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131. "From Zion to Diaspora," Society (Transaction: Social Science
and Modern Society) Vol. 15, No. 4 (May-June 1978), pp. 92-101.
For people to be in charge of history, rather than subject
to laws they do not understand or control, is an option of the
postnuclear era, not a prediction. This is what my work is
about. When I first joined the Columbia University faculty, C.
Wright Mills was still around, but most of the senior faculty did
not care for his brand of sociology. Soon a senior colleague
took me aside and advised me to stay off the stuff; i.e., off
critical, normative, activist sociology. He was very warm and
meant well. "Mixing socialism with social work" (his sarcastic
labels for active sociology) is not the way to .,make it." I was
told at the time. And I did try to comply. I wrote A
Comparative Analysis of Complex Organizations (1961) which was
regarded as "neutral" sociology and got me tenure three years
after I graduated from Berkeley. But meanwhile I did organize a
nationwide group for the gradualist way to peace (in favor of
multilateral arms reduction and cessation of the cold war) which
attracted the media's attention. The ideas involved were
published in 1962, in The Hard Way to Peace. The rest followed
naturally: marches, petitions, speeches, membership on the
national board of Americans for Democratic Action (ADA), and so
on.
How was this activist-optimist orientation shaped? Quite
simply, I had seen in my own experience and from a rather early
age that such things could be done, that a movement could take
off, could transform societal conditions. My father was a German
Jew and a Zionist. Thus, at age seven I found myself at the edge
of a small town in Palestine; my parents, with four other
families, left daily for a vacant field some miles into nowhere,
where they built a new farm settlement. Soon there was a water
tower, a fence (to head off Arab Bedouins who pitched their tents
nearby), and the plowing of virgin land. By the time I completed
primary school there was a full-grown village known as Kfar
Schmaryahu, about twenty miles north of Tel Aviv.
The village was 800 yards from the Mediterranean shore. On
the shore was a small Arab fishing village and major British
police station. Jews were fleeing the ovens of the concentration
camps in Nazi Germany and arriving in Palestine in small boats.
The British were trying to stop this "illegal" immigration. Four
times during my school years I served as a runner when refugee
boats, run by the Jewish underground, anchored at night, and
weary Jewish families were carried ashore between the fishing
village and the police station, hidden for a night in my family's
and others' homes, and sent on the next day to settlements deeper
inland. It was more exciting than playing cops and robbers and
more educational.
However, the formative experience came in 1946. I was
sixteen and in high school. Efforts to disinvite the British,
who governed Palestine as a "mandate," were mounting. but no one
I knew really believed that the British could be made to leave.
The British troops totaled 100,000, armed to the teeth. The
entire Jewish community, including women and children. numbered
about 600,000. Their weapons consisted of homemade hand
grenades, old rifles, and such. And there were Arabs on all
sides--less friendly than the British, to put it mildly. But we
tried anyway. I dropped out of high school and joined the
underground (Palmach). Then came November 1947. Ben-Gurion
wanted to go "all the way," to recreate the Jewish state,
interrupted some two thousand years ago; but nearly everybody
said he was a visionary. Moshe Sharett, later Israel's foreign
minister, was more cautious and moderate. So was Chaim
Weitzmann, later Israel's first president, and so were many
others. But Ben Gurion prevailed and the United Nations set
aside parts of Palestine as a Jewish homeland. Kibbutz members
danced on the communal tables with their heavy work boots on, an
astounding expression of exuberance. The next day, the Arabs
invaded. While what followed is well known, a sociological
footnote is called for.
What Israel achieved was much more than winning a war of
national liberation (against the British) and an international
war (against the seven Arab states). The birth of Israel
advanced a project begun by a social movement two generations
earlier. It created a statehood-homeland for the wandering Jew
and in the process turned the occupational. stratificational, and
political pyramids; made farmers and soldiers out of merchants
and intellectuals, turned a middle-class community into a full-fledged society; evolved an institutional fabric which granted
priority to equality and democratic socialism over small-town
capitalism; and turned a defenseless community into one able to
protect itself.
