Wednesday, March 12, 2014

For the Record: 1 Boring Old Man: The academy itself ... (in re #markingson)

“The way to gain a good reputation is to endeavor to be 
what you desire to appear.” (Socrates)

Editor's Note: 

My colleague Leigh Turner has written a piece for Community Voices on MinnPost entitled: "The U of M should thoroughly investigate issues in the Markingson case."

Dr. John Nardo, aka 1 Boring Old Man, subsequently posted the following piece on his most excellent blog.

In the interests of calling attention to both pieces, I re-post below Dr. Nardo's comments, with his permission,  on the original Nelson post:

(Highlighting is mine)

I think many of us thought that the University of Minnesota’s Senate calling for an investigation of Dan Markinson’s suicide would finally bring this decade old case to a proper hearing, a real investigation into this particularly egregious piece of research misconduct. But now this:

Bioethicist Carl Elliot’s twitter post sums it up: "Bizarrely, the ‘Resolution on the Matter of the Markingson Case’ will exclude the Markingson case." The university administration has resisted any serious investigation of this case for a decade, and is making a mockery of the insistence from its own faculty – adding yet another senseless twist to this already convoluted tale [as if it needed any more].

Markingson was enrolled into this volunteer study to avoid involuntary hospitalization. So long as he cooperated and took the assigned medicine, he could stay out of the State Hospital, yet the outcome measure was how long the patients continued the medication [voluntarily].

In spite of the reports that he was doing fine, at the end of six months, his commitment was extended for another six months [the duration of the study]. Not long after this extension, he killed himself in a dramatic way.

Unlike the usual complaints of over-medication and unnecessary restraint, Markingson was inadequately medicated and placed in an environment that did not offer appropriate restraint. The magnitude of his impairment was neglected in the service of the clinical trial – an unnecessary trial of the expirimercial variety. The absurdity is that until he killed himself, he was on the road to being declared a treatment success since he was still taking the study medicine [albeit anything but voluntarily]. In a more reasonable world, one would expect the Sponsor [AstraZeneca], the Principle Investigator [Jeffrey Lieberman, current APA President], and the organization actually running the trial [Quintiles] to have some interest in knowing what went wrong in their study.

If the story is actually as I have just told it, it is an example of clinical neglect leading to a fatality in the service of performing an unnecessary clinical trial for marketing purposes. At this point, only an outside, unbiased investigation can determine the truth. The Study Coordinator has already been censured by her professional organization for her part in the story, but the University administration has hindered any further general probe. This current tack of limiting the investigation to current conditions, leaving Markingson’s out of the investigation, and putting it out for bidding along with office furniture on a request for proposal site can only be seen as deliberate obstruction of the faculty senate mandate – and a direct insult.

My roots are showing here, but the only analogies I can think of that equal the University of Minnesota’s behavior in this case are the antics of some of our southern politicians during the Civil Rights days – people who felt that they could twist the rules and abuse their powers at will. And in this instance, this case has now expanded a notch, from the ethics of human experimentation to include the ethical integrity of the academy itself…


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