a paradigm….

Posted on Sunday 30 November 2014

I just wrote three posts reviewing the case of Dan Markingson, but I’m not going to even post them. We all know that case only too well. Over Thanksgiving, Carl Elliot posted a news video of a new whistleblower [INVESTIGATORS: Nurse questions integrity of U of M drug researchers], nurse Nikki Gjere who was a nurse coordinator who was there when Dan was hospitalized. She was the person other nurses spoke to at the time. Her video report is definitive and damning. I’m not going to go through the whole case again because she confirms exactly what Carl Elliot said four years ago in The Deadly Corruption of Clinical Trials which couldn’t be clearer. Dan was inappropriately put in a questionable experimercial trial [conducted for commercial rather than scientific reasons] under the most absurd of circumstances – an involuntarily committed patient declared incompetent who was allowed to volunteer to be in a trial so long as he took the medication in return for a less restrictive environment, when the trial endpoint was how long the patients would voluntarily stay on the medicine [which he couldn’t stop]. After six months with no improvements on the medication, he brutally killed himself. Why was he in a such an obviously wrong and dangerous place? The investigators were behind on their recruitment is the most likely answer [see almost inevitable…].

    par·a·digm  (pr-dm)
    noun: paradigm; plural noun: paradigms
    1. [technical] a typical example or pattern of something; a model.

The case of Dan Markingson is a paradigm representing something terrible, a period in our medical history when the scientific processes designed to evaluate medications for use in the treatment of illness were perverted and used for commercial purposes. Surely, with the addition of such strong testimony as that of Nikki Gjere, the long avoided investigation of this case will finally become a reality. There are others: Paxil Study 329, a trial that fallaciously reported that a medication was effective and safe in childhood depression; Seroquel Study 15, a trial that was definitive but unpublished because the sponsor didn’t like the outcome. But these paradigmatic trials are just the tip of an iceberg of scientific misbehavior – all in the service of pharmaceutical profits. And the ticket into the scientific literature were the names of prominent academic physicians on the author by-line. Many of these articles were analyzed by the sponsoring corporations that stood to gain and deceptively presented by professional writers skilled in the art of spin. 

In Dan’s case, he had a particularly virulent condition. His mind was dominated by an apocalyptic complex delusional system in which he believed he would be called on to be a killer. It was a classical presentation of paranoid schizophrenia or whatever you choose to call it now. But it’s often the least medication responsive and the most likely to be acted on. He needed a vigorous individualized treatment program aimed at what he had, not some commercial enterprise like the CAFE study offering a generic blinded trial of medication. There is no remotely rational justification for what happened in this case.

Below is the current posting on Carl Elliot’s blog, and I hope he/they can find a way through legal channels to finally break the log jam that is blocking this case from being brought into the light, becoming the paradigm it deserves to be for much needed change. It’s worth reading the whole letter:

An excerpt from Leigh Turner’s letter to Minnesota Attorney General Lori Swanson, after Tuesday’s revelations by Niki Gjere:

University officials like to emphasize that Dan Markingson died ten years ago. They claim his case is “old news.” However, if the numerous local citizens that have contacted Professor Carl Elliott and me are credible, and I believe they are, Dan Markingson is one person among numerous victims of psychiatric research misconduct. Some of these victims reportedly were harmed after Markingson’s death. Perhaps treating Markingson’s death in the CAFÉ study as ancient history not worth revisiting has enabled more patients to be harmed. Niki Gjere has the same concern. Asked  by Mr. Baillon about her “greatest fear in the current environment,” she responded, “That it continues to happen. That patients are continuing to be harmed, that nothing’s been fixed.” 

Responsible university presidents investigate reports of research misconduct. Unfortunately, President Kaler functions more as a college mascot – a Goldy Gopher in a suit and tie – than as an accountable leader. The University of Minnesota is never going to conduct an honest and thorough investigation of alleged psychiatric research misconduct. You need to do it. Any additional delays risk putting more vulnerable individuals at increased risk of harm.
    December 3, 2014 | 6:30 PM

    I believe the research doctors at the umn psychiatry department are opportunistic sociopaths, too… Something more needs to be done to protect patients. Yeah, Dan’s law is great and all, but abuse is still happening.

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