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Aug 1, 2005  Serious ethical lapses in every aspect of the healthcare industry have suddenly become commonplace as more and more people or companies entrusted with the health and welfare of the public are being caught in all types of highly questionable or even criminal conduct.

This conduct includes: duping seriously ill patients; withholding negative information; altering or falsifying records thereby jeopardizing the health of unsuspecting patients; Medicare fraud; failing to report medical mistakes and even suspicious deaths; violating federal and state laws; conducting misleading advertising campaigns; and misleading federal regulatory agencies.

These betrayals of the public trust can be separated into the following categories:

• Financial gain which relies upon: withholding negative information (research, tests, reports, complaints, etc.); altering or fabricating records; misleading or false advertising claims; or undue influence or conflicts of interest.

 • Fraud committed on Medicare or unsuspecting patient for financial gain.

• Avoidance of liability or preservation of reputation by questionable, unethical, or criminal conduct.

• Questionable research practices involving falsification or alteration of data, ignoring the use of flawed data, questionable interpretation of data, plagiarism, ignoring major aspects of rules governing studies with human subjects, and changing the designs, methods, or results of a study “in response to pressure from a funding source.” This conduct can be for financial gain, avoidance of liability, or advancement of reputation.

The Pharmaceutical and Medical Device Industries and Data Manipulation

The pharmaceutical and medical device industries often finds themselves in conflict of interest situations when dealing with the FDA and when releasing critical data and information about specific drug trials, adverse reactions, defects, and malfunctions.

These industries are bound by federal law and ethical standards to be forthcoming and honest about all relevant details concerning their products, even if unfavorable. Yet, exhibiting remarkably human-like behavior, they often withhold, misrepresent, delay, and otherwise improperly manipulate negative information in order to minimize or avoid harmful financial and legal consequences.

Pharmaceutical companies have: (a) ghostwritten medical journal articles relating to drug safety and trials; (b) delayed the completion of market studies and the subsequent release of the data related thereto; (c) prevented full disclosure about drug trials; (d) withheld important data from the FDA and the public; and (e) engaged in misleading, improper, and false advertising campaigns.

Fast-track approvals, which are usually based on short-term testing of small test groups, have had disastrous results when used for drugs which are specifically designed for long-term or lifetime use by large segments of the population.

Medical device manufacturers are no more credible or trustworthy than their drug manufacturing counterparts and have been caught engaging in similar bad acts.

Consider the following:

• A study published in the Journal of the American Medical Association (JAMA) in 2004 found that 65% of findings of harmful effects were not fully reported in medical-journal articles. Results are often “cherry-picked” so that only the positive data is published.

The JAMA study also found that 62% of trials had at least one piece of data or one result that was changed, added, or omitted to make the drug appear better.

• Federal law requires that pharmaceutical companies disclose all trial results to the FDA so that they can be used by doctors and academic scientists. There is yet to be a law that requires pharmaceutical companies to disclose this data to the general public. Some companies such as Eli Lilly have begun to post hundreds of trial results on the web while other pharmaceutical companies are reluctant to release that information.

Therefore, there is still no comprehensive database or list where the general public can go to when they want to find out more about any prescription drug. Patients simply do not have access to critical information which can be hidden by any company wishing to withhold unfavorable trial data.

• Recently, Eli Lilly came under scrutiny for suppressing reports relating to the potential increased risk of suicide risk suspected during early clinical trials. Current clinical trial data that has confirmed this elevated suicide risk. One trial showed that 3.7% of Prozac users attempted suicide while less than 1% of participants on non-SSRI depressants exhibited the same behavior. Thus, it is reasonable to assume that had there been full disclosure of the early trial data and reports, lives could have been saved.

• Merck & Co. is in the midst of a debacle relating to its COX-2 inhibitor, Vioxx. Many of the allegations of wrongdoing on the part of Merck relate to misrepresentation and suppression of clinical data and internal reports which disclosed the increased risk of heart attacks associated with the drug. Eventually, the risk was confirmed and the Vioxx was withdrawn from the market. Of course, Merck made billions of dollars from the sale of Vioxx while it was able to be kept on the market.

• Johnson and Johnson’s heartburn drug Propulsid has been linked to 80 heart-related deaths and 341 injuries. Despite the adverse effects associated with the drug, Johnson and Johnson did not conduct safety studies and pushed to keep Propulsid on the market. Even with strong black-box warnings on the drugs label, Propulsid was prescribed inappropriately to both adults and children. After five years of reported problems, Propulsid was pulled from the market in 2000. In 2004, Johnson and Johnson agreed to pay up to $90 million to settle pending claims relating to deaths and injuries from Propulsid.

