The Diffusion Of Responsibility

Photo: simminch

Once while I was jogging along Lake Michigan, I came upon a large crowd surrounding a middle-aged man lying supine on the ground.  I stopped to assess the scene and saw the man wasn’t moving—at all.  Two people were bending over him and trying to shake him awake.

“What happened?” I asked.

“He fell,” someone, a woman, said.

“Did anyone see it?”

She nodded.  “He was walking along and maybe he tripped or something—I couldn’t tell—but then he just…crumpled.”

I identified myself as a doctor, pushed my way through the crowd, and checked to see if he was breathing.  He wasn’t.  Did he have a pulse?  He didn’t.

“Has anyone called 9-1-1?” I asked.

No one answered.

WHY DO WE FAIL TO ACT?

This wasn’t an evil crowd that was glad someone had collapsed.  It was a large crowd, of strangers, many of whom had undoubtedly seen him collapse besides the woman to whom I’d spoken.  They were all concerned, I’m sure—and at least two among them hadn’t entirely surrendered to the shock of seeing someone fall unconscious.  But no one, it seemed, had done the single most critical thing, the thing that meant the difference between life and death for him:  called 9-1-1.

In my view, the likely explanation relates to a phenomenon I call the diffusion of responsibility.  Simply put, when a task is placed before a group of people, there’s a strong tendency for each individual to assume someone else will take responsibility for it—so no one does.

Malcolm Gladwell famously put forth his notion of this as an explanation for why not one of Kitty Genovese‘s neighbors who presumably heard her scream intervened or even called the police while she was being murdered in the courtyard of her building in New York.  A subsequent uncovering of facts suggests the original story of 38 people watching her die through their windows while doing nothing represented a significant distortion of what actually happened.  But the truth that one or two of her neighbors heard her screams yet managed to explain them away as something less ominous than they were is likely not.

That kind of narrative rationalization—that is, a story we tell ourselves that relieves us of responsibility to act—is also what underlies the diffusion of responsibility.  Knowing that others heard the same scream, or received the same email request, or came upon a man down powerfully tempts us to assume someone else has taken responsibility for doing what needs to be done.

Many reasons for our falling prey to this assumption exist.  We’re all busy with our own lives and don’t want to get involved.  We may not believe we’re the best person to assume responsibility.  We may not care about the issue involved.  We may be lazy.  After all, no four words in the English language are ever easier to say than:  it’s not my problem.

EVERYTHING IS OUR PROBLEM

You can choose to live your life that way, dividing obstacles that come your way into yours and theirs, ignoring the principle of dependent origination, which essentially states that we’re all in this together and whether we realize it or not all rise and fall as such.  Certainly when help could be requested but isn’t or when it’s offered and refused, the problem isn’t yours to solve—but to not care whether it’s solved, to turn your back on someone else’s plight in your heart—well, the more you practice that, the easier it becomes to tell yourself someone else will take care of things you should be taking care of instead.  And if the world becomes populated with enough people who think that way, that someone else will do it (whatever “it” is), we’ll only be seeing more disasters like the BP oil spill, and debacles like the Holocaust and the Rwandan genocide will repeat themselves.  Just remembering these tragedies isn’t enough.

Or, you can live with the consistent assumption that you’re here to help others in whatever way you can, stepping up constantly to whatever plate life thrusts before you without being asked.  It only takes practice.  People who think this way don’t ask, “Who will do it?”  They just assume if a problem finds them it’s theirs to help solve.

LEVERAGING THE DIFFUSION OF RESPONSIBILITY

Knowing the principle of diffusion of responsibility holds sway in the hearts of many may explain the often frustrating inaction with which we find ourselves faced on an almost daily basis, but it also points the way to changing it.  The key is getting others to feel personally responsible for helping to solve problems they may not consider their own.  Truly great companies know this, which is why they put incentives in place to motivate their employees to provide great customer service.  If you’ve ever had the fortune to encounter a service provider who works in a system that provides such incentives you know just how refreshing and wonderful people are who take responsibility for helping others solve problems.

