Thursday, May 26, 2016

Crumbling Infrastructure at University of Minnesota

Falling (Far) Behind

"Now, here, you see, it takes all the running you can do to keep in the same place.  If you want to get somewhere else, you must run at least twice as fast as that!"
Lewis Carroll, Through The Looking Glass (1871)

Facing a crumbling academic infrastructure, the U of M administration submitted a $300 million capital request to the state legislature this year.  The failure of the legislature to pass a bonding bill means that the administration will no longer be able to avoid the consequences of its own decades long failure to allocate sufficient funds for the maintenance of academic facilities. 

One-third of the buildings on the Twin Cities campus are rated in poor or critical condition.  See section 2 in The Management of the University Part II .  In February a University vice president acknowledged that the University should be spending twice as much as it currently spends simply to maintain the facilities in their current condition!  See p. 8 of the February 23, 2016 report of the Senate Committee on Finance & Planning.  It would cost a staggering $1 billion to bring all facilities to at least fair condition.  See section 3 in The Management of the University. 

Yet the administration continues to erect new buildings (which generate additional maintenance costs).  In February the University opened a $165 million clinics and surgery center.  The clinics had been located in the huge Phillips Wagensteen Building which is now half empty.  No one knows at this time how that space will be used or where the funds will come after the next fiscal year for the maintenance of all that vacant space (in a building that is already rated in critical condition). 

Just as the maintenance of roads and bridges is an essential responsibility of state and local governments, the maintenance of academic facilities should be a priority for a university administration.  In 2015, as the deterioration of the academic infrastructure continued, the University administration spent $80.3 million on "leadership" and $143.6 million on consulting and professional services.  See line 4(f) and line 18(b) and (d) of the 2015 Administrative Cost Benchmarking Report at p. 46 of the October 2015 FIN Docket.  University administrators and consulting firms across the country have created a variation of the military-industrial complex in higher education. 

Students and their parents do not expect that their payments of ever increasing tuition will be used to support highly paid senior administrators and outside consultants.  Nor do legislators expect that state appropriations will be used for that purpose.  We need a University administration and a Board of Regents that will allocate the substantial resources of the University for the right priorities.  

Michael W. McNabb
University of Minnesota B.A. 1971; J.D. 1974
University of Minnesota Alumni Association life member

Monday, May 9, 2016

For the Record: More on the University of Minnesota Bioethics Center and Retirement of Dr. Steven Miles

From City Pages:

When Steven Miles, an endowed chair and full professor at the University of Minnesota’s Center for Bioethics announced his retirement last week, he humbly reflected on his many accomplishments, which include designing MinnesotaCare and investigating the U.S. military’s use of torture during the war on terror.

After 35 years, he told the Minnesota Daily that he had Voltairian dreams of quietly cultivating his garden.

Miles also left a bittersweet admonition for the U’s administration.

 Over the last 15 years, the U “has experienced a series of damaging ethics scandals including: ALG, Anafranil, GHB, INFUSE, MCL, Caremark recent issues in psychiatry and others,” he wrote. “All of these have arisen at the nexus of powerful faculty, commercial funding and advances in research. These scandals have led to government hearings, criminal trials, huge university allocations of staff time and [National Institutes of Health] sanctions.”

Meanwhile, the U slashed the Center for Bioethics’ budget year after year. Faculty who retired or resigned from the center were not replaced. Now, there are only five bioethicists on staff at what was once regarded as one of the best programs for the study of ethics in biomedical research. Ten years ago, there were three times that many.

“The University needs much more robust programming in bioethics situated proximately but independently of its research enterprise,” Miles pleaded in the letter. “The attrition of the depth and breadth of Bioethics expertise … is counter to the University’s interests.”

Miles declined to say any more about the future of bioethics at the U. But his colleague, Prof. Carl Elliott, says that while researchers in the medical school dash toward the blinding lure of lucrative new drug studies funded by Big Pharma, the Center for Bioethics has become a nuisance for the University.

Elliott admits that he and fellow bioethicist Leigh Turner have been huge nuisances for the U ever since they put up a stink over the suicide of Dan Markingson. In need of intensive treatment for his schizophrenia, Markingson was instead drafted into an experimental drug study for AstraZeneca in 2003 by his treating psychiatrist, U researcher Stephen Olson. Markingson killed himself six months into the study. The U denied responsibility for more than 10 years until the Legislative Auditor forced President Eric Kaler to reckon last year.