• In the past few years, the FDA has been forced to issue dozens of warning letters to pharmaceutical manufacturers. The FDA Division of Drug Marketing, Advertising and Communications has about three dozen employees to review 30,000 to 40,000 Direct-to-Consumer (DTC) ads each year. Lester M. Crawford, then Acting Commissioner of the agency noted that “our patience is sometimes worn thin” by all the advertising claims.

Several times each year, the FDA issues warnings to pharmaceutical manufacturers for a variety of reasons associated with their advertising claims and marketing approaches. Unsubstantiated or exaggerated claims of effectiveness, advertising a drug for unapproved uses, minimizing or omitting information regarding side-effects, and improperly casting doubt on similar drugs manufactured by competitors are but some of the ways in which prescriptions drugs are over-promoted.

• Adrienne Fugh-Berman, a professor of alternative medicine at Georgetown University, claimed that she was asked to write an article for AstraZeneca about the adverse interactions associated with the combination of Coumadin, a blood-thinner, and dietary supplements and medicinal herbs. AstraZeneca hoped that this information about Coumadin would help them begin to market their own experimental blood-thinner, Exanta.

Fugh-Berman claimed that AstraZeneca then sent her the completed article with her name already on it, before she agreed to write anything. AstraZeneca denied the charge. Later on, Fugh-Berman was asked to review a paper for a medical journal which turned out to be the same paper she was previously asked to pass off as her own.

• In 1992, the FDA established an accelerated-approval program for new drugs which requires pharmaceutical companies to continue studying and monitoring a drug even after its market approval. Yet a review by Rep. Edward J. Markey, (D., Mass.) showed that pharmaceutical companies have not completed about half of these studies.

The Markey report indicated that out of 91 studies on 42 different products that were approved from 1993 to October 2004, 46 were completed, 42 were not completed, and three were delayed. Markey argued that “it is outrageous that drug companies and the FDA have been dragging their feet when it comes to conducting required post-marketing studies.” Markey plans to introduce a bill that would allow the FDA to state in a label whether or not a drug has received this accelerated approval so that the public is aware that the drug is still undergoing additional studies.

• Significantly, the FDA has funded the fast-track approval program with millions of dollars in order to ensure that potential blockbuster moneymaking drugs get to market on an accelerated basis. Thus, FDA has placed itself in a compromising position by accepting huge sums of money from the pharmaceutical industry to fund the agency’s Office of New Drugs which is now expected to “fast-track” drugs to market. That division has about 740 employees. Unfortunately, no such funding is given to the FDA for post-approval monitoring of adverse reactions and side-effects by the Office of Drug Safety which only has about 112 employees.

• On May 19, Able Laboratories stopped all shipments of its products. Four days later Able recalled its entire product line, suspended all manufacturing and withdrew seven approved applications to market various medications. The massive recall was based on what the FDA itself stated were “serious concerns that they (all of Able’s products) were not produced according to quality assurance standards.”

The FDA has now revealed that its drastic enforcement action was the result of agency inspectors having found massive record falsification and mismanagement by Able in order to elude FDA detection of several defective medications. Some of the violations included alteration and falsification of test data and covering up deficiencies by changing results. Able has been effectively put out of the pharmaceutical business as a result of its highly improper conduct.

• Hitachi warned by FDA about serious reporting violations and problems with respect to its MRI and PET equipment - On July 13, FDA issued an extensive warning to Hitachi Medical Systems America, Inc. The warning followed inspections of Hitachi’s medical device manufacturing facilities by an FDA investigator with respect to the magnetic resonance imaging (MRI) systems manufactured by Hitachi Medical, Tokyo, Japan which are medical devices as defined in section 201(h) of the Federal Food, Drug and Cosmetic Act (the Act).

The above inspection revealed that Hitachi’s devices are misbranded in that the company failed to furnish material or information required under the Act and the Medical Device Reporting (MDR) Regulation. Specifically, Hitachi had received complaints relating to four separate events for which it failed to submit an MDR to the FDA within 30 days of receiving information that the devices may have caused or contributed to a death or serious injury.

• On May 24, Guidant Corporation disclosed for the first time that it had waited three years before disclosing it had been aware of the electrical problem that had caused some 28 of these defibrillators to malfunction. The revelation came in the form of an alert to physicians which was not issued until Guidant learned that The New York Times was about to publish a story on the defibrillator.

