Honesty Is Not the Same as Transparency

When I taught strategic communication at NYU, I emphasized a principle that is more misunderstood than ever: always be honest, but don’t assume you must disclose everything. Honesty is an ethical duty; openness is a matter of judgment.

That distinction matters in politics, business, and daily life. It is even more crucial in government, where leaders handle private, sensitive, or consequential information. Public officials should tell the truth, but avoid revealing everything on impulse.

Donald Trump has long blurred that line. He and his defenders equate indiscriminate disclosure with authenticity, as if speaking publicly automatically makes a statement honest, brave, or transparent. It does not. Recklessness is not candor, and indiscretion is not openness. Neither deserves applause.

Two recent episodes highlight this issue. They are not merely examples of poor taste or sloppy leadership; they reflect a deeper confusion about the true nature of honesty.

Earlier this spring, Trump publicly disclosed highly personal medical information about Rep. Neal Dunn of Florida. He said Dunn had been told he would be “dead by June.” Speaker Mike Johnson quickly cut in: “OK, that wasn’t public.” Reports confirmed Trump had revealed information that had not been public before.

The issue is not whether Trump was factually correct. Even if he was, the disclosure is not admirable. A president does not become more truthful by exposing someone else’s private medical crisis; doing so shows a lack of restraint, empathy, and judgment – not honesty. Telling the truth does not grant a license to violate every boundary.

The second example is more troubling because it involved military operations. At a White House briefing on the rescue of a downed American airman in Iran, Trump asked Joint Chiefs Chairman Gen. Dan Caine how many personnel had participated. Caine tried to prevent disclosure, responding, “I’d love to keep that a secret, Mr. President.” Trump persisted, saying it involved “hundreds and hundreds” of people. Media outlets described the exchange and the concerns about revealing sensitive operational details.

Again, the problem is not lying but rather the performance of candor without the discipline required of real leadership. The public deserves to know why a military action was taken, whether it was lawful, what it cost, the risks, and the possible outcomes. That does not mean, however, that a president should brush aside a general seeking to protect sensitive details in real time.

This is where the conversation often goes astray. Transparency does not mean total disclosure. The government should be open about decisions, motives, policies, and the use of power, but it should not treat privacy, confidentiality, or security as expendable. Mature honesty requires discretion.

We recognize this principle in every serious aspect of life. A doctor is expected to tell the truth without exposing a patient’s private condition. A lawyer must be candid without violating privilege. A friend should be honest without betraying a confidence just to appear blunt or “authentic.” The same standard should apply in public office: not every fact belongs on a podium, in a briefing room, or in a president’s improvisation.

Trump’s admirers often mistake his lack of filter for proof of authenticity. When he speaks impulsively, they label it as courage. When he is indiscreet, they interpret it as transparency. However, honesty is not about the volume or frequency of disclosure – it rests on whether what is said is true, responsible, and appropriate for the moment.

That was the lesson I tried to teach my students. As a country, we must reclaim it. Truth matters, and so does judgment. In public life, truth without judgment is not integrity – it is carelessness masquerading as virtue.

Predicting Change in the Age of Trump - We Need a T.H.E.M.E.

How long is too long to wait for change? If you’re at a red traffic light for more than a few minutes, you’re probably wondering if it’s broken and contemplating an isolated break with a societal norm.  

But what drives us to wait or to move on? I wrote about the change many predicted Donald Trump would make following his victory in the Republican primaries nearly five years ago. Surely, conventional wisdom dictated, he would pivot quickly from fiery agitator to energetic statesman. After waiting the duration of a campaign, a presidential term and then another campaign, I think it’s safe to say the wait is over. Change is not coming and it never will.

In 2016, a New York Times editorial (The Donald Trump Pygmalion Project) focused on Donald Trump’s behavior and how “Mr. [Paul] Manafort’s ambition is to turn this Eliza Doolittle into a candidate more acceptable to decent society, in time for the general election.” 

But too few were paying attention when Mr. Trump said, “I sort of don’t like toning it down.” That rare, honest admission should have been a clue. More questions needed to be asked; intentions should have been probed.

I love checklists and acronyms, and this looks like the perfect place for both. In politics, as in personal and business relationships, we need think about and evaluate others in terms of a THEME:

Transparent. Do we have a clear view into this person and his or her intent? Is what we see what we get?

Honest. Are rules, and the rule of law respected? Are we getting the facts, the truth or some belief, some wishful thinking? 

