Federal Doctor Says He Was Removed For Resisting Unproven Coronavirus

[Dr. Courtney]

My view is that government scientists should have full academic freedom in speaking and publishing on purely scientific matters, but when they are speaking as representatives of government institutions, there can be reasonable restrictions regarding what they say on public policy matters.

If an employee disregards reasonable restrictions when speaking on public policy matters, removal is an option.

If someone is really that good a scientist, there should be available work in the private sector.

 

[phinds]

My view is that government scientists should have full academic freedom in speaking and publishing on purely scientific matters, but when they are speaking as representatives of government institutions, there can be reasonable restrictions regarding what they say on public policy matters.

This thread is not about a pubic health official commenting on policy matters and getting in trouble but on a public official / scientist talking about scientific fact and getting in trouble. There has been a lot of that lately in America.

 

[hutchphd]

My view is that government scientists should have full academic freedom in speaking and publishing on purely scientific matters, but when they are speaking as representatives of government institutions, there can be reasonable restrictions regarding what they say on public policy matters.

If an employee disregards reasonable restrictions when speaking on public policy matters, removal is an option.

If someone is really that good a scientist, there should be available work in the private sector.

I'm sorry but this is so generic as to be cryptic.

1. Scientific and Public Policy matters are almost never distinct.
2. How is reasonable determined? Do we allow the mentally ill to do it?
3. The private sector is almost certainly more restrictive: one of the lures of public service is that it is, well, public

Your final sentence is chilling.

 

[Vanadium 50]

Should a DOE program manager be able to say "Despite the administration's objections, the science of a Chinese high energy pp collider is compelling and the US should participate."?

 

[Ygggdrasil]

Should a DOE program manager be able to say "Despite the administration's objections, the science of a Chinese high energy pp collider is compelling and the US should participate."?

I think this issue is very clearly one of policy, whereas the issue of which treatments for a disease deserve more funding (the issue over which Richard Bright was allegedly removed from his position) is more clearly a scientific issue. Ultimately, the administration has the ability to make funding decisions like these, but if the decision was really made to place the scientific judgement of the President on the effectiveness of chloroquine as a treatment over the scientific judgement of Bright, I believe that this reflects some very bad practices within the leadership of the administration.

Speaking of unproven Coronavirus treatments, here is a selection from the transcript of yesterday's presidential Coronavirus briefing:

THE PRESIDENT: Thank you very much. So I asked Bill a question that probably some of you are thinking of, if you’re totally into that world, which I find to be very interesting. So, supposing we hit the body with a tremendous — whether it’s ultraviolet or just very powerful light — and I think you said that that hasn’t been checked, but you’re going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way, and I think you said you’re going to test that too. It sounds interesting.

ACTING UNDER SECRETARY BRYAN: We’ll get to the right folks who could.

THE PRESIDENT: Right. And then I see the disinfectant, where it knocks it out in a minute. One minute. And is there a way we can do something like that, by injection inside or almost a cleaning. Because you see it gets in the lungs and it does a tremendous number on the lungs. So it would be interesting to check that. So, that, you’re going to have to use medical doctors with. But it sounds — it sounds interesting to me.

So we’ll see. But the whole concept of the light, the way it kills it in one minute, that’s — that’s pretty powerful.

https://www.whitehouse.gov/briefings-statements/remarks-president-trump-vice-president-pence-members-coronavirus-task-force-press-briefing-31/

On the broader issue of whether political figures should overrule scientific appointees on scientific issues, I present the above as Exhibit A.

 

[Dr. Courtney]

I'm sorry but this is so generic as to be cryptic.

1. Scientific and Public Policy matters are almost never distinct.
2. How is reasonable determined? Do we allow the mentally ill to do it?
3. The private sector is almost certainly more restrictive: one of the lures of public service is that it is, well, public

1. 
   
   I'm not suggesting any restriction on freedom of speech when a scientist is speaking as an individual, only when they are speaking as a representative of a government institution.
   
   In practice, when I was on the faculty of the Air Force Academy, we submitted papers to the research office for them to read and approve. The final approving authority had a PhD in a STEM field and did a great job separating science from public policy stuff. All one needed to do to publish public policy stuff the research office rejected was remove "United States Air Force Academy" from one's affiliation listed in the paper.
   
