Termination of Baclofen Study at UofL Discloses Influence of Catholic Health Initiatives on University Research.

Informed consent forms reflect Ethical and Religious Directives of the Catholic Church.

A recent report by Kate Howard of the Kentucky Center for Investigative Reporting on the withdrawal of federal funding for a University of Louisville research study conducted at Frazier Rehabilitation Hospital shines a bright light on how research –specifically research involving human subjects – is performed at the University of Louisville and in its partner institutions. The specific research protocol in question, directed by UofL faculty member, Dr. Susan Harkema, was intended to examine if adding the muscle relaxer Baclofen to a regimen of physical therapy on a treadmill improves or worsens function in patients who are partially paralyzed as a result of spinal cord injury.  The study holds out what is in my opinion an insufficiently proven hope of a possible increase in ability to stand or ambulate. Many aspects of the study were criticized by both federal authorities and by the university’s own investigation. I believe those criticisms to be valid but will not address them in this article.  In my own professional opinion, the study as designed and conducted had very little chance of producing meaningful data in any event.

Informed consent – The ethical core of human subject research.
Human subject research must be reviewed and approved by the University of Louisville’s research Institutional Review Board (IRB) using a rigorous national set of requirements and guidelines designed to put the interests of the research subject first. These rules comprise a ‘Federal Policy for the Protection of Human Subjects’ and collectively are called the ‘Common Rule‘.   Violation of the Common Rule can result not only in grant support being withdrawn as it was here in Louisville, but in prohibition of future human subject research.  To put things in perspective, this would be the equivalent of a death-sentence penalty from the NCAA.  By contract, KentuckyOne has agreed to use the UofL IRB to supervise research performed in its facilities, including in University of Louisville Hospital.

Problems with informed consent.
The IRB’s own recent internal investigation revealed that that some Baclofen study participants signed the wrong consent forms.  Specifically, this had to do with whether or not the research subject was aware that they would be personally responsible to pay for the (expensive) experimental physical therapy that is at the center of the research protocol.  Initially some subjects were surprised to get very large bills for their participation on top of the unreimbursed travel and housing expenses required for the several-month study. The consent form had been changed by the IRB to make it clear that there were financial implications to participation.

I too was concerned about the informed consent forms used, but for a very different and profoundly more significant reason.  In my opinion, full informed consent was not being given.  Additionally, the template consent form required by the University of Louisville’s IRB had been altered to conform to the religious tenants of the Roman Catholic Church – changes which I and others had been promised would not occur.  If these alterations to the standard informed consent form template were made without the documented express permission of the IRB, this would constitute a major violation of research protocol and ethics.  If my University’s IRB did in fact approve the changes, my earlier concerns have been realized and I am ashamed for it.  Let me explain. Continue reading “Termination of Baclofen Study at UofL Discloses Influence of Catholic Health Initiatives on University Research.”

Meeting Tomorrow of UofL Trustees to Consider Resignation of President James Ramsey.

sign[Addendum 26 July:  Meeting cancelled this morning!  This is what I was met with with I showed up.]

Another short-notice meeting of the possibly legally appointed UofL Board of Trustees is scheduled for tomorrow.  The first item on the published agenda is consideration of the resignation of President James Ramsey. The next and only other item on the agenda, making it seem like a decision has already been made, is consideration of transition planning and search for a next president.

I was unable to make it the last meeting and was preparing an analysis of the reports in the Courier-Journal, Kentucky Center for Investigative Reporting, Insider Louisville, WDRB-41, and the Louisville Cardinal.  I will submit my additional thoughts later, along with a summary of tomorrow’s meeting.

Buy-out?
In interviews over the past weeks was mention of a buy-out of Dr. Ramsey’s contract.  One question that I hope will be asked tomorrow is, “if President Ramsey has resigned, why is an issue of buy-out even be on the table?”  Surely given all that has come before, no additional financial burden should be placed upon the shoulders of an already debt-burdened student body. The presence of student questioners clearly influenced the outcome of last week’s consideration of the University’s budget with its 5% raise in tuition.  Additional seven-figure payments to Dr. Ramsey will surely raise objections by others than myself.

We shall see what we shall see.

Peter Hasselbacher, MD
Emeritus Professor of Medicine, UofL
25 July 2016

Surprise Full UofL Board Meeting Today.

With 24 hours of notice, a meeting of the full newly appointed University of Louisville board of Trustees will be held. A main item on the limited agenda is approval of a budget for the current academic year. It contains the controversial 5% tuition increase and at least one other mandatory fee increase directly affecting students. I suspect that President Ramsey and /or his aids felt great pressure to approve a budget before the judicial hearing today in Frankfort following which the very legitimacy of the Board may be prolonged for some time more.

It is difficult to believe there has not been much discussion among Board members and the administration ahead of this meeting out of public view. I wonder how that could have been done without triggering open meeting requirements? The fiasco of the first meeting of this Board over apparent violation of open meeting law sharpens the focus on how the University and its Board of Trustees conducts their business. If the matter today is handled in a rubber-stamp manner we will be able to see the future. No human being can grasp the UofL budget in a single week! Continue reading “Surprise Full UofL Board Meeting Today.”

President Ramsey Leaves Board Meeting Abruptly and Did Not Return.

Ibevin-ramsey07132016n what began as a routine initial Board of Trustee meeting in which Governor Bevin began in person with an expression of gratitude to the new members has progressed in a dramatic way.  In the middle of the Executive session in which personnel  matters were discussed, President Ramsey was quickly accompanied out without allowing opportunity for questions.  His spokesperson told the assembled reporters that Dr. Ramsey would not be returning to the meeting and would have no comment.

When the Executive session was over, the rest of us reentered the meeting room to a panel of very sober/glum/subdued faces. New Chairman Pro Tem Bridgeman reported that personnel and litigation had been discussed but that no decisions were made and that there was nothing to report. The meeting was concluded quickly thereafter. Continue reading “President Ramsey Leaves Board Meeting Abruptly and Did Not Return.”