How can you make someone care about an outcome as much as you do?  It’s not easy, but the following may get you thinking about it creatively:

  1. By displaying leadership.  Inspiring others generates internal motivation—a far more effective means than external motivation for getting others to care.
  2. By making it seem personal.  Find a way to give others a stake in the outcome, whether financial, emotional, moral, or otherwise.  Figure out why someone else should care and explain it to them.  Don’t make the common mistake of presuming that if something is important to you it’s important to others.  This, by the way, is something Congress would do well to think about.  Rather than set up watchdogs to motivate industries externally, the systems they set up would be far more effective if they were constructed with incentives that motivated desired behaviors (increased attention to safety, proper banking practices, etc.) internally.  The country is too big to count on watchdogs catching everyone’s mistakes/negligent behavior.  We need systems in which people are incentivized to catch themselves.
  3. Target individuals rather than groups.  Don’t allow the psychology of the diffusion of responsibility a chance to take hold in the first place.  Don’t request help from groups; request it from individuals.  This applies to every form of communication but especially, I think, to email where the impulse to include more than one person in the “To:” field is strong.

I was thinking specifically of this last point when I found myself confronted with the unconscious man lying along the running path on the shores of Lake Michigan.  After assessing his condition myself, I looked up directly at the woman who’d answered my questions initially and said, “Call 9-1-1.  He isn’t breathing.”  By asking only her I made only her and no one else personally responsible.  I administered CPR until the paramedics arrived, about five minutes later.  They only had to shock him twice before they got a pulse back.  And then he did the most amazing thing, something I’d never seen happen as fast in all my years of watching people’s hearts stop and be restarted in hospitals:  he opened his eyes.

Next weekThe Problem With Prevention

27 comments to The Diffusion Of Responsibility

  • thquah

    Alex,
    You know what you really save a life.

  • My husband and I have witnessed several vehicle accidents while driving across the country in our RV. Without having ever really discussed why, we automatically do this: he gets out and goes over to the scene, assessing the damage. Sometimes he directs traffic. I immediately call 9-1-1 and stay on the line to report what he has found.

    But I always get nervous, and worry that I am not the first to call and will therefore be clogging up the 9-1-1 line. Maybe that’s part of the hesitation? Not wanting to be a burden? I often feel that someone else could do a better job of being the first reporter, but do it anyway.

    I also get on the CB radio and warn the truckers. Once I was so flustered that I announced the accident over the radio as being on a completely different road, in a different state! The truck drivers gently asked for clarification and were so sweet. One thanked me and told me to take care of myself.

    Our reptile brains definitely kick in when there is an emergency. Fight or flight. For many people, I think the instinct is to “fly” away from responsibility.

  • Kathy

    I learned once in an emergency response training that it’s good to give specific people specific jobs. Be the one who jumps in and takes charge. Tell one person to call 911, tell another to stand by the door or road to wave the paramedics in the right direction, give another the person’s wallet to call loved ones. When I was working as a cashier once at a drug store, a kid on a bike was hit by a car in the street outside. I orchestrated the whole thing, calling 911, assigning duties, without even being on the scene. I was just a teenager myself, but all the “grownups” were freaking out and doing nothing. At the end of it, I was amazed that all these adults would listen to me, but the truth is just what you say, most people are good and want to help, but they are paralyzed in a group and don’t know where to start, so they do nothing. Great article. Thanks!

  • Maria

    In my scuba diving courses, when it came to first responses, they would tell us something similar. If you come upon an emergency, take up the responsibility and get help from the others specifically, e.g “you, the man in the red shirt, call 911 and get back to me.” It works really well.

    And speaking about emergencies, everyone should know emergency first response! Take a course and then a refreshment course every year, we never know when we might need it!

    Knowing what to do under stressful circumstances also helps in standing up to the responsibility.

    Maria: I completely agree.

    Alex

  • Mike

    Cialdini writes about this in his book “Psychology of Persuasion.” The problem isn’t so much diffusion of responsibility but social proof. In uncertain situations we look to see what others are doing and take that as the norm. So if someone is lying on the ground but nobody passing by seems too concerned, we tell ourselves that its nothing to be concerned about. This may sound like diffusion of responsibility but its different; studies and anecdotal evidence show that once the a few people in the crowd decide to get involved, people are happy to help out.

    Mike: Gladwell makes a similar argument. Social proof is different from the diffusion of responsibility, I agree, but I think both are valid concepts and play a role in emergency situations. I used an emergency situation as a anecdote here but I hope I got the point across that the diffusion of responsibility plays a role in many other situations as well.

