Government shouldn't be less capable or ethical than the pill-pushers. But is it?

What the 1982 Tylenol murders reveal about ethical decision-making today

When it comes to protecting people, is the government even as good at the job as Big Pharma pill-pushers? (Photo by Amanda Jones on Unsplash)

In the 1930s, a single street on Manhattan’s Lower East Side — in those days, an enclave of Jewish immigrants from Eastern Europe — was home to 80 pickle merchants. Sidewalks and store aisles displayed big-bellied oak casks stuffed with aromatic vegetables aging in spicy brine. A customer could lift a barrel lid, pick out some pickles and fold them in a waxed paper bundle, then happily go on their way.¹

No longer. There are no pickle barrels anymore, because while wood-slatted casks aged pickles better than glass containers, they can’t be cleaned to meet food safety regulations. Anyone eager for a kosher dill now needs the strength of Superman — also, by the way, a product of 1930s New York — to screw open a factory-tightened pickle jar.

The challenge of the pickle jar is nothing, though, compared to the annoyance of over-the-counter medicine packaging. In our house, it usually comes down to kitchen shears, a steak knife and some colorful curses aimed at Big Pharma. There are triple-sealed containers to be cut, plastic shrink bands to be sliced, heat-sealed flats to be lacerated. You’d think all that would surely pose a risk of accidental self-harm considerably more likely than poisoning from any tampered medicine.

Sorry about what may seem to be an altekaker rant about something that seems hardly worth fussing over — how hard it is to open anything — but it arises because the other day we were reminded of how all this over-zealous protective packaging came about. Police in a Boston suburb this week reported the death of the only suspect in the terrifying 1982 Tylenol murders in the Chicago area, caused by the poisoning of seven people from cyanide-laced Extra-Strength Tylenol.² It’s the incident that gave rise to regulations on drug packaging, which in turn led to tighter food packaging, and even to impossible-to-open packaging on such consumer products as batteries and computers.³

James Lewis, who died at 76, was never charged with the Tylenol murders — police couldn’t find enough evidence linking him to the crime — but he was convicted of extortion for demanding $1 million from Johnson & Johnson to “stop the killing.” He spent a dozen years in federal prisons for that, and had a lot of other encounters with law enforcement. Reading coverage of his death, you’re struck by a sense of how different things were four decades ago. There’s something remarkable in how quickly the Tylenol incident led to widespread change — namely, to tamper-resistant packaging that’s now ubiquitous in America.

That fast action seems odd in retrospect because we seem to have lost the skill to respond collectively to dangers that rises among us. Business schools have been teaching leadership skills based on the reaction of Johnson & Johnson to its Tylenol crisis for the past 40 years. Too bad it seems to have escaped the notice of the public sector.

Within days of the deaths in Illinois — people of various ages, all suddenly felled moments after swallowing Extra-Strength Tylenol — J&J issued public health warnings about its product and demanded that stores pull 31 million bottles of the drugs off the shelves. Tylenol had been the best-selling non-prescription painkiller in the nation, holding 37 percent of the market; it accounted for one-third of the company’s year-to-year profit growth and 17 percent of its net income. After the recall, market analysts predicted that the brand would never recover. Panic selling caused J&J share prices to tumble.

But corporate leaders quickly put forward a message that J&J would put safety first. They issued warnings not to use Tylenol and set up a toll-free line for worried consumers and questioning reporters, and laid out what it was doing to protect consumers.⁴ Within weeks, Tylenol was relaunched with triple-seal packaging — including a cotton wad, a foil seal, a childproof cap and a plastic sealing strip.

That became the industry standard the next year, when the Food and Drug Administration, responding to the Tylenol murders, issued a regulation requiring tamper-resistant packaging on all over-the-counter drugs. Congress followed by making it a crime to tamper with that packaging.

The episode was costly for Johnson & Johnson: The drug recall and relaunch cost the company $100 million. But less than three months after the first death was reported, J&J’s stock topped its pre-crisis high, and within a few more months Tylenol regained its market share. The company’s crisis management is considered a model in curriculums for marketing, communications and business ethics.⁵

Americans aren’t fans of Big Pharma, and for good reason. The industry is seen as inflating drug prices to drive profits, aggressively marketing prescription drugs directly to consumers in a way that physicians say can endanger patients, and protecting the secrecy of dubious relationships with insurers. But the quick action of Johnson & Johnson in 1982 not only saved a company’s image, but also saved consumers. Who knows how many more bottles of cyanide-tainted Tylenol were on store shelves, putting countless people at risk, when the company warned off buyers and recalled the drugs?

Consider for a moment, then, how that record contrasts with what we might consider the crisis management strategies of institutions of our federal government today.

Far more than at any time in contemporary history, the U.S. Supreme Court is facing powerful questions about the ethical behavior of justices. Strong investigative reporting by several news organizations has uncovered activities by justices — appointed for life, let’s remember, and subject to no clear code of ethics — that would lead officials in other branches of government to be pushed out of office, and judges on lower courts to risk impeachment.

