For the Record: The Silence of the Bioethicists #markingon

Well, Clarice - have the lambs stopped screaming?

My colleague Leigh Turner writes in Health in the Global Village:

Silence from the Bioethicists

University of Minnesota Bioethicists Remain Silent as a Research Scandal Unfolds

For four years, my colleague Carl Elliott has made an extraordinary effort to help Dan Markingson’s mother, Mary Weiss, and her friend, Mike Howard, fight for justice by calling for an independent investigation of alleged psychiatric research misconduct at the University of Minnesota. During this time, many faculty members at the University have become involved in challenging university officials’ refusal to conduct a credible inquiry. Numerous faculty members signed a petition that asks Governor Dayton to establish a panel tasked with investigating Markingson’s death. Last December the Faculty Senate passed the “Resolution on the matter of the Markingson case.”  Bill Gleason has for years written about Dan Markingson and pressed for an inquiry into possible research misconduct.  Kirk Allison  organized a campus screening of Off Label, a documentary that addresses the Markingson case. I have written to President Kaler, the Board of Regents, Governor Mark Dayton, and Minnesota’s Attorney General, and urged them to investigate Markingson’s death and related allegations of psychiatric research misconduct.

University faculty – myself included – should have done more to hold senior administrators accountable. Still, there has been some dissent at an institution ruled by officials who refuse to investigate disturbing reports of possible research misconduct.  Acknowledging these critical voices, I am struck by the silence of my colleagues at the Center for Bioethics.  The faculty members who should have been most vocal in response to allegations of research misconduct at our own institution have remained silent.

Jeremy Olson and Paul Tosto first reported Dan Markingson’s death in 2008.  Elliott’s Mother Jones article, “Making a Killing,” was published in 2010.  Since then, there has been extensive news coverage of alleged research misconduct at the University.  During this period, faculty members at the Center for Bioethics have never had a meaningful discussion addressing Markingson’s death; the possibility that serious psychiatric research misconduct occurred at our university; and university officials’ repeated refusals to support a credible investigation.  There seems to be an unspoken yet collective understanding within the Center for Bioethics that it is taboo to discuss Dan Markingson’s death and related allegations of psychiatric research misconduct. The silence is deafening.     

University officials have responded to Elliott’s investigative work and whistle-blowing by attempting to frame him as a lone, self-promoting, rogue employee who twists facts and uses this “unfortunate tragedy” to advance his own interests.  My bioethicist colleagues have done little to counter this institutional script.  Remaining silent, they have allowed university administrators to isolate, insult, and attempt to intimidate Elliott.

Mark Rotenberg

Despite former General Counsel Mark Rotenberg’s misleading claims  in reply to Elliott’s article in Mother Jones and subsequent blog posts, at no point did bioethics faculty members at the University ever challenge Rotenberg and demand credible responses.  Rotenberg has made many inaccurate assertions about the Markingson case. Faculty members at the Center for Bioethics have never demanded better responses from senior university officials.

Justin Paquette and Brian Lucas         

When Justin Paquette, a public relations representative for the University’s Academic Health Center, claimed that Elliott’s “unfounded logic” and “personal crusade against our psychiatry department” amounted to “fiction” motivated by Elliott’s interest in “marketing” his books, bioethicists at the University did not respond to Paquette’s ad hominem attacks.  I was among those who should have immediately condemned Paquette’s ugly exercise in character assassination.  Faculty members in bioethics also remained silent when Brian Lucas, another public relations employee, speculated about whether Judy Stone, author of numerous pieces critical of the university’s handling of the Markingson case, is “a wacko.”      

Aaron Friedman

Aaron Friedman, former dean of the medical school and vice president for health services, has on  numerous occasions  dismissed Elliott’s concerns and supported Stephen Olson and Charles Schulz, two psychiatrists at the center of allegations of psychiatric research misconduct.  In an Op-Ed, Friedman writes, “as Elliot (sic) clamors for more examination, he seems to feel no responsibility to accurately report what has already been done.”  Friedman’s commentary accuses Elliott of making “unfounded accusations” and providing a “selective and distorted narrative.” Friedman’s diatribe went unchallenged by faculty members at the bioethics center.  