    Alex

  • Jay

    Fear of making a mistake, I suspect, is the greatest deterrent to offering help. Even looking stupid anonymously threatens our self concept. As a physician, you immediately had confidence and credibility to others. If you were a plumber, you might have hesitated. “Let me through, I’m a plumber!” May not have been particularly effective in those circumstances. Assigning roles to difference unnerved participants (and they are participants) allows everyone to share the mistake, as it were, and dilutes the embarrassment. We are much more concerned about our being fools than becoming hero’s. Thus, leadership is the willingness to possibly make publicly wrong decisions. Emergency situations are distilled daily decision-making conditions in instant now. To prepare us for leading any charge requires Louise’s plan, Kathy’s confidence, Maria’s experience, and Mike’s awareness. Thanks, Alex, for readying us for this afternoon’s challenges.

    Jay: I think you raise an excellent point, that embarrassment plays more of a role than many think.

    Alex

  • Craig

    Alex,

    There’s a similar situation which you may wish to wax more eloquently on that I studied in a “Philosophy of Thought” course some 20 years ago. It’s the “Mattress on the Highway” metaphor.

    A mattress falls onto a highway and a huge traffic jam ensues. By the time each individual car reaches the mattress, those individuals have paid the total cost to themselves for the event.

    To me this is not “diffusion of responsibility” and it may not even be an interesting spin on your concept of “dependent origination” since that simply recognizes that one should consider the consequences (positive or negative) on their actions (but not necessarily failure to act) especially when their is a cost or danger to oneself.

    What is it in human nature that compel some to pay more to move the mattress off the highway while all others to that point have continued on their way?

    Craig: Fascinating question. Why are some more predisposed to consider the pain of others and motivated enough to take action to alleviate it, when others think only of their own pain? Or perhaps a better question might be, what brings out the impulse to act compassionately and what suppresses it? The most compassionate person in the world could be having the worst day of her life and drive right by that mattress, while the biggest jerk in the world could be worried his mother is a car behind him and move it for her. In Buddhism, how we behave at each moment is considered the result a continual battle between our good and bad impulses. It takes far more work, it seems, for many of us to manifest the good than the bad.

    Alex

  • Kate

    If you read the research about how some people have been successful (or survived) in a crisis, one of the main points is that the people who did well were the people who prepared for what could happen to them. In a fire, these are the people who knew how to get out. In an airplane, these are the people who knew the emergency procedures and where the exits are. In a medical emergency, these are the people who knew first aid and live saving skills.

    Bottom line: these are the people who have mentally and sometimes physically prepared themselves for disaster. This is why police and other first responders practice over and over again how to respond to emergencies. It’s the preparation and practice.

    My guess is that these are probably the same people who will stand step in a crowd and get involved in a crisis.

    Kate: You must be channeling my wife! Preparedness is her constant mantra. Also, I wrote a post that addresses this called Preparation Prevents Piss-Poor Performance.

    Alex

  • Mary Carlisle

    I’ve seen this a lot it’s disturbing and maddening in some cases, but I’ve also witnessed people at accidents all scrambling to call 911 at the same time. This also falls into your previous post “Dependent Origination” separating yourself form others and acting only if it suits you. People also have used the excuse “they don’t want to get involved.”

    I think this happen in big cities were people are more closed off and guarded from each other.

    I can understand this more when people are fearing for their lives. My friend who’s a police officer works in a division of Los Angeles that covers South Central (which is completely gang infested) she said this is the biggest problem getting people to say anything at all to help them solves murders, assaults, etc…and it’s usually people that witnessed the whole thing.

  • I too think our evolutionary roots have a lot to do with our response/non-response. We can either become frozen or flee from danger. My father was the classic, “Don’t get involved” guy, though on a personal level he was generous to a fault.

    Most of us feel a bit alienated from the crowd, through which we flow likes ants on a predetermined path. Also, fallen comrades (animals) are often weak or injured, and it is contrary to instinct to help (unless you’re an elephant). It takes a step beyond instinct to give a damn.

    Thank you, Alex—you have saved more than one life.

    Lisa: How nice of you to say that, thank you.

