Managing in the Gray
48
of duties. This is because rights and duties are two sides of
the same coin: If I have a right to my property, you have a
duty to respect it. If you have a right to be told the truth, I
have a duty to tell you the truth. In short, the idea that we
have strong, binding duties to each other shapes our lives and
institutions and suffuses our thinking.
Why is this the case? There is no definitive answer, but evo-
lutionary theory suggests a fascinating and provocative expla-
nation, one that we seem to be able to confirm in our everyday
experience.
8
The basic idea is that, as a result of a genetic roll
of the dice, some prehumans had a better sense of empathy
than others. They could quickly grasp—perhaps relying on
what some neurologists believe to be mirror neurons—what
others were thinking and feeling. The prehumans with this
capability did a better job of working together in groups to
find and store food, protect their young, and fight predators.
Hence, they were more likely to survive and pass their genetic
disposition on to their children, who ultimately evolved into us.
That is speculation, of course, but daily life seems to con-
firm it. Think of explicit television coverage of child abuse
or a violent crime. When we see these reports, we react vis-
cerally. We feel—and seem to know with certainty—that
what we have seen is wrong.
9
Something tells us, loud and
clear, that human beings should never do these things to each
other. And we can also feel there is something wrong with
people who don’t react this way. Some are odd birds who
need a conceptual explanation of why these vicious actions
are wrong. Their problem is that they are seeking “one rea-
son too many.”
10
Others seem completely unmoved, and we
fear they are defective or depraved.
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What Are My Core Obligations?
49
In short, the second question is a resounding chorus and
not a solo performance. It pulls together a wide range of
long-standing, profound insights—insights shared, not just
by brilliant and compassionate thinkers, but by most of us in
our everyday experience. The refrain is simple: we have basic
duties to treat each other in certain ways. As human beings,
these obligations should guide our decisions and our lives.
The philosopher Kwame Anthony Appiah stated the princi-
ple with crystalline clarity. “No local loyalty,” he wrote, “can
ever justify forgetting that each human being has responsibil-
ities to every other.”
11
The second great humanist question reflects this profound
principle. It explains why it would be wrong for the police
to make you an involuntary organ donor. It is why President
Truman hated the thought of killing the Japanese children.
The second question expresses a fundamental voice in the
long conversation about what really matters in life, how
the world really works, and the best way to make difficult,
important decisions. That is why this question is so import-
ant for resolving gray area issues. It also means people who
ignore this question when they face hard decisions are per-
forming impressive feats of hubris, denial, or self-absorption.
The second question is vitally important, but is it practical?
Imagine, for example, that you have been grappling with a gray
area problem. You have approached it as a manager, working
with others and developing the best information, analysis, and
informed assessments you can reasonably get. Now you have
to decide what to do. How will you know, specifically, what
your core human obligations require in this situation? Where
will you find the bright lines you cannot cross? To answer
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Managing in the Gray
50
these questions, we will now turn to a manager who faced
an extraordinarily challenging gray area problem and think
through his situation in terms of his basic human duties.
The Practical Challenges
Imagine yourself in the position of Jim Mullen, the CEO of
Biogen Idec. In 2004, Biogen was a small biotech company.
After long years of effort, it had developed a new drug for
treating multiple sclerosis, a disease that afflicts millions of
people around the world and has unpredictable, frightening,
sometimes severe symptoms. These range from fatigue, tin-
gling sensations, weak muscles, and loss of balance to seizures,
depression, cognitive decline, and, in very severe cases, death.
Biogen’s new product, called Tysabri, seemed to be a major
step forward in treating MS. As one patient put it, “I got bet-
ter. Not miraculous jump up and run a race better, but I did
walk to the duck pond with my two five-year-old boys. I stood
up long enough to cook dinner and I smiled more often. That
is what hope does. That is what Tysabri does for me.”
12
Because Tysabri proved so effective during the first year of
clinical trials, the Food and Drug Administration approved
Biogen’s request to introduce the drug before the full clini-
cal trials were complete. The company raced to get Tysabri
to market. In a single year, Biogen built two new manufac-
turing facilities, arranged for third-party payments, reorga-
nized its sales force, completed the final phase of research for
the FDA, and had seven thousand patients taking Tysabri.
Another fifteen thousand patients were waiting for their
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What Are My Core Obligations?
51
managed care providers to approve it. Biogen Idec’s stock
reached a record high.
On a Friday morning in February, Jim Mullen held a
town hall meeting for Biogen Idec employees to thank them
for their hard work and congratulate them on all they had
accomplished. When he got back to his office, he found a
voice mail message from the executive responsible for product
safety. It said, “Jim, we need to talk. Call me immediately.”
Mullen knew this was bad news. He quickly learned that a
patient in the Tysabri clinical trial had died of progressive
multifocal leukoencephalopathy (PML), an extremely rare
brain infection, and another patient, who seemed to have the
same illness, was in critical condition. This was a very rare
infection. One incident might have been an isolated event,
but two pointed toward Tysabri as a contributing factor.
We will return to Mullen’s problem and the decisions he
made in several of the following chapters, because they illus-
trate important ideas and themes. For now, however, notice
what this situation reveals about the challenges of meeting
your basic human obligations when you face a gray area
problem.
Mullen’s situation raised a long series of questions about
his duties. The first was how to deal with the multiplicity of
duties he had. The PML problem involved his legal duties to
current patients, prospective patients, the doctors and nurses
treating them, government regulators in many countries, and
various groups of shareholders. Mullen also had a parallel set
of duties—ethical duties—to each of these parties. And, if
we look closely, we find that none of these legal and ethical
duties was simple.
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Managing in the Gray
52
For example, what were Mullen’s duties to patients taking
Tysabri? Was he obligated, legally or ethically, to immedi-
ately inform their doctors about the PML cases? Did he have
a duty to inform the patients right away? Or did he have an
obligation to first get to the root of the problem? Perhaps his
duty was to withdraw Tysabri immediately. Or did patients
have the right to decide whether to keep taking the drug and
run the risk of PML, once they had been informed about the
problem?
Mullen’s problem with a multiplicity of duties is hardly
unique. Put the Tysabri case aside for a moment and think
about the many rights that people frequently assert. Lists of
these rights go on and on. One list included, “A right to life,
a right to choose; a right to vote, to work, to strike; a right to
one phone call, to dissolve parliament, to operate a forklift,
to asylum, to equal treatment before the law, to feel proud of
what one has done; a right to exist, to sentence an offender to
death, to launch a nuclear first strike, to castle kingside, to a
distinct genetic identity; a right to believe one’s eyes, to pro-
nounce the couple husband and wife, to be left alone, to go to
hell in one’s own way.”
13
All of these rights create duties for
others. Like insects in a rain forest, duties and duty-generating
rights swarm all around us.
The further complication is that these duties come in all
different forms. Some are legal and regulatory; some are
familiar, others esoteric; some seem inconsequential, and oth-
ers shape our lives. So do some duties or types of duty have
priority over others? And what about situations in which
duties conflict? An everyday example is the conflict between
telling the truth and being kind to our friends. In short, the
Chapter_03.indd 52 11/06/16 2:23 AM
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