On Mother’s Day, May 12, ethics Professor Carl Elliott had an Op-Ed published by the Minneapolis Star Tribune, “The University of Minnesota Research Case Needs Scrutiny.”
The Star Tribune began to post comments, the first being:
Minnesoda73 May. 12, 13 6:10 PM
The University of Minnesota has investigated itself and found itself innocent. It has nothing to gain by doing this. When the UM makes a mistake, it always does the right thing. Stop the U bashing.
A bit later, there was:
meegwichMay. 13, 13 5:06 AM
I'm confused; the principal investigator of the drug study treating the young man worked at the UMN, for the UMN. The young man was only treated under the drug protocol at the University and after his death the doctor settles a malpractice suit filed against him by the young mans mother but the University walks because they claim immunity. Then, the doctor claims that as a state employee of the University he's entitled to immunity from punitive damages from the malpractice settlement because the state doesn't allow employees to pay punitive damages even when they're warranted. So how can the psychiatrist settle a malpractice suit and admit fault, all the while working at the U-MN, and the U can't find any wrongdoing. How does the U explain the psychiatrist settling a malpractice suit in the death of his patient, and they can't find a thing wrong.
luxaeternaMay. 13, 13 8:50 AM
The case was investigated by the MN Attorney General, the MN Board of Medicine, and the Federal Government (FDA). They found no wrongdoing on the part of the U. How many more investigations are needed?
Since I pride myself on now knowing a bit more about this case than the average Joe, after seeing some of the ignorant comments, I thought perhaps I could provide some clarification. I promptly wrote this response, which I publish here, as the Star Tribune has refused to publish it:
I could not agree more with Dr. Carl Elliott and the Markingson family’s plea that you appoint an independent panel to investigate apparent ethical breaches at the clinical research program of the UMN’s Department of Psychiatry.
Since December, 2012, when I first began to explore the case in depth, I have been increasingly appalled by the numerous ethical breaches that have been uncovered. My own research on the case, studies of documents, and interactions with the UMN General Counsel’s office has transformed my perspective from a totally objective, journalistic and academic orientation to that of advocacy to not only correct this particular injustice, but likely similar breaches involving other vulnerable patients in UMN studies.
In my series at Scientific American, “Molecules to Medicine” column, I’ve looked at issues of “good clinical practices” and ethics: consent, investigator responsibilities and conflicts of interest. Then I examined the university’s response and then turned to the importance of careful documentation of consent. Next, I explained in some detail how and why I was transformed by Dan’s story from looking at it simply as an objective case lesson in clinical trial ethics, to an advocate for an independent investigation of the University of Minnesota. I then shared my dismayed reaction to the announcement that Mark Rotenberg, the UMN’s General Counsel, was leaving Minnesota to assume a similar post, now as Counsel and Vice-President at Johns Hopkins University. Most recently, I posted an essay in memory of the anniversary of Dan’s death.
I have no doubt that Dr. Elliott will continue his research and writing about the UMN. I know that I will, too, because although it is time-consuming and at times tedious, I write a lot about clinical trial ethics and there is a lifetime of learning to be had here. Most importantly, seeking justice on this case is the right thing to do.
Governor Dayton, part of my appeal to you is because of the brush off I got not only from the UMN Counsel’s office, but more unexpectedly and disappointingly, from the Minnesota Attorney General’s office.
I understand that the UMN has powerful lobbying groups and brings in a great deal of money to the state. The question is, how much blood do they have to have on their hands before anyone in power in Minnesota will step up and do the right thing. There appears to be a cult-like culture at UMN reminiscent of that seen at Penn State with the cover up of their sex abuse scandal. We all know how that came down.
The cat’s out of the bag on this one. When you have a petition calling for an investigation signed by “nearly 2,500 people, including three former editors of the New England Journal of Medicine; the editor of the Lancet; a former editor of the British Medical Journal, and the former health and disability commissioner of New Zealand,” as well as “More than 200 experts in medical ethics and related disciplines [who] also have signed, including six members of the Institute of Medicine and the medical historian who uncovered the Guatemala syphilis studies, which resulted in an apology by President Obama in 2010,” you should know this issue is not going away.
Furthermore, critics of Dr. Elliott should recognize that he does not stand alone, given the array and caliber of people supporting this request for an independent investigation.
So Governor Dayton, please stand up and do the right thing—for Dan Markingson, for other vulnerable patients generously offering to help clinical research, and for your state. Appoint an independent panel to investigate not only this case, but the related breaches in good clinical trial conduct.
“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.” Margaret Mead
The story gets considerably weirder from here, as was reflected on twitter yesterday:
Four people have emailed me to say their comments on my @StarTribune op-ed were blocked. I sense a pattern. Can't even get my own published.
@drjudystone my comment wasn't posted either---
@StarTribune Please note your comment moderator is blocking legit comments, picking and choosing, not following your stated policy. Thanks.
While episodically tweeting my frustrated messages, I also tried several times to e-mail the Star Tribune. I got this response:
“If you have not heard from us further within 10 days, feel free to place your material elsewhere. (If timeliness is a factor, we will do our best to take it into account.)”
This am, I received a polite note informing me they would not publish my response to Dr. Elliott, essentially as they did not feel it added anything to the dialogue.
I bring this to your attention because, rather than educate readers and engage them with intelligent conversation and stimulate a healthy exchange about the University's behavior, the Minneapolis Star Tribune missed a huge opportunity. Whether intentional or not, they appeared to be selectively censoring comments supportive of Dr. Elliott throughout the day, only posting them after considerable ill will had developed, including multiple e-mails to their op-ed department and biting back and forth on twitter. All of this makes the paper look bad and fuels suspicions about the University, which are already growing.
So @StarTribune, if you want to really contribute substantively to the discussion about the UMN's Department of Psychiatry and help both your community and your paper's stature, put an investigative reporter on this story. There is so much more serious reporting to do--and so many unanswered questions. Maybe you'll win a Pulitzer.
And readers, you can find the petition asking Governor Dayton to appoint an independent investigation of apparent research misconduct at the University of Minnesota here.
Censorship image: Andria/Flickr
"Molecules to Medicine" banner Michele Banks