book-project-inferno - Guido palazzo

“Put on your management hat” – How framing contributes to unethical decisions

NASA and the teacher in space marketing trick

In the mid-1980s, NASA was in a deep crisis. While the moon landing of Apollo 11 had created a hype around their activities, their budget was painfully cut in the 70s and 80. American had somehow lost its interest in space flights. Space Shuttle Challenger flight STS-51-L scheduled for January 28 was of utmost importance for the future of the organization. They needed to win back the hearts and minds of the Americans to get the political support in Congress for a future investment in the space flight program. And they had a strategy for that: On board of this January flight were six professional astronauts and a schoolteacher, Christa McAuliffe from New Hampshire. She was supposed to teach her students from space. McAuliffe had been selected to participate in the NASA Teacher in Space Program, making her the first private citizen to fly in space. The crew and mission were highly publicized, and the launch was watched live by millions of people, including many school children.

The problem of the O-Rings

The Challenger was a space transportation shuttle consisting of three different parts. The Orbiter at the top, in which the astronauts were sitting, the External Tank for the gas, and the Solid Rocket Booster. (SRB) The latter is the engine that propels the space ship into space for the first two minutes of the flight to an altitude of about 45 kilometres, then it disconnects and returns to be recovered and reused. The SRB has eleven different sections which are connected with joints – so-called O-Rings. These joints prevent gas from leaking out. The below photo shows the three parts of the space ship with the white SRBs left and right of the Orbiter. The engine was constructed by NASA supplier Morton Thiokol.

This Photo by Unknown Author is licensed under CC BY-NC-ND

The night before the Challenger was supposed to be launched, the weather forecast predicted a temperature of 20 F/-6 C. On the next morning, the temperature had risen to 36 F/2 C. Such low temperatures created problems for the O-Rings. They were made of rubber and would shrink and become stiff when the temperature went down. This problem of the O-Rings was well known since 1977. When analyzing O-Rings from recovered SRB, engineers found that some of them had either partially or fully eroded. Only in 1985, this problem had occurred in six out of nine launches. The most severe erosion had been found in the O-Rings of a launch that had taken place at 53 F/11 C. Therefore, Morton Thiokol engineers had recommended to define this temperature as the minimal temperature for a space shuttle launch. The forecasted temperature for January 28 was clearly below that limit.

Pressure on NASA supplier Morton Thiokol

The launch of the Challenger had been postponed three times already because of bad weather conditions and the window of opportunity was closing fast with a drop in temperature expected for the days and weeks to come after the 28th of January. The night before the launch, NASA management met with Morton Thiokol managers and engineers in a telephone conference. Engineers at the supplier had raised doubts about the flight, arguing that the forecasted temperature was below the defined minimum. During the meeting, the Morton Thiokol team raised their concerns about the O-Rings. Lawrence Mulloy who was representing NASA in this meeting was not happy. He wanted green light for the flight. He asked the engineers to prove that the launch was unsafe, to prove with data that the risk was too high.

Morton Thiokol did not have systematic data that would provide the evidence of a link between cold temperatures and the erosions of the O-Rings. They only had observations from safely returned flights and there had been no official and written information on the problem. At NASA, such observations, based on informal data were categorized as a “weak signal.” However, only “strong signals” were considered important enough to cancel the flight. And since the erosions had become so frequent (6 out of 9 flights in 1985), the safe return of all those flights was considered a confirmation of the interpretation that the problem was not a serious one. The risk was acceptable. Inside NASA, such minor problems were considered a “level III issue”, which was even too irrelevant to be escalated and communicated to a higher level in the organization’s hierarchy.

The tragic meeting

Morton Thiokol engineers insisted that they would not recommend launching the Challenger the next day and Mulloy angrily told them that he was appalled by their position. Jerry Manson, the top executive of Morton Thiokol who oversaw the meeting asked Mulloy for a short break to speak with his engineers. For thirty minutes, Morton Thiokol managers and engineers discussed among themselves. The three engineers who participated in the meeting insisted on their risk evaluation. The O-Rings would be exposed to a too low temperature and thus might not properly function. NASA had clearly expressed their intention to launch, but they needed the green light from Morton Thiokol. At that time, the company was under pressure. They were in the process of negotiating a new contract and knew that NASA was internally discussing to switch to a different supplier for the SRM. Morton Thiokol did not want to lose this important contract. In the heated discussion with his engineers, Manson made clear that he did not agree with them, and he invited his colleagues “to take off their engineer hat and put on their management hat.” The engineers gave up their resistance. Back in the teleconference with NASA, Morton Thiokol communicated their recommendation: The data on O-Rings was inconclusive and therefore, they gave green light, sending a fax to Houston that the Space Shuttle was “safe to fly.”

