Part IVChapter 21

Eight boys from white, stable, upper middle-class families were among the most delinquent – “Saints” Parents and community unaware that the

“saints” were constantly occupied with truancy, drinking, wild driving, petty theft, vandalism

None were arrested during two years of observation

Six lower-class white boys, same high school but different gang – “Roughnecks”These boys constantly in trouble with

police and community even though rate of delinquency about the same as Saints

Part 4: Ch. 21

Part 4: Ch. 21

Getting out of school as early as possible They did so with minimum danger of

detection through elaborate procedure for obtaining “legitimate” release from classFor example, one boy would ask to use

bathroom but instead get another boy out of another class by saying he was needed for a drama rehearsal, the boy released would do same for another, etc.

Part 4: Ch. 21

The boys would then go to car and leave school for a day of fun

On average about five boys would get away and this pattern was repeated often

Once leaving school, they would go to pool hall at lower-class side of town or to a café in the suburbs where they were unlikely to meet people they knew

Part 4: Ch. 21

Part 4: Ch. 21

They traveled to Big Town - 25 miles from their town most Fridays & Saturdays

Activities included drinking heavily in bars, drunk driving, committing acts of vandalism & other pranks

In spite of their activities, the boys managed to avoid being stopped by police most of the time

Their activities were surely delinquent but they did not see it that way: they were merely having a little fun Part 4: Ch. 21

Part 4: Ch. 21

Highly successful in school, the Saints had “B” averages with two getting straight “As”

Boys were popular and many held offices and played sports

Teachers and school officials saw them as role-models who would “make something of themselves”

Cheating on exams was rampant but teachers usually gave them benefit of doubt

Local police saw boys positively, as among leaders of youth in community

If on rare occasion a boy was stopped by police for speeding, they would be polite, contrite and plead for mercy: none ever received a ticket Part 4: Ch. 21

Part 4: Ch. 21

Roughnecks were somewhat “opposite” of Saints

Although boys engaged in equal amounts of wild-oat sowing, the not-so-well-dressed, not-so-well-mannered, not-so-rich boys were seen negatively as heading for trouble

The Roughnecks were constantly in trouble with the police which reinforced community’s view of them

The Roughnecks

Part 4: Ch. 21

Town’s view of gang delinquency was distorted: both groups more or less delinquent than community realizedFighting activities were readily and

accurately perceived by everyoneEngaged in drinking alcohol which town

was aware of More serious was theft which community

did not realize was as extensive as it was for the Roughnecks

The Roughnecks

Part 4: Ch. 21

High level of mutual distrust and dislike between Roughnecks and police: Boys felt strongly that police were unfair

and corrupt which may have been trueMain source of boys dislike of police came

from fact that police would periodically harass them

Police viewed them as engaged in criminal activities and saw their job as keeping tabs on them and preventing their crimes

The Roughnecks

Part 4: Ch. 21

Part 4: Ch. 21

Boys behavior in school not especially disruptive - while they would like to have avoided it & were unsuccessful, they attended regularly

Some were seen as incapable of meeting academic standardsTeachers, like the community, saw boys

negatively, as heading for trouble, uninterested in making something of themselves

The boys had a “C” averagesTwo of them were good football players

Part 4: Ch. 21

Why did the community, the school and the police react to the Saints as though they were good, upstanding, non-delinquent youth with bright futures but to the Roughnecks as though they were young criminals headed for trouble?

Why did the Roughnecks and the Saints have quite different careers after high school, careers that for the most part lived up to community’s expectations?

Part 4: Ch. 21

In sheer number of illegal acts, Saints were more delinquent and in terms of “seriousness” – not much difference :The cost of Roughnecks’ stolen property may

have been slightly higher than the SaintsRoughnecks more prone to physical violence

& sought opportunities to fight (sometimes each other) whereas Saints never fought

Yet Saints frequently endangered their own and others’ lives in their drunk-driving & in some of their pranks – removing traffic or construction signs on roadways

Part 4: Ch. 21

Visibility: differential treatment of groups possibly due to fact that one gang was more visible than other This was a direct function of the economic

standing of the familiesSaints had cars & could remove

themselves from community’s view whereas Roughnecks didn’t own cars & so could not leave community

As a result, Roughnecks hung around downtown & were highly visible

Saints, on the other hand, could hide their time-wasting from community Part 4: Ch. 21

Demeanor: another reason for differential treatment of two groups

Different responses of group members to outside interventionSaints when confronted by police would

be apologetic and penitent The Roughnecks would show hostility and

disdain

Part 4: Ch. 21

Bias: Roughnecks were simply seen as committed to deviance as a way of life while Saints were seen as basically good kids

What all of this comes down to is class structure which favors middle and upper-class youth over their lower-class counterparts

Part 4: Ch. 21

Part 4: Ch. 21

Most Saints went to college right after high school; 5 graduated in 4 years & two finished college a little later after stints in armed forces

Three went to graduate education: law, medicine, and a Ph.D.

