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A New University of Minnesota Mystery-The Curious Departure of Mark Rotenberg

The views expressed are those of the author and are not necessarily those of Scientific American.


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All that is necessary for the triumph of evil is that good men do nothing.

-Edmund Burke

Hear no Evil

One month ago, Mike Howard, family friend of Dan Markingson, who committed suicide while participating in a clinical trial at the UMN, launched a petition requesting that Governor Mark Dayton launch an independent investigation of research misconduct in the university’s psychiatry department. Since that time, the petition has garnered almost 2000 signatures, from a range of people, including mental health professionals, families affected by mental illness, both non-affiliated Minnesota residents, and from prominent scholars from all over the world. A sampling of comments follows, below.

This Monday, the University of Minnesota dropped a bombshell of an announcement—that Mark Rotenberg, the General Counsel, would be leaving to pursue a similar opportunity at Johns Hopkins University in Baltimore.

This announcement has taken many observers by surprise…yet the Minnesota Post notes that the petition has been signed by “a veritable Who’s Who of top academics here and abroad,” after consent documents from different patients surfaced that were inexplicably identical, raising more alarming questions about possible research misconduct. The Post continues, “And so it is perhaps natural for his departure to occur while he’s in the headlines.”

Good vs Evil

The Star Tribune spoke with Rotenberg about how he “has navigated the dual roles of general counsel, defending the U as well as investigating its wrongdoing.” Rotenberg responded, “You need on the one hand to be a defender, an adviser, a counselor, a trusted partner…And on the other hand, you must also be a government lawyer who protects the public interest when the client is engaged in, or alleged to be engaged in, bad acts. If you fail at either task, you’re not doing your job.”

President Kaler stated that Rotenberg “has epitomized the kind of integrity and accountability that all public institutions like ours strive for.” As the comments on the petition reveal, not everyone shares that assessment.

For a countervailing view, see Bill Gleason’s tender farewell and reminiscences.

What do you make of this turn of events?

Signatories to the petition include three former editors of the New England Journal of Medicine, former editor of the British Medical Journal, the editor of the Lancet, and numerous scholars from all over the world.

Here is a representative sampling of comments. If you wish, you can add your voice to the petition.

The protection of research participants is an issue that concerns everyone.

Francoise Baylis   Dalhousie University, Halifax, Canada

As an American academic residing and teaching ethics in Israel, I am concerned about the possibility of such serious misconduct and suspected cover-up in a respected American university, especially one supported by the state!

Norm Zohar          Bar-Ilan University, Jerusalem, Israel

I am a professional bioethicist, and to me the attitude of the university to bend any rule to forestall an investigation is appalling.

Christian Munthe         University of Göteborg, Sweden

This is exactly why the Nuremberg Code was developed and why the principle of informed consent is #1 on the list of 10 standards.

Elisabeth Clark             Montreal, Canada

I’m a University of Minnesota alum and I’m outraged by the school’s response to this scandal… There is substantial evidence of multiple forms of misconduct, some of which are felonies. The trial’s coordinator has been censured. The Minnesota legislature passed a law to avoid some of these exploitative practices in the future…

To call this merely shameful would be wholly inadequate. There must be a thorough and independent investigation of the University’s treatment of Dan Markingson, its conduct in related litigation, and its attempts to intimidate critics into silence. If, as it appears, University employees committed criminal acts, they should be prosecuted. And if the University’s counsel withheld documents and/or knowingly produced altered or faked documents in litigation, those attorneys should be disbarred.

Matt Lamkin               Stanford University

Attended U of MN Medical School. then U of MN Psychiatry Residency – ashamed of the Psychiatry Department – have been in private practice since 1977 – Have seen first hand the hijacking of Psychiatry by BigPharma.

David Bransford MD      Grand Rapids, Mn

As a faculty member at a University (Penn State) now notorious for failing to investigate abuses, I find the refusal of the University of Minnesota to confront this scandal sadly familiar. Granted that the abuses that occurred here were of a very different nature unfolding in very different circumstances, our experience should nonetheless be evidence enough for any institution that the only way forward when abuses have occurred is a thorough, transparent investigation conducted by an independent authority.

Jesse Ballenger   Pennsylvania State University, State College, PA

The institutional stonewalling on the part of University of Minnesota, and the further horror of suing Mary Weiss for legal fees is staggering. Please investigate this case.

