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Freedom’s Just Another Word for . . . Restriction?

What tools does a university administration have at its disposal to shut up critics on its own faculty? The University of Minnesota wants to know.

The university’s administration is exploring this question because its own Carl Elliott won’t shut up about the Markingson case. Elliott, a professor in the Center for Bioethics, just keeps talking about what went wrong at his medical school in a 2003 industry-sponsored drug trial in which research subject Dan Markingson killed himself. Since publication of a muckraking article on the subject in Mother Jones, Elliott has criticized the FDA’s response to the case and led a group of faculty in asking the University Trustees to look into the case.

Like many others who continue to follow this story, Elliott is drawn to this case by issues of justice both local and global. Locally, he seeks accountability for what happened to Dan Markingson and to his mother, who tried repeatedly before Dan’s gruesome suicide to convince involved clinicians that study participation went against Dan’s best interests.

But Elliott also sees in this story the impetus for global change that could strengthen protections for patients who become subjects. In this he is hardly alone. Although she has failed to move the University of Minnesota toward any admission of culpability in her son’s death, Dan’s mother, Mary Weiss, took to the state legislature her concerns about the institutional infrastructures that harmed her son. With Elliott’s help, she got the legislature to pass “Dan’s Law,” which prohibits clinician-researchers from recruiting mentally ill patients under a commitment order into psychiatric drug studies.

“The facts of the Markingson case clearly show that something is wrong with the protection of mentally ill research subjects,” said Naomi Scheman in an e-mail message to me this week. Scheman has been following developments both as faculty in philosophy and as president of the University of Minnesota’s AAUP chapter. She elaborated, saying that subjects worth revisiting include “the acceptable risks in clinical trials, especially when there exists a financial reason for the university to support research with minimal scientific value; the role of IRBs in approving clinical trials and exercising oversight over how the research is actually carried out; and the limitations of the guidance of the Common Rule concerning mentally ill research subjects.”

Scheman concluded, “The University of Minnesota has the opportunity to act as a national leader in formulating best practices, and it is highly regrettable that the only administrative responses have been defensive, including the current efforts to mobilize faculty voices against drawing attention to these problems.”

Indeed, the administration at the University of Minnesota seems only interested in focusing its energies on getting Elliott et al to quiet down. So at an April 8 meeting of the faculty’s Academic Freedom and Tenure Committee, the administration asked the committee, “What is the faculty[’s] collective role in addressing factually-incorrect attacks on particular University faculty research activities?” The administration brought Elliott’s activities as the example to talk about. Some involved have since tried to claim that the committee wasn’t working on the Markingson case in particular, but rather on global questions of “civility” and “bullying.” The minutes seem to belie that claim.

In an interview about this with the Chronicle of Higher Education, university counsel Mark Rotenberg opined, “The faculty, as a collective body, should take an interest in attacks on their members that serve to deter or chill controversial research.” Rotenberg seems to be implying that Elliott is guilty of intimidating researchers, but I wrote to Rotenberg to ask whether his own actions might “serve to deter or chill controversial research?” He has not answered.

Rotenberg hasn’t answered another question I put to him. At the April 8 meeting, Tim Mulcahy, vice president for research, tried to compel the committee to act by telling it that “the federal government requires in those cases [where researchers are supposedly wrongly accused] that institutions do all they can to protect the reputation of the accused.” But where, I asked Rotenberg, do regulations require this?

Needless to say, Rotenberg also hasn’t answered my question about what exactly Elliott has gotten wrong about the facts. Notably, the University has not asked Mother Jones to correct anything, nor would its representative answerprevious questions from me about what Elliott supposedly got wrong.

By now the administration may have figured out that it played its cards poorly on this. Alarmed by what went on April 8, a number of faculty members attended the subsequent meeting of the Academic Freedom and Tenure Committee on April 22 to object.

When I asked her about why she went to the April 22 meeting, Karen-Sue Taussig, a medical anthropologist, replied: “I was worried the committee might be being used to intimidate a member of the faculty who was critical of the University. It seemed to me that there was a logical inconsistency in the University counsel’s position: he did not provide any evidence that any individual faculty member felt chilled by Carl’s work, yet his bringing up the issue clearly posed the threat of chilling Carl’s speech. . . . In short, I was concerned about the possibility of an Orwellian attempt to invoke academic freedom in order to chill academic freedom.”

Philosopher and historian of science Ken Waters, who also attended the second meeting, was just as concerned. “The University’s general council planted a false question, the implicature of which [the committee] seemed to be uncritically accepting (that Carl was advancing factually incorrect claims),” he wrote to me in an e-mail. “And in planting the question, the counsel was trying to turn the tables and squelch my colleagues’ academic freedom by somehow suggesting that they were impinging upon the academic freedom of others.”

Waters told me that he spoke to the committee from his own disciplinary background: “I have examined the history of genetics, much of which took place here at the University of Minnesota. We have a lot of research in genetics of which we should be proud. But we also have a lot of which we should be ashamed, namely eugenics. And the faculty involved in eugenics here were exonerated time and time again. Does that mean that debate about genetics should have stopped? No, of course not. Academic debate is what universities are about.”

Bioethics has not traditionally been a field featured in cases involving questions of academic freedom, presumably because bioethicists have rarely done what Elliott has done: criticize their own schools. But as Hilde Lindemann, former ASBH president, wrote to me in an e-mail: “The very least we bioethicists can do is call out serious wrongdoing when it’s right under our noses. I am only sorry that some of those in authority at Carl’s university don’t understand this.”

Colleagues may recall that, in 2009, Lindemann led the ASBH board in defending Ezekiel Emanuel and Robert Pearlman against false representations of them in the national press. Who ever expected that bioethicists like Elliott might need the same kind of protection much closer to home?

Alice Dreger is a professor of clinical medical humanities and bioethics at Northwestern University Feinberg School of Medicine. She has collaborated with Carl Elliott on various occasions and was on the faculty of the University of Minnesota in 1995-96.

Published on: April 27, 2011
Published in: Activism, Clinical Trials and Human Subjects Research

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