    Alex

  • I remember studying that case in Social Psychology. Very strange. I remember the idea of “diffusion of responsibility” and “social proof.”

    That is probably why when you take St. Johns Red Cross they tell you the exact same thing: take charge, tell someone to call 911, etc.

    Also to deal with the idea that no one wants to get sued if they try to help, we have the “Good Samaritan Act” here in Canada. Don’t know about the U.S.

    Maureen: We have Good Samaritan laws here in the U.S. but the details vary from jurisdiction to jurisdiction.

    Alex

  • Ann

    Your post reminds me of an incident several years ago and my inaction then haunts me still. I was making my way through a crowded airport departure hall in Beijing when I came across a man—non-Chinese—lying face-up on the ground, eyes closed and making feeble movements. Nobody was attending to him. There were airport staff close by and I assumed they must have called for medical help.

    But it bothered me that were bantering among themselves. I worried that they might not have (sufficiently) reassured him that help was coming. It also bothered me that the man’s spectacles were askew—resting somewhere around his mouth.

    I had the urge to crouch beside him for a few seconds to straighten his spectacles or put them in his pocket, offer some words of kindness…but what could I say? I was intimidated by the fact that everyone—staff and passengers—were minding their own business in apparent oblivion to this person’s fears/loneliness and I didn’t want to come across as overly emotional.

    So like the other passengers, I walked on.

    Ann: Sounds like you fell victim to the “social proof” effect mentioned by one of the earlier commenters. Please go easy on yourself. It’s a powerful effect that’s extremely difficult to resist, especially if you haven’t thought specifically about it and rehearsed a different set of behaviors in your mind (the value of which another commenter pointed out). You can still create value with your experience by using it as a strict reminder to behave differently were you ever to be confronted with a similar situation in the future.

    Alex

  • Susan

    One day while driving near my home, I spotted a toddler running down the middle of a busy street. Cars whizzed by without stopping. I immediately pulled over to the side of the road, dodged the cars zooming by, grabbed the child and ran for the curb. Looking at the houses nearby, I finally spotted an old man about 150 yards, obviously searching for the child. When he got to within about twenty-five feet of me, I put the little girl down and she happily ran toward the man. He scooped her up and calmly walked back towards one of the houses without a word to me. Perhaps he didn’t realize she’d even been on the road.

    What shocked me was that I was the only one who stopped. At least fifteen cars went by between the time I saw the child and the time I got her off the road. It was a miracle she wasn’t hit.

    The incident was so strange. Of course, I couldn’t have just driven on.

    Afterward, it was almost like it never happened, except for my pounding heart. It felt like one of those if-a-tree-falls-in-the-forest-and-no-one-hears-it-does-it-make-any-noise? moments. I know that the child would have likely been killed or badly injured if I had not stepped in, but I was surprised at the empty feeling the lack of any acknowledgment left in me. We’re funny creatures, aren’t we?

    Susan: My own heart started beating just reading about your experience (and thinking about it happening to my own two-year-old). I think the part of us that feels satisfaction at having done the right thing, at having helped another person, is quite distinct from our ego, which craves recognition for the good we’ve done. So it’s not too surprising to me you could be motivated to help as you did, feel good about it, and still feel disappointed by the lack of appreciation. We rarely feel only one way about anything. Doesn’t take away from the fact that you did good. I certainly appreciate what you did, if that means anything!

    Alex

  • Zara

    I liked this post, since it reflects my own thoughts when I was in my twenties.

    At that time I noticed that when I saw (for example) a pickpocket, I was not able to help the victim. This happened to me 2-3 times. Example: I saw a man walking in the street. He was about 50 meters far away from me. He accidentally dropped a banknote. At that time I would have to work 3 days to earn that money. And before I could think of how to react, whether to shout or to run after him, another man who was walking just behind him picked up the banknote and put it in his pocket. I was in a shock because I thought he would return it to the owner, but he didn’t. It all happened very quickly. Obviously the best thing would be to run after the second man ask ask him if he was going to give the money to the owner. But I was young and shy, so when I got to them I told the man who dropped the money what had happened, and he replied: Well, but if I ask him to give me the money back he won’t.