Justice Clarence Thomas accepted hundreds of thousands of dollars of gifts and lavish travel accommodations from a billionaire Republican campaign donor, then failed to disclose them; his wife played an active role in an attempt to overturn the election of Joe Biden, which Thomas implicitly endorsed when Donald Trump’s effort to unravel American democracy came before the top court. Justice Samuel Alito took expensive fishing vacations on the dime of a different billionaire, who later had business before the court.⁶ The wife of Chief Justice John Roberts made $10 million in commissions by matching lawyers seeking jobs with elite law firms, including some with business before the court. The taxpayer-funded staff of Justice Sonia Sotomayor has urged groups asking her to speak to buy bulk orders of her books.⁷

Alongside that is the question of whether the justices are pursuing a political agenda in the rulings they make on ostensibly constitutional grounds. The Dobbs decision overturning abortion rights that had been established law for 40 years is opposed by 59 percent of American adults.⁸ The court’s apparent elevation of religious freedom over every other right guaranteed by the Constitution, seen in several recent cases, is jarring in a nation that has long valued the separation of church and state. A court can stand independent of the views of the society it serves, but it risks its credibility if it rigidly adheres to the biases of a minority.

As the court has taken a hard right turn with the seating of three justices appointed by Donald Trump, public opinion surveys have shown a sharp decline in public trust for the court, and a rise in the view that it is fundamentally partisan. That can’t help but undermine respect for the law the court sets.

How is the court responding to this crisis of credibility? By telling us that everything is actually fine. “I want to assure people,” Roberts said last month, “that I am committed to making certain that we as a court adhere to the highest standards of conduct.”

Great. Let’s go with that crisis management plan, then: John Roberts has got us covered.

But maybe there’s another approach. Senate Democrats are pushing a bill that would require the court to adopt a code of ethics, set up a process to investigate alleged violations of that code and improve disclosure requirements.⁹ Republicans are pushing back, claiming it’s just a partisan assault on a conservative-led court, but 62 percent of voters told pollsters this spring that they have not very much or no confidence in the Supreme Court. That’s not good for democracy. You might consider it a crisis.

Of course, Congress has more than enough of its own crises to confront. A showdown is looming over the usually nonpartisan annual authorization for military spending. House Republicans this week muscled through divisive amendments to the National Defense Authorization Act to roll back Pentagon initiatives aimed at assuring service members’ access to reproductive care and protecting diversity — provisions that won’t win approval in the Democrat-led Senate, where the act can’t pass without bipartisan support.¹⁰

The amendments were demanded by the hard-right Freedom Caucus, which is made up of about one-fourth of the Republicans in the House — a group that is big enough to block the legislation from passing. The clout of that small band of radicals imperils final passage of the legislation needed to pay U.S. troops and support the weapon systems that defend us and the rest of the free world. Here’s what’s even more worrisome: A similar stance by Republicans this fall on must-pass federal budget bills could lead to a government shutdown.

What is being done in the face of this crisis? Look hard; maybe you can see something I cannot. House Speaker Kevin McCarthy happily defended the bill as proving “that Republicans continue to keep our promises” to assert conservative principles in legislation. The Democratic whip, Katherine Clark of Massachusetts, said the defense spending bill had been “transformed into an extremist manifesto.” Neither side shows any sign of blinking.¹¹

But that’s not the crisis that some of official Washington is doing its best to avoid addressing. No, that would be climate change, which is drawing shrugs on Capitol Hill even as its presence is overwhelmingly obvious in representatives’ districts. Experts say it’s likely that the heat wave just now enveloping more than 115 million people from Florida to California will set all-time records, both for duration and intensity. Incidentally, all ten of the fastest-growing cities in the United States are in the broiling southern states, where years of drought threaten water supplies. Meanwhile, heavy flooding this week overwhelmed Northeastern communities, including Vermont’s capital, Montpelier.

Yet Republican control of the House yields little action on the crisis, and the Senate is held back from aggressive climate action by the Democrat from Coal Country, Joe Manchin. In many parts of the country led by Republicans, laws have been enacted to block agencies from even considering climate change in their planning.

Human-induced climate change threatens the world, scientists agree, but the response to it is partisan: Only 23 percent of Republicans think that global climate change is a threat to the country, compared to 78 percent of Democrats, according to Pew Research. Republican lawmakers and the right-wing commentators on such platforms as Fox News — those talking heads who both lay out the politicians’ talking points and then amplify their words — have convinced people that this crisis is one best handled by doing very little.¹²

Back to 1982, then: Imagine if the makers of Tylenol had responded to the crisis on drugstore shelves by doing nothing, or by pushing back against efforts to make the public safe. Picture not only the impact on the business success of Johnson & Johnson — what might have happened, that is, if consumers hadn’t regained confidence in Tylenol — but also the lives that might have been lost if more tainted drugs had reached consumers.

It's notable that private industry set the standard of performance that quickly was adopted by the federal government — during the administration, let’s recall, of Ronald Reagan, who was elected on a fiercely anti-government platform. Even Reagan recognized that standing by as tainted drugs moved off stores shelves was an untenable strategy. That’s why we have tough standards for safe packaging of drugs today, and why we really don’t need to worry that anybody is shooting cyanide into pills.

