Opinion Today: How the morally unthinkable comes to seem normal

Speaking out about wrongdoing requires being able to recognize it for what it is. [View in browser](~/AAAAAQA~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)|[nytimes.com](~/AAAAAQA~/RgRoIeLyP0SxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwNTExJmluc3RhbmNlX2lkPTEyMzAyOCZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNjYzNDMmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) [Ad](~/AAAAAQA~/RgRoIeLyP0SlaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9MTYyMTM5JmxpPVRZJm09YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDcmcD1UWV8yMDI0MDUxMSZzdHBlPWRlZmF1bHQmdGU9MSZubD1vcGluaW9uLXRvZGF5JmVtYz1lZGl0X3R5XzIwMjQwNTExVwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) [Opinion Today](~/AAAAAQA~/RgRoIeLyP0TAaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vc2VjdGlvbi9vcGluaW9uP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwNTExJmluc3RhbmNlX2lkPTEyMzAyOCZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNjYzNDMmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) May 11, 2024 Medical traditions are notoriously difficult to uproot, and academic medicine does not easily tolerate ethical dissent. I doubt the medical profession can be trusted to reform itself. [A photograph of two forceps, placed handle to tip against each other. ] Lindsey Beal By Carl Elliott Dr. Elliott teaches medical ethics at the University of Minnesota. Several years ago, I started teaching a class on medical research scandals. It is easily the most demoralizing class I’ve ever taught: All scandals, all the time, for an entire semester. My reasons for teaching the class were personal. I had just emerged from a long, bitter fight with the University of Minnesota, where I teach, over the [suicide](~/AAAAAQA~/RgRoIeLyP0TvaHR0cHM6Ly93d3cubW90aGVyam9uZXMuY29tL2Vudmlyb25tZW50LzIwMTAvMDkvZGFuLW1hcmtpbmdzb24tZHJ1Zy10cmlhbC1hc3RyYXplbmVjYS8_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA1MTEmaW5zdGFuY2VfaWQ9MTIzMDI4Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE2NjM0MyZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZjPyXT9mscwhqVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) of a young, mentally ill man who had been coerced into a research study in our department of psychiatry. That fight had not gone well, for reasons I was struggling to understand. I wondered: How do these things typically play out at other institutions where research scandals have occurred? The answer to that question was the most demoralizing part. Almost never do medical institutions admit fault in research studies unless they are forced to, even when the wrongdoing is clear. It is rare for research subjects who have been mistreated or their families to get any financial compensation or apology. In many cases, doctors and nurses know for years that subjects are being harmed and exploited, yet they say nothing. The whistle-blowers who dare to speak out are often ostracized, [smeared,](~/AAAAAQA~/RgRoIeLyP0T4aHR0cHM6Ly93d3cuY2JjLmNhL25ld3MvY2FuYWRhL2hvc3BpdGFsLXN1c3BlbmRzLWRvY3Rvci1mb3Itd3JpdGluZy1wb2lzb24tcGVuLWxldHRlcnMtMS4xODk2NTE_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA1MTEmaW5zdGFuY2VfaWQ9MTIzMDI4Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE2NjM0MyZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKZjPyXT9mscwhqVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [dismissed](~/AAAAAQA~/RgRoIeLyP0ToaHR0cHM6Ly9zcGVjaWFsLnNlYXR0bGV0aW1lcy5jb20vby91bmluZm9ybWVkX2NvbnNlbnQvd2hpc3RsZWJsb3dlci9zdG9yeTEuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDUxMSZpbnN0YW5jZV9pZD0xMjMwMjgmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTY2MzQzJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0QgpmM_JdP2axzCGpUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) or [reported to the police](~/AAAAAQA~/RgRoIeLyP4QRAWh0dHBzOi8vdXB3b3J0aHlzY2llbmNlLmNvbS9hLXN0YXItc3VyZ2Vvbi1sZWZ0LWEtdHJhaWwtb2YtZGVhZC1wYXRpZW50cy1hbmQtaGlzLXdoaXN0bGVibG93ZXJzLXdlcmUtcHVuaXNoZWQvcGFydGljbGUtNT9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDUxMSZpbnN0YW5jZV9pZD0xMjMwMjgmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTY2MzQzJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0QgpmM_JdP2axzCGpUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~). It was this class, as well as my own