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Surgeon promotes fraudulent research that kills people; his employer, a leading hospital, defends him and attacks whistleblowers. Business as usual.

Paul Alper writes:

A couple of time at my suggestion, you’ve blogged about Paulo Macchiarini.

Here is an update from Susan Perry in which she interviews the director of the Swedish documentary about Macchiarini:

Indeed, Macchiarini made it sound as if his patients had recovered their health when, in fact, the synthetic tracheas he had implanted in their bodies did not work at all. His patients were dying, not thriving.

In 2015, the investigator concluded that Macchiarini had, indeed, committed research fraud. Yet the administrators [at Sweden’s Karolinska Institute] continued to defend their star surgeon — and threatened the whistleblowers with dismissal.

But then there was the fact that the leadership of the hospital and the institute had, instead of listening to the complaints, gone after the whistleblowers and had even complained [about them] to the police.

What was he thinking???

Check out this stunning exchange from the interview:

MinnPost: Did you come to any conclusion about what was motivating [Macchiarini]? It seemed at times at the documentary that he really cared about the patients. He seemed moved by them. And, yet, he then abandons them. He doesn’t follow up with them.

Bosse Lindquist [director of the documentary about this story]: I think that he feels that he deserves success in life and that he ultimately deserves something like a Nobel Prize or something like that. He thinks the world just hasn’t quite seen his excellence yet and that they will eventually. He believes that he’s helping mankind, and I think that he construes reality in such a way that he actually thinks that he was doing good with these patients, but that there were minor problems and stuff that sort of [tripped him up].

This jibes with my impressions in other, nonlethal, examples of research incompetence and research fraud: The researcher believes that he or she is an important person doing important work, and thinks of criticisms of any sort as a bunch of technicalities getting in the way of pathbreaking, potentially life-changing advances. And, of course, once you frame things in this way, a simple utilitarian calculation implies that you’re justified in all sorts of questionable behavior to derail your critics.

All of this is, in some sense, a converse to Clarke’s Law, and it also points to a general danger with utilitarianism—or, to put it another way, it points to the general value of rules and norms.

And what about the whistleblowers?

MP: And what about the whistleblowers? Have they been able to go back to their careers without any professional harm?

BL: No. Two of them have had to change cities and hospitals. Two are still there, but they have been subjected to threats from management and from some of their colleagues who were involved with Macchiarini. They have not received any new grants since this whole thing happened. It’s a crying shame.

MP: That’s quite a terrible outcome, because that may stop other people from stepping forward in similar situations.

BL: Exactly.

MP: Do you feel that everyone who was responsible for ignoring the warnings about Macchiarini has resigned or been fired?

BL: No, no, no. A number of people are still there and have their old jobs and just carry on. Some have been forced to change jobs, to get another job — but in some other function within the hospital or in the government.

And, finally . . .

This:

MP: What has happened to the patients. One was able to successfully have the tube removed, is that correct?

BL: Yeah. One person.

MP: And everybody else has died?

BL: Yes.

The whole thing is no damn joke.

I originally called this “research-lies-allegations-windpipe update update,” but I can’t laugh about this anymore, hence the revised title above.

P.S. Alper writes:

According to the NYT’s Gretchen Reynolds, the Institute is looking into breathing again:

Two dozen healthy young male and female volunteers inhaled 12 different scents from small vials held to their noses. Some of the smells were familiar, like the essence of orange, while others were obscure. The subjects were told to memorize each scent. They went through this process on two occasions. For one, they sat quietly for an hour immediately after the sniffing, with their noses clipped shut to prevent nasal breathing; on the other, they sat for an hour with tape over their mouths to prevent oral breathing.

The men and women were consistently much better at recognizing smells if they breathed through their noses during the quiet hour. Mouth breathing resulted in fuzzier recall and more incorrect answers.

But, no numerical notion of “how much better.” And only “two dozen” subjects? Despite the defrocking of Paolo Macchiarini, the Karolinska Institute is undoubtedly still solvent so it seems strange that it undertakes a study that is more typical of a psychology professor, who has little or no funding, and seeks a publication using his students as convenient subjects. One is reminded of the famous sweaty T-shirt study.

I guess there’s always a market for one-quick-trick-that-will-change-your-life.