Empathic. Does this person really care about me, about others and the common good? What is this person’s motivation – is he concerned about helping others, greedy, or a narcissist?

Moral. What does this person value? Is there an understanding how his or her actions might affect others?

Ethical. What is the character of this person? Is this a principled person with a consciousness of his or her actions? 

This is the lens through which we need to view our leaders, colleagues, even friends and family members when it comes to gauging the probability of change. Of course, we need to remember that no one is perfect and giving the benefit of the doubt is generally better than immediately cutting off relationships. 

But when it comes to the current President, we already had years of answers to the questions in my THEME. We should have been able to avoid the mistake of the fabled frog. I’m referring to the story of the Scorpion and the Frog where the scorpion, unable to swim, asked a frog to ferry it across a river. The frog responded that it was afraid of being stung by the scorpion. The scorpion answered in logical terms: If I sting you, he said, then we’d both drown. Thinking the scorpion wouldn’t risk its own life, the frog allowed the creature on its back. Well, you guessed it. In mid-crossing, the predatory arachnid stung the frog. As they began sinking toward their deaths, the frog asked, “Why?” The scorpion replied, "I couldn't help it. It's who I am." The echo of 2016 Donald Trump is loud and clear.

The frog did ask, though. He questioned. Sadly, he believed the lie. He hoped and trusted when he should have been skeptical and suspicious.

Too few challenged Donald Trump and still don’t, even after all the facts were in plain view: the self-dealing, the hush money, the loyalty tests, the muzzling of scientists, and the targeting of the news media as “enemies of state.” The passivity of some and the enabling by others empowered an unabashed, unaccountable, downright lawless Administration. After hundreds of years of steady though non-linear progress, our country has actually devolved. Americans are worse off now than in decades past. Our people are sicker, more polarized, less trusted. The planet is unhealthier, more fragile, less stable.

It’s not too late to reverse course. The whole country won’t respond right away and some people never will. But what differentiates us as human beings is that we’re able to learn, adapt, and progress. Let’s do that.

Between posts, I invite you to follow me @pauoestreicher.

The Secrecy Bucket is Full of Holes

Get Used to It

The following was published in PRWeek:

The FDA has been under fire for years. Approvals are too slow. No, approvals are too fast. Inspections are not rigorous enough and enforcement is too weak. No, FDA is over-reaching. There's too much interaction with industry. No, there's not enough. This push and pull has been played out in Congress, in the industries that FDA regulates (or hopes to regulate), in advocacy organizations and in the news media.

How do we know so much about some of these sharp divisions and controversies? It's because there have been loads of information leaking out of the FDA -- internal disputes, data allegedly ignored and stories of staffers being pressured to make various decisions. To plug the holes, Acting Commissioner Frank Torti sent an internal memo last month reminding staff about the types of information that must remain proprietary. Want to guess what happened next? Yup, the memo was leaked (and criticized by those who believe such a memo inhibits transparency).

Dr. Torti sent a farewell memo the other week to FDA staff which -- no big surprise -- was leaked, too. (He is returning to Wake Forest University to make room for incoming Commissioner Margaret Hamburg.) Despite the roiling atmosphere, he had some interesting perspectives and high praise to share with the agency: "The FDA is now defined by others. You must speak up and take the FDA back. It's yours, not theirs. You do more good day in and day out than most others, inside or outside of government." He added that, "what's written about the FDA is always from the outside, and I wish there was a way we could communicate what we've done, sometimes under very difficult circumstances."

I see three key points. First, the FDA has, indeed, lost control of its message. Regaining its public relations footing is possible but the agency is in a tough spot: dealing with hugely complex issues that can defy the sound bite, being overseen by elected officials eager to score political points, walking a tightrope trying to balance on the safety and efficacy of new drugs and devices, the list goes on. And when they tried to get some PR help late last year, it backfired. They were taken to task for awarding a no-bid contract.

Second, while transparency is crucial (as I have written here in the past) it cannot be used as a blunt instrument. There really are secrets that must be kept, at least for some period of time. Premature release of information can create a panic among patients in the case of drugs and devices, or among the entire public in the case of food. Or, there may be patent issues or patient information that demand confidentiality.

Third, we need to examine just how much secrecy we should expect these days. Our interest in inclusion means more people are exposed to secrets. More people means more mouths. And with people involved in social issues in addition to work, they often feel forced to choose sides. I can remember working for Roche and getting a call from an HIV/AIDS activist asking me to confirm some data that the company had sent down to the FDA just hours earlier.