The ChalIenger was launched at 11.38 on January 28, 1986. 73 seconds after the launch, the Space Shuttle exploded in a white gaseous cloud. The accident was caused by the failure of an O-ring seal in the SRB, which allowed hot gases to escape and ignite the main fuel tank. The Morton Thiokol engineers had been right in their risk evaluation. Six astronauts and a schoolteacher lost their lives.

explosion-challenger
Space Shuttle Challenger explosion on January 28, 1986

This Photo by Unknown Author is licensed under CC BY-NC-ND

The power of framing

Why did the meeting between Morton Thiokol and NASA take such a tragic turn? A catastrophe like the explosion of a Space Shuttle has of course many mutually reinforcing reasons. I would like to highlight one important aspect here: The power of framing.

When Jerry Manson was asking his colleagues to take off their engineering hat and to take on their management hat, he was imposing on them a change of perspective. They had to choose a different frame from the one they were using in the discussion. Frames are mental structures that simplify and guide our understanding of a complex reality. They focus our attention and force us to view the world from a particular and therefore limited, perspective. Take for example the below figure, which is called the “duck-rabbit illusion”.

Duck-Rabbit Illusion
Duck-Rabbit Illusion

This Photo by Unknown Author is licensed under CC BY-NC-ND

What do you see? Well, as the name of the illustration already indicates, it depends on the perspective that you chose. From left to right, you will see a rabbit, from right to left a duck. Most importantly, you cannot see both at the same time. When we frame, we focus on one set of information. The price we pay is that the other perspective becomes invisible. If you do not believe me and you are convinced that you can see both together, try to look at a window and through a window at the same time. It is not possible. You either see the window or the world outside. If you focus on the latter, the window becomes invisible and if you concentrate on the window itself, the world outside becomes blurry and unclear.

Inattentional blindness

Being blind for information sounds like a rather dysfunctional feature of our brain. It isn’t. Framing turns us into fast and efficient decision makers because we can rely on a particular expertise, a particular routine that we have developed to solve a very specific task. If you hunt a mammoth, you do not need to reflect about the nice flowers you could pick or the beautiful cloud you could observe in the sky. You focus on what it takes to kill the mammoth, because otherwise it will kill you. However, the price we pay is that frames blind us for some potentially important aspects and pieces of information.

Distorted frames and the Challenger explosion

Two framing processes contributed to the tragic explosion of the Challenger. First, by approaching risks along a very narrow definition of weak versus strong signals NASA had defined a process in which a problem like the O-Ring erosion could not be perceived as a serious issue and thus would not move up in the hierarchy of the organization. Second and more importantly, under the pressure of their client, Morton Thiokol managers imposed a management frame on their engineers, which meant that they were supposed to look at the launch of the Challenger as a business decision, not a technological decision. A risk calculation morphed into a decision on costs, schedules, marketing, supplier-customer relationship. The shift of frames silenced the engineers.

Why do good people sometimes make unethical decision with severe consequences? One answer to this question is that they are caught in a too narrow frame of their decision and become victims of unintentional blindness. They do not see what they need to see to make the right decision. Afterwards it might be obvious to them as it is obvious to us when we analyse past scandals and catastrophes. But in the heat of the moment, under the pressure of the situation and applying an inappropriate frame, they do not see it. Using a broader set of perspectives helps to avoid such framing risks. Imposing a too narrow frame on a team or worse, assembling a team of people who all think alike will increase the risk of unethical decision making.

References:
McDonald, A., & Hansen, J. (2009). Truth, lies, and o-rings: inside the Space Shuttle “Challenger” disaster. University Press of Florida.
Vaughan, D. (2016). The Challenger launch decision: Risky technology, culture, and deviance at NASA. Chicago: The University of Chicago Press.
Roger Commission. (1986). Report to the President By the PRESIDENTIAL COMMISSION On the Space Shuttle Challenger Accident (Rep.). Washington D.C, Washington.

0 Comments

Submit a Comment

Your email address will not be published. Required fields are marked *

If you liked the post, feel free to share it with your network