UNIVERSITY OF MINNESOTA
Trin Cee Campus Center for Bioethics 1504 Boynton
410 Church Sect SE
Minneapolis, MIN 55455-0346
e12-s4 960
November 29, 2010 aarti
E-mail: bioetx@unn.cdu
‘we bioethicesamn eds
Board of Regents
University of Minnesota
600 McNamara Alumni Center
200 Oak Street SE
Minneapolis, MN’ 55455-2020
Dear Board of Regents Members:
‘On May 8, 2004, a young man named Dan Markingson committed suicide in a psychiatric
research study at the University of Minnesota. The study was sponsored by the pharmaceutical
‘company, AstraZeneca, Over the past (wo years, articles in the St, Paul Pioneer Press and
Mother Jones magazine have suggested an alaiming series of ethical violations and lapses with
that study which, if true, suggest serious problems in the way that clinical research is conducted
and overseen at the University. Those ethical violations include: recruiting a mentally ill,
possibly incompetent subject into a research study while he was under an involuntary
‘commitment order; large financial conflicts of interest on the patt of the University researchers
conducting the study; a payment structure for the study which included financial incentives to
recruit and retain subjects rather than provide them with standard therapy; an allegedly biased.
study design aimed at generating positive results for AstraZeneca rather than investigating a
‘genuine scientific question; the failure of University researchers to address the legitimate
concems of Mr. Markingson’s mother, Mary Weiss, who warned that her son was suicidal and
‘who attempted for months to have him removed from the study as bis mental condition
deteriorated; the apparent development of a specialized unit in Fairview Hospital designed to
identify severely mentally ill subjects for recruitment into research studies; and finally, a failure
of the institutional oversight system for protecting human subjects of research,
Although the University of Minnesota and AstraZeneca were cleared of blame by an FDA
investigator in 2005, we believe that the problems outlined in the Pioneer Press and Mother
Jones articles are serious enough to warrant further investigation. These reports raise troubling
questions that to date have not been addressed in the University's response to the death of Mr.
Markingson. Patients participating in research studies at the University of Minnesota need to be
confident that the University is doing everything it can to protect them from harm. For this
reason, we respectfully request that the Board of Regents appoint an impartial panel of experts in
research ethics and University governance of medical research to investigate the Markingson
case, particularly any larger structural or financial conditions that might have played a role in his
death and which may still be putting patients at risk.
Given the ongoing controversy over conflicts of interest in the Academic Health Center, we
believe that it is important that pane] members come from outside the University of Minnesota
and have no financial or professional relationships to the researchers responsible for the study inwhich Mr. Markingson died. While it is understandable that some of our colleagues will have
little interest in revisiting this case and the ethical issues it raises, we are persuaded that there is,a
disturbing and unjustifiable gap between how the University has responded to this death and the
careful, critical investigation it warrants. We therefore seek your intervention in this matter.
Yours sincerely,
Qse
Carl Elliott MD, PhD
Professor, Center for Bioethics; and Departments of Pediatries and Philosophy,
University of Minnesota
7 /
ry WH Bath?
Dianne Bartels, RN, MA, PhD
Assistant ah Center for Bioethics; and Department of Medicine, University of Minnesota
GaxI* eacthenles
Joan Liaschenko, RN, PhD, FAN
Professor, Center for Bioethics; and School of Nursing, University of Minnesota
Marpaté Wolf
Mary Faith Marshall, PhD
Professor, Center for Bioethics; and Department of Family Medicine and Community Health,
University ee ‘Minnesota
John Song, % MPH, MAT
Associate Professor, Center for Bioethics; and Department of Medicine, University of Minnesota
Leigh Turner, PhD
Associate Professor, Center for Bioethics; and School of Public Health and College of Pharmacy,
‘Susan Craddock, PhD
Chair, Department of Gender, Women, and Sexuality Studies; and Affiliate Faculty Member.
Center for Bioethics, University of Minnesota
Le Che
Joan Tronto, PhD
Professor, Department of Political Science; and Affiliate Faculty Member, Center for Bioethics,
University of Minnesota