Here’s what I think about, then, as I struggle to open a pill bottle: We’re protected from potentially adulterated drugs because a crisis was met with swift action based on ethical standards. That’s the sort of response that seems so sadly uncommon just now.

You can’t help but figure that if the right-wing crisis deniers of today were in charge a few decades back, we might still be digging in wooden barrels for pickles. We would pull out some tasty pickles, yes, but we wouldn’t get the security that a complex society has a right to expect its government to deliver.

1. https://momentmag.com/lost-magic-wooden-pickle-barrel/

2. https://www.nytimes.com/2023/07/10/us/james-lewis-tylenol-poisonings-dead.html

3. https://www.washingtonpost.com/archive/politics/1982/11/05/fda-issues-rules-requiring-tamper-resistant-drug-packaging/96fd5565-feb2-4173-bb90-042674290d82/

4. https://www.nytimes.com/2002/03/23/your-money/IHT-tylenol-made-a-hero-of-johnson-johnson-the-recall-that-started.html

5. https://interestingengineering.com/innovation/tamper-resistant-packaging-began-in-1982-with-7-still-unsolved-murders

6. https://www.npr.org/2023/05/05/1174057179/supreme-court-congress-ethical-hearing

7. https://apnews.com/article/supreme-court-sotomayor-book-sales-ethics-colleges-b2cb93493f927f995829762cb8338c02

8. https://www.npr.org/2023/05/03/1173382045/americans-arent-thrilled-with-the-government-the-supreme-court-is-just-one-examp

9. https://www.ny1.com/nyc/all-boroughs/politics/2023/07/14/sens--durbin--whitehouse-introduces-ethics-bill-for-scotus

10. https://www.washingtonpost.com/national-security/2023/07/13/pentagon-abortion-policy-house-republicans/

11. https://www.nytimes.com/2023/07/14/us/politics/defense-bill-house-ndaa.html

12. https://www.weforum.org/agenda/2023/04/what-the-data-says-about-americans-views-of-climate-change/

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ENDNOTE 07.15.23

What’s lost when local news vanishes

Fifty summers ago, I ws an intern reporter for a tiny newspaper in northwestern Indiana, and I learned about the importance of pigs and kids on a ballfield in community life.

As the low man on the totem poll at the Rensselaer Republican, it was my job one warm summer evening to get photos of the grand champion and reserve grand champion pigs — and the youngsters who raised them — at the Jasper County Fair. Kids in rural areas have long competed in 4H clubs for this sort of honor, and as I got to the pig barn at the fairgrounds on the outskirts of town, I noted that the scrubbed pigs were handsome, indeed, in a porcine way.

But here is something you may not know about pigs: If you move to put a camera in a pig’s face, he is likely to turn around and offer you his rump instead. Fine. Move around the outside of the pen to where the pig’s face is now situated, and the peevish pig will shift on you again. The pigs had no interest in my front page photo assignment.

That is why the photos of the grand champion pig and the reserve grand champion pig in the Rensselaer Republican front page one day a half-century ago are taken from a bit of a distance, with the youngsters proudly posed nearer to me. In fact, that turned out to be better photo composition than what I had in mind when I arrived at the fairgrounds. Depth, with interesting visuals in both the foreground and background, always adds interest to a photo. Count that as one lesson learned from the pigs.

Here’s the other: Alongside the watchdog function of local news reporting, there is a community value to what local newsrooms do. Steven Waldman, cofounder of Report for America and one of the leading thinkers about the future of American journalism, cites the “community cohesion role” of local newsrooms that is now at risk as a result of the 57 percent drop in the number of reporters at work in the U.S. in the last two decades, according to the Bureau of Labor Statistics. There are now more local librarians than local newspaper reporters, BLS reveals.

What is lost? Little league team photos, which I also shot (16 teams, as I recall) that hot summer in Indiana, to the delight of the families of each of those kids. Also, school board meetings, amateur theater productions, obituaries, a couple’s 50th wedding anniversary, new businesses opening and little community gatherings like Rensselaer’s “Little Cousin Jasper Festival,” named (at my suggestion!) for a poem written by Hoosier poet James Whitcomb Riley. “In fact,” Waldman writes, “the decline of local reporting has helped fuel polarization, misinformation and the growing tendency for Americans to demonize each other.” He adds, “If we have any hope of addressing these democracy-crushing problems, we have to dramatically strengthen local news.”

That can be done by supporting your local news organization. Maybe it’s a longtime newspaper that you can back by buying a cheap digital subscription. It might be a good local public radio station. Maybe you’re lucky enough to live where a new not-for-profit newsroom is serving you. Or maybe you’re in a state that is considering tax law changes that might spur employment in local journalism.

Please do what you to help journalism where you live. It will help sustain your community. You don’t know what you might find out from a local reporter. Like, for example, how to photograph an Indiana pig.

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-REX SMITH