In the United States, being active was at first a much more
disjointed experience. There was no shortage of social . .
movements to join; e.g., as a member of the ADA I helped make
sure that liberal congressmen did not leave Washington before
pivotal votes were taken on civil rights of legislation,
especially the 1964 Voter Registration Act. During the same
period I became involved in the peace movement (seeking to curb
the nuclear arms race) and not long after, in the antiwar
(Vietnam) movement. Here too, the cause seemed at first as
hopeless as that of the Jews in Palestine; then, activism yielded
fruit.
Rather than try to recount here all I tried to do and the
mixed bag of consequences, let me provide two brief
illustrations. In 1961 and 1962 Charles Osgood, myself, and some
others argued for a "psychological disarmament," a lowering of
the high level of tension between what were at the time two
relatively solid and hostile blocks, the West, led by the United
States, and the East, led by the Soviet Union. This, we said,
could be achieved by a series of limited unilateral steps such as
minor arms cuts, a limited ban on nuclear tests, release of a few
cold war prisoners. Such steps. we argued, would lead to
reciprocation by the other side. The resulting better atmosphere
would open the door to mutually agreed upon, more significant
arms reductions and international agreements.
Well, in 1961-62 these ideas were viewed as strictly "pinko"
stuff; treasonous to some, silly to others. In 1963, however,
President John F. Kennedy launched such a policy in his "Strategy
for Peace" speech. It gained the expected reciprocation from the
Soviets and opened the door to some arms reductions, SALT, and
detente.
In 1964 (on June 28, to be exact) I published an article in
the Washington Post arguing against the war in Vietnam. I gave a
lot of time and energy to this cause in the following decade, as
did many others. We were at first a small outcast minority; then
a nationwide protest movement; then--national policy shifted
toward our views. It is odd now to see establishmentarian
figures, who used not just to fight us off but scoff at us,
trying to explain away their war roles.
Side-Effects of Activism
My FBI, CIA, and USIA files--copies of which I recently
acquired under the Freedom of Information Act--showed that to be
active tends to generate some countercurrents. Let me he the
first to say that I was neither run out of office, job, or
country. As I was prepared to be criticized one I chose to be
critical, the resulting pain was less than overwhelming; indeed
one incident borders on the humorous.
In what must have been a moment of confusion and ineptitude,
the University of Frankfurt in West Germany decided to add to the
afflictions of its students (and possibly some faculty) by
inviting me to deliver a lecture. This might not have involved
the powers of the U.S. government, had not my colleagues in
Frankfurt been ever so slightly too enterprising: they asked to
house the lecture to be delivered by an American professor at the
Amerika House. They probably simply assumed that a lecture hall
maintained by the USIA in Frankfurt for purposes of improving
German-American cultural contacts was a proper locale. Little
did they know. It turned out that the scheduling clerk of
Amerika House was concerned with more than assigning rooms,
providing chalk. and other such matters. He also "cleared"
lecturers with Washington, D.C. In the USIA headquarters in
Washington, D.C., a review was undertaken which established,
using information from the House Unamerican Activities Committee,
the FBI, and other sources, that while Etzioni was not a security
risk, his attitude toward U.S. foreign policy was "critical" and
"negative." On September 2, 1966, Bonn was cabled: "On basis of
available information Agency advises against lecture use of
Amitai Etzioni." A year and a half later: "Security office needs
know if Post used Amitai Etzioni which was subject adverse Agency
recommendation re appearance 1966-67. Advise soonest." When
Uncle Sam wakes up, he is in a hurry. Bonn responded that by and
large they had "adhered to the Agency's advice." However, in
Etzioni's case,
while USIA Bonn recognized that the professor was not
an approved speaker, we also had to contend with the
fact that he was the invited guest of the university
and that the invitation to him had been made and
accepted without our knowledge months before the date
of the lecture. The post felt that cancellation of his
appearance might seriously threaten our relationship
with the university. USIA Bonn therefore gave Amerika
House Frankfurt a one-time approval with the
understanding that no special effort should be made to
attract a large audience.
