Representative Rick Hansen Chair, Legislative Audit Commission Evaluation Subcommittee 247 State Office Building 100 Rev. Dr. Martin Luther King Jr. Blvd. Saint Paul, Minnesota 55155 March 20, 2015 Dear Representative Hansen: We, the undersigned, have been actively seeking an independent investigation of psychiatric drug testing at the University of Minnesota. Last spring, the Office of the Legislative Auditor was asked to investigate how many research subjects had died or been seriously injured in psychiatric drug studies at the university over the past decade, as well as the circumstances surrounding those deaths and injuries. Yesterday, the Legislative Auditor delivered a solid report on one of those deaths: that of Dan Markingson, who committed suicide in an antipsychotic research study at the university in 2004. It found evidence of coercion, multiple conflicts of interest, inadequate research protection, and a pattern of defensive, insular, misleading public statements by university leaders designed to prevent an investigation of just this sort. But this report examined only one case out of many. Given these findings, as well as the damning external review of research protection delivered to the university earlier this month, there is every reason to believe that many more subjects have been coerced into research studies, and that many more subjects have died or been seriously injured in those studies. For this reason, we urge the Legislative Audit Commission in the strongest possible terms to authorize the Office of Legislative Auditor to continue its investigation into psychiatric research misconduct at the University. What is especially alarming to us has been the uniform response of university leaders to any effort at public scrutiny. At every turn, our efforts to have serious ethical problems investigated have been rebuffed by the Board of Regents, the President, and his management team. The most egregious response came in 2008, when University lawyers filed a legal action against Mary Weiss, the mother of Dan Markingson, demanding that she pay the university $57,000. Later, Mary Weiss and Mike Howard were physically escorted from the President’s office by security guards simply because they sought a meeting. Last summer, the Dean of the Medical School, Brooks Jackson, issued a formal reprimand against Professor Carl Elliott for his refusal to “retract” a lecture at Hamline University about the Markingson case. Both Leigh Turner, a faculty member in the Center for Bioethics, and Niki Gjere, a psychiatric nurse at University of Minnesota Medical Center – Fairview, have endured harassment and been subject to a hostile work environment.

Both the Legislative Auditor’s report and the external review singled out the leadership of the University as the most serious barrier to reform. The external review team said their most striking finding was “the commonly conveyed sense of doubt in leadership’s commitment to human subjects protection.” The Legislative Auditor’s report went even further, calling out the university’s leadership for misleading the public about the Markingson case, especially the claim that the case had been “exhaustively reviewed.” Although these claims have been repeatedly discredited as false, university leaders continued to make similarly misleading statements about the case in the hearing room on Thursday. President Kaler’s response to the audit largely repeated the discredited propaganda that has been the hallmark of the cover-up. He claimed that no previous review “reported regulatory violations or alerted us to ethical breaches.” This is false. Not only did reports by the Board of Social Work and Office of the Ombudsman for Mental health and Developmental Disabilities alert the University to serious ethical breaches, but the University’s handling of the Markingson case has generated international condemnation. The case has been reported in Science, which is arguably the most important scientific publication in the world; three former editors of the New England Journal of Medicine joined 175 international experts in calling for an investigation; The Medical Journal of Australia even compared the Markingson case to the Tuskegee syphilis scandal. In fact, Carl Elliott informed President Kaler of the serious misconduct in the Markingson case even before President Kaler arrived at the University. Yet President Kaler has repeatedly refused to meet with Elliott or Leigh Turner to discuss the case. We believe the Board of Regents, the President and his management team should be held to the same standards of truthfulness as apply to the faculty and students of the University. If a student propagates deceit and advances falsehoods as truths he will be punished and likely expelled. And if a faculty member did exactly what the President and the Board of Regents have done, they would be up for removal. Why should University administrators and leaders be held to lower standards? We believe that it is imperative that the Legislative Audit continues in order that the full truth can be disclosed. Respectfully submitted, Arne H. Carlson, former Governor of Minnesota Carl Elliott, Professor, Center for Bioethics, University of Minnesota Leigh Turner, Associate Professor, Center for Bioethics, University of Minnesota Mike Howard, retired, family friend of Mary Weiss Niki Gjere, Clinical Nurse Specialist, University of Minnesota Medical Center

Cc Rep. Connie Bernardy, Sen. Mary Kiffmeyer, Sen. Warren Limmer, Rep. Phyllis Kahn, Rep. Duane Quam, Sen. Michelle Benson, Sen. Linda Runbeck, Sen. Jim Metzen, Sen. Roger Reinert, Sen. Sondra Erickson, Sen. Ann Rest