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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