   When my wife was on the West Point faculty, the approval process was very similar, as was the freedom to publish anything one likes (other than classified stuff, of course) simply by removing the government affiliation.

 

[phinds]

I'm not suggesting any restriction on freedom of speech when a scientist is speaking as an individual, only when they are speaking as a representative of a government institution.

And apparently you include when he is ONLY speaking about scientific fact. I think a lot of us here disagree with that point of view. I certainly do.

 

[hutchphd]

That is useful to know. Was there any blowback if your affiliation was included in a bibliography for a less formal article or as preamble to a lecture ?

You have also not really commented directly about the situation in question here...was this an assessment of efficacy a scientific adjudication or policy? Doesn't seem so clear cut, and so I am interested in your judgment

 

[Dr. Courtney]

And apparently you include when he is ONLY speaking about scientific fact. I think a lot of us here disagree with that point of view. I certainly do.

Perhaps you missed my logic. I support full freedom of speech for scientists (and everyone else) when speaking as individuals and when they are publishing science.

But I support every employer's exercise of power in limiting the speech of employees when speaking in their capacity of employees. I don't make an exception for government employees, and I don't make an exception for scientists.

The rules on speaking and publishing are usually available and known when one accepts a position as an employee. If they are objectionable, one should exercise one's freedom to find a different job with more acceptable terms.

Every time I accept a job or contract, I carefully review the terms to understand the impact on my freedom of speech. I usually specify a much higher bill rate when I can't publish my results. I tend not to accept jobs or contracts that limit my freedom of speech in areas not directly relevant to the contract.

 

[Stephen Tashi]

How can we expect to find cures/vaccines when the doctors capable of doing it are removed?

The removal of an official is a political act. The only non-political aspects of the situation are whether science supports the doctor's position. The way the topic is posed, that is taken for granted. So, what's left to talk about? - humor? I don't object to that approach!

 

[Stephen Tashi]

Perhaps you missed my logic. I support full freedom of speech for scientists (and everyone else) when speaking as individuals and when they are publishing science.

But I support every employer's exercise of power in limiting the speech of employees when speaking in their capacity of employees.

One form of freedom of expression is to disobey laws, disobey employers, break contracts etc. Whether laws take precedence over other aspects of life gets into philosophy - presumably as prohibited a topic as politics.

 

[Dr. Courtney]

One form of freedom of expression is to disobey laws, disobey employers, break contracts etc. Whether laws take precedence over other aspects of life gets into philosophy - presumably as prohibited a topic as politics.

When one violates a contract or an employer policy, the consequence of that is often termination. The employer or other party to the contract retains their liberty to bring the expected consequences.

When an employee speaks or writes in their official capacity to manipulate policy decisions that are above their pay grade, they can reasonably expect to be fired. I won't judge such terminations to be unreasonable as long as they are in accordance with law and the employment agreement.

Nor will I grant scientists some special exception in such circumstances. Should Ernest Moniz or Steven Chu have had more freedom to publicly disagree with their Commander in Chief as DOE Secretary than Rick Perry, because they are scientists? Of course not. If you publicly challenge the policy decisions of those with a higher pay grade, you may be out of a job.

 

[Vanadium 50]

One form of freedom of expression is to disobey laws, disobey employers, break contracts etc.

That is true. However, this freedom doesn't always mean "freedom from consequences."

 

[Stephen Tashi]

When one violates a contract or an employer policy, the consequence of that is often termination. The employer or other party to the contract retains their liberty to bring the expected consequences.

That's a statement about social and political realities. Laws and contracts do no prohibit things in the physical sense of making them impossible. Laws create certain consequences of certain actions. So the person violating the law can be "right" and the person enforcing the consequences can also be "right", depending on the philosophical point of view used in judging what is right. In fact, both the violation and the consequence could be right!

As far as topic of the current thread goes, it's taken for granted that an employee did something that displeased an employer, and the employee suffered a consequence. Non-philosophical aspects of this event are legalistic questions of whether the employee's contract with the employer legally allowed the consequences. Perhaps social and psychological aspects along the lines of "The employer would have been smarter to ..." or "The employee would have been smarter to..." can be discussed.

 

[russ_watters]

I think this issue is very clearly one of policy, whereas the issue of which treatments for a disease deserve more funding (the issue over which Richard Bright was allegedly removed from his position) is more clearly a scientific issue.

