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.”


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