    Another time I saw a taxi driver beating a woman who was on her knees. There was a crowd gathering around them. Nobody tried to protect the woman. Again, I was quite far, but the scene upset me very much, so I decided to become the person who would stop the taxi-driver from beating the woman. It happened in a good area; I would have been in no personal danger if I had tried to defend that woman. I hurried up to be at the spot as soon as possible. While getting there, I noticed that the taxi driver was checking his car door for possible scratches. He stopped his car at a crossing. I could only guess he stood in the way of the pedestrians. I could only guess the woman kicked the door of his car and he was afraid that she had scratched the door. But now she was kneeling on the ground. I was determined to stop the awful scene, but as soon as I reached the circle of the crowd gathered around the car, I was suddenly unable to help the woman. I guess I fell into some sort of hypnosis. Again, everything happened so quickly, and it was all over before I was able to react.

    I became quite annoyed with my inability to react properly in these situations. Finally, once when I saw three pickpockets in the underground stealing something from a woman’s handbag, I grabbed the shoulder of one the pickpockets and shouted to that woman: Watch your handbag. The woman, I believe, noticed the danger, but the pickpocket turned round and looked at me and with a big scorn he said: “What’s this?” At that moment I got scared and ran away and changed for another line in haste. Well, they didn’t pursue me, but I was afraid.

    After some time I came to peace with myself and understood that sometimes I am able to help a stranger and sometimes I am not.

    Another time I saw a drug addict. He was in great distress, he kept speaking to himself: “I had told him not to take that stuff.”

    I called the ambulance. They didn’t send an ambulance. I judged the situation, and I knew I would not be able to start any sensible conversation with that drug addict. So I left. If was in an underground station. In the morning hours. A lot of people passing by.

    What I want to say is: it’s not that some people try to help and others don’t. I would say it’s more about their current personal situation and pre-occupations. Only recently I read in a book [unfortunately I cannot remember what book it was now :-) ] about an interesting experiment into human conscience:

    The researchers asked future priests (young men in training) to give a speech on various biblical themes. One of the topics was the story of Good Samaritan, but there were other topics as well. The settings were following: The researchers gave the young men instructions in one building, and then they told them to go to another building and give the speech there. The young men didn’t know this was for research, and they were stressed by the prospect on giving a speech in public. The researchers made the settings even more complicated: They told them that they either have to hurry, because they are late, or that they have still plenty of time to get there. The future priests had to walk through a small alley. A rugged man was asked to lie there and pretend to be in pain. Most of the men who were in a hurry didn’t even stop to ask him if he needed help, some of these even stepped over him to get through the alley. About 60% (I am not sure about the exact number) of those who were NOT in a hurry tried to help.

    I guess I even gave a notice at a school where I used to work as a teacher for reasons related to this matter. As teachers we were responsible for the students in case of an accident. But we had no training to help us solve possibly dangerous or life-threatening situations. I know that common sense makes this very simple, but the school system worked against the common sense. I worked at that school for five years. I was overworked. In my final year I made some statistics: I worked 10-12 hours a day (if calculated to 5-day working week), and most of this time (besides full-time teaching, of course) I had to do paperwork at the expense of lesson preparation or test correcting…I was too tired to notice any signs of dangerous situations when at trips with students in groups as big as 50 or 60 for 7-10 days. I was afraid that in case of emergency I might make impractical decisions on the spot. I repeatedly asked my boss for some clear instructions regarding the safety of the students. I got no instructions. I was told that previous guidelines were not valid any more, new guidelines had not been made yet. I was asked to make some guidelines on my own (which meant extra work of course, so I was not able to do it because lack of time and money). When I gave the notice, my boss started the gossip that I suffered from depression. Well, that’s quite a difficult opinion to fight if you are in a position of an employee exhausted by following the orders of your boss. Only one of my colleagues stood up in front of her in my defense. Others told me privately that I was right not to put up with that situation any longer. Well, so they did, but 3 years later when I meet them, they say that it’s good that I managed to keep good health. I did not have depression, my decision to quit was one of the best decisions I have made in my life. I was just exhausted by extra workload of paperwork which was not paid and which I thought was less important than my daily classes. Well, as the bible says, it’s better to be in the position of the abused one, than in the position of the abuser.

