Part IV Chapter 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 class

For 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 caf 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 rolemodels 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

The Roughnecks
Roughnecks were somewhat opposite of

Saints Although boys engaged in equal amounts of wild-oat sowing, the not-so-well-dressed, not-sowell-mannered, not-so-rich boys were seen negatively as heading for trouble The Roughnecks were constantly in trouble with the police which reinforced communitys view of them

Part 4: Ch. 21

The Roughnecks
Towns view of gang delinquency was distorted:

both groups more or less delinquent than community realized

Fighting activities were readily and accurately

perceived by everyone Engaged 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

Part 4: Ch. 21

The Roughnecks
High level of mutual distrust and dislike between

Roughnecks and police:

Boys felt strongly that police were unfair and

corrupt which may have been true Main 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

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 standards
Teachers, like the community, saw boys negatively,

as heading for trouble, uninterested in making something of themselves The boys had a C averages Two 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 communitys 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 Saints Roughnecks 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 families Saints had cars & could remove themselves from communitys view whereas Roughnecks didnt 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 timewasting from community
Part 4: Ch. 21

 Demeanor: another reason for differential

treatment of two groups Different responses of group members to outside intervention

Saints 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 didnt 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 view

Their 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 communitys 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 IV Chapter 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 doctors 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 Doctors 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