Thursday, December 19, 2013

For the Record: More #umn alums blast admin for #markingson denial

From the Star-Tribune:

Will the U review or whitewash a research subject's death?

The Dan Markingson case, involving a drug trial, has been a self-perpetuated cloud over the school for a decade.

As scholars of medical ethics and proud alumni of the University of Minnesota, we have been pained by the cloud that has hung over our alma mater in the decade since Dan Markingson killed himself while enrolled in a university-sponsored drug trial.

Many prominent voices have called for an independent investigation into Markingson’s death, including editors of the world’s most prestigious medical journals and more than 250 other ethicists, physicians and scholars.
Unfortunately, rather than working to be accountable and transparent, the university administration has taken a relentlessly defensive posture — hiding behind its lawyers, targeting its critics and distorting the facts.

Most notably, the administration has dismissed the need for an independent investigation by claiming that the university’s treatment of Markingson “has been exhaustively reviewed by federal, state and academic bodies since 2004,” in the words of the university’s general counsel. However, some of these claimed reviews simply did not occur, while others did not examine the most troubling aspects of the Markingson case. For example, the administration has repeatedly claimed that the Hennepin County District Court exonerated the university in a lawsuit brought by Markingson’s mother. In fact, the university convinced the court that it had legal immunity from the suit and could not be held liable no matter how badly it may have treated Markingson.

The administration’s refusal to commission an independent investigation of the Markingson case has tainted the university for far too long. That began to change recently when the Faculty Senate responded to a letter signed by more than 175 scholars asking for an external, independent investigation into the Markingson case. By an overwhelming margin, the Faculty Senate voted to approve a “Resolution on the Matter of the Markingson case” and endorse an inquiry into clinical research practices at the university.

Yet University of Minnesota President Eric Kaler appears intent on continuing the university’s efforts to avoid scrutiny. In a recent interview with the Minnesota Daily, Kaler said that the inquiry will not look at Markingson’s death at all, but rather will focus solely on “what we are doing now and what we’re going to do moving forward.”

Such a limited inquiry would defeat the purposes of the Senate’s action. Although the resolution does call for an inquiry into the university’s current practices, the Senate left no doubt that the aims of that investigation included resolving “questions [that] continue to be raised about the policies and procedures followed in the Markingson case” and addressing the harm to the university’s reputation “in consequence of this tragic case and its aftermath.”

Any inquiry that merely considers the university’s forms and policies without examining the experiences of actual research subjects would only further erode confidence in the institution and compound the harm to its reputation.
In addition to seeking to limit the scope of the investigation, Kaler seems intent on handpicking the investigators. Any involvement by the administration in selecting the members of the investigative panel would destroy the body’s credibility. The offices of the president, the general counsel and the Academic Health Center are all important players in the Markingson controversy whose roles must be examined by the investigative panel. It would be a clear conflict of interest for the targets of this inquiry to select their own investigators.

Finally, the investigative body must be given the legal authority it needs to conduct a thorough investigation. It must be empowered to look at financial records, to obtain internal e-mails and communications, to give legal protection to whistleblowers, and to interview former patients and research subjects and protect them from retaliation. For example, the panel should have the authority to waive confidentiality agreements that former patients and their family members may have signed as part of legal settlements with the university.

The Faculty Senate’s resolution presents an excellent opportunity to bring closure to a tragic case that has sullied our university for far too long. But this can only happen if the investigation is thorough, broad and independent, rather than carefully managed by the administration.

Matt Lamkin is an assistant professor at the University of Tulsa College of Law.

This article was also submitted on behalf of 
Emily Smith Beitiks, deputy director of the Longmore Institute on Disability at San Francisco State University; 
Joseph E. Davis, director of research at the Institute for Advanced Studies in Culture, University of Virginia; 
Alicia Hall, assistant professor of philosophy, University of Alaska, Fairbanks; 
Susan Hawthorne, assistant professor of philosophy, St. Catherine University; 
James Harold, associate professor of philosophy at Mount Holyoke College; 
Ramona Illea, associate professor and chair, Department of Philosophy, Pacific University; 
Monica Greenwell Janzen, faculty member, Hennepin Technical College; 
Greg Kaebnick, editor, The Hastings Center Report; 
Barton Moffatt, assistant professor of philosophy, Mississippi State University; 
Susan Parry, philosophy instructor, Hennepin Technical College; 
Elita Poplavska, assistant professor, Riga Stradins University, 
and Maran Wolston, Philosophy Department faculty member, Minneapolis Community and Technical College.