    The problem is that we can never be quite sure on which side of the barrier we stand in different sorts of situations. I prefer not to think much about situations in which I probably didn’t behave very well. Sometimes those against whom we commit some injustice/act of ignorance don’t tell us, and I know why they don’t tell us. Because frequent response is more abuse or hurtful disregard. How can they see in advance how we are going to react to any sign of disagreement?

    [I am aware that the safety rules in the US schools are very strict in these matters, because schools cannot afford any risks. Well, comparison of school systems is another topic, I guess.]

    I am sorry my response is so long. I would have liked to make it brief, but I tend to fall for details every time I tell a story.

    ***I guess Jay had been able to say all this in one paragraph :-)
    I will understand if you will not publish this response on your site because of its excessive length :-)
    Sincere greetings to you and your readers
    Zara

    Zara: I think you raise an excellent point in bringing up the priest study. Our own inner life state vacillates moment-by-moment and if we’re not in a compassionate place for whatever reason our reaction to people in distress may not be what we want it to be. Keep in mind though I was only using that as an anecdote to make a larger point. Thanks for writing.

    Alex

  • I love your blog, I love this story.

    When I was an ER nurse, many years ago, I was at a mall parking lot to shop on my day off and stopped to let two older women cross to the store. As they were walking, one just fell backwards to the ground. I could barely believe it. I put the car in park, in the middle of the very busy parking lot, and ran to her. She had no pulse, was not breathing. A bunch of people came to stare, but no one moved. I did CPR all by myself. Everyone kept telling me her head was bleeding, that I should stop and check it. I was doing CPR, but they could only see the blood.

    Finally I looked up and asked if anyone had called an ambulance. No one had. This was in the 80′s before cellphones. I looked at one woman and asked her to go into the store and call for the ambulance and tell them it was a full cardiac arrest outside of Sears. It took forever it seemed for the ambulance to arrive. They said they were told that someone had passed out in Sears. They intubated her, shocked her with no result. Off to the ER. Since I worked there, I stopped in to see her. She was alive! They thought she had fibrillated suddenly. She had complained of SOB and had an EKG that morning at her MD’s office and was told she was fine. No MI. Just sudden arrhythmia.

    I never told her I did CPR. I just said I was a nurse in the ER. She smiled at me. She was still intubated, but on a T-tube. It was the best smile I had ever seen.

    I still remember that smile today.

    I also remember how the crowd of about 20 just stood there watching. Gawking. Now I know why.

    Janice: Your story is far better than mine. I’m sure you’re aware of just how rare it is for someone outside the hospital who arrests to survive. Without a doubt you saved that woman. Very nice.

    Alex

  • Jill

    Lot’s of things to think about, Alex. I realize I’ve never been tested like this in all of my 40+ years…and I wonder how or if I’d respond.
    This post is good ammunition if I ever am and find myself hesitating.
    Thanks,
    Jill

  • Zara

    :-) I thought I had understood your larger point, but I am not so sure now…

    I thought your larger point was about how to initiate/enable/or just allow the change for the improvement… or at least not being a cause of hindrance…

    Zara: Yes, that, but also that we shouldn’t allow the presence of others around us to dull our sense of personal responsibility to respond to others in need.

    Alex

  • Jody Clauson

    Nice post, Alex. This reminds me of a story that was on the news about a year ago when there was a teen beat to death on a school property. All the kids stood around and did nothing. They held a special interview in efforts to try to understand WHY they did nothing and fear (on many levels) seemed to be the resounding dynamic.

  • jeffery kumorek

    Doctor, as you know you have saved my life. In over thirty years of law enforcement I have witnessed this so many times. I enjoy your writing please continue.

    Best
    Jeff Kumorek

    Jeff: Thanks so much.

    Alex

  • Lil Gluckstern

    Really liked your post, and I think you have clarified some things for me. I have learned that we are all accountable and responsible. But sometimes, it seems impossible to do what should be done. I live in a Senior development which has individual alarms in every apartment. When that alarm goes off, there are always a few of us who go running to see who might be in trouble. What amazes me is that it has nothing to do with who is physically able, but everything to do with who is a “good citizen” here. Also, sometimes I don’t want to, but I guess that’s okay too. This business of being human is difficult at times. Thank you for your writings.

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  • Grimmy

    I just have to make a general comment, that I am amazed at how your posts, every week, touch a nerve in me. And makes me want to become a better friend, a better lover, a better father, a better colleague. And you have the ability to give very concrete advice although you target a very large and diverse crowd. Keep it up Alex, I’m happy to have found you and you have made a difference in my life.