The USIA is resourceful. and its labor bore the desired stunted
fruit. "Twenty-five persons were present at the lecture." Well,
God and country were save, almost. A year later, a request to
reprint an article by Etzioni from Science, in one of the USIA
magazines, and later one from the New York Times Magazine, was
turned down on the same grounds. The first article dealt with
the biological and sociological issues raised by parents'
choosing the sex of their offspring. It has quite often been
cited in subsequent studies on the matter. The second article,
entitled "Confessions of a Professor Caught in a Radical
Revolution," reflects critically on student violence at Columbia
University. In a letter to the editor which followed its
publication, the Left-leaning students criticized it for, among
other things, arguing that the students abandoned traditional
constitutional means of protest without adequate cause. One even
lumped me with Sidney Hook.
Somewhat more serious was the fact that the FBI's
investigation of me was so sloppy. On November 2, 1972, the
acting director of the FBI, L. Patrick Gray, forwarded to an
unidentified "Deputy Assistant to the President, the White
House," the results of a comprehensive FBI investigation of me.
The information collected in the course of the investigation
included interviews with at least ten of my colleagues at
Columbia University and elsewhere, three or more of my neighbors.
government agencies for which I consulted, eight of my employees
at a research center I direct, a search of police files, credit
agencies' records and various government agency files, a search
in newspaper morgues, and reports from FBI bureaus in New York,
Washington, San Francisco. St. Louis. Baltimore, Philadelphia,
Columbus (Ohio), and Cincinnati. The report to the White House
led off with the observation that the investigation had been
instigated due to "allegations that Etzioni had made statements
critical of the United States' foreign policy, that he had
defended the position of Red China and the Soviet Union, and had
made unwarranted accusations against the military and
intelligence organizations of the United States." At issue were
viewpoints and veracity, not acts or even intention for action.
The constitutional issue involved here is clear, as it has often
been discussed: whether or under what circumstances it is
appropriate to launch a police investigation to ascertain a
citizen's political beliefs. But I shall be concerned here with
another question: What chances does a citizen stand that the
assessment made will be reasonably accurate?
The final synopsis of the FBI's investigation provided to
the White House composed the following picture of one Amitai
Etzioni: First, it is stated that Etzioni, in his writing and
teaching, calls for disarmament; was included in a group of
professors protesting a new regulation forbidding campus
demonstrations against official guests of the trustees. Also
noted is a Times article captioned "Young Radical Group Created
Tension among Sociologists." The synopsis goes on to characterize
Etzioni as an "activist" who "reportedly" participated in a
teach-in. His position is summed up as "indicating the U.S. was
using Southeast Asia as a training ground for military forces. .
. saying the U.S., not China is the sole aggressor." Finally, in
a debate at Swarthmore, Etzioni "was reported" to have been very
critical of the CIA, .'claiming that agency was guilty of
everything the Soviet Union was doing." The net conclusion of the
report, especially if read in the context of the time it was
composed before the revelations about illegal CIA activities,
during the Vietnam War, etc.--must be a sense of an individual
who is at least in disloyal opposition, one-sidedly against the
United States, its agents and agencies, and on the side of the
Communist powers.
It is difficult to describe oneself without sounding
defensive or self-congratulatory. Let me just list a few points
which did not find their way into the FBI report. I must admit
that on matters of national security and communism I am rather
what a number of my students call "reactionary." First, accidents
of my past deprived me of the sequence through which quite a few
of my colleagues passed: fashionable Left in the thirties;
liberal chick in the forties; and increasingly conservative from
the McCarthy through Nixon eras. It was not my superior
foresight, but the circumstances of my youth which rendered me
hopelessly anticommunist from the first days of political thought
and action. The reason was elementary: I grew up in Palestine.
There the intellectual bankruptcy and lack of integrity of the
small band of Jewish Communists were particularly evident.
Whereas in those days before Yugoslavia's breakaway all Communist
parties followed in detail and with precision in line laid down
in Moscow, elsewhere they could try to conceal the fact that when
Soviet interests and those of their own nationality were at odds,
they would toe the Moscow line. In Palestine this was not
possible because Moscow instructed Jewish Communists to identify
with Arab workers and nationalism. because at the time Arabs were
viewed as entitled to all of Palestine; Jews as the bourgeoisie
or colonizers. This led the Communists to oppose Jewish
immigration from the gas ovens of Nazi Germany to Palestine. even
joining with Arab terrorists who, among other things, threw hand
grenades into my school bus. If the American Communist party had
supported Japan after Pearl Harbor by acts of violence. it could
not have been more discredited than Communists were in the Jewish
community, during my formative years. Stalin's pact with Nazi
Germany (which preceded the German invasion of the Soviet Union)
and openly anti-Semitic acts only helped to cement the feeling.