From comments posted on this piece:

I'm certain President Kaler would like to continue to bury the details of this case. Hopefully more ethical officials at the university will prevail.

Excellent article. If Kaler actually thinks the Markingson case was simply a one-of-kind tragedy at the U-MN he's beyond help. Wake-up Mr. Kaler, your psychiatry department has ruined many lives.

This egregious and disgusting behavior by the University's president has to come to a halt. This man and his ideas and morals are certainly part of the problem not part of the solution. We have lost all respect for the University over this scandal and the others that have been kept in the dark. Shame on Mr. Kaler and either do the right and ethical thing and step aside, or resign. It's apparent you are not able to lead this university with integrity and truthfulness.

At the very least, everyone involved at the U of M in the epic and continuous fumbling of the PR on this episode should be fired.

It seems that the University must be afraid that many more Markingson's will appear if such an investigation takes place. There is no other logical explanation for all the repeated statements of no-wrongdoing from the administration. Had this been case, the University would simply have produced all the documents that prove their claims and this case would have ended. That has never happened and agree with the fact that the PR representatives at the U that have been allowed to speak or answer inquires are some of the worst in their field.

I can appreciate the fact that many years have past since this young mans death, what I don't understand though is why the UMN has repeatedly offered up the same excuses time after time trying to defend themselves. And they are just that, excuses, not credible documentation that they looked into this death and how and why it happened, and any steps they've taken to prevent something as tragic as this from happening again. It isn't so much the act of suicide here from an obviously unbalanced young man, but the enabling to cover it's tracks afterwards by the University's top officials and legal team of any violations of human rights or human subject's protection. A totally independent investigation is long overdue, and if/when other such cases surface, the University has to be transparent in their handling of such tragedy's. Until that happens, I have lost all respect for research at the UMN.

It would be fitting of President Kaler to demonstrate the same amount of enthusiasm for seeking the truth about not only the Markingson case, but for the others the University is aware of or have taken great pains to avoid, as he displays on the football sidelines during gophers games. To have ignored this scandal for so long is such an embarrassment for the University as well as the state.
We are witnessing an abdication of responsibility on the part of University President Kaler. He has positioned himself as an executive unaccountable to anyone but himself. He must have been made fully aware of the Markingson scandal and agreed beforehand to staying on the University’s road of denial as a condition of his employment. It’s not rocket science folks, the University simply cannot allow a totally independent investigation conducted by qualified unattached investigators, knowing full-well what that investigation will reveal. How many more abused human subjects are there that the University knows about and have also tried to stifle? Hint: There are numerous. I’m old enough to recall Nixon raising his two fingers above his head and claiming that he’s not a crook following Watergate…The University by their denials are simply mimicking that disgusting behavior.

As a U-alum I am ashamed of this total disregard of responsibility from President Kaler. This scandal has hung like a cloud over the university for years and finally Kaler was given an opportunity to save face and claim he was just acting on the vote from the Faculty Senate and appoint an independent investigation of not only the Markingson case, but of the others that exist. President Kaler has a responsibility to answer to everyone and not just his immediate conspirators in cover-up mode. I was once proud of the reputation of the University of Minnesota's Medical School, and all of it's accomplishments. That pride has really taken a hit over this episode.

Agree with almost all of the posts. For Dr. Kaler to not recognize the fact that there are more human subjects and their families that have had research violation issues with the department of psychiatry is just ludicrous. The recent Fox News report showed another individual, and it's 100% guaranteed that there are many more such patients that were taken advantaged of, or had their rights abused by researchers at the University's psychiatry clinic's and hospital wards. I know personally of three such individuals.

It's quite amusing to think that the state's Attorney General's Office prosecuted Accretive for violating 100's if not thousands of patients protective health records at Fairview, and yet Kaler and University want everyone to accept and believe that nothing like that occurred with mentally ill patients within the two University controlled wards at Fairview? Having had a family member that worked on those and other mental health wards at Fairview, she was disgusted and alarmed on a regular basis over the violations occurring by research psychiatrists or their staff. For Kaler to insinuate that those incidents didn't take place on a regular basis is just ridiculous. To claim that all is 'today' without recognizing and admitting the the wrongs from the past just invites more of the same in the future.

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