experience, that led me to interview some of these medical whistle-blowers for my book, “The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No.” The book begins with some memories of my own complicity in the mistreatment of patients during my time in medical school in the 1980s, such as pelvic exams on anesthetized, unconscious women who had not given their consent. This is the experience I reflected on this week in my [guest](~/AAAAAQA~/RgRoIeLyP0TfaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wNS8wNy9vcGluaW9uL21lZGljYWwtZXRoaWNzLWRpc3NlbnQuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDUxMSZpbnN0YW5jZV9pZD0xMjMwMjgmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTY2MzQzJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0QgpmM_JdP2axzCGpUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) [essay](~/AAAAAQA~/RgRoIeLyP4QcAWh0dHBzOi8vd3d3Lm55dGltZXMuY29tLzIwMjQvMDUvMDcvb3Bpbmlvbi9tZWRpY2FsLWV0aGljcy1kaXNzZW50Lmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyNDA1MTEmaW5zdGFuY2VfaWQ9MTIzMDI4Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTE2NjM0MyZzbWlkPXVybC1zaGFyZSZ0ZT0xJnVubG9ja2VkX2FydGljbGVfY29kZT0xLnFFMC5wNi1qLlNUYUh2eDdwWklnSiZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~) for Times Opinion. Why is it so difficult to break ranks and speak out against practices that are cruel, exploitative or unfair? READ DR. ELLIOTT’S FULL ESSAY HERE [Guest Essay In Medicine, the Morally Unthinkable Too Easily Comes to Seem Normal Before you decide to speak out about wrongdoing, you have to recognize it for what it is. By Carl Elliott](~/AAAAAQA~/RgRoIeLyP0TfaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wNS8wNy9vcGluaW9uL21lZGljYWwtZXRoaWNzLWRpc3NlbnQuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDUxMSZpbnN0YW5jZV9pZD0xMjMwMjgmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTY2MzQzJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0QgpmM_JdP2axzCGpUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) [A photograph of two forceps, placed handle to tip against each other. ](~/AAAAAQA~/RgRoIeLyP0TfaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wNS8wNy9vcGluaW9uL21lZGljYWwtZXRoaWNzLWRpc3NlbnQuaHRtbD9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDI0MDUxMSZpbnN0YW5jZV9pZD0xMjMwMjgmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTY2MzQzJnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0QgpmM_JdP2axzCGpUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAM~) ADVERTISEMENT [Ad](~/AAAAAQA~/RgRoIeLyP0SkaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjQwNTExJnN0cGU9ZGVmYXVsdCZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyNDA1MTFXA255dEIKZjPyXT9mscwhqVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) [Ad](~/AAAAAQA~/RgRoIeLyP0SkaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjQwNTExJnN0cGU9ZGVmYXVsdCZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyNDA1MTFXA255dEIKZjPyXT9mscwhqVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAD) THE WEEK IN BIG IDEAS ~/AAAAAQA~/RgRoIeLyP0TtaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vaW50ZXJhY3RpdmUvMjAyNC8wNS8wOS9vcGluaW9uL3B1cmVicmVkLWRvZ3MtaW5icmVlZGluZy5odG1sP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwNTExJmluc3RhbmNlX2lkPTEyMzAyOCZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNjYzNDMmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~ The New York Times This Quiz Will Change the Way You Think About Dog Breeding We may not mean to, but we are hurting the dogs we claim to love. By Alexandra Horowitz ~/AAAAAQA~/RgRoIeLyP0TwaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyNC8wNS8wOC9vcGluaW9uL2lzcmFlbC1pbmN1cnNpb24tcmFmYWgtaGFtYXMtbmV0YW5oeWFodS5odG1sP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjQwNTExJmluc3RhbmNlX2lkPTEyMzAyOCZubD1vcGluaW9uLXRvZGF5JnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xNjYzNDMmdGU9MSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmYz8l0_ZrHMIalSG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAw~~ [Smoke billows over buildings in the distance, with several figures in the foreground.] Ramez Habboub/Associated Press Guest Essay Israel’s Rafah Incursion Helps No One Except Netanyahu Judging by the war’s conduct to date, it’s more likely that in the end, the operation will do more damage to Israel. 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