Sunday, December 09, 2007

Memory Hole (7 December): A case study in ethical medical leadership

Scientific Misconduct Blog Memory Hole: Events of December 7th

9 years ago today: A critical commentary on the role of leadership in medicine

On 7 December 1998 Professor Manuel Buchwald wrote a letter which has become a case study in medical ethics.

In that year Professor Brenda Gallie held the position as leader of the Research Division of Cancer and Blood at the Hospital for Sick Children at the University of Toronto. Her line manager was Professor Manuel Buchwald (OC, PhD FRSC, and Lombard Insurance Chair of Pediatric Research, Hospital for Sick Kids Chief of Research). Buchwald is one of the co-discoverers of the Cystic Fibrosis gene. He is listed in the Canadian Who's Who.

Manuel BuchwaldIn May 1998 Gallie learned that Dr. Nancy Olivieri, a member of her Division had failed to persuade Buchwald or the hospital administration to assist honestly with a critical ethical crisis involving clinical research funded by the Canadian Pharmaceutical Company Apotex.

Gallie wrote to Buchwald and the hospital President suggesting that the matter required urgent action. They responded by telling her that she "did not know the whole story", and should not become involved. It later became known that Apotex were involved in granting tens of millions of dollars to the University, and that the University were about to attempt to whitewash the embarrassing affair. The funding from Apotex was promised to increase to $55million, and university leaders were encouraged to act according to the wishes of Apotex. As part of a widespread campaign of bullying, the leadership of University of Toronto began to attack a series of academics who had attempted to stand up for honesty in science. On the 7th of December 1998 Buchwald wrote the below letter to Gallie. It is self explanatory. It includes a wonderful series of comments on integrity in medical leadership. Moral duty, our duty to patients and our duty to colleagues are, according to Buchwald, inconsistent with being a leader. Moral integrity is apparently incompatible with the overriding duty of a leader to the institution.

Snippet of letter by Manuel Buchwald
For the complete letter see here - Manuel Buchwald to Brenda Gallie, 7 December 1998

This letter is derived from the morality of Auschwitz. It would seem to me to disqualify someone from being a respected scientist involved in human research. The University of Toronto did nothing to discipline Buchwald. Gallie was appalled, and resigned her leadership position. She moved her research program to the Ontario Cancer Institute.

Great intellect implies neither humanity nor ethical insight. It's all in the ventromedial prefrontal cortex several inches behind the brow. Buchwald, as a younger scientist had held himself as an advocate for human rights.

Earlier|Later|Main Page


Anonymous said...

Very timely reminder of these events.

The WaPo link doesn't work for me - is it possible to give the name of the article so that I might find it another way?

Aubrey Blumsohn said...

Thank you. Broken link fixed.

Radagast said...

I think this is quite an interesting case, not because of the apparently appalling absence of any kind of leadership qualities at the UoT, (and what influenced that), but in how the initial complaint was dealt with, as if there could be any amount of information, which could turn a crap situation into a good one. "You don't know the full story," indeed!

And then, when that didn't work, the bullying and discrediting starts. Is there a handbook for this shit, somewhere, that I can get my hands on, such that I don't have to degrade myself copying these fuckers, in order to understand how it's done?

Why does nobody tell one useful things about the world, at school? I suppose that every adult feels responsible, in some way, for the grotesque anomaly that the "real" world has become. Everybody knows that they could do something about it, but is too afraid of losing what little they have, should they rock the boat.

I have a theory for you. I think that, along with money, everything that is deemed to be valuable, including information, is coveted by a select few at the head of society's hierarchy. By controlling the things that they have perceived to be "key," they believe that people may be controlled. And do you know what? To a large extent, they're right. But they'll never be completely right, which is a problem for them.