The push toward more secret sharing is bound to accelerate. We have a generation growing up on Facebook, MySpace and Twitter, and all the other generations are aching to catch up. The amount of personal information people are willing to share is stunning. Clearly, the need to unleash our inner narcissist has overpowered our interest in keeping information private. A secret isn't what it used to be.

Disclosure - Keep It Coming

Try to Avoid Taking Two Steps Forward and One Step Back

Slowly but surely, pharmaceutical companies are stepping up. Unfortunately, at times (too many times) it's been painful to watch the industry progress toward a more open and transparent orientation.

On the good news side, Pfizer announced that it is the first pharmaceutical company to be accredited by the Association for the Accreditation of Human Research Protection Programs (AAHRPP). This helps to ensure the ethical treatment of clinical trial volunteers no matter where the research is conducted. The accreditation process is rigorous and took 15 months.

On the bad news side, this is 2009. Reports of unethical clinical trials have been popping up for decades. Indeed, Pfizer said that "AAHRPP accreditation is another step in Pfizer's ongoing efforts to earn public trust for integrity in research." So, why has this taken so long and why is Pfizer the only pharmaceutical company to mark the milestone so far? The AAHRPP has been awarding accreditation to programs since 2003.

This reminds me of the years that it has taken for pharmaceutical companies to post information about their clinical trials in public databases. Even after it was reported that a number of pharmaceutical companies were cherry-picking data from selected clinical trials that favored their investigational products, there was intense resistance to disclosing the existence of the previously unknown studies. Only after exposure in the news media and threats from Congress did the industry acquiesce. And still there's a steady flow of news about critical information being withheld here and there from the FDA.

There's just too much kicking and screaming, and it's not only about the progression toward more openness. Think of the history of the Medicare drug benefit, or instituting reforms on gifts and promotions.

The industry is full of smart, driven and ethical people, and they are supported by a lot of smart, driven and ethical consultants. I'm sure that they all recognize that the best way to run a business and to manage an issue is to move the information -- good or bad -- out quickly. More often than not, it's the tone and timing of the message that matters more than the severity of the issue. In practice, though, it's a different story. Of course, there are legitimate secrets and there are sometimes limits on what can be said. Still, we see companies (and governments and all manner of institutions) undermining their reputations by dribbling out crucial information over long periods of time.

There are lots of issues out there. Many companies are good at taking stock of their situations, writing extensive Q&A documents, developing "what if" scenarios and building advocacy networks to support their positions. But a lot of companies stumble on the next step -- getting out ahead of the issues. They're coming, you can see them. So, step over them, step around them, confront them head on, whatever. Just don't get run over again.

New Bedside Manners

Tell Me – Not the Internet – How You Feel
I haven’t conducted a formal survey but I’d be willing to pull some money out from under my mattress and bet that two of the most often-used words these days in the worlds of business and politics are transparency and accountability. There’s been little choice, if you think about it. The collision between out-of-control companies and politicians with public outrage and instant communication tools has sparked unprecedented demands for truth and openness.

The push to expand transparency and accountability has given rise to numerous rating sites on the internet – everything from food to teachers to virtually any product. This long list includes about 40 web sites where one can rate their healthcare provider.

In an AP story last week, “Docs seek gag orders to stop patients' reviews,” Lindsey Tanner reported how some physicians are coping with anonymous, negative patient commentaries on sites like RateMDs.com. Intrigued, I went to the web site and saw that over 185,000 “doctors” were rated, but this includes acupuncturists, chiropractors, podiatrists, psychologists and dentists. I clicked on the most reviewed doctors and found that the top four are ob/gyns and number five is a cosmetic/plastic surgeon. (Number six, I must note, is the fictitious Dr. Gregory House.)

It’s not a big surprise that women, the most influential healthcare decision makers in the family unit, are the most vocal. Randomly scrolling through, I found some posts to be reverential and others to be scathing. These comments are a one-way street, however. The doctor’s name is used but not the patient’s and, because of rules protecting patient confidentiality, there’s no way for the doctor to respond.

Here’s where a company called Medical Justice comes in. For a fee, they offer physicians a service that monitors the internet for patient comments and a contract (“mutual privacy agreements”) for their patients to sign where they “agree not to post about their doctor on the Web without the doctor's permission.” In addressing First Amendment rights, the site states that “Patients are free to discuss their care with other doctors, family, friends, licensing boards, attorneys, and any number of institutions. Mutual privacy agreements do not create a choice between healthcare and one's right to free speech (as some have erroneously claimed).”

