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The U of M should thoroughly investigate issues in the Markingson case

u of mn
The university administration is seeking what looks more like a public-relations exercise than a thorough inquiry.

In yet another twist to the University of Minnesota’s longstanding refusal to investigate alleged research misconduct in the Department of Psychiatry, university officials, instead of asking for a credible inquiry, are soliciting “bids” from prospective contractors interested in reviewing “current policies, practices, and oversight of clinical research on human subjects.” This limited review is both absurd and fully consistent with the decade-long refusal by university administrators to promote anything resembling a legitimate inquiry into possible research misconduct involving vulnerable patients with mental illnesses.

The latest episode began in December, when the University of Minnesota Faculty Senate approved a measure titled “Resolution on the matter of the Markingson case.” Dan Markingson was an acutely psychotic young man who was recruited into a psychiatric clinical trial while under a civil commitment order. His psychiatrists kept him in the trial despite the desperate pleas of his mother, Mary Weiss. Markingson stayed in the study until he committed suicide by nearly severing his head with a box-cutter.

In the years since then, many critical questions about the circumstances surrounding his death have remained unanswered or contested: whether Markingson was coerced into the trial, whether he was enrolled without having the capacity to provide informed consent, whether he was given inadequate care by psychiatrists with significant financial conflicts of interest, and whether his privacy rights were violated.

Leigh Turner
umn.eduLeigh Turner

Last fall, a group of 181 professors from outside the university wrote to the Faculty Senate, asking it to endorse an investigation of the circumstances surrounding Markingson’s death. The Senate passed a resolution by a vote of 67 to 23; its preamble noted the reputational harm the university has suffered “in consequence of this tragic case and its aftermath,” as well as the many unanswered questions raised by Markingson’s death.

Still, university officials continue to dodge a legitimate inquiry. Instead of asking for an investigation by a panel of independent experts in research ethics or a law-enforcement body, university officials have posted a request for proposal (RFP) to the MBid System on the university’s Purchasing Services website. This is the website ordinarily used to solicit bids for services such as furniture reupholstery contracts and laboratory supplies. Unless the Presidential Commission for the Study of Bioethical Issues routinely trolls for contracts on the MBid website, it is unlikely that the kind of organization that registers with MBid is going to have the expertise, credibility, investigative powers, and forensic skills needed to conduct a thorough investigation of possible psychiatric research misconduct.

The wrong mandate

Even if a credible body with relevant expertise receives the contract, it is being given the wrong mandate. According to the RFP:

The intent of this review is to ensure that the University’s processes for clinical research on human subjects meet or surpass the established best practices and norms and to instill confidence among faculty and the public that the University of Minnesota research is beyond reproach. It is to be forward looking, productive, transparent and independent review of current practice by an external expert panel.

Setting aside the suggestion that the primary mandate of the contractor is to engage in a public-relations exercise for the university by “instilling confidence” that research conducted at the University of Minnesota is “beyond reproach,” the emphasis on being “forward looking” while examining only “current” policies, practices, and oversight of clinical research is profoundly disturbing. I believe the purpose of an investigation should not be limited to reviewing current policies, but must also include a careful investigation of past conduct — including alleged misconduct in the Markingson case.

It is true the Faculty Senate’s resolution was poorly worded. Rather than explicitly calling for an investigation of alleged misconduct, it called for an “inquiry examining current policies, practices and oversight of clinical research on human subjects at the university.” The narrow wording gave university officials a loophole they were eager to jump through: to do a review of “current” policies and practices. Thus, in a bizarre turn, the “Resolution on the Matter of the Markingson Case” has been transformed into a review that will exclude examination of the Markingson case.

Any sensible person can see that it is not enough — for a decade now it has not been enough — to look exclusively at current practices and policies. Rather, there needs to be a thorough investigation of allegations of psychiatric research misconduct, and this can be done only by examining whether serious violations research subjects’ rights has occurred in psychiatric research studies. For the sake of the university, for the sake of the faculty members alleged to have engaged in research misconduct, and — most important — for the sake of the alleged victims, the past must not be ignored.

Under a cloud  

Prior to passage of the Markingson resolution, University of Minnesota philosophy professor Naomi Scheman stood before the Faculty Senate and provided a powerful justification of why the university needed to conduct a thorough investigation that included a substantial historical component. “We are all of us under this cloud, and this cloud needs to be removed,” she said. “Only a credible investigation of what happened in [the Markingson] case and as well as into continuing policies and procedures will remove that.”

By failing to address alleged research misconduct, senior administrators at the University of Minnesota have guaranteed that the clouds hanging over the university will remain. The solicited review will, by design, fail to investigate that. 

When confronted with allegations of research misconduct, university regents and officers have a duty to make reasonable inquiries and determine whether or not wrongdoing has occurred. This “review” of current practices and policies subverts the process of reasonable inquiry and replaces a legitimate investigation with its spurious substitute. Of course, after a decade of such activity, there is no reason to be surprised.

Leigh Turner, Ph.D., is an associate professor at the Center for Bioethics & School of Public Health, University of Minnesota.

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Comments (1)

  1. Submitted by Bill Gleason on 03/12/2014 - 08:22 am.

    Dr. Mickey Nardo – One Boring Old Man comments on article

    link: http://ow.ly/uvn5b

    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.

    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].

    …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…

    —————–

    The behavior of the administration of the University of Minnesota in this matter has been despicable.

    With all the talk of Grand Challenges, I have one:

    Clean up your own act.

    Or, as Socrates put it:

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

    William B. Gleason
    University of Minnesota alum and faculty member

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