This seems to be Brer Rabbit and the Tar Baby, with big egos involved, and ordinary people trying to patch this together. Seems communications were bungled. I imagine that getting all staff on the same page would be like herding cats? I hope if this was meant to be it will be allowed to be.
1
In Bob Woodward’s book Fear there’s a scene in the Oval Office, wherein Trump is slamming his top generals, for not monetizing commodities in Afghanistan and Iraq. Echoes of this at MSK board meetings.
10
There is the set of former cancer patients who died during treatment or comfort at MSK, my son among them in 2009. As his father, I have serious objections that his gene codes will be made available to a hedge fund managers earning profits from his pain. It raises the question, who speaks for those who cannot speak for themselves. MSK and AI are going to have a serious reckoning regarding this decision, as I, and others I hope, will be speaking loudly about it. MSK and AI need to heed the wisdom of one of their former patients that,
“With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease–because it has not expressed itself.”
Susan Sontag, “Illness as Metaphor”
To: MSK Board and AI - Seriously, are you going to make her gene codes available for a version of your own ‘Tuskegee’? Answer me that!
19
The greed here is sickening, disgusting. Three of the board members who invested are billionaires (Druckenmiller and Kravis) or the child of a billionaire (Robertson). That they needed the upside more than the hospitals, more than the thousands of patients whose trust is placed in their system, more than the thousands of employees whose careers are placed in their hands, is absurd.
So the chairman says, "We were desparate... we couldn't find investors..." and billionaires leap into the void for self sacrifice? If it was so risky, and to benefit the hospital, why couldn't these people donate their money and have the hospital invest and reap the rewards?
All three investors and the chairman are willfully blind to the grasping nature of this move. All four should be removed from this and all other non-profit boards for a lengthy period until they have had enough time to recognize the purpose of their responsibilities, that the charity comes first, and they never get on the list of rewardees. Every single time.
20
I think this arrangement needs to be looked at in a bigger context, because hospitals share and sell de-identified patient data to all kinds of private entities - and many of the recent AI start ups rely on big databases gleaned from healthcare systems. That data is collected from a variety of sources within hospital settings, depending on how up to date the hospital is and ranging from medical devices and equipment, smart facilities, tissue and blood samples, you name it. It is De-identified, true, but patients are not necessarily informed in advance.
I don't know the arrangement here well. But the controversy raises broader questions about our use of healthcare data and how we collect it, and whether at the academic medical center level, it is OK to give for-profit ventures exclusive rights to patient samples ie data, when many researchers in the field are pushing for data sharing arrangements. That may be fueling this particular controversy--access to highly coveted, high quality tissue samples is an ongoing challenge for researchers, and with this arrangement, it looks like they won't get access to one of the nation's premium cancer center's sample bank . These issues need to be aired publicly.
10
This news must be incredibly demoralizing to the hospital’s beloved staff. These trustees are shameless.
17
I was treated for cancer at MSKCC a decade ago. It is probably the finest hospital that I have ever been too. The entire staff -- from pathologists, to surgeons, to oncologists, to administrative support -- acted with competence and compassion. MSKCC has always been, and must continue to be, at the cutting edge of research, diagnosis, and treatment if it is to maintain its excellence. Therefore the hospital's exploration of the application of AI is not surprising. The problem seems to be the intersection of private profit motives with MSKCC's non-profit mission. It is also part of a broader societal issue regarding equity in the distribution of wealth. I am dismayed to see the number of hedge fund investors who are on the board and financially involved with this project. They are part of a small class of hyper wealthy people who balk at the idea of paying more taxes yet have been sucking up a greater and greater percentage of America's wealth unto themselves by profiting off the work of others. This is what has the pathologists so upset. [Pathologists, by the way, are not amongst the highest paid members of the medical profession yet their work is critical to the proper diagnosis and treatment of cancer and other diseases]. MSKCC seems to be in a position of having to be adopted by self dealing billionaires in order to fund its mission. This is no way to run a medical system (or many other areas of our society).
17
Actually, pathologists are among the most highly paid subspecialities.
4
Today I'm celebrating 7 years since the end of my treatment at MSKCC. The doctors, nurses, and staff that helped me were all supremely smart, caring, and human. I would be honored if my slides and experiences could in anyway help other patients in the future.