Sarah Lewis                  Dover, NH

As a bioethics and law professor, I have been profoundly disappointed and dismayed by the lack of serious investigation by the University of Minnesota and various US agencies mandated to protect human research subjects into what happened in the Dan Markingson case and in other cases of alleged breaches of research ethics and research subject protection standards at the University of Minnesota. There clearly are sufficient indicia to warrant a full fledged investigation, yet the University and other agencies seem to be hiding behind formal procedural rules to avoid any further inquiry. This is unacceptable for any academic institution, let alone a publicly funded institution.

Trudo Lemmens   University of Toronto, Canada

The largest employer in the state should take better care of Minnesotans.

George Hoagland  Duluth, MN

It is a blatant misuse of state, economic, and institutional power that has resulted in at least one death.

Matt Levine                  Minneapolis, MN

An independent investigation has now become absolutely necessary.
The scandal is shameful. The response of the administration of the University of Minnesota has been even more shameful.
By the way, I did my postdoctoral fellowship in bioethics at the University of Minnesota

Jing-Bao Nie                 University of Otago, New Zealand

I am a graduate (CLA, 1981) and ashamed of the way the University continues to handle this tragic case. According to the Board of Regents, Minnesota is committed “to the advancement of learning and the search for truth….” Let the whole story about Dan Markingson and the clinical trial come to light. The protection of research subjects is a matter of great public import that demands public accountability.

Joseph Davis                University of Virginia, Charlottesville

As an academic psychiatrist and a director of a psychiatry residency program, I am appalled by the circumstances surrounding this case. While I was deeply concerned about the recruitment and management of this particular study and the death of this patient, I am perhaps even more alarmed by the attempts to avoid and/or distort an appropriate and objective inquiry. When there is morbidity and mortality associated with any clinical interaction, we are obligated to make sure that we do anything and everything to make sure it doesn’t happen again. Many times this means asking for help and accepting constructive criticism. I urge the University of Minnesota to do the right thing: appoint an external panel to conduct a thorough, independent and transparent investigation.

Hal Elliott, MD    East Tennessee State U, Johnson City, TN

Society deserves honesty and transparency from researchers and the pharmaceutical companies funding them.

Nancy Hokkanen  Bloomington, MN

As an historian who has written on US experiments in both Tuskegee and Guatemala, it is imperative that when injustice happens it be acknowledged and investigated. This is not something we must do only for the past.

Susan Reverby     Women’s and Gender Studies Wellesley College

If the University has nothing to hide then an investigation into the death of Dan should be welcomed by them. Ensuring that those who are vulnerable are protected from harm is a cornerstone of research ethics – the fact that a young man who was vulnerable died during a research project demands that the circumstances leading to his death are investigated. It’s the least the University ought to do. To threaten Dan’s mother with legal action to cease her campaign smacks of the worse kind of insensitivity and arrogance.

Phillipa Malpas    University of Auckland, New Zealand

The lack of transparency and willingness to look into how research and clinical trials are conducted is, in itself, a breach of trust that casts a pall on the university and the psychiatric community. As a psychiatrist, I am deeply concerned about the widespread complicity between the profession and the pharmaceutical industry.

Laurence Kirmayer McGill University, Montreal, Canada

As a researcher, I am horrified by so many elements of this abuse of power. We must not let this go unacknowledged and unpunished, or the future of all research is at stake. People cannot make safe, well-informed decisions to participate in research if they do not know their interests will be protected. Thank you for your time and attention.

Erin Morgan Center for Victims of Torture, St. Paul, MN

I’ve been following this story, open-mouthed, as its unfolded. The very least that can be done is to shine some light into what are apparently some very murky corners.

Iain Brassington University of Manchester, England

This petition is important for more reasons than space will allow to list. Having known another participant in the Cafe study and how he and his family were treated by the researcher and the coordinator is disgusting. It was stay in the study at all costs, no recommendation for a second opinion, and no referral for any psychiatric help if he didn’t stay in the study. For the University of Minnesota to have conducted this charade for so long that they were not responsible is incomprehensible. If Governor Dayton will not listen then this petition needs to go to Washington DC.

