Sunday, July 08, 2007

More on the David Kern affair at Brown University

Dr David KernI have written previously about the depressingly familiar treatment of Professor David Kern at Brown University. The reputation of Brown was brought into disrepute through those events and through other parallel scandals such as that involving Professor Martin Keller. As Kern states "while our medical school and university administrators continue to proclaim a dedication to truth, to the search for knowledge, and to the advancement of civilization, it is all pretense as wordsmithing triumphs over truth and as knowledge is buried."

The best description of the Kern affair is hidden within the (non electronic) archives of the International Journal of Occupational and Environmental Health. It is the now the 10th anniversary of those events. Brown University have yet to make any public apology, conduct any public exploration of their actions, or explain their actions. The main point of this posting is to make available the full text of the 1998 Kern manuscript detailing those events of 1997. I do so with the kind permission of the IJOEH editors. It is mandatory reading for anyone who cares about research integrity and the functioning of universities.

The manuscript is here (IJOEH 1998, 4(1) 19-40):
Manuscript (1.1 Mb)
Appendices (0.2 Mb)

An important quote in the paper comes from The American Thoracic Society who stated:

"Barriers to the open communication of scientific information must be resisted. In particular, the threat of litigation and/or elimination of financial support to prevent the open communication of scientific information is abhorrent."

Kern emphasizes the points actually at issue: the need to protect the freedom of scientists to communicate findings important to the health of the public, and the physician's overarching professional responsibility to his or her patients.

Some extracts from the paper follow:

We are left confronting arrogance, dishonesty, and a callous disregard for the health of workers. While our medical school and university administrators continue to proclaim a dedication to truth, to the search for knowledge, and to the advancement of civilization, it is all pretense as wordsmithing triumphs over truth and as knowledge is buried. What makes such pretense infuriating goes beyond hypocrisy to the failure of these administrators to realize that people's lives hang in the balance. They either fail to appreciate or are unwilling to acknowledge that their words and actions have jeopardized the health of individual workers, have contributed to the potentially irrevocable loss of an opportunity to advance both scientific understanding and the public health, and have undermined the collective sense of trust and mission in this academic community.

At the close of the meeting, I provided the company with a draft of a scientific abstract, describing the clinical dimensions of the ILD outbreak, which I was planning to submit to the American Thoracic Society for presentation at its annual international conference in May 1997. Two days later, Mr. Fulks called to say that I could not submit the abstract and, that if I did, the company would take legal action against both the hospital and me.


During the following week, I contacted the University Grants Office and was referred to Peter Shank, Associate Dean of Medicine and Biological Sciences. Dr. Shank wrote to me, stating: "I see no way in which you can publish results of your studies at the company with-out their written approval . . . you should immediately withdraw your abstract to the national meeting." He copied his letter to both Rick Dietz and H. Denman Scott, MD, Physician-in-Chief at Memorial Hospital. [Professor Shank's letter is here]


The following day, Dietz told me that he would arrange for me to speak with the hospital's legal counsel. He then went on to say that given the absence of any public health concern it seemed to him that I should withdraw the abstract. When I asked him why the disease outbreak did not pose a public health concern, his response was that no other company in the world makes what this company manufactures and that NIOSH personnel were already conducting an investigation at the company. I explained that this is not the only company in the world manufacturing these products, to which he replied, "Yes it is." I noted the existence of two other companies in Rhode Island, a considerable number of business competitors throughout New England, and an international trade organization having at least 50 member companies. With that, he became somewhat agitated, stating that I was going to destroy the company.


Perhaps worthy of note is that Microfibres is one of eight benefactors responsible for construction of the hospital's histology laboratory. Three members of the company owner's family serve as members of the Memorial Hospital Corporation. More troubling, however, is that the company was asked to contribute to the hospital's Primary Care Center Capital Campaign at approximately the same time as Frank Dietz and Dr. Scott were attempting to allay the company owner's anger about our having submitted a scientific abstract on the disease outbreak. Moreover, the solicitation was made jointly by Rick Dietz and the Chairman of the Capital Campaign. The Chairman of the Capital Campaign also serves both as Vice Chairman of the hospital's Board of Trustees and as hospital attorney. In the latter role, he has provided guidance to Frank Dietz on how to deal with the confidentiality agreement, the submitted scientific abstract, and me.


On December 20, I asked Dr. Scott for clarification of two points. When I asked what would happen if I re-fused to withdraw the abstract, I was informed that if the company sued the hospital, the hospital would in turn countersue me. When I explained that what I had really been asking was what would happen to my job, he answered that he did not know. When I asked what Frank Dietz had meant in stating that our occupational health program no longer existed, Dr. Scott answered that I could not have any contracts with industry.


Over the following month, the actions and statements of both Dean Marsh and the Committee of Inquiry made it clear that a search for truth was not in progress.

A Committee of Inquiry released its report. While the committee concluded that my academic freedom had been violated, it reached this conclusion on the basis of tortured legalistic reasoning and all but ignored the truly compelling facts and issues. It is difficult to imagine how anyone can take the report seriously given such conclusions as: "The company's attempt to have the abstract withdrawn is not considered by the Committee to be an attempt to compromise the health of its employees but rather an effort to avoid bad publicity and to protect its economic position."


Representatives of the company, the hospital, and the university have gone to great lengths to distort the truth. Yet, even were their claims true, their points of contention are irrelevant to the critical issues in this matter. That is [not], whether ... the confidentiality agreement in question has any legal standing [but]
  • attempts to suppress the dissemination of scientific findings critically important to the public health
  • interference with my professional responsibilities to care for patients, and
  • immediate termination of our occupational health program.
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1 comment:

InformaticsMD said...

Congratulations, Brown Univ.

As former occupational medicine practitioner, and manager of medical programs and Medical Review Officer (drug testing review officer) for a large unionized municipal transit authority, I can state that Brown officials' actions were as bad as, or worse, than militant union thugs with (alleged) mob connections.

These situations did in fact result in accidents, as well as harm to transit employees.