In the heat of that fight, the U has been punishing the Center for Bioethics, Elliott says. “The University administration has decided to starve the Bioethics Center as punishment for the sins of Leigh and me,” he says.  and investigating the U.S. military’s use of torture during the war on terror.

Miles stayed neutral about the U’s failings in the Markingson case. While doctors from all over the country urged the U to acknowledge fault, he declined to sign any petitions callings for independent investigations into the young patient’s death. He said nothing critical of the U publicly. When Kaler appeared at a press conference last spring to announce patient protection reforms at the U, Miles flanked him in support.

“I think a lot of this is not an issue that's uniquely problematic for the University of Minnesota,” Elliott says. “You can look at scandals that have happened in a lot of other places, and look at the way that the bioethics centers that are located in the institutions themselves, and generally they respond by doing very little. I think the reasons are obvious. Bioethicists realize this is not going to go well for me if I do the right thing, essentially.”

Wednesday, May 4, 2016

For the Record: Bioethicist Dr. Steven Miles to take Voltaire's advice: "We must cultivate our garden."

From the Minnesota Daily:

After almost 35 years at the University of Minnesota, Medicine Professor Dr. Steven Miles announced Sunday to medical school leaders that he plans to retire after the 2016-17 school year. 

While his peers have praised Miles’ work for human rights at the University’s Bioethics Center, some in the center say they worry they’ll continue to lose administration support following his departure.

In a letter to administrators and department heads, Miles highlighted his accomplishments at the University, including changes in patients’ end-of-life care and ending the use of restraints in nursing homes. 

He also noted his work involving short-course tuberculosis therapy in open refugee camps, writing the standard interpretation of the Hippocratic Oath and “accurately excavating United States military medicine’s complicity with torture during the war on terror,” among others. 

Miles served on the center for Victims of Torture board for several years, which CVT Executive Director Curt Goering said was an asset because of his international reputation and knowledge of medical ethics. 

“I would be hard-pressed to find someone who’s had more of an impact,” Goering said. 

In his letter, Miles pointed to the importance of the Bioethics Center in the wake of several ethical controversies at the University involving research practices. 

In the past 15 years, Miles said, these controversies have led to government hearings, criminal trials, huge University allocations of staff time and National Institutes of Health sanctions. 

“All of these have arisen at the nexus of powerful faculty, commercial funding and advances in research,” Miles wrote, adding that only one of the University’s scandals has been brought into the public light by faculty at the Bioethics Center.

The center’s long-term operations under interim and year-to-year directors, as well as the University’s denial to conduct a national search to replace faculty, has contributed to its difficulties, Miles said in the statement. 

The center’s plight has also drawn the attention of the legislative auditor’s office in the aftermath of the 2004 death of Dan Markingson, who committed suicide after being recruited into a University drug trial. 

In a report last year that raised questions about research practices at the University, auditors questioned why University officials did not include the Bioethics Center in research ethics discussions. 

“It leaves us wondering why the University of Minnesota has a Center for Bioethics when University officials will not meet with the center’s faculty to discuss the very real and important bioethical questions the Markingson case raised,” the report said.

Miles wrote that in the past decade other academic health centers “established and fortified their medical and bioethics centers,” but the University has moved in the opposite direction. 

When bioethics professor Carl Elliott came to the University in 1997, he said the Center for Bioethics was viewed as one of the best bioethics units in the world. But in the wake of multiple ethical concerns regarding the University’s research practices, faculty members now run thin. 

“Now, all that’s left is a skeleton crew.” Elliott said. “The administration has decided that the solution to 25 years of scandals in the medical school is to asphyxiate the center quietly and relentlessly, making the bioethicists so miserable that they leave. It has been a brilliant strategy.” 

Miles expressed a similar concern and wrote, “The attrition of the depth and breadth of Bioethics expertise at the AHC is counter to the University’s interests.”

Miles said he plans to spend his retirement traveling and gardening. 

“I love the University of Minnesota and am proud of, and have enjoyed, nearly 35 years on the faculty,” he said. “I just finished a chapter and am going out to garden now.”