Dan Markingson, the 2009 Frank Premack Award, and the "financial incentives that can compromise a doctor’s decision-making"

Readers of the Star Tribune could be forgiven for thinking that there is only one person at the University of Minnesota who is worried about the current state of human subject protection.  In a recent editorial, Aaron Friedman, the Dean of Medicine, ignores the 2500 people who have called for an investigation of the suicide of Dan Markingson and portrays the call as my own personal vanity project.

Friedman has also apparently forgotten that the Minnesota Journalism Center, which is part of the University of Minnesota's School of Journalism and Mass Communications, awarded its 2009 Frank Premack Public Affairs Journalism Award for excellence in investigative or analytical reporting to Paul Tosto and Jeremy Olson for their Pioneer Press series on Markingson's death. The judges wrote:

In this piece, Olson and Tosto reported for the first time on schizophrenia patient Dan Markingson’s death and the resulting lawsuit and probes. In the process, they pulled back the curtain on the rarely viewed world of industry-funded clinical research and the financial incentives that can compromise a doctor’s decision-making.

Premack judges in this category said: “Through the eyes of one patient, this story shed considerable light on the complicated and competing interests between the development and path to market of new drugs, funding needs of the University and the integrity of medical research. The judges are hopeful that the new ethics task force implemented at the U of M is resulting in changes in conflict of interest policies.”

Unsurprisingly, the public relations staff at the Academic Health Center did not publicize the Frank Premack Award. Nothing has changed since 2009, and the rules permitting the "financial incentives that can compromise a doctor's decisionmaking" are still in place.

Not a scandal? Seriously?

Bill Gleason responds to Aaron Friedman's blustering, Nixon-like claim in yesterday's Star Tribune that the suicide of Dan Markingson is "not a scandal."  Read Gleason's response here.

Note to New York Times reporters: read the New York Times

Have a look at this well-intentioned, oddly blinkered story in today's New York Times, titled "Baffling Rise in Suicides Plagues the U.S. Military." Like many reporters before them, James Dao and Andrew Lehren report that suicides in the military have risen to record levels.  What they don't mention is the fact that prescriptions of psychotropic drugs, many of them with black box warnings for suicide, have also risen to record levels. 

It was only a month ago that psychiatrist Richard Friedman wrote in the Times:

"Worse, according to data not reported on until now, the military evidently responded to stress that afflicts soldiers in Iraq and Afghanistan primarily by drugging soldiers on the front lines. Data that I have obtained directly from Tricare Management Activity, the division of the Department of Defense that manages health care services for the military, shows that there has been a giant, 682 percent increase in the number of psychoactive drugs — antipsychotics, sedatives, stimulants and mood stabilizers — prescribed to our troops between 2005 and 2011. That’s right. A nearly 700 percent increase — despite a steady reduction in combat troop levels since 2008."

In fact, several months before Friedman's op-ed, Paul Scott made an even more persuasive case in Men's Journal.  

"American soldiers (active soldiers as well as retired) have never been more medicated than they are now: In 2010, more than 213,000 service members (roughly 20 percent of active-duty military) were taking medications the military considered "high risk" – from epilepsy drugs to psychiatric pills like Seroquel. But what's more incredible is that Seroquel and other antipsychotics are expensive (as much as $10 a dose) and not proven to be effective in treating the very conditions for which the military and VA most often prescribe them: insomnia and PTSD. But that didn't prevent their use by the military from increasing tenfold between 2002 and 2009."

And:

"The causes of suicide are complex, and no single factor is to blame for the rise in self-harm. To their credit, the military and the VA have launched a help line, funded studies, advocated for talk therapies, researched alternative methods, and hired thousands of new mental-health professionals. But they have yet to question a glaring contradiction at work when a soaring number of veterans and soldiers are taking medications that come with suicide warnings. It's a group of drugs that include antidepressants, benzodiazepines, anticonvulsants, and certain atypical antipsychotics like Seroquel. Dr. Peter Breggin, a psychiatrist who testified before Congress about veterans' medication and suicide in 2010, says, "I'd say it is near-criminal to send young men and women off to combat with a 180-day supply of drugs that can cause an increase in violent suicide."

How is it possible that Times reporters can write a lengthy, front-page story on this "baffling" problem and fail even to mention the rise in psychotropic drug prescriptions as a possible contributing factor?

"A surprising number of whistleblowers have been given closets for offices."

 A passage from Fred Alford's excellent book, Whistleblowers: Broken Lives and Organizational Power:

"Usually the whistleblower is not fired outright. The organization's goal is to disconnect the act of whistleblowing from the act of retaliation, which is why so much legislation to protect the whistleblower is practically irrelevant. The usual practice is to demoralize and humiliate the whistleblower, putting him or her under such psychological stress that it becomes difficult to do a good job. If the whistleblower is under enough stress, he or she is likely to make a bad decision, justifying disciplinary actions. A surprising number of whistleblowers have been given closets for offices. One was ordered to go into his closet at nine and not come out until five.  A few whistleblowers have been transferred to positions for which they lacked the requisite skills, virtually guaranteeing that they would fail. A series of bad efficiency reports would follow, along with psychological evaluations.  Only then was the whistleblower dismissed."

"My father was in a concentration camp and this sounds like some of the things his captors did."

That's the comment just left by Brown University physician David Egilman on the petition to investigate psychiatric misconduct at the University of Minnesota.

Will President Kaler sign the petition to investigate the U?

Leigh Turner thinks he should.  Read his open letter.

"I saw the best minds of my generation destroyed by the Academic Jobs Wiki."

 From anthropologist/journalist Sarah Kendzior on Savage Minds.

"Graduate students live in constant fear. Some of this fear is justified, like the fear of not finding a job. But the fear of unemployment leads to a host of other fears, and you end up with a climate of conformity, timidity, and sycophantic emulation. Intellectual inquiry is suppressed as 'unmarketable', interdisciplinary research is marked as disloyal, public engagement is decried as 'unserious', and critical views are written anonymously lest a search committee find them. I saw the best minds of my generation destroyed by the Academic Jobs Wiki."

"The cult mentality of academia not only curtails intellectual freedom, but hurts graduate students in a personal way. They internalize systemic failure as individual failure, in part because they have sacrificed their own beliefs and ideas to placate market values. The irony is that an academic market this corrupt and over-saturated has no values. Do not sacrifice your integrity to a lottery — even if you are among the few who can afford to buy tickets until you win."