As I grew up politically in the Israeli Labor party (Mapai),
believing in social-democratic tenets, Stalinism had little to
offer. Years of service in the Palmach deepened my Fabian
conviction that the use of violence should be reserved for self-defense. Alien was the communist motto that you have got to
crack eggs (i.e., heads) to make an omelet (i.e., revolution).
After becoming an American citizen, I served for seven years on
the National Board of ADA--itself an adamant anticommunist force--a natural continuity. Within the antiwar movement--often torn
by rifts between those linked to communism, or unwilling to
attack it because this was to conform, or be McCarthyite, or
"divide the camp"--I sided with the anticommunist peace groups.
At one point I became so dismayed with the naivet‚ of unilateral
disarmament that I wrote two books for multilateral disarmament
and founded a national organization of people who shared, if
nothing else, these feelings (it was called Gradualist Way to
Peace).
In more than a hundred newspaper and magazine articles and
in a similar number of public lectures, I was a member of what is
best called "a loyal opposition." I opposed U.S. involvement in
Vietnam, clandestine and armed support of dictators in other
countries, the cold war attempt to isolate China and confront the
Soviet Union. Not to belabor the point, I cannot but point out
that John F. Kennedy followed, as of 1963, the views others and I
developed regarding the cold war (especially after his Strategies
for Peace speech at American University); that Kissinger
implemented our views of a detente with the Soviet Union and
China and initiated the multilateral arms control thrust we
favored; and Carter has adopted our concern with human rights.
It may well sound immodest. but as I see it, since 1961, when I
first became politically active in this country, U.S. foreign
policy did shift gradually from a cold war mentality to one of
detente my colleagues were arguing for, until by 1977 there was
but a difference of details. This was possible because our line
was always a legitimate variant within the U.S. national
interest, although McCarthy, Nixon, and for a while Johnson tried
to make it look otherwise.
While I did enjoy a measure of popularity in the student
movement because of my active role in the antiwar cause, once the
students turned to violence, they found me adamantly, opposed,
both in public dialogues and during an often reported (and
photographed) dramatic confrontation on the steps of Fayerweather
Hall at Columbia University during the 1968 "uprising."
Relatively little of all this found its way into my FBI file
and practically none into the final synopsis sent to the White
House. By very selective reporting, facts which would depict me
as a loyal American were left out; those which were ambiguous
were reported in such a way as to create doubts principally by
confusing the difference between one critical of the Vietnam War,
some CIA practices, and other elements of the cold war foreign
policy--and an American advocate of Soviet and Red Chinese
policies.
From Sociology to Social Analysis
Over the years my interest has moved from the study of
smaller social units to that of larger ones; from greater concern
with conceptualization to an emphasis on the social relevancy of
social science; and from a fair segregation of the role of the
sociologist and the active citizen to a greater effort to
integrate the two. In so doing, I believe my work reflects
trends which affect the social sciences in general and sociology
in particular. I shall focus first on these trends, then briefly
discuss a contribution I might have made to their extension.
Many a sociological article in sociological journals as well
as in often-cited sociological works opens with a definition of a
new concept and a discussion of methods to be employed to measure
it. This is frequently followed by presentation of data relevant
to the new concept and relating it to familiar sociological
variables (e.g., "the distribution of xyz by age and sex in
cities with a population of over 100,000"). Many sociologists,
the author included, feel that such combination of theory and
methods is a foundation on which sociology as a science ought to
be and is being built. But many of us also feel that something
is lacking. What is lacking is social analysis, the systematic
exploration of social issues. That is, concern with the great
issues of our age, which tend to involve the study of macroscopic
societal units. The subject of social analysis is the issues,
not the sociological building stones; the prime purpose is to use
the concepts, not to add to The Vocabulary. The aim is to
elevate the analysis of societal issues, to improve on amateur.
intuitive, or journalistic sociology.