    Grimmy: Thanks! Your comment made my day!

    Alex

  • This reminds me of a more institutional type of diffusion of responsibility—the way that some hospitals organize floor nursing staff.

    When a patient pushed the call button and would say “I need to see a nurse” the call would be transmitted to every nurse’s beeper. No one nurse had the responsibility to answer and response times were slow and sometimes non-existent. The nurses were prone to thinking “oh someone else will get that” or “surely someone else has taken care of that by now.”

    The patient could fare better by asking for a specific service, such as “I need help getting to the bathroom.” In that case, the call could be given to a specific nurse’s aide or assistant, as it was determined that no license was needed to provide that service.

    After a repeated call (three times) over the course of an hour specifically for help going to the bathroom (a surgery patient told not to try getting out of bed alone), the patient finally decided trying it on her own would be better than wetting the bed. She fell. This hospital was also equipped with doors to the patient rooms that shut automatically—to stay open they had to be propped open with something fairly heavy.

    She laid there on the floor calling for help, but no one could hear her. She was discovered by a visiting family member. Fortunately for everyone, she was only bruised.

    After a meeting between family members and hospital staff, the hospital instituted a check system where nurses broadcast their “acceptance” of a call. In follow-up correspondence, the hospital told the family that the nurses were much happier with the new system also.

    Donna: Great solution. I still see this slow response at my hospital for the very same reason.

    Alex

  • Heather

    Every time I see a turtle crossing a highway or a loose dog near a highway, I know I should stop and wrangle the situation so the animal is not killed, but I almost never do. The speed at which I am traveling has something to do with it, I’m sure… but also the hope that “someone else will deal with it.” I’ll be more aware now, of my individual responsibility to take action.

  • Trish Dredze

    That story of the woman in NY back in the late 60′s was wildly inaccurate, as you mentioned (a number of people did call 911 but unfortunately, Kitty managed to stagger around to the door to her apartment, which was behind the building, so when the police first got there, they saw nothing and left—ditto for some people who heard the screams and went to the window—the attacker, after moving his car, came back and found her and finished off the job) but the more interesting part of the story was how they ended up catching him. (He was caught later.) He was in the process of robbing an apartment, and a neighbor of the robbery victim saw him walking out of the apartment with a TV. The neighbor questioned him as to what he was doing and the man replied that the guy’s neighbor was moving and he was helping him. Well the neighbor was surprised, and asked another neighbor if he knew anything about that. Realizing that something was amiss, one of the neighbors went inside to call the police and the other one wrote down the license plate, so that when the police got there, they were able to apprehend the man. Later he confessed to the Kitty murder. (I believe he thought he was also being arrested for that, and sort of ratted himself out. He said that he moved his car that night when he attacked Kitty, specifically because of the shouts of a few people who heard her scream and he waited until the police left the scene initially before going back to look for her again.) So the interesting thing to me is that the man was actually captured because of a good neighbor that got involved.

    Nonetheless, you are correct in that without specific direction, everyone will assume that someone else has done something or is going to do something, so they don’t have to.

    Love your blog. :)

    Trish: Thanks for filling in those interesting (and more accurate) details of the Kitty Genovese murder.

    Alex

  • Mike Ford

    Many years ago, when I was a child, I was beaten up and had many bones broken. Nobody helped. There was a crowd that watched me get beaten. A few weeks later, I was in a body cast and a leg cast and while walking to school on crutches in the middle of winter, I slipped and fell. Because of my cast, I was unable to get up. Cars drove around me. It seemed like an eternity before somebody actually stopped and helped me up. That was in 1969. I still have dreams about those two events right up to this day. I vowed then, at twelve years old, to never stand by when somebody is in need. And I have kept my word,, because I know what it feels like to be ignored. Please help your fellow man… always.

    As an adult, I cannot even imagine seeing a kid on the street injured and just driving around him.

    Mike: What a story. I’m not glad that happened to you, but I am that you stand against it happening to others as a result.

    Alex

  • [...] for example.  Further, the larger the company, the more responsibility for outcomes becomes diffused, often preventing any one person from feeling accountable for the quality of any one [...]

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