expanded to check for cocaine. You see where this is going. The process repeats and, in the end, everyone’s getting tested all the time for everything. The slippery slope argument against drug testing in the workplace is that individual liberties are so important that they must be entirely protected from the very beginning. Stated slightly differently, rights can’t be done halfway. You either have and protect them, or you don’t. If that’s persuasive, then everyone should band together against drug testing, even those who’ve never had a drink or smoke in their lives.

A fourth argument against drug testing is about half ethical, half technical. It concerns drug test reliabilityThe extent to which a drug test returns false positives or erroneous negatives.. Even top-notch manufacturers concede that their products produce false positives in some very infrequent cases. A 1 percent error rate seems, on the face of it, acceptable, but if you personally happen to be that 1 percent, your perspective may change. Of course, to a certain extent this objection can be answered by technical advances: if a 1 percent error rate is too high, the product can be improved and now it’s 0.1 percent or 0.01 percent. Probably, however, there’ll always be some possibility of error, and as long as there is, the argument remains that the ethical cost of misidentifying a clean worker as a user outweighs the benefits accrued from correctly identifying those who really are using.

Finally, in the face of the organization’s justifiable desire to impose drug tests, the arguments against accepting testing are:

• The right to privacy
• The right to freedom
• Slippery slope concerns
• Imperfect testing