No more Dan Markingsons

A few weeks ago I gave a talk in Seattle in which I pointed out that science is not sufficient to define moral behavior. A substantial part of that talk was a catalog of atrocities, such as the Tuskegee syphilis experiment. I said that in purely scientific terms, that was a good experiment; if the subjects had been mice, for instance, setting aside an untreated control group to study the progression of the disease would have been considered an essential part of smart experimental design. One could still argue that the needs of the many outweigh the needs of the few…if one were willing to distance oneself from the humanity of the subjects.

Yes, one can always retreat to the excuse that these were cases of bad science, where the scientists violated the rules of their own profession. But where do the ethical guidelines come from? Not science.

Dan_Markingson

I missed a trick, though. I talked mainly about old cases, when there's a clear case of the conflict between ethics and science playing out right now, right at my home university: the case of Dan Markingson, the young man who was enrolled in an experimental pharmaceutical study and kept there, even as his mental illness worsened, and who eventually committed suicide.

There's a new article by a bioethicist on this case.

markingson2

The research abuse in this case is so stunning that when I first learned about it I could scarcely imagine it happening anywhere, much less at the university where I work. In late 2003, psychiatric researchers at the University of Minnesota recruited a mentally ill young man named Dan Markingson into a profitable, industry-funded research study of antipsychotic drugs. The researchers signed him up over the objections of his mother, Mary Weiss, who did not want him in the study, and despite the fact that he could not give proper informed consent. Dan was acutely psychotic, plagued by delusions about demons, and he had repeatedly been judged incapable of making his own medical decisions. Even worse, he had been placed under an involuntary commitment order that legally compelled him to obey the recommendations of the psychiatrist who recruited him into the study.

For months, Mary tried desperately to get Dan out of the study, warning that he was getting worse and that he was in danger of committing suicide. But her warnings were ignored. On April 23, 2004, she left a voice message with the study coordinator, asking, “Do we have to wait for him to kill himself or someone else before anyone does anything?” Three weeks later, Dan committed suicide in the most violent way imaginable. His body was discovered in the shower of a halfway house, his throat slit so severely that he was nearly decapitated, along with a note that said, “I went through this experience smiling.”

You know, I've been impressed with my university on many occasions: their commitment to academic freedom has been exemplary, my interactions with the university's lawyers (I've had a few of them…) has always left me satisfied that they are fair and pragmatic. But this is a failure not just of the scientists involved, but the administration of the university. It's an embarrassment.

Yet for three years the University of Minnesota has managed to bluster and stonewall its way through all the criticism, insisting that it has already been exonerated. Even when the state Legislature passed “Dan’s Law” in 2009, banning psychiatrists from recruiting mentally ill patients under an involuntary commitment order into drug studies, the university continued to insist it had done nothing wrong.

I suspect that the stonewalling is out of fear of opening the door to legal action against a university that is already struggling with constantly dwindling support from the legislature. But it's necessary that they confront this issue and deal with it honestly — it's the only way to restore confidence with UM's ethical culture, and it's the only way to make sure there are no future Dan Markingsons.

And it's that last bit that is the important concern.

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Science is a natural, universal fact and has nothing to do with morals. It has always been there and is unchanging. Even though man plays around with it in an effort to understand it doesnt take away from 'science' ( in all its forms) that it is something that existed before we happened to stumble upon it. Science is neither moral nor immoral. Only two groups of people suffer when a scientific fact is found; The group that will profit from the findings monetarily or otherwise/or not. Then there are those whose religious facts or beliefs become shaky and uncertain. Only because we live in both those worlds, is why science and morality can clash.

By Jane Berkel (not verified) on 17 Apr 2013 #permalink

Thank you so much, PZ, for posting on this.

Interested readers might wish to consult this link:

http://chn.ge/10XrlFT

Where they will find a petition to the Governor of Minnesota

Governor Mark Dayton of Minnesota: Investigate psychiatric research misconduct at the University of Minnesota

There are also links to plenty of additional information should people wish to decide for themselves whether further investigation is warranted.

By Bill Gleason (not verified) on 17 Apr 2013 #permalink

Well, I suppose constantly dwindling support from legislature could be a more charitable reason the university went after Mary Weiss (Dan's mother) for legal fees. :|

It seems a patent non sequitur to suggest that since experiments can be both proper in their construction and clearly immoral in their execution that science can have no (or even a limited) bearing on morality. It rests on the idea that the propriety of an experiment is solely a function of the quality of data that can be obtained. Why should we distinguish between a proper experiment which would be immoral to conduct and an improper experiment? Actual people devise and carry out these actions, and those actions can be moral or otherwise, and just because they claim as justification some scientific purity cannot impugn the ability of science to make a moral determination.

Why should we distinguish between a proper experiment which would be immoral to conduct and an improper experiment?

Why shouldn't we? After all, different things are wrong with those two kinds of experiments.

By David Marjanović (not verified) on 18 Apr 2013 #permalink

Maybe I've been brainwashed by Sam Harris, but I think Myers could choose his language more carefully. The atrocities he is likely to have listed (I can't find a transcript or a recording) may well be laudable attempts at data collection yet scientifically, ethically, obviously repulsive. I consider this crucially distinct from some group of actions that could be described as a "good experiment".

It's with science we can establish what is useful (and the implied "usefulness" generally [my apologies for saying "generally"] resembles increased biodiversity and less painful existences for all lifeforms), and therefore at the very least from a Spinozan perspective, what is good -- consistently and with better results than any prior moral framework. And isn't "One could still argue that the needs of the many outweigh the needs of the few…if one were willing to distance oneself from the humanity of the subjects." clearly a false dilemma?

In an absolute morality, the global effects of a moral action should be considered. Increasing total knowledge would have a positive effect, by allowing more informed choices that are consequentially more likely to be useful to be made. The cost of this knowledge is prohibitive, however, and I nor anyone else who thinks that we can construct ethics from scientific analysis *and is in possession of the same relevant moral data as me* would consider it morally beneficial. Nor would I say science "is not sufficient to define moral behavior" purely because some people have historically undertaken this moral analysis poorly or not done it at all -- if Myers isn't basing his claim on this observation alone, then I suppose at some point he is implying a deconstruction of the science of morality.

Science is not generally unprofitable because some people have historically undertaken experiments that were financially infeasible. Science is not generally at room temperature because some if not most people have historically undertaken experiments at standard conditions. Science is a system for interrogating reality.

By too few words (not verified) on 19 Apr 2013 #permalink

I have n ot read one intellegent comment. When patients are in danger of committing suicide during psychiatric research, they are suppose to drop them from the research and enter the side effect into data. There is no reason, scientific or otherwise, compelling a researcher to keep the subject in the experiment. The researchers should be jailed and sued in civil court. Just because there is not enough science in psychiatry to prove the drug caused the problem, we can not give poor behavior like this a pass. They forced a person to take a drug or placebo and it led to his death. Pull it together people.Houston ~ we have a huge effing problem. An entire university of educated people and no one stepped in to correct this behavior. Depressing to say the least.

Harris starts from a couple of goals that he doesn't question, and then he demonstrates how science can get us there. But he doesn't use science to choose the goals in the first place.

By David Marjanović (not verified) on 20 Apr 2013 #permalink