Traditional training in sociology is no more a preparation
for social analysis than training in biophysics or biochemistry
is for medical practice. Social analysis requires special
training as well as distinct methods, knowledge. and a
professional tradition. It requires more than the simple
application of an existing body of social science knowledge to
the study of a set of problems. When sick, one would hardly
exchange treatment by one M.D. for that of two Ph.D.'s in
biology. The M.D. is closer to the body, less abstract. more
interested in the total system. and more concerned with results
than the research scientist. Similarly, society needs, aside
from sociology as a science, social analysis as a new element of
sociological study, and training, i.e., a professionalization of
sociology--for adding to sociology as a science (as the
institutionalized desire to know) the systematic concern with
application of knowledge (the institutionalized desire to help).
What is the substance of social analysis and what generic
problems does its study raise? The focus and raison d'ˆtre of
social analysis are the problems of the age, application of
sociology to the understanding of society, its major
subcollectivities, and a society's place in more encompassing
communities. Biochemistry views the blood as having varying
chemical compositions; medicine sees it as infested with
illnesses. One day--when our knowledge of hematology is much
more advanced--the distinction might disappear; meanwhile
somebody had better be concerned with how to cure illnesses,
using the very partial biochemical information available. The
methodological question in medicine is how to act under partial
information. Sociological theory and research slice society into
social systems, role sets, and reference groups; social analysis
is concerned with applying such concepts to the evolution of a
world community, the redistribution of wealth, efforts to advance
the growth of human rights, the development of have-not
countries, etc. We train students to achieve higher levels of
precision by drawing better samples, using more refined measures,
more specific concepts. The trained sociologist often shies away
from major segments of social data because he cannot obtain the
kind of precision we taught him to look for. The field of
analysis of societal problems is often left wide open to social
commentators who have no methodological training. We should
develop and teach the methods to be applied when information is
fragmentary and vague, as it so often is, because the trained
sociologist can still do much better--especially when he is
trained to face this problem--than the uninitiated social
observer.
A hardly novel historical approach to sociology serves to
emphasize our position. We started with grand social theories,
formulated in emotion-laden terms (e.g., progress), covering no
more and no less than all of history and mankind. We began by
flying so high on the verbal trapese that most of our
propositions could not he pinned down and those that could often
did not withstand empirical tests. Our grandiose designs
collapsed.
Then we foreswore high jumps. We preferred to advance step
by step, even if it should take us a hundred years to learn to
walk firmly, rather than engage again in breathtaking but also
neck-breaking gymnastics. We sharpened our tools on the radio-listening of housewives and focused our concepts by observing
small groups of college sophomores. Such concentration was
essential for a transitional period; but behavior suitable for
student days becomes an adolescent fixation when it dominates the
behavior of a mature man. While sociological theory ought to be
further extended and methods of collecting and analyzing data
improved, we should recognize that our wings have sprouted; we
are ready to fly. It would be an overreaction to our earlier
misadventures to remain earthbound to a restrictive
interpretation of our discipline, to delay a new test flight of
social analysis.
Another reason we, as a profession, shy away from social
analysis is our fear of value judgments which, we sense, are more
rampant in social than in sociological analysis. In the time
elapsed since the publication of my theoretical book The Active
Society, one question has been raised more often than any other--how can I maintain that the theory advanced is both critical
(i.e., normative) and objective. My answer is that we are
critical in that we take the human needs and values of the
subjects of our study, members of society, as our basis for
evaluation. We compare various social structures in terms of the
extent to which they are responsive to their members; asking what
factors prevent them from being more responsible than they are,
and the conditions under which their responsiveness may be
increased. We thus do not evaluate a social structure in terms
of our preferences but in terms of those of its members. This
position is hardly novel--Gunnar Myrdal followed a similar
approach in The American Dilemma: he did not state that Americans
were failing to live up to his creed, to his conception of
equality, but to theirs.
