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|In: Business Ethics|Last Updated:

The future got here a while ago. But thanks to IBM’s Watson, we can’t ignore it any more.

Some background: IBM is turning Watson into a diagnostic support tool. The FDA wants to treat it as a medical device. IBM disputes that categorization and is spending sums that are, shall we say, significant lobbying to avoid this regulatory roadblock.

Fortunately, KJR’s crack medical policy division has come up with a solution that should be satisfactory to all concerned.

IBM has created an AI diagnostician, and claims it isn’t a medical device? Fair enough. Force-fitting it into a medical-device regulatory framework is force-fitting a hexagonal peg into an elliptical hole.

But we don’t need new legislation to cover this. We already know how to certify diagnosticians. They complete medical school and have to pass tests covering each course in the curriculum. They then go through three years of residency before being allowed to hang out their shingle as a medical doctor.

Why should Watson be allowed to bypass any of this, just because it isn’t built out of flesh and blood? The solution is straightforward: Each Watson sold must first pass all medical school exams, then go through three years of as near a replica of actual medical residency as can be devised.

Problem solved. You’re welcome.

But of course, like most solutions to most problems, this solution raises new problems of its own.

Imagine you’re a physician, in a practice that’s acquired a Watson of its very own. Watson provides a diagnosis and recommends a treatment for one of your patients, and you disagree.

Now what?

You have two choices — allow Watson’s judgment to override your own, or override Watson’s judgment with your own.

And your patient later dies. Not only is your conscience torturing you, the absence of tort reform is torturing you with a malpractice action.

It doesn’t matter whether you followed Watson’s judgment or your own. You’ll be susceptible to the tort and torture whether you allowed Watson to override your good judgment, or you overrode Watson’s.

It’s Hobson’s choice. The question for medical ethicians is how to deal with this unresolvable question, and before they even start we know they’ll never come up with a fully satisfactory answer.

We can all thank our lucky stars we don’t have to deal with ethical questions this thorny.

Only, when we thank them we’ll be fooling ourselves, because we’re all dealing with this situation already. It’s the situation we face when our GPS gives us directions we don’t think make sense. We have to decide whether our GPS is routing us strangely because it knows more than we do about the traffic conditions ahead, or whether there’s a glitch in the algorithm and it’s pointing us in the wrong direction.

Not as ethically interesting? If you’re meeting someone for drinks after work, no it isn’t. But what if you’re driving someone to the hospital because they’re in intense pain and the cause might be grave?

It’s the physician and Watson, up close and personal, in real time.

It’s a question of who or what’s in charge, human beings or information technology. It’s a question with a simple answer: Humans, of course, both because we program the computers and because we’re ultimately responsible for the decisions, too.

Except that answer doesn’t always work. A computer-controlled traffic light is an easy-to-understand and inarguable example, because overriding the computer’s recommended course of action (stop before entering the intersection) isn’t merely a violation of traffic laws. It’s a decision with potentially lethal consequences.

When it comes to traffic lights we obey the machine.

The world of commerce is hardly immune from these challenges, starting with the requirement that humans are sometimes required to obey computers here, too. That’s what you face if you work in a call center. A computer (the ACD — automated call distributor) directs a call to your phone. What do you do? You answer it. You, the human, obey the ACD, a computer.

Or, you’re a manager, responsible for a decision that could be influenced by some form of automated support, whether it’s an old-fashioned Decision Support System, a no-longer-fashionable data warehouse, or ultrafashionable Hadoop-driven big-data analytics.

If the analytics indicate a course of action that doesn’t seem right to you, how is that different from the physician deciding about Watson’s diagnosis and recommended treatment?

There are no answers that are both easy and useful, and the questions are becoming more pressing as each day goes by.

Your phone is ringing. It’s the future, calling to let you know it just got into town and would like to meet you for drinks.

Time to get out the GPS.

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|In: Business Ethics|Last Updated:

From the KJR mailbag regarding last week’s column on performance improvement plans (PIPs):

Hi Bob …

The only time I received a PIP, it was clearly to start building a documentation trail (your point about the recipient building his own trail cannot be over-emphasized) that would lead to my termination, ostensibly for cause.

My prior performance reviews had also been excellent. I continued to perform to the best of my abilities while conducting what little job search I could due to the enormous demands that the job placed on my time.

In due course, I was pulled into the resign-or-be-fired meeting and given 15 minutes to collect my personal effects and leave. The company subsequently fought my unemployment claim all the way to a judicial hearing (I won). Of course, the CEO said it was not personal. Of course, I did not (and do not to this day) believe her.

The story ends well. It prompted my move from Long Beach, CA to [current location], converting a long-distance relationship to one that ended in a fulfilling marriage. My journey led me to [employer name], where I have found meaningful work that has brought fulfillment.

Bob says: First, thanks for sharing your story. Second … of course it’s personal. Criticism might not be personal for the critic, but it’s always personal for the criticized, by definition. Beyond that, many managers don’t differentiate between “your performance is substandard” and “I don’t like you.”

Often, they’re yellers.

Third, you give me too much credit. You’re right that “my point about the recipient building an independent document trail cannot be overemphasized,” except for one thing: I neglected to say it. On behalf of everyone reading this, thanks for filling the gap.

* * *

Bob …

My experience is that PIPs are rigged against the employee. Their manager has already decided to fire them, but has to jump through legal hoops and have some “justification” so the company can’t be sued.

The best thing is for the guy to do the minimum, devoting his time to the job search.

Maybe also see a lawyer and send a registered letter to the company noting how the PIP is impossible and rigged for failure, to negotiate a better severance.

Bob says:

Depends on the company, and the manager. Some PIPs are sincere and legitimate. You’re right often enough to taint the whole process, but not so often that it’s a safe generality. Also, as most companies are “at will employers,” the lawsuit threat is overblown. They can and often do terminate employees with no stated cause at all.

Still, most of your advice is sound, except that employees on PIPs do need to be open minded about the possibility that they really do need to make some changes.

* * *

Bob …

Having been on all sides of this:

  • Good managers will tell you they’re unhappy long before you get a PIP. Bad ones may not.
  • If you’re reporting to a new manager, read your past appraisals to see if there is anything to suggest your previous managers had the same concerns but didn’t want to go to the trouble of going through the process. Your new manager might just be the first one willing to do so.
  • One way to know if the PIP is real and not window dressing or the result of a hidden agenda: What you need to do will be totally within your control and you will have what you need when you need it.
  • If you have a bad manager, hitting the PIP’s goals would save your job, but you may not get the support you need when you need it to hit them.
  • If you have a manager with an agenda, it won’t matter how hard you work, and factors beyond your control — factors that aren’t obvious to anyone in HR — may conspire to keep you from reaching the PIP’s goals. Example: needing the support of other people for whom you and your goals are a low priority at best.
  • Might you have annoyed a higher-level manager, whether directly or indirectly? You might be dealing with “delegated discipline,” at which point you have a manager with an agenda.
  • Ask HR what rights you have. Then ask someone who’s been around a while the same question. If HR seems to be leaving things out, you probably have a boss with an agenda and HR is backing them.

Bob says …

This is excellent advice. Thanks!

Someone once said we’re all smarter than any of us are. Thanks to all who, by writing, helped demonstrate the point.

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