In March, a 21-year-old college student, Joshua Oukrop, who required a defibrillator because he suffered from a genetic heart disease, died while on a spring break bicycling trip. These events prompted an investigation by the FDA.

As the story developed, however, the number of potentially defective defibrillators still in use reached almost 50,000; the 28,900 with the electrical problem and another 21,000 which could malfunction due to a computer memory error. There had been 2 reports of failures associated with these other models. Neither report involved injury or death.

Then, a third problem came to light with respect to another potential short-circuit risk associated with two other models. Out of those 16,000 devices, 15 reports of failures had been received including one involving a death on May 30.

As a result, Guidant issued recalls for all of these devices. Many experts are now questioning a monitoring system which essentially leaves the question of disclosure, with respect to potential flaws in such critical medical devices, entirely to the manufacturer.

In the Guidant case, it seems clear that the impending expose? by the New York Times, instead of 2 deaths and 45 reported failures, prompted the manufacturer’s belated revelations. Attorneys who are suing Guidant as well as many of their clients see Guidant’s long delay as a damaging admission by the company which they believe must be held accountable for its actions. None of this, however, even begins to address the problem of some 50,000 heart patients with implanted defibrillators being very jittery about their safety since, if normal heart rhythm is not restored, death will result within minutes.


Fraud has always been an especially dangerous practice when it invades the healthcare profession. Insurance fraud, improper Medicare bills, or the substitution of real treatments with bogus ones are all examples of fraudulent practices that occur within the healthcare industry. Sometimes the fraud costs money and sometimes the fraud injures or kills. Either way, the public suffers for the greed of others.

• In Southern California, doctors gathered hundreds of people, many of whom were recent immigrants, to voluntarily undergo routine medical procedures such as endoscopies or colonoscopies. Insurers were then billed tens of thousands of dollars for each routing procedure, the total amounting to somewhere around $500 million.

Insurers became suspicious when they observed that the patients in question had traveled hundreds or thousands of miles to undergo such routine procedures. Twelve Blue Cross and Blue Shield health-insurance plans sued the health care-clinics, physicians and others involved in this fraudulent practice. This is one of the first insurance fraud cases where individual doctors are named.

Perhaps the most disconcerting aspect of this fraud case is that these patients had to undergo procedures that exposed them to medical risks. Some of the volunteers received free or discounted cosmetic surgery while others got cash for their role in this fraudulent occurrence which is highly illegal with or without insurance fraud.

• As is often the case, money is also part of the problem. Simply stated, no medical facility wants to get rid of a good earner and, as luck would have it, doctors with disciplinary problems are often among the top third of moneymakers at their given hospitals. Doctors who are consistent and plentiful income producers are often praised for their ability to provide a constant patient stream to the hospital while actually avoiding punishment for any questionable practices resulting in preventable medical errors.

In this regard, consider the chilling situation that occurred at Redding Medical Center in California. One particular cardiologist was single-handedly responsible for making his small, rural hospital one of the most lucrative business enterprises for its owner, Tenet Healthcare. Unfortunately, the doctor was only able to do this by intentionally making false diagnoses of heart-related problems in order to justify performing hundreds, if not thousands, of unnecessary procedures and surgeries.

While other staff members were suspicious of the goings on at the hospital, their concerns were dismissed by their superiors until the scheme was exposed by one patient, a 55-year-old reverend, who sought a second opinion after he was told he needed emergency triple bypass surgery. A highly qualified cardiologist was shocked by the diagnosis and told the patient that his heart was in perfect shape.

Federal agents raided the hospital and Tenet was eventually forced to pay $54 million in penalties for the unnecessary heart procedures. This, however, does not change the fact that this single doctor was a staple at the Redding Medical Center for almost two decades and was being protected by his superiors who were only concerned with the enormous annual revenue he produced and not the quality or legitimacy of his practice.

 • In 2001, chiropractors received almost $285 million in improper Medicare payments. Medicare is only supposed to cover chiropractic care when there is a “reasonable chance of correcting a problem or improving the patient’s ability to function.” Yet the majority of the ineligible payments, totaling almost $186 million, were for routine maintenance treatments given to many people for the purpose of maintaining mobility and reducing pain.