14 Comments

  1. jrkrideau says:

    Whistle blowers are almost always attacked for their actions, up to the point of death threats and, IIRC, there are some suspicions of actual murders but it is long enough ago that I don’t have the references.

    It usually is a career destroying action in any large organization. You may find your duties to suddenly be reduce to showing up or you may be transferred to the Fort Conger branch office and so on.

    In extreme cases such as Julian Assange you can find yourself living in a closet in an embassy somewhere.

    That nose study sound like fun. And extremly crappy. I’d say it looks like a Clarke’s Law contender.

    • There can be happy endings for whistleblowers, though: “Duke University settles research misconduct lawsuit for $112.5 million” “… [whisteblower] Joseph Thomas… could receive as much as 30% of any settlement reached between the United States and the university. (RetractionWatch has reported Thomas will receive $33.8 million.)” I don’t know more about the story.

      • Thanatos Savehn says:

        I know something about the meta-story. Several law firms are putting together practice groups to either go after or defend universities engaged in such behavior. Indeed I got a flyer on the subject just the other day. Such qui tam cases are usually triggered by disgruntled employees; and from what I see on academic Twitter there are a lot of bitter young academics out there. When Uncle Sam starts deputizing greedy lawyers to uncover federal payments made to unis under false pretenses (will QRPs count?) it’s time to either circle the wagons or make sure the research promises the institutions have made are being, to the best of their ability, kept – because once the battle’s in earnest even the innocent tend to get targeted.

        • Interesting – so more universities should consider what the University of Toronto has in place now “Post-Approval Reviews that our REB started last year [2016] as this is now mandated. We do random checks to see if the ethics protocol is being followed – this includes looking at how data is handled and stored.”

          • Brent Hutto says:

            I’m not sure such “data is handled and stored” initiatives are related to how research is carried out, much less to straightforward research fraud. At most institutions, these reviews are being driven by intense worry over potential breaches of research-participant privacy, confidentiality or identities.

  2. Ethan Bolker says:

    Recommended read:

    Annals of Health Care

    February 4, 2019 Issue

    The Personal Toll of Whistle-Blowing

    Why one physician took the risk of becoming an F.B.I. informant to expose alleged Medicare fraud.

    By Sheelah Kolhatkar

    https://www.newyorker.com/magazine/2019/02/04/the-personal-toll-of-whistle-blowing

  3. If you want to support whistleblowers, you can donate to https://www.whistleblower.org/.

  4. jrc says:

    If KI has decided to move away from experimental death medicine and towards noise-mining for psycho-pop, I’m cool with that.

  5. Greg Francis says:

    I think the P.S. is rather unfair. Macchiarini sounds like a bad person, and the administrators at the Karolinska Institute deserve some scorn for how they handled his fraud. But for the post to then critique work done by other researchers at KI makes an implicit argument of guilt by association. Why not evaluate the new work on its own merits?

    Indeed, the critique of that work seems little more than an abstract complaint about a small sample (the other complaint about “how much better” can easily be answered by reading the journal article–so that complaint is really about the NYT’s reporting). A critique about sample size could be appropriate, but only by looking at the details. I’m not an expert on this field, but there are aspects of memory that are reliably reproduced by (almost) every subject (almost) every time an experiment is run. Labs 16-33 at

    https://coglab.cengage.com/labs/labs.shtml

    pretty much work for everyone in a very unstructured environment (across the Internet). [The labs are part of a textbook and so require paid access. I can provide login information to anyone who wants try out the labs. Just email me.] I am not saying that the KI’s investigation of breathing and recognizing smells is as reliable as these experiments; but since a sample of 1 subject is sometimes sufficient, it seems plausible that a sample of 24 subjects is more than enough for their study.

    Disclosure: I do not know any of the authors of the KI study, but a friend recently joined that lab and I will be visiting this summer.

    • Andrew says:

      Greg:

      Thanks for the comment. Without passing any opinion on the study describes in the P.S., let me just express agreement with your general point that, yes, we can learn from N=1 or small-N studies. In such cases, I think it’s typically important to gather a lot of relevant information on the few people in the study.

      Regarding unfairness: It could well be that the P.S. is unfair to the Karolinska Institute. But I don’t think it’s unfair to the New York Times which reported this smell study under the headline, “Breathing Through the Nose May Offer Unique Brain Benefits.”

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