In the past, mainstream sociologists argued that sociology
must be neutral to be objective. Critics have posited that it
cannot be neutral and urged that one's normative position ought
to be explicitly stated. As long as this course is followed,
sociology is either normatively sterile (at least claiming to be)
or subjectively based, which undermines its scientific
foundation. Using the subjects' values rather than our own
allows sociology to leave behind the either/or position.
Another problem arises. Members of society, the subjects of
our study, may be inauthentically committed and unaware of their
real needs and preferences. Our proposition is that ( I one can
empirically test when the declared preferences are the real ones
and when they are inauthentic (e.g., when there is a significant
gap between declared and real needs, respondents tend to be
defensive about their positions); and (2) the attributes of the
real needs can be empirically determined.
It is said that sociologists, by learning to walk, will find
out how to fly. You can learn from the fruit fly, it is
correctly suggested, new laws of genetics that apply to all
animals and plants. Similarly, we can derive from sophomores'
chit-chat universal laws of interaction which enrich our
understanding of social behavior in general. While it is true
that in this way we can learn the universal elements of our
theory--all the universal chemical characteristics of water are
represented in any drop--we cannot study the emergent properties
of complex units in noncomplex ones. We will not learn much
about the anatomy of elephants by studying that of fruit flies.
While we ought to continue to study small groups for their own
sake and for the light they cast on social behavior in general,
we ought to invest more of our resources in macroscopic
sociology.
As a second line of defense in favor of our present low
(though rising) investment in social analysis, it is said that
one cannot direct scientists and tell them what to study. If
sociologists find race relations an unrespectable subject, unless
it can be used to perfect survey methods or to redefine the
concept of prejudice, what can we do? What we can do is realize
that the distribution of scientific resources is not random, does
not follow a laissez-faire pattern. and is "interfered with"
regularly anyhow. The distribution of sociological manpower is
directly affected by the advantage of required courses, which as
a rule include theory and research techniques over optional
courses; by Ph.D. committees that approve and encourage some
subjects and discourage others, by foundations and federal
agencies--which we advise--who support some subjects to the
neglect of others, by space awarded in our journals; as well as
attention granted at professional meetings, to some subjects over
others. All these are occasions where theory and methodology are
celebrated while social analysis is given, at best, second-class
citizenship.
The role pair of sociologist-intellectual is a particularly
effective one. Not that all sociologists were ever intellectuals
or vice versa, but there seems to have been a much higher degree
of overlap in earlier generations. The growing tendency to
dissociate the two roles is particularly regrettable because the
virtue of such a role combination is greater now than in the days
when it was more common--for now we command a body of theory and
methodology as well as a store of validated knowledge about man
in society which can provide much-needed background for
speculation about society. The social analysis of Daniel Bell,
Lewis Coser, Nathan Glazer, David Riesman, Dennis Wrong, and
other contemporary sociologists who fill this role pair is much
more hardheaded, soundly based, and politically sophisticated
than that provided by earlier generations of social analysis or
by their former college mates who majored in English literature
and still interpret the American scene in the light of moods
revealed in Moby Dick, or "understand" the Soviet Union because
they suffered with Dostoevsky.
Policy Research and Action
The deliberations outlined in the preceding pages lead me to
write numerous articles and essays aimed at citizens and
policymakers rather than only colleagues, and to publish them in
the New York Times, the Washington Post, and elsewhere where they
could reach a wide audience. In 1968, attempting to develop this
line of work, I founded a research center, the Center for Policy
Research.
Policy research seeks to guide action, while basic research
seeks to uncover truth. While in the long run basic research
nourishes policy research with its findings, and policy research
provides data for basic research, in the short run their foci
diverge. Policy research must focus on malleable variables,
i.e., those most readily subject to deliberate change. For basic
research, uncharted territories are especially alluring, though
technically all variables are equal candidates for analysis.
Policy research must concern itself with decision points, lest
recommendations come too late; basic research is timeless.
Policy research is inevitably normative, as it deals with
implementing public purposes which are never value-free (e.g.,
alternative housing, welfare, national health programs and
policies). Basic research often aspires to neutrality. Policy
research must communicate with leaders and citizens; basic
research can be esoteric.