• A federal grand jury in California recently indicted Orange County physician Dr. George Kooshian and his assistant, Virgil Opinion, for intentionally giving AIDS patients lower than the prescribed doses of medications while billing insurance companies for the cost of full treatments.

Allegedly, Kooshian ordered Opinion and other staff members to administer medication at 50% or even 25% of the prescribed dosage. In some cases, he is even accused of ordering saline or water injections be given in place of actual medication. An investigation into Kooshian’s offenses did not begin until after Opinion left her job in 2001. At that time, Opinion and a former patient Bryan Noble filed lawsuits stating that Kooshian charged as much as $7,000 dollars for treatments of saline. In a 2001 interview with the OC Weekly, Opinion made the accusations public.

According to U.S. Attorney Jeannie Joseph, the law suits were settled for an undisclosed amount. Joseph argues that while Kooshian’s actions may not directly have caused deaths, his preying upon vulnerable and suffering patients caused unnecessary distress for those who put their care in his hands. She remarks "We can't say with any certainty that what he did caused anyone's death, but it certainly affected his patients' quality of life."

 • In what can only be described as a despicable crime, two Canadians, Michael Reynolds of Toronto and John Armstrong, of Penticton, British Columbia, have been charged with promoting a worthless cancer treatment and bilking some 850 cancer patients around the world out of millions of dollars.

The treatments, which cost as much as $20,000, were marketed through seminars, brochures, telemarketing, and on the company’s website, which has now been dismantled. The so-called cell-specific cancer treatment, or "zoetron therapy," was supposed to treat lung, breast, prostate, skin, colon, and brain cancer by targeting and eliminating cancer cells without destroying healthy ones.

Patients were placed in machines that resembled those used for MRIs. However, Mark Stainsby, acting assistant deputy commissioner with the Competition Bureau's Ontario branch confirmed that: "We've had a number of experts look at the equipment, and that machine can't do any of those kinds of things that they've claimed,"

The former company, called CSCT, was based in Kitchener, Ontario, and Penticton, with out-patient clinics in the Dominican Republic, Mexico, Switzerland, and Spain. Authorities estimate that the company cheated unsuspecting and often desperate cancer patients out of $12.75 million from August 1996 to February 2003. Some 37 of the victims of the scam were Canadian. Many of those victimized have since died.

The two men are each charged with 10 counts of knowingly or recklessly making representations to the public that were false or misleading as well one count each for defrauding the public of more than $5,000. The reports of this disgraceful scheme have prompted outraged health-care activist groups to speak out. Joel Alleyne, executive director of the Canadian Health Care Anti-Fraud Association said: "To have somebody that is doing this at this time of people's lives, preying on them both financially and offering them false hope in this way, it's just unconscionable."

• UnumProvident, which is a giant conglomerate of Unum Life Insurance Company of America, The Paul Revere Life Insurance Co. and The Provident Life and Accident Insurance Co., has been repeatedly accused of wrongfully and systematically denying legitimate claims for which policyholders should have been covered.

Unum gave excuses to thousands of policyholders simply heard the same excuses as to why Unum had denied their claims such as allegedly failing to receive documentation on time and allegedly failing to receive medical reports to the condition involved was no longer a covered disability. Unum would also pay far less than a policyholder's regular income and then tell the policyholders they were never disabled and threaten that, unless the policy was surrendered, Unum would sue for all prior payments.

A class-action lawsuit was commenced and charged that UnumProvident operates "disability denial factories," wrongly denying disability claims by its policyholders. Some 2,500 individual policyholders also filed their own actions against UnumProvident. The lawsuit also claimed Unum used non-medical personnel to decide which claims to deny and then used its staff of 100 doctors to create a "paper trail" justifying the decision.

Last November, UnumProvident, Unum Life Insurance Co., The Paul Revere Life Insurance Co. and The Provident Life and Accident Insurance Co. agreed to settle a multi-state investigation affecting some 215,000 disability insurance claims denied by these companies since 1997. The settlement requires UnumProvident and its subsidiaries: (1) to reassess approximately 215,000 claims that previously had been denied; (2) to completely restructure their claim handling procedures to ensure objectivity and fairness; and (3) to pay a $15 million fine.

• The FBI, the Florida Department of Health, and local law enforcement agencies are investigating allegations that some storefront clinics in Broward County are paying HIV-positive homeless people $100 to $300 to undergo expensive and unnecessary medical tests which the clinics then bill to Medicare for reimbursement.

