Discussion Exercise 10.

3 pg 215 questions 1-4

Case Summary
The case which has been presented in chapter ten describes how the anti-vaccination movement
started in 1998. It describes how the initial researcher, Dr. Andrew Wakefield, acted unethically,
abused his power, created discord in the medical field, and had a visible conflict of interest in his
concerns over the use of the MMR vaccination. He was stripped of his license to practice
medicine and yet still believes to this day that he has done nothing wrong. It has created much
discord in the medical community and the non-medical community as a whole. As many parents
still believe that MMR has a link to autism.

1. What were the perceived conflicts of interest in the Wakefields research activities?
There were many conflicts of interest in Wakefields research activities; however, there
are two that stand out. Originally, he failed to disclose that a follow up study to his
original paper was funded by a legal aid group. This particular legal aid group was
documented as helping parents who believed that their children had been harmed by the
MMR vaccines. He received $90,000 dollars from this group but did not disclose this
conflicted relationship. Wakefield also supported three separate vaccinations rather than
MMR. This would have been fine if it had not been for the fact that in these three
vaccinations it included an experimental product under development by a company in
which he had a financial interest. He was actively warning parents to avoid MMR while
advocating for this other product that he had this financial interest in.
2. If Wakefield had disclosed the source of the funding of his study and his interest in the
experimental vaccine, would that have added credibility to his campaign against MMR?
Why or why not?
If Wakefield has disclosed the source of funding and his interest in the experimental
vaccine it would have greatly hindered the credibility of his movement against MMR.
People would have been aware that he had these outside interests that relied on his
pursuit of an issue with the MMR vaccine. It was a serious conflict of interest and people
would have seen this straight away.
3. Why did Wakefield lose his license to practice medicine?
Wakefield lost his license to practice medicine after a lengthy 2 year investigation.
The investigation ensued because a 13 year old boy, who had not received the MMR
vaccine, ended up dying. There was an issue that Wakefield was a gastroenterologist,
which is a Doctor who is trained in diseases of the digestive organs, at the time of the
study. This title did not give him ethical approval or medical permission, in the opinion
of the Council, to conduct tests outside of his approved area. He was taking brain scans
of patients and doing spinal taps which were outside of his range of expertise. During his
follow up study he also acted unprofessionally, taking blood samples from children of

fellow medical professionals at his sons birthday party in return for payment. In another
article, it was also published that several of the children in his study did not even have the
inflammatory bowel disease the he claimed. Also, he had the above conflicts of interest
which the Council could not turn a blind eye to. These together provided more than
enough information for the Council to revoke his license.
4. The GMC found that Wakefield brought his profession into disrepute with his conduct.
What could he have done differently to share his concerns about MMR?
He could have been open originally with his theory and his vested interests in his
research. He could also have conducted his research with the help of people who were
approved in that area that he was trying to reach conclusions for. He could have also
apologized for his conduct instead of being unrepentant. Sometimes apologizing goes a
long way in the eyes of the medical profession and the general public. Even though he
was stripped of his license he still remains a popular advocate with parents who are
convinced that there is a link between MMR and autism.
Discuss all the pros and cons of all possible outcomes/decisions/choices
Pros and Cons: There are considerable cons to the decisions that Wakefield made as a whole.
The original paper which he submitted alluded to the fact that while no association between the
MMR vaccine and the condition had been proved, the implication of this was still there. Parents
then began to question everything, it provided an opportunity for parents to have a scapegoat for
a condition that had no known cause. This has now created an issue for the general population as
more and more children are not being vaccinated against preventable disease which the MMR
vaccine vaccinates against. Outbreaks of these preventable diseases occur when parents decide
not to vaccinate their children (Immunization Action Coalition, 2016). This is the world that he
has created for those trying to prevent the spread of disease in communities.
On a pro side, his choices have also led to more intense studies being done into vaccines and
their implications. This should technically ease the minds of angry parents. It is important that
people raise questions and concerns about medical advancement. It keeps research studies
unbiased and more ethical in approach, making sure that rules and regulations are heavily
followed. This helps prevent things like the thalidomide issue in the 1950s to ever occur again.
His decisions have also led other people in his profession to think before they act. Doctors need
to be aware of their actions, the implications of their actions and that their job affects so many
other lives. People in the non-medical community are very impressionable and do not always
understand all the facts which are presented.
Relation to Chapter:
This case greatly relates to the chapter as a whole because it considers how important
transparency is in ethical business conduct. The medical community has a written code of ethics
and in this case Wakefield broke this code and needed to be reprimanded to the fullest extent. He
was used as an example of what not to do for fellow doctors and researchers. This helps people
of the medical community understand that codes need to be followed for a reason and that you
will get reprimanded for misconduct.

