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Part IV

Chapter 21

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Eight boys from white, stable, upper middle-

class families were among the most delinquentSaints Parents and community unaware that the saints

were constantly occupied with truancy, drinking,wild driving, petty theft, vandalism

None were arrested during two years ofobservation

Six lower-class white boys, same high school butdifferent gangRoughnecks

These boys constantly in trouble with police andcommunity even though rate of delinquency aboutthe same as Saints

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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.

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The boys would then go to car and leave schoolfor 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

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They traveled to Big Town - 25 miles from theirtown 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

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Highly successful in school, the Saints had Baverages with two getting straight As

Boys were popular and many held offices andplayed sports

Teachers and school officials saw them as role-models who would make something ofthemselves

Cheating on exams was rampant but teachersusually gave them benefit of doubt

Local police saw boys positively, as amongleaders of youth in community

If on rare occasion a boy was stopped by policefor speeding, they would be polite, contrite andplead for mercy: none ever received a ticket

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Roughnecks were somewhat opposite ofSaints

Although boys engaged in equal amounts ofwild-oat sowing, the not-so-well-dressed, not-so-

well-mannered, not-so-rich boys were seennegatively as heading for trouble

The Roughnecks were constantly in trouble withthe police which reinforced communitys view of

them

The Roughnecks

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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 theRoughnecks

The Roughnecks

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High level of mutual distrust and dislike betweenRoughnecks and police: Boys felt strongly that police were unfair and

corrupt which may have been true

Main source of boys dislike of police came fromfact that police would periodically harass them

Police viewed them as engaged in criminalactivities and saw their job as keeping tabs onthem and preventing their crimes

The Roughnecks

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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

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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?

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In sheer number of illegal acts, Saints were moredelinquent 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 andothers lives in their drunk-driving & in some of

their pranks removing traffic or construction

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Visibility: differential treatment of groupspossibly 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 time-

wasting from community

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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

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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 structurewhich favors middle and upper-class youth over

their lower-class counterparts

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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.

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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

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The community responded to Roughnecks asboys 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

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Their alienation resulted in more expression of

disrespect & hostility toward teachers, policeand others; in turn this increased communitys

negativism, perpetuating entire process

College scholarships for two Roughnecks helped

to break this cycle by providing new basis forself-identity & interactions with others

Likewise, Saints were viewed as good kids who

would make something of themselves which

happened for the most of them

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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?

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Part IV

Chapter 22

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Recognized as a privileged caste able to heal thesick, a privilege won through difficult years ofeducation & exhaustive training

This honored rank, however, createsopportunities for doctors to commit crimeswithin profession

Attributes connected with medical practice:

high status, trustworthiness & professionalautonomy, provide doctors with protective cloakthat shields them from scrutiny

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Doctors high status derives from high salaries &

occupational prestige, enabling them to retain

elite social positions

Affords doctors protection necessary to commitcrime: historically there has been reluctance to

use criminal law against high status offenders

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Altruistic image projected by doctors rooted in codeof 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 toprove charge of intentional wrongdoing on part of

doctor

Physicians altruistic image engenders trust from

patients who can become easy targets of fraud or tooverlook negligent medical care

This reflects a pattern of deference to doctors

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Doctors have been relatively immune to legalscrutiny because of medical professionspreference for self-regulation

State medical review boards (typically composed

of other physicians) are first & often only reviewof doctors conduct

They can discipline & suspend or revoke medicallicenses

This may facilitate criminal opportunities byshielding its members from more effective orharsher punishments

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Kickbacksinvolve payments from one party to

another in exchange for referred business or

other income-producing deals

Their acceptance by doctors is unethical andillegal because of conflict of interest between

doctors commitment to quality patient care and

their own financial interest

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Fee spli t t in goccurs 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 sincethey 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

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Self-referralsinvolve sending patients tospecialized medical facilities in which the

physician has a financial interest

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Prescription violations - a few doctors

overprescribe or mis-prescribe drugs to patients

which may cause serious illness or death

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Unnecessary treatmentsor surgery may berecommended 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

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Sexual misconduct - sex may be exchanged forprofessional services

Doctors trust and authority may be used to

exploit relationship with patient

Doctors may sexually assault patients when

under anesthesia

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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 servicesor items not performed

Many doctors adopted defiant attitude toward

Medicaid because viewed it as illegitimate

intrusion on their autonomy even though intentwas to provide health benefits to the poor

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What kinds of retaliatory avenues exist for

patients who are mistreated or abused by

physicians?

How are deviant doctors able to avert the labeland what consequences are faced by most?

Part 4: Ch. 22