Medicare officials became aware of this rip-off in 2003 and have been attempting to end it ever since. The scam begins when clinic recruiters go to homeless shelters and drug treatment programs in the Fort Lauderdale area to find poor people who are HIV-positive. Many of these unfortunate souls already qualify for Medicare.

The recruiters offer these “patients” cash to board vans to travel to the clinics for injections costing up to $6,000 a session. The investigation has led to three arrests at the R.A. Medical Center in Little Havana, Miami-Dade County. In addition, Medicare has blocked $214.5 million in claims from these clinics and suspended more than 24 providers.

Many of the clinics are still open for business, however. ''I don't see why this isn't being yelled from the rooftops,'' said Ken Fountaine, a staff member at Shadowood II, a Fort Lauderdale shelter for the homeless with HIV/AIDS. ``They're taking advantage of the lowest of the low. I don't understand why they can't go there and shut them down right now.''

The Miami Herald has been following this story. Medicare’s computers have been set up to ''red flag'' and block certain providers and patients connected with this investigation. In the five months these new programming protocols have been in place, Medicare has stopped $144.5 million in payments to suspect clinics.

One bogus patient showed the Miami Herald bills that show she was given injections of immune globulin at $6,000 each. Medicare paid for at least two at $4,092.96 each. The patient said she and others were paid $100 each time they visited the clinic.

Many activists and AIDS specialists believe any clinic that pays people to become patients should be immediately suspect. Some doctors are even aware that their patients are being paid up to $300 a visit for one to three unnecessary trips a week to clinics. Desperation drives many of these homeless people into the scam.

Avoidance of Liability

Although avoiding liability is a prime objective of most businesses, the practice can be quite dangerous when it is committed by pharmaceutical companies, medical device manufacturers, hospitals, or doctors. Since all of these entities are extremely concerned with protecting their reputation and financial wellbeing, they will often to go great lengths to avoid liability by not reporting adverse reactions, medical errors, defective equipment, and even suspicious deaths.

• A recent survey of more than 200 hospital executives in six states found that the majority believe that mandatory public reporting of medical errors made in hospitals would lead to fewer errors being reported and would not improve patient safety.

These executives also claimed that full disclosure of medical errors made by hospital personnel would only lead to more lawsuits. Some hospitals have voluntary reporting systems while others have begun to use a mandatory reporting system.

Advocates of patient-safety have argued that medical professionals need to be more accountable to the public for their errors. In 1999, a study at the Institute of Medicine found that between 44,000 and 98,000 patients die in hospitals every year as a result of medical mistakes.

 • In April 2005, the prestigious New York-Presbyterian/Columbia Hospital admitted that a patient's death in March 2005 it had originally claimed had not been caused by Legionnaires' disease was, in fact, caused by that very illness. The hospital was forced to reverse itself on April 26, 2005 when an autopsy showed that the disease had indeed led to the death. The hospital also said that the bacteria associated with the disease were found in the water supply of two of its buildings even though the water was routinely treated to kill the bacteria.

• On May 24, Guidant Corporation, manufacturers of an internal heart defibrillator, disclosed for the first time that it had waited three years before admitting it had been aware of the electrical problem that had caused some 28 of these defibrillators to malfunction. At least two people died as a result of the defects and tens of thousands more remain at risk by keeping these flawed products which should have been pulled from the market as soon as Guidant became aware of the danger.

 • In the last decade, 84% of Health Maintenance Organizations (HMOs) and 60% of hospitals failed to report medical errors to the government, allowing many health care professionals to literally get away with murder. Many experts see this disregard of reporting requirements as being as close to having a “license to kill” as you can come without being James Bond.

Consider the recent case of Charles Cullen, a registered nurse who may have killed as many as 40 patients at 10 hospitals in New Jersey and Pennsylvania over the course of 16 years. Although Mr. Cullen was investigated on a number of occasions with respect to misusing potentially lethal drugs and was fired or allowed to resign from a number of hospitals, he was permitted to “hopscotch” from hospital to hospital without the slightest difficulty.

Questionable Research

Another major problem facing the public today is the apparent regularity and ease with which scientific research is tampered with, falsified, and manipulated. Pharmaceutical companies have also engaged in highly questionable practices in order to influence the creation of and conclusions reached in reports and studies involving their own (or even competitor’s) products. This is by far one of the most disconcerting and frightening practices occurring in the medical profession.