The NIKE case- How they made it work

Throughout the 1990s Nike was under huge scrutiny for allegations of the use of sweatshops
and child labour. Nikes former business model outsourced its manufacturing to third world
countries and used the money to create huge marketing campaigns in first world countries. The
biggest issues started in 1991 when Jeff Ballinger published a report which documented the
horrendous low wages and poor working conditions in Nike factories in Indonesia. The hits then
kept coming as abuse allegations in Vietnamese factories surfaced as well, and protestors in
America began to boycott Nike products.
A change was made in 1998 due to the heavy criticism, a speech by Nikes CEO at the
time Phil Knight explained that the Nike product has become synonymous with slave wages,
forced overtime, and arbitrary abuse. He then went on to announce that Nike would be
monitoring factories closely, raise the minimum age of workers, and adapt the OSHA clean air
standards of the USA in all of its Nike factories (Nisen, 2013). This was Nikes first step in
becoming a better company as a whole, and realizing their horrendous mistakes were costing
them larger profits. Over the next few years they were hard at work to commit to the change that
they desired to make.
A huge step for Nike in 2005 was that they decided it was time for their company to
become transparent. To do this they published a list of their contract factories, ensuring that the
general public and other business giants knew where Nike was contracting out from. They also
wrote a CSR report which explained their continued issues within some of their contracted areas,
working conditions, and pay scale (Nisen, 2013). They brought in people to conduct audits on
their factories worldwide as well. This movement has not gone without many issues, ones which
Nike has been honest about in their various reports over the past 10 years.

Pros of their decisions:

The biggest pro to their decisions has been that Nike as a whole has become more
socially and ethically responsible for their actions. These steps to betterment benefit our society
and the different countries which they contract out from. They have slowly regained the trust of
the general public through their transparency. It helps to hold accountability for the actions of
their contractors, suppliers, and themselves. They have moved towards a better understanding of
corporate social responsibility and also responsibilities towards the environment. They are
starting to become leaders in caring about the environment as well stating that Nike will
eliminate hazardous chemicals from its global supply chain by 2020 (Nisen, 2013). All this
being said Nike now provides a good model for companies, especially to those that are having

their own difficulties, to have a better understanding and higher goals of corporate social
responsibility and ethical decision making.
Cons of their decisions:
No matter what Nike accomplishes there will always be critics of this large company. It is so
large that it is harder than ever to keep up their new standards. While their decisions to provide
transparency are admirable they must be careful that they are able to do what they say they are
going to do. Nike is in the spotlight and with technology so prevalent it is easier than ever to
receive a bad image.

Relation to Chapter:
The new model that Nike adopted after 1998 reflects teachings from chapter ten of the text.
They made their company more transparent, created a reporting system, delegated third party
auditors, and addressed issues from critics publicly. This is all outlined in the text as ways to
help making progress towards sustainable corporate social responsibility and ethics.
References
Immunization Action Coalition. (2016, March 6). Importance of Vaccines. Retrieved from
Vaccination Basics: http://www.vaccineinformation.org/vaccines-save-lives/
Nisen, M. (2013, May 9). How Nike Solved its Sweatshop Problem. Retrieved from Business
Insider: http://www.businessinsider.com/how-nike-solved-its-sweatshop-problem-2013-5