A City Looks To Its Moral Compass in Lean Times
Sunday, December 14, 2008
Faced with painful choices about who will suffer most from looming budget cuts, Alexandria officials have taken the unusual step of paying a professional ethicist to help them grapple with the moral issues involved.
Just a few of the vexing decisions his advice helped Alexandria policymakers confront in recent weeks: They took apartments being built for the mentally ill and temporarily turned them into housing for the disabled. They cut a parenting counselor for jailed minors with kids but preserved aid for belligerent preschoolers. They scaled back drug prevention but kept the methadone pills available to ease the cravings of withdrawal.
"It is very uncomfortable to admit you're going to have to say no. It's very uncomfortable to make decisions that, quite frankly, are going to make some people's lives go worse," said Michael A. Gillette, an ethicist who helped mental health officials in Alexandria write guidelines for prioritizing assistance when there's not enough money to go around. At the urging of top city officials, Gillette also pushed more than 100 other senior and mid-level managers to wrestle with the ethics of shrinking government.
"If the limb comes off, at least you saved the life. That's what true scarcity feels like," said Gillette, a Lynchburg, Va., City Council member who often uses the battlefield clarity of old "M*A*S*H" episodes to goad his listeners.
With resources scarce across the region, talk about spending increases and "best practices" has given way to the deflating and unfamiliar concept of "triage." Montgomery County teachers agreed not to take 5 percent raises to keep class sizes stable. Nonessential Fairfax County workers will miss work Jan. 2 so they can spare more jobs from layoffs.
In Alexandria, social service officials first began seeking Gillette's advice on clinical quandaries, which represent the bulk of his work. But over time, especially since the weakening real estate market stung the city last year, money questions have gained urgency. They now pay him a $9,000 annual consulting fee.
Although it's common for public hospitals to hire ethicists to help make difficult patient-care decisions, it is unusual for local officials to seek their advice on budget matters.
"I haven't heard of any particular attempt to get consultation on that," said David A. Treasure, director of Maryland's Office of Budget Analysis. That doesn't mean ethics don't underlie many public actions, he said. "Informally, it's just part of the ethos of working in this domain. You can't escape it," he said.
But with money tight and worthy hands all around, from police and teachers to social workers and parks, the explicit guidance on ethics has been valuable, said Alexandria City Manager James K. Hartmann.
It's vital "that everybody have some grounding and some empathy for those that may be hurt," Hartmann said. "It causes us to have more discussion and debate and understanding for the consequences of our actions."
Not everyone embraces the idea of paying for ethical advice.
"Every penny is essential," said Pat Troy, a former Republican City Council candidate who owns an Old Town restaurant. If city officials "aren't smart enough to be able to figure these things out for themselves, something's wrong."