So, on one hand we have sites that allow unfettered forums for blasting (or praising) health care providers. On the other hand, we have an effort to limit where patients can express their views. Here are a few thoughts:

Health care providers need to accept the reality of our information society. Telling someone they can’t do something is a sure-fire way to promote the opposite of what is intended.

Entering into a contractual arrangement with a patient over issues of speech may raise questions about the doctor’s motives, potentially damage the relationship and erect a barrier that decreases communication.

If women are using this medium most frequently, then some special attention needs to be paid to their concerns and communication preferences. There should be an office environment where concerns can be aired before they hit the internet. And, if face-to-face commentary is uncomfortable, perhaps an anonymous mail-in survey should be made available.

While both sides have legitimate positions, I think we require a third hand. What’s needed is a forum where patients can post justifiable comments, where those who read them can have some assurance that no axes are being grinded. Health care providers need assurance that inaccurate, reputation-killing commentary is kept off the web, where it’s so difficult to excise.

Patient advocates and organized medicine should collaborate on setting standards and policies – a code – for responsible, ethical rating sites. Both patients and their doctors need to get on the same side of the fence on this issue. When it comes to your health and wellness, I can’t think of an issue where it’s more important for all the parties to act as a team.

Betting on Vetting

This article also appears in odwyerpr.com.

Why We Need To Ask (and Answer) Questions
It happens every four years but also in lots of places in between. It’s the political vetting process.

Despite the development of an unprecedented process of detailed queries by the Obama administration (including a seven page survey with 63 separate requests for information), it’s been a banner year for viewing some high-profile nominees go down in flames. These include Tom Daschle for HHS Secretary and Bill Richardson for Commerce Secretary. Either the answers to the questions were inadequate or the vetters themselves were inadequate or both.

Sarah Palin, who remained on the GOP ticket after a much maligned shotgun-wedding-of-a-vetting process, might have been the most talked about case. Yes, there were the serious issues of her readiness to be a heartbeat away from the presidency, the ethics investigation in Alaska, her husband’s DUI arrest and her unwed teenage daughter’s pregnancy. But it communicated more. Reputations suffered. The unraveling episode was a reflection of the McCain team, and of the man himself and his judgment. Some argue that the Daschle and Richardson picks (and throw in Timothy Geithner and Nancy Killefer) cast similar doubts on the President.

Of course, this isn’t new. I’m not a political historian but just off the top of my head I can remember Thomas Eagleton for Vice President in 1972, John Tower for Secretary of Defense in 1989, Zoë Baird for Attorney General in 1993, Bernard Kerick for Homeland Security Secretary in 2004 and Harriet Miers for the Supreme Court in 2005. The reasons for these falls from grace are various, including mental health issues, tax problems, outright corruption and limited qualifications.

Politics is just the tip of the iceberg when it comes to the lack of vetting – just ask those who were ripped off by Bernard Madoff. It’s clear that questions should have been asked but I don’t have an answer on how to overcome blind faith or greed that blinds.

There are several points here:

Taking the time to ask questions – good questions – is essential. But equally essential is the need to receive good answers – truthful answers – in a timely fashion.

The truth will out. Being transparent and honest is the first, best – the only – approach. And, let’s face it, our 24/7 on-line world is relentless in its pursuit of a good story.

We must accept, however, that decisions must get made eventually and that time is often an enemy. The best decision-makers know when collecting more and more information leads to diminishing returns. We need to learn how to manage and accept risk.

If we are to wear an ethical mantle, then we must commit to ethical standards… all the time, not just when it’s easy or convenient or in public. And, we must ensure that those with whom we work or hire also adhere to those principles.

These lessons are not new to professionals in the communications field. Strategic communicators ask questions and gain insight through rigorous analysis of information. They look around the corners, predicting outcomes and the potential unintended consequences of a particular course of action. They prepare scenarios (from those with high probability but little impact to those with low probability but a high potential for damage) and engage in “wargaming” exercises. They develop comprehensive Q&A documents, and pay attention to language and tone. They determine, in advance, who might be an advocate and who might be an adversary. Once prepared, they move forward.

The call from Washington for more transparency and higher standards is a good thing. Openness and sharing information is what democracy is about. Perhaps some day down the road we might learn that sweeping bad or embarrassing news under the rug is bad business. If not, someone will always be around to ask, “What’s that lump under the carpet? Let’s see what’s there!”