perspective
The Anatomy of Research Scandals BY CARL ELLIOTT
F
or the past two years, I have taught a seminar on sion broadcaster, aired a devastating documentary film by medical research scandals. The syllabus looks like a Bosse Lindquist called The Experiments. The film presented highlight reel of exploitation and abuse: children fed damning evidence that Macchiarini had falsified research plutonium-laced breakfast cereal, prisoners dosed with the data, deceived patients, and performed deadly experimental active ingredient in Agent Orange, mental patients given transplants on patients who did not have life-threatening psychedelic drugs and massive electroconvulsive therapy be- illnesses. Four surgeons at the Karolinska Institute had filed fore being sent into curare-induced paralysis and a coma. I an internal complaint against Macchiarini two years earlier, designed the seminar to crush the idealism of future physi- but the result had been stonewalling and intimidation. Yet cians by illuminating the dark patterns that research scan- within weeks of The Experiments , both the head of the Karodals typically follow. linska Institute and the secretary of the Nobel Assembly had The most recent scandal we examined happened to be resigned. Macchiarini is currently facing criminal charges of one of the most lurid. In June 2014, when NBC aired its involuntary manslaughter. two-hour special A Leap of Faith, Paolo Macchiarini was As sensational as the Macchiarin Macchiarinii scandal is, there is at a charismatic thoracic surgeon, a moleast one way in which it is typical: distorcycle-riding Italian who did “the senters who try to use internal institun seemingly impossible, going where no tional channels to expose the abuse of other has yet dared.” After performing research subjects rarely succeed. Intera series of novel trachea transplants in nal channels failed with the Tuskegee Spain, Macchiarini was offered a facsyphilis study, with the “unfortunate ulty position at Stockholm’s prestigious experiment” at National Women’s Karolinska Institute, the home of the Hospital in New Zealand, with the raNobel Prize in Medicine or Physioldiation experiments at the University n ogy. There he began an even more auof Cincinnati, with the Protocol 126 dacious series of experimental treatments: transplants of a cancer trials at the Fred Hutchinson Cancer Center, and stem-cell–seeded stem-cell –seeded artificial trachea. Those transplants trans- with the Markingson and Huber cases at the Univer University sity of formed Macchiarini into a celebrity. Minnesota. Of course, it is possible that there are other, as As A Leap of Faith Faith was being filmed, Macchiarini de- yet-unkno yet-unknown wn cases in which institutions did the right thing clared his love for Benita Alexander, one of the film’s profor mistreated research subjects yet managed to keep the ducers. A proposal of marriage soon followed. Macchiarini entirety of the affairs quiet. But if the cases in my course said he had arranged for the wedding to take place at the are typical, it is only when the press exposes a scandal that Papal Palace of Castel Gandolfo, with Pope Francis offici- justice is done. ating and a guest list including the Obamas, Elton John, When social scientists ask witnesses to corruption or and Vladimir Putin. Alexander commissioned a celebrity safety violations why they remained silent, they usually designer to make her wedding gown, and she quit her job at get one of two answers. First, many people are afraid that NBC to move to Europe. Not until two months before the blowing the whistle will be futile; second, they’re afraid of wedding was scheduled scheduled did Alexander Alexander discover discover that that she had retribution. With medical research scandals, unfortunately, been conned. There would be no papal ceremony. The self- both of those fears appear well-founded. One of the most glorifying stories Macchiarini had told her were completely unusual things about the Karolinska Institute scandal is fabricated. the fact that Macchiarini was eventually punished. Many In February 2016, a week after these revelations appeared researchers who mistreat human subjects escape unscathed, in Vanity Fair , SVT, the Swedish national public televi- while the whistle-blow whistle-blowers ers who spoke out against them are vilified. And until that situation changes, witnesses to misCarl Elliott is a professor in the Center for Bioethics and the treatment will have little reason to speak out.
Internal channels usually fail.
Department of Pediatrics at the University of Minnesota. DOI: 10.1002/hast.704