Peter Richardson Roseville, MN

I am a researcher and advocate regarding the rights of human subjects enrolled in clinical trials research. This petition is important because we need to carefully investigate every case of possible conflict of interest. In this case, the circumstances surrounding Dan’s Markingson death are extremely serious and shouldn’t be overlooked. As citizens, we need to know that every trial is bringing a potentially new drug or treatment to the table and that the researchers are not conducting them enticed by the prospects of short term financial gain. Protecting subjects’ rights is critical because without their altruistic participation no drug development would be possible. Research subjects are assuming risks to benefit us all. The least we can do is to make sure these risks are minimized by avoiding, or investigating, every case of research malpractice. This petition won’t bring Dan back but it can make a big service by contributing to minimize some of the behaviors that killed him in the first place.

Roberto Abadie City University of New York

“When I taught at the U some years ago, we had to undergo research ethics training because of the unethical conduct of John Najarian. How did the Psychiatry Department avoid the training? Do you really want the great University of Minnesota to become an academic pariah?”

Helen Longino  Stanford University

I was the editor of the British Medical Journal and have a long standing interest in research misconduct and experience of many cases. I’d have thought that the University itself would have been keen to investigate this case–because there is clear evidence that things went badly wrong and the University would surely want to learn from a bad experience. Much might be learnt. Sadly I’ve encountered many examples of universities being unwilling to run the risk of finding serious problems with their own staff, which is why in this case an independent inquiry may be needed–but the University will have to cooperate.

Richard Smith former editor, British Medical Journal, London

I don’t care much for evil.

Jed Wolfe Los Angeles, CA

 

Credits:

“Molecules to Medicine” banner © Michelle Banks

Hear no Evil – M.A.S.K. Productions/Flickr

Good vs Evil-HaydenChristensenfan/Deviant Art

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Judy Stone About the Author: Judy Stone, MD is an infectious disease specialist, experienced in conducting clinical research. She is the author of Conducting Clinical Research, the essential guide to the topic. She survived 25 years in solo practice in rural Cumberland, Maryland, and is now broadening her horizons. She particularly loves writing about ethical issues, and tilting at windmills in her advocacy for social justice. As part of her overall desire to save the world when she grows up, she has become especially interested in neglected tropical diseases. When not slaving over hot patients, she can be found playing with photography, friends’ dogs, or in her garden. Follow on Twitter @drjudystone or on her website. Follow on Twitter @drjudystone.

The views expressed are those of the author and are not necessarily those of Scientific American.





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  1. 1. Bremsstrahlung 7:58 pm 04/11/2013

    Mark Rotenberg is leaving UMN to take the job of Vice President and General Counsel with Johns Hopkins University.

    Link to this
  2. 2. Judy Stone in reply to Judy Stone 8:33 pm 04/11/2013

    Yes. But why now? And how will this affect a sorely needed investigation? Or Hopkins?

    Link to this
  3. 3. Bremsstrahlung 9:07 pm 04/11/2013

    Mr. Rotenberg replaces Frederick Savage, who has served as JHU’s general counsel on an interim basis since Steve Dunham departed last summer. It was time for JHU to find a permanent replacement for the position, and Mr. Rotenberg will also be Vice President of JHU.

    Was Mr. Rotenberg the Vice President of UMN?

    Link to this
  4. 4. Judy Stone in reply to Judy Stone 10:01 pm 04/11/2013

    Understood. But I suspect much more to it than that. Obviously, we have different perspectives on the cause and perhaps about the implications.

    Link to this
  5. 5. Bremsstrahlung 5:38 am 04/12/2013

    Just as we are all entitled to our opinions, you are entitled to your suspicions. I thought it appropriate to identify a fact that had not yet been included.

    Oh, and in re your conjecture about what change, if any, in the probability that the investigation you seek will come to pass due to Mr. Rotenberg’s career advancement, the answer is, of course, that it will increase.

    Link to this
  6. 6. Judy Stone in reply to Judy Stone 8:02 am 04/12/2013

    Again, not sure that we agree. You’ve heard of “too big to fail?”

    Link to this
  7. 7. Bremsstrahlung 7:03 pm 04/12/2013

    I not surprised we disagree, but with the departure of Mr. Rotenberg, there’s one less local luminary to embarrass. That, in turn means the political cost benefit matrix shifts towards having an independent investigation. Now, whether the political cost benefit matrix shifts ENOUGH in favor of having an independent investigation to actually precipitate one requires knowledge of more academic politics local to UMN than I have. Nevertheless, Mr. Rotenberg’s career advancement does increase the probability that it will come to pass.

    Link to this

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