• Chester Douglass, a professor at the Harvard School of Dental Medicine was accused of covering up data that suggested a link between fluoridated tap water and osteosarcoma, a rare form of bone cancer, in adolescent boys. He is currently being investigated for claiming that there is no correlation between fluoride and osteosarcoma when previous research and data suggests otherwise.

In fact, his own doctoral student came forward with data from Douglass’s study which concluded that: “Among males, exposure to fluoride at or above the target level was associated with an increased risk of developing osteosarcoma. The association was most apparent between ages 5-10 with a peak at six to eight years of age.”

Douglass’ attempt to falsify and cover-up his data is an incredible breach of the public trust. In addition, Douglass was editing a newsletter funded by Colgate-Palmolive Co. which creates a serious conflict of interest since Colgate-Palmolive manufactures toothpaste with fluoride.

• In 1996, Dr. Andrew Friedman was caught faking data in some of his studies that had been published in medical journals. Investigators found that he had been making up information relating to hormonal treatment for gynecological conditions and this information had passed through peer reviews to become published data. He agreed to be excluded from working on federally funded research for three years.

• This past year, Eric Poehlman, a professor at the University Of Vermont College Of Medicine, was charged with falsifying research data on issues like menopause, aging, and hormone supplements in order to receive millions of dollars in grant money from the federal government.

• In November 2004, Dr. Ali Sultan was discovered to have plagiarized tests and data in his malaria study but substituting results from one type of malaria for another. When charged, he placed all the blame on a postdoctoral student. He later resigned and became a faculty member at the Cornell Medical College in Qatar.

 • Anne Butkovitz, a coordinator at a pediatric practice involved in an FDA approved clinical study, has been charged with falsifying data with respect to follow up contact information she was supposed to obtain directly from the parents of children vaccinated with an experimental rotavirus vaccine. Rotavirus causes severe diarrhea in infants. The purpose of the follow-ups was to determine if there had been any serious adverse experiences (SAEs).

It is alleged that Ms. Butkovitz did not make the required contacts and yet claimed that she had on report forms. In one case, she is accused of having actually falsified information with respect to the SAEs of a patient enrolled in the clinical study. As a result of Ms. Butkovitz’s actions, the pharmaceutical company involved removed the pediatric practice she was employed by from the study and disregarded the data it had generated.

• A survey involving 3,247 scientists who were based in the United States and who had received funding from the National Institutes of Health revealed that about 33% of the participants stated that, within the previous three years, they had engaged in at least one practice that could get them into trouble.

The types of questionable conduct included circumventing minor aspect of rules for doing research on people (8%) and ignoring another researcher’s use of flawed data or questionable interpretation of data (about 13%). Less than 2% admitted falsifying data, plagiarism, or ignoring major aspects of rules governing studies with human subjects. Surprisingly (or maybe not so surprisingly), almost 16% admitted they had changed the designs, methods, or results of a study “in response to pressure from a funding source.”

 • The National Institutes of Health (NIH) is conducting an internal review with respect to consulting payments from pharmaceutical companies to scientists employed by the agency. Of the sample, more than half (44 of 81) admitted to conduct which violated one or more NIH rules. Of those, 36 are still employed by the agency and were referred for possible disciplinary action. Nine of those 36 have also been referred to the HHS Office of Inspector general for further investigation. The 8 who left the agency are not subject to administrative action.

The House Energy and Commerce Committee requested the review after comparing NIH records to consulting agreements maintained by 20 pharmaceutical companies. The Committee found 81 cases between 1999 and 2004 where the agreements were not listed in the NIH records provided to the committee.

Excerpts from the findings of the investigation, provided by NIH Director Elias A. Zerhouni to three members of Congress included the following statement: "We discovered cases of employees who consulted with research entities without seeking required approval, consulted in areas that appeared to conflict with their official duties, or consulted in situations where the main benefit was the ability of the employer to invoke the name of NIH as an affiliation.” Although Zerhouni requested the release to Congress to be treated as confidential, Committee leaders released it as a matter of compelling public interest.


The above examples of unethical, dangerous, and criminal conduct, although extensive, only tell a small part of the story. Many more similar situations have occurred and are presently occurring. Many more will never come to light.

The public has suffered and continues to suffer from this complete breakdown in ethical and moral standards throughout the healthcare field. Each act of wrongdoing either costs members of the public vast sums of money or threatens their very lives.

Whether for financial gain, avoidance of liability, or advancement of reputation, none of this outrageous conduct can be justified in the slightest. In the end, this behavior is no different than the highwaymen of old demanding “your money or your life.”

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