Really? It's nice to say that in principle, but in reality that isn't anywhere close to true. Money spent on disease treatment research is not at all well correlated with scientific concerns. Why is breast cancer so much better funded than other forms of cancer? Because it kills a lot of people? No (it doesn't), because it's a convenient and attractive cause for women and people who want to sell things to women. And maybe because breasts are more attractive than colons.

Nor do I think scientists themselves are immune. The disease treatment most deserving of funding is of course the one *I'm* working on right now.

 

[russ_watters]

That's a statement about social and political realities. Laws and contracts do no prohibit things in the physical sense of making them impossible. Laws create certain consequences of certain actions. So the person violating the law can be "right" and the person enforcing the consequences can also be "right", depending on the philosophical point of view used in judging what is right. In fact, both the violation and the consequence could be right!

Evidently, the employee in question thinks his re-assignment was illegal and intends to file a whistleblower complaint about it:
https://www.bbc.com/news/world-us-canada-52400721

 

[russ_watters]

Should a DOE program manager be able to say "Despite the administration's objections, the science of a Chinese high energy pp collider is compelling and the US should participate."?

...Steven Chu...

I would have liked to see some whistleblower complaints against the scientific, legal and ethical violations of Steven Chu, but that's another topic...

...or maybe not. My whole concern with today's line of discussion is the absolutely laughable idea that scientists are free from personal and political motivations.

 

[BillTre]

It's nice to say that in principle, but in reality that isn't anywhere close to true. Money spent on disease treatment research is not at all well correlated with scientific concerns. Why is breast cancer so much better funded than other forms of cancer?

This is a political decision made at the level of funding and is probably mandated by congress in funding bills.
It is not very relevant to decisions on how the money legally designated for breast cancer research will be best utilized for research or treatment development.
Pushing the inappropriate use of funds designated for such purposes, for perhaps injecting a toxic chemical into a patient, as some kind of political favor, would be a much better comparison.

No (it doesn't), because it's a convenient and attractive cause for women and people who want to sell things to women. And maybe because breasts are more attractive than colons.

Your argument is with the funding bills (therefore congress and the president).

 

[Dr Transport]

I do not believe that any politician with no medical background should be allowed to control medicine or give medical advice to the public.

Isn't that practicing medicine without a license? Most states that is a felony.

 

[BillTre]

Here is a different situation that raises similar problems, but not so much with politicians, but with the business world.

Health care professionals dealing with Coronavirus often lack the reasonably necessary personal protective equipment (PPE), to keep them safe which also protects those they care for (a double health hazard you might say).
Recently, there have been several stories about nurses and others getting fired from hospitals (big businesses with corporate lawyers) for stating publicly that there are PPE shortages and these shortages can have profound consequences (like death of carers, or the more likely infection of patients).
Maybe there is something in their contracts about not saying things (in their official capacity or as a representative of the company or not), or perhaps they just displeased some company dude because it made them look bad (there are many cases of this being reported in the press).
Irregardless, it would seem to be difficult to find any way to ethically support this kind of corporate behavior.

It smacks of trying to keep problems quite that could:

• end up killing people.
• may cause the company problems because they might have to address the issue by spending money in some way that they might otherwise be able to ignore (hard to tell if they prevent transparency).
• scamming (defrauding) the consumer (patient) who is arguably getting into a situation (the hospital) expecting a reasonable amount of protection from disease (not getting sick from their doctor/nurse/other health care provider).

 

[Ygggdrasil]

Really? It's nice to say that in principle, but in reality that isn't anywhere close to true. Money spent on disease treatment research is not at all well correlated with scientific concerns. Why is breast cancer so much better funded than other forms of cancer? Because it kills a lot of people? No (it doesn't), because it's a convenient and attractive cause for women and people who want to sell things to women. And maybe because breasts are more attractive than colons.

I think it's perfectly fine for policy to direct priorities to different areas, but that is also not at issue with this case. Bright claims he was dismissed from his position for resisting efforts to fund research into chloroquine and hydroxychloroquine and for limiting the agency from recommending the broad use of the drugs. Typically, when government funds a particular area of research, they leave it to scientists working for the government to decide what particular projects in that area of research merit funding (i.e. merit is decided through a system of peer review run by the NIH, NSF or other agency). Similarly, political figures typically do not interfere with decisions to approve individual drugs, and instead leave these decisions to experts at the FDA (that said, the Obama administration was the first to engage in such interference). The circumstances of Bright's firing seem more akin to these situations than deciding to fund breast cancer research at a higher level than other cancers.