Part 4: Ch. 21

Two Roughnecks who played football received scholarships to college, both graduated and became high school teachers/coaches

Two other Roughnecks didn’t graduate high school & both eventually went to prison for murder

Another Roughneck became (illegal) bookmaker for gambling

Part 4: Ch. 21

Part 4: Ch. 21

The community responded to Roughnecks as boys in trouble and the boys embraced this viewTheir pattern of delinquency was

reinforced & departure from it became unlikely

As the boys acquired self-image as deviants, they sought new friends who affirmed that identity

As that self-conception became more entrenched, they became more willing to try new & more extreme deviance

Part 4: Ch. 21

Their alienation resulted in more expression of disrespect & hostility toward teachers, police and others; in turn this increased community’s negativism, perpetuating entire process

College scholarships for two Roughnecks helped to break this cycle by providing new basis for self-identity & interactions with others

Likewise, Saints were viewed as good kids who would make something of themselves which happened for the most of them

Part 4: Ch. 21

What was cause and result of this disparity between the Saints and the Roughnecks?

Could the explanation for the different reactions to these two gangs be simply that one group of boys was more delinquent than the other?

Part 4: Ch. 21

Part IVChapter 22

Part 4: Ch. 22

Recognized as a privileged caste able to heal the sick, a privilege won through difficult years of education & exhaustive training

This honored rank, however, creates opportunities for doctors to commit crimes within profession

Attributes connected with medical practice: high status, trustworthiness & professional

autonomy, provide doctors with “protective cloak” that shields them from scrutiny

Part 4: Ch. 22

Doctors’ high status derives from high salaries & occupational prestige, enabling them to retain elite social positions

Affords doctors protection necessary to commit crime: historically there has been reluctance to use criminal law against high status offenders

Part 4: Ch. 22

Altruistic image projected by doctors rooted in code of ethics which defines doctors as selfless professionals who perform invaluable service without regard for personal gain

Creates assumption of good will that makes it hard to prove charge of intentional wrongdoing on part of doctor

Physicians altruistic image engenders trust from patients who can become easy targets of fraud or to overlook negligent medical care

This reflects a “pattern of deference” to doctors

Part 4: Ch. 22

Doctors have been relatively immune to legal scrutiny because of medical professions’ preference for self-regulation

State medical review boards (typically composed of other physicians) are first & often only review of doctors’ conduct

They can discipline & suspend or revoke medical licenses

This may facilitate criminal opportunities by shielding its members from more effective or harsher punishments

Part 4: Ch. 22

Part 4: Ch. 22

Kickbacks involve payments from one party to another in exchange for referred business or other income-producing deals

Their acceptance by doctors is unethical and illegal because of conflict of interest between doctors’ commitment to quality patient care and their own financial interest

Part 4: Ch. 22

Fee splitting occurs when one physician (often a general practitioner) receives payment from a surgeon or other specialist in exchange for patient referrals - may result in higher patient costs since they have to be shared

Referral may be based on the largest fee to the referring doctor rather than the quality of the doctor’s work to whom one is referred

Part 4: Ch. 22

Self-referrals involve sending patients to specialized medical facilities in which the physician has a financial interest

Part 4: Ch. 22

Prescription violations - a few doctors overprescribe or mis-prescribe drugs to patients which may cause serious illness or death

Part 4: Ch. 22

Unnecessary treatments or surgery may be recommended to patients because of the fees the doctor will earn and not the well-being of the patient

This can be a very difficult matter to determine and opens the door to abuse

Part 4: Ch. 22

Sexual misconduct - sex may be exchanged for professional services

Doctor’s trust and authority may be used to exploit relationship with patient

Doctors may sexually assault patients when under anesthesia

Part 4: Ch. 22

Part 4: Ch. 22

Medical profession opposed original Medicaid legislation in 1960s as a threat to their autonomy because program set price of medical services

AMA lobbied against provisions to sanction doctors for violating the rules

As a result doctors billed for duplicate services or items not performed

Many doctors adopted defiant attitude toward Medicaid because viewed it as illegitimate intrusion on their autonomy even though intent was to provide health benefits to the poor

Part 4: Ch. 22

What kinds of retaliatory avenues exist for patients who are mistreated or abused by physicians?

How are “deviant” doctors able to avert the label and what consequences are faced by most?

Part 4: Ch. 22