November 11, 2013 Richard B.

Beeson Chair of the Board University of Minnesota Board of Regents 600 McNamara Alumni Center 200 Oak Street S.E. Minneapolis, MN 55455 Re: Open letter concerning new allegations of psychiatric research misconduct at the University of Minnesota Dear Mr. Beeson: I am writing to alert you to possible new instances of psychiatric research misconduct at the University of Minnesota. In November 2010, I was one of eight faculty members that contacted the Board of Regents and urged it to investigate the death of Dan Markingson. The Board declined to investigate. Since that time, senior administrators’ justifications for refusing to investigate have collapsed and new cases of possible research misconduct have emerged. I have already contacted President Kaler and informed him of these latest allegations. His previous responses suggest that he will not investigate these new claims. I believe that President Kaler is making a serious error in judgment, failing to determine whether vulnerable research subjects were harmed, and putting the University of Minnesota at risk of significant reputational and financial damage. I am therefore bringing my concerns to you and other members of the Board of Regents. After writing open letters to President Kaler on May 13 and June 5, 2013, I was contacted by family members of several patients who were allegedly harmed in psychiatric studies conducted here. The individuals who contacted me described their relatives’ experiences as “horror stories.” They stated that their loved ones had experiences comparable to that of Dan Markingson. They also described themselves as being dismissed and discarded by the University of Minnesota. Dan Markingson’s life ended in a gruesome suicide that occurred while he was enrolled in a psychiatric clinical study. Markingson was “consented” into a clinical trial even though on several occasions immediately before his inclusion in the study he was assessed as lacking decision-making capacity and unaware that he suffered from a mental illness. There are many unanswered questions about the evaluation process by which he was deemed competent to provide consent. He was recruited into the study while under a stay of commitment order that compelled him to follow his doctor’s treatment

2 recommendation. (A state law prohibiting such acts was passed after his death. It is called “Dan’s Law.”) When Dan’s mother, Mary Weiss, made repeated efforts to withdraw her son from the trial his physicians failed to address her requests. Following Markingson’s death, researchers and university administrators did not provide adequate responses to complaints brought by his family members. Other families have since come forward with new allegations of psychiatric research misconduct. Professor Carl Elliott, my colleague at the Center for Bioethics, has been contacted by an even larger number of individuals reporting grave concerns related to the conduct of psychiatric research at the university. He has gone to extraordinary lengths to alert senior administrators to the need for an investigation of psychiatric research misconduct. Administrators at the University have consistently refused to take any action or even listen to his concerns. They have also ignored the over three thousand individuals that signed a petition calling for an independent investigation of Dan Markingson’s death and the over one hundred and seventy scholars in bioethics, health law, and medical research that wrote to the Faculty Senate and called for a public inquiry. Pennsylvania State University provides a powerful example of what can happen when senior university administrators fail to address allegations of wrongdoing. In 2012, former Penn State assistant football coach Jerry Sandusky was found guilty of 45 counts of sexual abuse. He received a prison sentence that will run thirty to sixty years. An investigation by former FBI director Louis Freeh concluded that as early as 1998 several senior university officials were aware of allegations that Sandusky was sexually abusing children. Yet they failed to investigate these allegations or notify law enforcement authorities. Motivated by an apparent desire to protect the reputation of Pennsylvania State University, senior university officials tried to cover up acts that if disclosed would have been a public relations disaster. As a result, Sandusky was able to engage in far more acts of sexual abuse. At no point when allegations were made in 1998 and 2001 did senior administrators at Penn State alert that university’s Board of Trustees to reports that a football coach was sexually abusing children. While senior Penn State officials failed to provide essential information to the Board, the Board of Trustees shared some of the blame. Serious flaws in the operation of that Board—in particular, its failure to ensure adequate reporting of major institutional risks, complacency and unwarranted confidence in senior university administrators, and failure to investigate once allegations were finally brought to its attention—are described in Chapter 6 of the Freeh Report. That report highlights the moral and legal duty of such Boards to provide institutional oversight and engage in reasonable inquiry when notified of possible wrongdoing. Let me be clear: I am not accusing anyone employed at the University of Minnesota of engaging in criminal activity, I am not claiming that senior university administrators have conspired to engage in a cover-up, and I am not claiming that allegations of possible psychiatric research misconduct are proven. Rather, the point I wish to make is that when confronted with accusations of misconduct or criminal behavior university officials sometimes decide that their first duty is to protect the public image of their institution. At Penn State, this strategy was “successful” for years until it finally imploded. President Graham Spanier and football coach Joe Paterno were fired. Graham Spanier, former vice-president Gary Schultz, and former athletic director Tim Curley are charged with perjury, obstruction of justice and criminal conspiracy, endangering the welfare of children, and failure to report suspected child abuse. To date, Penn State has spent over $59 million settling lawsuits brought by victims. It has spent millions more on legal fees and public relations expenses. The final bill has not yet been tallied.

3 Of course, it is possible that the reports of research misconduct and abuse that I have received are unwarranted. It is also entirely possible that their complaints are justified. The only way to know is to conduct a thorough investigation that includes encouraging individuals with allegations of psychiatric research misconduct to come forward and articulate their concerns without fear of retaliation by the University. According to Richard Bianco, the university official responsible for overseeing research subject protection, the University of Minnesota never even investigated the circumstances surrounding the death of Dan Markingson. Likewise, there is no record of any investigation of these new allegations of research misconduct. Senior administrators at the University of Minnesota have failed to investigate claims that vulnerable individuals with mental illnesses have been harmed while enrolled in psychiatric studies. If these allegations are subsequently proven to be justified the consequences could be devastating. Senior university officials will have to be fired. Federally funded research could be suspended and funding agencies could impose significant sanctions on the University. Reputational and financial damage to the university could be severe. Trust in the University of Minnesota will be shattered. Without question, harm to victims is the most important issue when considering allegations of research misconduct. But it is worth considering the many ways in which the University of Minnesota could be damaged if senior university administrators and members of the Board of Regents all refuse to investigate accusations that subsequently prove to have merit. As the scandal at Penn State reveals, failure to investigate allegations of wrongdoing can have dramatic consequences not only for victims and their loved ones but also for academic institutions and their leaders. I hope that you and other members of the Board of Regents do not make the same error in judgment as President Kaler and other senior administrators at the University of Minnesota and instead choose to initiate a thorough, independent investigation of possible instances of psychiatric research misconduct. Yours sincerely,

Leigh Turner, PhD Associate Professor University of Minnesota Center for Bioethics N520 Boynton, 410 Church Street SE Minneapolis, Minnesota, 55455 Phone: 612.626.4830

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