Over the years more of my time has been devoted to policy
research. Two core notions, derived from The Active Society and
from policy research experience, guided me in two advocacy
situations: one in which I failed rather completely; the other in
which I believe I contributed to the winning team.
In 1975 the nursing home scandal was ten years old. Despite
exposes by Mary Adelaide Mendelson, Ralph Nader et al., and John
Hess of the New York Times, the 900,000 older Americans
institutionalized in nursing homes at great public expense
continued to be subject to gross personal, physical, and
financial abuse. The governor of New York appointed a Moreland
Act Commission to look into the matter and recommend solutions; I
became its first staff director, but soon resigned. As in most
human affairs, several factors led to my resignation, but one was
pivotal: I failed to convince the lawyers who dominated the
commission to form the power base my policy analysis suggested
was essential for its success.
The Moreland Commission helped call attention to the nursing
home tragedies through hearings it held; it issued seven reports,
and the New York State legislature passed ten of the eleven bills
the commission recommended. Yet when it completed its work,
investigative reporter John Hess of the New York Times wrote an
article entitled "Literally, It Is Business as Usual in the
Nursing Homes." Despite the sixty-five nursing homes closed, a
package of reform legislation on the books, and scores of
indictments in process, Hess concluded: "Nothing basic has
changed." I share that assessment.
Implicit in the commission's work was the theory that the
searchlight of public outrage leads to social change. The
commission conducted public hearings, visited nursing homes at
night accompanied by TV cameras, put Vice President Rockefeller
in the hot seat, etc. The main purpose of these hearings was to
call public attention to the abuses. It was assumed that the
revelations of the hearings would mobilize public dismay, which
in turn would make the legislature accept the commission's
remedies. As a socio-political lever, though, this approach
failed. First, the work of exposure had already been
accomplished through a series of articles in the New York Times,
coverage of the scandals by other newspapers and television, and
hearings held by Assemblyman Andrew Stein. Second, public
attention tends to be mercurial. Public concern and indignation
can be raised rapidly to a high pitch, but one must expect that
it will soon move on to another topic--as it did.
The exposure led to new laws, which brings us to another
erroneous social change theory implicit in the commission's
approach--one to which many lawyers are particularly susceptible,
though certainly not just lawyers or all lawyers. This is the
notion that a social problem is corrected by passing new laws,
formulating stricter regulations, and calling for the imposition
of stiffer penalties. These are helpful, but not cardinal. The
law is a tool of the state. The state is not a benign being,
acting on behalf of the public's needs. The state responds to
all inputs, including those of pressure groups, and not just
voters. Confronted on the one side with a well-organized lobby
and on the other with the amorphous public at large, the state
will most of the time bend toward the lobby. It is only when the
public (or segments of it) is organized to push the state
continuously in the desired direction in the long stretches
between elections that its course leans more toward the public
interest.
The political problem of nursing home residents is that they
have no such means of political expression, while the owners and
administrators are well organized. The lobbyists are bribing
legislators, judges are on the take, district attorneys are on
the take; the nursing home industry even got its own man--an
employee of the American Nursing Home Association--on the
committee that wrote the Medicaid regulations governing them.
Where is the vector to prod supervisors and inspectors to do
their thing?
I favored that the Moreland Commission act to form the
political base for nursing home residents. As these patients are
often quite old (average age is eighty), sick and immobilized,
and under drugs, they need outside backup. This could come from
three sources: (1) associations of members of their families; (2)
older American associations such as the National Council of
Senior Citizens, the American Association of Retired Persons,
etc.; and (3) main religious groups such as the American Jewish
Congress, National Council of Churches, and Catholic Charities.
