The following article is reprinted with the permission of the author. It first appeared in the University of Calgary Faculty Association newsletter, "Interview", May 1999.
The Greatest Academic Scandal of Our Era
by James Turk, Executive Director, CAUT
"The greatest academic scandal of our era" is how Professor Arthur Schafer, Director of the Centre for Professional and Applied Ethics at the University of Manitoba, has described the widely-reported case of Dr. Nancy Olivieri. The experiences of Dr. Olivieri highlight the question about the proper relationship between university researchers and private industry.
Dr. Olivieri is a clinical professor at the University of Toronto and the Hospital for Sick Children and a world expert on the blood disorders -- thalassimia and sickle cell disease. Her clinical research program in Toronto is the key link in an international chain of research centres focusing on these diseases.
In the course of her research on a new medication to treat thalassimia, Dr. Olivieri concluded that the new drug may have serious negative consequences for some patients. She felt obliged to publicize her findings but was threatened with a lawsuit by Apotex, Inc., a Canadian drug maker that had been funding her clinical trials. Dr. Olivieri had signed a confidentiality agreement with Apotex some years earlier.
Dr. Olivieri turned to the Hospital for Sick Children and the University of Toronto for support in her quest to fulfil her medical and public responsibility to publicize her findings. She found no support. Nevertheless, she informed her Research Ethics Board, her patients and the federal regulatory bodies. She then published her findings in the New England Journal of Medicine. Subsequently, the Hospital stripped her of her responsibilities as director of its haemoglobinopathy program, and the University of Toronto refused to intervene with the Hospital or Apotex. During this period, the University was negotiating with Apotex for a multimillion-dollar donation to the University for a new medical building.
After considerable pressure from Dr. Olivieri's colleagues and other researchers as well as substantial media attention, the Hospital unilaterally set up a limited review process headed by Dr. Arnold Naimark, a former president of the University of Manitoba. His impartiality was in question because the U of M had received a donation from Apotex during his presidency. Amidst considerable criticism of the inquiry, Dr. Naimark added two additional inquiry members after most of the inquiry's work was completed.
At that point, last November, the Canadian Association of University Teachers (CAUT) jumped into the fray. CAUT Council unanimously passed a resolution deploring the actions of the Hospital for Sick Children and the University of Toronto. CAUT called for a genuinely independent inquiry and asked CAUT's Academic Freedom and Tenure Committee to examine the matter.
In mid-December, the University of Toronto Faculty Association (UTFA) filed grievances on behalf of Dr. Olivieri and several of her colleagues who had also been disciplined by the Hospital charging the University of Toronto with failing to protect their academic freedom and to protect them from discrimination, harassment and intimidation. It also filed an Association grievance charging the University with violating policies guaranteeing faculty members certain rights and freedoms.
Later, it was learned that the very same day the Hospital had had a secret meeting of its chiefs of services and decided to fire Dr. Olivieri as Director of the Haemoglobinopathy program because they objected to the tone of a letter written by Dr. Olivieri's lawyers. But it was not until January 6, 1999, that Dr. Olivieri was informed of her dismissal as Director. Simultaneously, Dr. Olivieri and three of her colleagues -- including the head of cystic fibrosis research, the head of blood and cancer research and a senior research colleague of Dr. Olivieri -- were slapped with a gag order forbidding them to talk with the media except if authorized by the Hospital. The reason given for Dr. Olivieri's dismissal bore no resemblance to the minuted item for the December "chiefs" meeting. The Toronto Globe and Mail published a leaked copy of that meeting's minutes.
CAUT and UTFA held a press conference the next day, denouncing Dr. Olivieri's dismissal and demanding her immediate reinstatement. Letters from eminent researchers from around the world began to pour into the Hospital and the University, expressing outrage at the treatment of Dr. Olivieri and her colleagues.
The University and the Hospital remained unmoved. When CAUT and UTFA discovered, days later, that the affiliation agreement between the University and the Hospital had expired on December 31, both organizations approached the University and insisted that it not renew the agreement until full academic freedom for clinical faculty at the Hospital was assured. Two days later, in secret, the University renewed the agreement without the necessary assurances of academic freedom.
CAUT asked several of the world's leading medical researchers to come to Toronto to intervene in this matter. Sir David Weatherall of Oxford; Dr. David Nathan, head of the Dana Farber Cancer Institute at Harvard; Dr. John Porter, Professor of Medicine at University College, London; and Dr Alan Schechter of the National Institute of Health in Bethesda, Maryland, all accepted the invitation and came to Toronto. All are experts on clinical trials and haemoglobinopathies.
Drs. Porter and Schechter undertook a review of Dr. Olivieri's program and Drs. Nathan and Weatherall joined CAUT President Bill Graham, CAUT AF&T Chair Pat O'Neill, representatives of UTFA and of the researchers in a series of meetings with U of T President Rob Prichard and other U of T and Hospital officials.
The meetings won vindication for Dr. Olivieri and her colleagues. Dr. Olivieri was reinstated as head of her research program, reporting directly to the Toronto Hospital's Physician-in-Chief, and remains on active staff at the Hospital for Sick Children. The HSC will cover her legal costs up to $150,000 and will assume responsibility for legal costs should Apotex sue her for releasing her research findings. Dr. Olivieri will receive a 6-week "mini-sabbatical" now and a 12-month paid sabbatical within the next three years. The HSC has withdrawn its gag order, and the U of T's Dean of Medicine has agreed to provide Dr. Olivieri with an additional $45,000 in each of the next two years for senior research support.
This agreement leaves unresolved the larger issue of academic freedom for clinical faculty. As well, there still has been no proper investigation of the attempts to prevent Dr. Olivieri publishing her findings nor a revised agreement with the Hospital to prevent such occurrences in future.
CAUT's Academic Freedom and Tenure Committee is continuing its review of the case. CAUT is also asking all faculty associations at universities with medical schools and teaching hospitals to gather the university-hospital affiliation agreements. CAUT will systematically review these agreements and report on their findings.
CAUT is also exploring the broader issue of corporate-university partnerships and what is required to assure academic freedom and university autonomy.