Minor point:
Breast cancer has the highest incidence of all cancer types in the US accounting for ~ 15% of all new cancer cases (however, it responsible for the third most deaths behind lung cancer and colorectal cancer at 7.0% of cancer deaths). The National Cancer institute spends ~17% of its budget on breast cancer research (the most of any cancer type), which is fairly commensurate with the incidence of the disease (though not the mortality as you point out). If you want a better example of where incidence and funding are out of line, leukemia represents ~3.3% of new cancer cases and 3.8% of deaths but ~8.0% of NCI funding (third behind breast and lung cancer). (This is not to criticize funding of leukemia, however, as there are scientific reasons to justify the funding).

 

[chemisttree]

Well, it just another example of the extremely poor management of this whole mess by those who do the administrating nationally in this country, reagrdless of its consequences for the health and safety of its citizens.

I can hardly wait until they’re in charge of all of our healthcare!

How are we supposed to even consider the validity of his claim when by design we are only permitted to hear his side? You think his boss is going to disclose the reasons he was moved to another position. That’s illegal!

By the way, this guy wasn’t working on a vaccine although he has a history in that field. He’s (was) the head of procurement at BARDA!

What BARDA does.

 

[chemisttree]

I think it's perfectly fine for policy to direct priorities to different areas, but that is also not at issue with this case. Bright claims he was dismissed from his position for resisting efforts to fund research into chloroquine and hydroxychloroquine and for limiting the agency from recommending the broad use of the drugs. Typically, when government funds a particular area of research, they leave it to scientists working for the government to decide what particular projects in that area of research merit funding (i.e. merit is decided through a system of peer review run by the NIH, NSF or other agency).

So you would be interested to discover what his job actually was. At least what the law said it was...

Research and Development of Qualified Medical Countermeasures –
Section 2 of the PBS Act enacted Section 319F-1 of the PHS Act (42 U.S.C. 247d-6a), authorizing the use of a variety of streamlined procedures in awarding grants, contracts, and cooperative agreements relating to the research and development of qualified countermeasures. Reporting is required on the use of limited competition, expedited peer review, and increased simplified acquisition thresh- olds.

And a “qualified countermeasure” is:

(A)Qualified countermeasure
The term “qualified countermeasure” means a drug (as that term is defined by section 321(g)(1) of title 21), biological product (as that term is defined by section 262(i) of this title), or device (as that term is defined by section 321(h) of title 21), that the Secretary determines to be a priority (consistent with sections 182(2) and 184(a) of title 6)—
(i)
to diagnose, mitigate, prevent, or treat harm from any biological agent (including organisms that cause an infectious disease) or toxin, chemical, radiological, or nuclear agent that may cause a public health emergency affecting national security;
(ii)
to diagnose, mitigate, prevent, or treat harm from a condition that may result in adverse health consequences or death and may be caused by administering a drug, biological product, or device that is used as described in this subparagraph; or
(iii)
is a product or technology intended to enhance the use or effect of a drug, biological product, or device described in clause (i) or (ii).[/

https://www.law.cornell.edu/uscode/text/42/247d-6a

Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

[Mentor’s note: this post has been edited to remove an off-topic comment about an unrelated legal issue]

 

[atyy]

https://www.thoracic.org/covid/covid-19-guidance.pdf (April 3rd, 2020)
"For hospitalized patients with COVID‐19 who have evidence of pneumonia, we suggest hydroxychloroquine (or chloroquine) on a case‐by‐case basis. Requirements include all of the following: a) shared decision‐making in which the patient is informed about the possible benefits and potential side effects, b) collection of data in a manner that enables studies that use valid methods for causal inference and control of confounders for the purpose of interim assessment, c) the patient’s clinical condition is sufficiently severe to warrant investigational therapy, and d) there is not a shortage of drug supply."

PLease see also post #20 for possible dangers,

 

[Ygggdrasil]

I can hardly wait until they’re in charge of all of our healthcare!

It is important to separate the incompetence of a particular administration from the more general question of the efficacy of government. Polling suggests that Americans with government-run healthcare plans (e.g. veterans and people on medicare or medicaid) are more satisfied with the healthcare system than people with private insurance (from unions, employers or purchased on the market).

Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

Bright is certainly a disgruntled employee trashing his boss, and his comments should be taken with a grain of salt. However, he does bring up many important criticisms of how the federal government has been addressing the pandemic, and many of these criticism are consistent with information from other news reports. In particular, his criticisms reflect other reporting that the administration has consistently been ignoring warnings from scientists and other experts, and instead focused much too heavily on political concerns surrounding the upcoming election.

Ultimately, I think the administration's alleged plans to distribute millions of doses of hydroxychloroquine despite warnings of risks and no solid evidence of efficacy were wrong, and therefore see the firing of Bright as reflective of a managerial culture that overly values the opinion of the president over the opinion of experts. Reasonable people could disagree on this point, however (for example, the hydroxychloroquine plan did not go into effect and the US government officially recommends against hydroxychloroquine + azithromycin and states there is no evidence for the effectiveness of hydroxychloroqine or chloroquine, so the recommendation of scientific experts did win out in the end).

 

[Dr. Courtney]

It is important to separate the incompetence of a particular administration from the more general efficacy of government. Polling suggests that Americans with government-run healthcare plans (e.g. veterans and people on medicare or medicaid) are more satisfied with the healthcare system than people with private insurance (from unions, employers or purchased on the market).

I don't know a single veteran who is more happy with the medical service they get from the VA compared with the medical service my family gets from our private plan. They may be satisfied overall, because the fact that it is FREE outweighs the abysmal actual service.

The only dissatisfying feature of my family's private plan is the COST. But I wouldn't trade my family's private plan for the FREE VA plan based on numerous discussions with veterans I know who are using the plan. FREE is the only thing they like about it.

 

[Vanadium 50]

NPR published a correction four days ago: "An earlier version of this story described Richard Bright as a doctor, implying that he is a physician. He has a Ph.D. in immunology." Should the OP and/or the thread title be similarly corrected?

 

[hutchphd]

Sounds like he (Bright) thought that he was the boss. Sounds like a typical disgruntled employee trashing his boss.

Look.
Speaking inconvenient truth to power is, and always has been, a risky enterprise. That is inherent in any power structure. It does all "emanate from the barrel of a gun"
The question on the table is whether there has been an abuse of power. This is not a question legal authority but of moral authority
The President of the United States has the legal authority to launch a 3 megaton warhead on Pyongyang as I write this. Or Bejing.
Of course the captain can be relieved command. Of course guy who correctly evaluates projects can be terminated.
The question is on the morality of the act.

 

[Dr. Courtney]

Look.
Speaking inconvenient truth to power is, and always has been, a risky enterprise. That is inherent in any power structure. It does all "emanate from the barrel of a gun"

But it seems the fact here is that the PhD who was fired went beyond speaking the inconvenient truth to power - he went public with his complaint contrary to the rules of his employment.

One thing I loved about the Air Force Academy was the open door atmosphere. I could walk in and speak with anyone in the chain of command and politely voice my observations, views, and recommendations.

Airing dirty laundry in public is a much different thing than discretely speaking truth to power. It's trying to manipulate a preferred outcome by going public with one's views. Firing employees for such deliberate manipulative tactics is not usually an abuse of power, it is necessary for the efficient management of large organizations. Anything less is giving every employee permission to cause a PR hassle for the institution any time they have a burr in their saddle and can find co-conspirators in the media to give them their 15 minutes of fame.

 

[Ygggdrasil]

But it seems the fact here is that the PhD who was fired went beyond speaking the inconvenient truth to power - he went public with his complaint contrary to the rules of his employment.

Unless I am misreading the news reports, he was not removed from his position for going public with his criticisms. He released his complains to the media only after he was removed as director of BARDA.

In a statement Wednesday that was released by his attorneys, Richard Bright specifically cited his pushback against unproven potential treatments that President Trump has repeatedly advocated for during White House briefings and on Twitter.

Bright was director of the Biomedical Advanced Research and Development Authority and a deputy assistant secretary with the Department of Health and Human Services until, he says, he was removed on Tuesday. Bright said he has been transferred to "a more limited and less impactful position" at the National Institutes of Health.

https://www.npr.org/sections/corona...for-resisting-unproven-coronavirus-treatments