The Saints & the Roughnecks Chambliss

1. The Saints & the RoughnecksChambliss Part IV Chapter 21

2. 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

3. I. The Saints from Monday to Friday Part 4: Ch. 21

4. A. The Saints’ Main Concern • 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

5. 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

6. II. The Saints on Weekends Part 4: Ch. 21

7. A. Weekend Excursions • 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

8. III. The Saints in School and with the Police Part 4: Ch. 21

9. 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

10. IV. The Roughnecks Part 4: Ch. 21

11. The Roughnecks • 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 Part 4: Ch. 21

12. The Roughnecks • Town’s 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

13. 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

14. V. The Roughnecks in School Part 4: Ch. 21

15. A. Two Questions • 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

16. A. Two Questions • 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

17. A. Two Questions • 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

18. A. Two Questions • 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 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

19. A. Two Questions • 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

20. A. Two Questions • 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

21. VI. Adult Careers of Saints & Roughnecks Support Communal Views Part 4: Ch. 21

22. A. The Saints • 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

23. B. The Roughnecks • 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

24. VII. Reinforcement Part 4: Ch. 21

25. Reinforcement • 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

26. Reinforcement • 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

27. Review Questions • 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

28. Doctors’ Autonomy & PowerLiederbach Part IV Chapter 22

29. I. The “Protective Cloak”: Status, Altruism and Autonomy Part 4: Ch. 22

30. A. Status • 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

31. A. Status • 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

32. B. Altruism • 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

33. C. Autonomy • 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

34. II. Selected Medical Offenses Part 4: Ch. 22

35. A. Medical Kickbacks • 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

36. B. Fee Splitting • 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

37. C. Self Referrals • Self-referrals involve sending patients to specialized medical facilities in which the physician has a financial interest Part 4: Ch. 22

38. D. Prescription Violations • Prescription violations - a few doctors overprescribe or mis-prescribe drugs to patients which may cause serious illness or death Part 4: Ch. 22

39. E. Unnecessary Treatments • Unnecessary treatmentsor 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

40. E. Sexual Misconduct • 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

41. III. Medical Fraud and Abuse Part 4: Ch. 22

42. 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

43. Review Questions • 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