I need to start with the State Medical Board of Ohio and their reliance upon the American Medical Association for ethical standards. The document below is a set of screen captures from the State Medical Board and the American Medical Association websites detailing the ethical standards under which Dr. Vic Wulsin is bound to practice under.OH MedBoard ethics guidelines, AMA ethics guidelines, Wulsin AMA member page - Upload a Document to Scribd
I want to highlight a few items in particular:
Under the Principles of Medical Ethics under the AMA section is this:
A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights.Emphasis added.
And then there is this bit:
A physician shall uphold the standards of professionalism, be honest in all professional interactions, and strive to report physicians deficient in character or competence, or engaging in fraud or deception, to appropriate entities.Emphasis added...
Does the phrase "scientifically unsound and unethical" ring any bells here?
And now a third piece:
A physician shall respect the law and also recognize a responsibility to seek changes in those requirements which are contrary to the best interests of the patient.Emphasis added...
Number four:
A physician shall respect the rights of patients, colleagues, and other health professionals, and shall safeguard patient confidences and privacy within the constraints of the law.Emphasis added.
Five:
A physician shall continue to study, apply, and advance scientific knowledge, maintain a commitment to medical education, make relevant information available to patients, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated.Emphasis added.
Number Six:
A physician shall, in the provision of appropriate patient care, except in emergencies, be free to choose whom to serve, with whom to associate, and the environment in which to provide medical care.Emphasis added.
Doctor Wulsin had a choice...
Seven:
A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.Emphasis added.
I think this one also implies that a physician should also recognize when NOT to do those things as well...but we could be verring into legal semantics on this one...
Eight:
A physician shall, while caring for a patient, regard responsibility to the patient as paramount.Emphasis added.
Does this mean that since Dr. Wulsin was conducting a "literature review" that she had no responsibility to the patients since she was not "caring for the patient"?
Nine:
A physician shall support access to medical care for all people.Those are the guidelines, as established by the American Medical Association for medical ethics.
Let's move to Page Three of the document above and let's take a look at this passage:
Physicians have an ethical obligation to report impaired, incompetent, and/or unethical colleagues in accordance with the legal requirements in each state and assisted by the following guidelines:Does this mean that Dr. Wulsin had a responsibility to actually report Heimlich and the Institute for engaging in a process that was "scientifically unsound and unethical"?
...
Unethical conduct. With the exception of incompetence or impairment, unethical behavior should be reported in accordance with the following guidelines and, considering, as necessary, the right to privacy of any patients involved:
Unethical conduct that threatens patient care or welfare should be reported to the appropriate authority for a particular clinical service. Unethical conduct that violates state licensing provisions should be reported to the state licensing board. It is appropriate to report unethical conduct that potentially violates criminal statutes to law enforcement authorities. All other unethical conduct should be reported to the local or state professional medical organization.
When the inappropriate conduct of a physician continues despite the initial report(s), the reporting physician should report to a higher or additional authority. The person or body receiving the initial report should notify the reporting physician when appropriate action has been taken. Physicians who receive reports of inappropriate behavior, including reports submitted anonymously, have an ethical duty to critically, objectively, and confidentially evaluate the reported information and assure that identified deficiencies are either remedied or further reported to a higher or additional authority. Information regarding reports or investigations of impairment, or of incompetent or unethical behavior should be held in confidence until the matter is resolved. (II)
Dr. Robert Baratz seemed to think something was amiss because he filed a complaint which you can find below...
I have to assume that the State Medical Board called Dr. Wulsin to a hearing (see the next set of documents) to ascertain her level of involvement in the malariotherapy experiments. And I have a few questions about that as well...but we're getting ahead of ourselves. Here is a set of documents from the State Board, including the results of their investigative hearing.
Now, for the aftermath, I think we need to go to PolitickerOH for the recap:
A letter from the board to Wulsin, released by the Wulsin campaign to the Cincinnati Enquirer, doesn't say that the claim had no merit, but does say the board has closed the complaint.The Board is not saying much about this because they treat these hearings as confidential. They will not even confirm or deny that such a hearing took place.
Wulsin (Corrected from earlier) communications director Kevin Franck previously released a statement saying, "The Board found that there was no merit whatsoever to the complaint and declined any further action on the issue. These false allegations represented the lowest form of sleazeball politics."
The Wulsin campaign released two letters addressed to Wulsin from the board to the Enquirer. The first letter requests Wulsin to attend an investigative office conference to discuss her activities while employed by the Heimlich Institute. The second letter states that after a "thorough review, the Secretary and Supervising Member determined that no further action was required by the Board and the complaint had been closed."
Remember Dr. Baratz? Here is his reaction:
Baratz said he had been contacted by a board investigator "some time ago," and on more than one occasion, but he was not asked to attend or notified of a review of the complaint. Baratz said if he had been contacted for such a review he could have provided the board with more information relevant to the complaint.So, the Board didn't even circle back with the guy who files the complaint in the first place...
"The short answer is they did not contact me prior to the review and I was unaware that it had even happened until after the fact," he said. "Most state boards, until the case is, I'll say adjudicated, the investigations are supposed to be confidential. Obviously, you can hurt someone's character by a lot of false fights."
Baratz said that, from his perspective, the fact there was a complaint is not confidential and so that's why he made it public. He said the board, on the other hand, considers it confidential and will subsequently give no comment.
"Basically, after they've done their thing, unless there is a sanction, or discipline or something else of the licensee, they aren't going to do anything in terms of publicizing," he said. "But let's say they decide to hold a hearing, for example -- a formal hearing -- I believe that becomes public."
Baratz then referred to Wulsin's meeting with the board at the investigative office conference.
"This meeting that was held sounds to me like something that wasn't a formal hearing, but it obviously was some kind of official meeting and I've never seen anything like that before," he said.
Baratz said that the scenario might exist in Ohio but in his 25 years of dealing with 20 different boards across the country in discipline cases he's never heard of this scenario.
"In other words, if you meet with a board in a formal way and it is a hearing that is open to the public, or it's not. And if it's not, why are you meeting with the board? The board has investigators and they either charge you or they don't."
As for "no further action", here is Ohio Medical Board Executive Staff Coordinator Joan Wehrle on that subject:
"Often, with what we call ‘office conferences,' there's no further action that needs to be taken by the board. It's not a situation that really rises to the level that we need to take a disciplinary intervention."Unless somebody other than Dr. Wulsin wants to come clean about what really happened and why somebody didn't shut these experiments down, I am not real comfortable with that answer.
I am of the opinion that the public has a vested interest in knowing whether or not Dr. Wulsin acted in appropriate manner in carrying out her duties as a practioner of medecine in regards to her "literature review" of malariotherapy. I think somebody ought to address the ethical issues that have been raised in this case, and that somebody needs to be an objective and expert source.