These should have been invited to participate in formulating
the new laws, to secure their ongoing interest in and support for
them. The political energies of these groups should have been
permanently mobilized through the creation of a permanent
watchdog commission composed of representatives of the three
groups, with rights to visit nursing homes, follow up complaints,
and the duty to report annually about conditions in nursing
homes. As this did not happen, it was no surprise that the one
Moreland bill that failed was the one which would have cut
deepest into the political power of the nursing home lobby,
namely, the ethics bill. It would have barred state legislators
and their aides from representing clients in their capacity as
private attorneys before state agencies. During the Moreland
Commission inquiries it was suggested, for example, that when
nursing home entrepreneur Bernard Bergman sought to influence the
decisions of the Departments of Health and Mental Hygiene
regarding a facility he was building on Staten Island, he hired a
state senator from the area and a legislative aide to the speaker
of the assembly as attorneys to represent his interests. A
former Health Department official testified that he experienced
this as political pressure and in particular viewed the
involvement of the legislative aide as evidence of a personal
interest on the part of the assembly speaker. Such
representation of private interests by legislators has been and
remains legal and is one of the prime ways to weaken and negate
effective nursing home regulatory efforts.
If the issue in nursing home reform (and many others) is a
question of identifying the forces which may support reforms and
specifying the conditions under which they can be mobilized, the
issues raised by developments in genetic engineering are more a
matter of consensus building. Here too, power is far from
irrelevant; for instance in the struggle between the scientists
who wish to go on with experiments involving the recombination of
DNA more or less unfettered, and those who seek to curb them if
not ban them altogether. But in many other issues raised by
recent developments in biology and related areas of medicine, the
issue is to arrive at a new value consensus. I sought and
support the mechanisms which would enhance that process. Working
with many others, we are getting there.
My initial interest in genetic engineering was highly
personal. I had three boys and wondered what could be done to
ensure that the next child be a girl. This led to my most widely
cited (and misquoted) article, "Sex Control, Science, and
Society," published in Science (vol. 161, September 13, 1968), on
the societal effects of the forthcoming imbalance in sex ratios.
Years later, when the interest in genetic engineering was much
broader, I was invited to an international conference of
scientists on the basis of this article. During the conference,
alarmed by reports of wanton experiments conducted on babies,
embryos grown in test tubes, cloning of people and such, I
drafted a resolution to form an international body of scientists,
humanists, citizens, to prepare guidelines for such work. The
resolution, after a struggle detailed in my book Genetic Fix, was
passed. Joining with others, I worked in the United States for
the introduction of the Mondale bill which would set up a
national commission for such guidelines in America. Over recent
years significant progress has been made in setting up a national
commission to protect human subjects in experiments, and in
evolving guidelines for safety in work with recombinant DNA and
other risk-prone materials. Much more is still necessary. To
social scientists, the way in which changes were brought about is
of interest. It was first and foremost by public dialogue,
stimulated by the media urged on by dramatic incidents (such as
the Karen Quinlan case), congressional hearings, and
participation by active scientists and humanists.
The role of public dialogue in forming a new consensus can
be briefly illustrated by what is happening to the definition of
death. Medical technology has rendered the traditional, widely
held definition obsolete. To do "all one can for a loved one,
until the heart stops and the lungs cease to function" may now
mean keeping a body with irreversible brain damage "alive" for
years. Medical science has responded with a new definition of
death; briefly stated: forty-eight hours of flat brain waves.
For this definition to be accepted by the public, to allow
doctors openly to "pull the plug" at this point, could not be
achieved without several billion hours of interpersonal and
public debate, until gradually the new definition came to be
understood and accepted among an ever-larger body of citizens.
A note on the nature of participation in such a project is
called for. The more successful a drive, the more people join
it. The more encompassing, the more difficult it is for any one
person to claim credit for his or her contribution. Thousands of
drops make a tributary, and scores of tributaries join to form a
new river. One must be willing to find satisfaction in being
part of such a social current, and not expect to be able to
measure with any precision how much, how far one's own
contribution has reached. The goal is not ego glorification, but
the desired social change.
While the roots of my activist orientation lie in the early
formative and later reinforcing experiences I have described, it
also has its own inner logic and force. It feels good to be
engaged, involved. True, you must work for the long run; and you
must be prepared for brickbats. But as long as you believe in
what you are doing, it is endlessly more rewarding than plowing
the dust in the stacks or adding to the microfiches. And while
often one cannot but fear one will fail to make it to the
promised land, there is just enough progress to keep feeling that
it is better to keep marching than existing in any other way.
Amitai Etzioni is professor of sociology at Columbia University and director
of the Center for Policy Research. His most important book is The
Active Society.
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