Tim Mulcahy, Aaron Friedman, Mark Rotenberg, and the Academic Freedom and Tenure Committee

In 2011, two University Vice Presidents, Aaron Friedman and Tim Mulcahy, attended a meeting of the Academic Freedom and Tenure Committee and explored ways to silence or challenge Elliott.  They were there as  a question former General Counsel Mark Rotenberg posed at another committee meeting.  “What,” Rotenberg had asked, “is the faculty[’s] collective role in addressing factually-incorrect attacks on particular University faculty research activities?”  Minutes from the meeting suggest that the purpose of the vice presidents’ time with the Academic Freedom and Tenure Committee was to explore ways of restricting Elliott’s academic freedom and sanctioning him for making what they alleged were inaccurate claims.  I was the only one of Elliott’s colleagues from the Center for Bioethics to attend the committee’s next meeting and ask whether Rotenberg’s comment was a dog whistle call to restrict Elliott’s academic freedom.  While Karen-Sue Taussig, an anthropologist, and philosophers Valerie Tiberius, Ken Waters, and Naomi Scheman attended the meeting and  offered robust support for Elliott’s academic freedom and right to call for an investigation, despite the principles at stake there was no additional representation from the Center for Bioethics.    

Debra DeBruin and Steven Miles

Even when directly asked to investigate, faculty members at the Center have refused to address allegations of psychiatric research misconduct. Debra DeBruin and Steve Miles have both served as directors of the University’s clinical research ethics consultation service.  Despite being requested to conduct an inquiry into Markingson’s death and examine the adequacy of human subject protections in the Department of Psychiatry, both DeBruin and Miles refused to investigate.     

The Letter to the Board of Regents

The only exception to the collective silence at the Center for Bioethics has been single letter that was sent to the Board of Regents.  In November 2010, eight faculty members wrote to the Regents and called for an investigation of the Markingson case. Notably, however, Jeffrey Kahn, then the director of the Center for Bioethics, did not sign the letter.  Debra DeBruin, then the associate director and now director of the Center for Bioethics, did not sign the letter.  Steven Miles and Susan Wolf, two of the Center’s most senior and prominent bioethicists, did not sign the letter. Throughout a serious research scandal, bioethicists who claim they are concerned with justice, protecting the vulnerable, and responsible governance of human subjects research have remained silent.  

The University’s Power Structure

It takes little insight into the power structure of the University to understand why faculty members at the bioethics center remain silent. Anyone paying attention to President Kaler, former Vice President Aaron Friedman, former  Vice President Mulcahy, former General Counsel Mark Rotenberg, and current General Counsel William Donohue would have noticed that senior officials all dismiss calls for an investigation of psychiatric research misconduct.  To publicly call for an investigation is to swim against the institutional tide.  It is much easier to keep quiet than to confront the university’s most powerful administrators.   

Silence in the Face of Injustice

When does remaining silent during a research scandal lead to complicity in wrongdoing?  Will collective silence from bioethicists prompt blunt questions concerning why the University of Minnesota has a Center for Bioethics? Might collective silence diminish bioethics as an area of study by suggesting that bioethicists, when confronted with allegations of misconduct at their own institution, do little more than defer to authorities? What happens if an investigation at some point determines that serious research misconduct has occurred at the University of Minnesota and most bioethicists at the Center for Bioethics here said and did nothing rather than confront wrongdoing?

Contemporary bioethicists look at the Tuskegee research scandal and question why so many individuals chose to remain silent in the face of wrongdoing.  “It was a different time, a different place,” we say, and congratulate ourselves on the progress we assume we’ve made.  We look at the past and we think we are distinguishable from people who responded to injustice with silence and indifference.  But doesn’t the silence of those who have voices and could choose to use them for good bind past to present and connect us to what we thought we had surpassed?
 
“The Silence of the Bioethicists”, an earlier version of this post, appeared March 24, 2014 on the blog, Impact Ethics.