This new venture, however, definitely feels hinky, I don't want my tissues and pain to go to a profit-making corporation. Where is my cut?
This has the feel of an insider sweetheart deal, where so many assets and decades of professionalism are given to a very connected private entity to mine for value, and financially benefit a chosen few. That is what I take issue with and what I will bring up at my next checkup.
15
It appears the only conflict is about the value of the medical data. Indeed, "Paige.AI" has negative value without the medical data, people writing algorithms that are "AI" are a dime a dozen. Without the training data that "AI" will not work (using today's obsolescent image related methods).
The medical data should be put out for bid to determine its value, or made freely available. It could very well be the case that the former value is small due to the development risk as claimed by Paige.AI, but no one knows unless a bid process is done.
8
Prior to the FeDeral Trade Commission decision in the 1970s that found that medicine was a profession with characteristics of a for profit business, medical ethics and state medical boards proscribed the ownership of pharmacies by prescribing physicians. It was held that the physician who orders the use of a drug should not profit from its sale.
How far we have come from the days when the practice of medicine was classed as a calling in which the interests of the sick were held paramount by clinicians.
At memorial Sloane Kettering , cancer care seems to have become a business that requires professional physicians to care for patients at the bedside while department chairpersons and board members reap profits from the business exploitation of patients medical record database . Those individuals personally contributed nothing to the economic market value of MSK’s medical records.
If the MSK corporation wished to use profits from that enterprise , it could have created a specific tax exempt 501c-3 foundation and devoted any profits to future medical research and care of medically indigent patients.
Instead a select few physician and layman board members chose to use their insider knowledge and their pIviliged position in the MSK corporation to exploit the professional skill of MSK’s medical staff for their own personal financial gain. When does this become a crime as well as an ethical lapse?
9
The unethical nature of the agreement is clear. It is also very clearly illegal for non-profit board members to self deal and give valuable intellectual property to a corporation in which they own an interest. When I served on the board of a non-profit I took training that very clearly said this arrangement would be illegal. Besides being unethical and illegal if I were a patient there I would refuse to donate my tissue to their research if I knew of this agreement for profit from my tissue.
12
I'm a lymphoma survivor who was treated at MSKCC.
MSKCC is a first class organization and I hate to see this lapse in judgement tarnish the reputation.
The best way to remedy the situation is for these people to transfer all ownership to MSKCC and adopt and enforce a stringent conflict of interest policy.
8
So I pay a hospital or clinic thousands of dollars for treatment, and somehow my tissue samples or other biological flotsam will become their property?
I am eager for these materials being used altruistically for research that will help others. But if there are profits being made, surely I'm entitled to a cut.
13
The key is the exclusive use of data. No healthcare system or group should make the data exclusive. That is risky from both a research perspective, completely unfair to patients and sets an extremely poor and corrosive precedent. If the assumption that the data is being used ethically and respecting HIPAA and other privacy standards it shouldn't be limited to a very few stakeholders. Bad judgement on Sloan's part.
10
I work at a large research hospital that also strives to profit from the ideas and inventions of its employees. The institution, which owns all intellectual property deriving from employee work, sometimes provides early phase funding to develop IP into marketable products, using an "Innovation Fund" that is advised by a group of experienced VCs. I think it is good for non-profit research centers to develop income streams by licensing IP-- the income must then of course support non-profit activities. However, there is clearly a need for more "open market" evaluation of IP value to counterbalance the insider access and potential for self-dealing by hospital board members and VC advisors. Unfortunately, it appears that many individuals with the expertise to evaluate IP of this sort are unlikely to treat valuable inside information in a manner that best represents the hospital's and patients' interests.
9
Often institutions that create intellectual property through their own work can see opportunities for commercialization but the path to get there is not exactly clear and clean all of the time. It's common for research-academic institutions to recruit high net worth individuals to their board for purposes of fund-raising, and if these folks also jump into driving investment decisions on the IP it can get sticky fast. MSK says they were "desperate" for investors but I have to wonder how hard they looked. An exclusive option to plumb and develop AI tools from this institution would have lit up the eyes of a whole host of health care investors that even I know of. I just think they decided (hedge fund masters of the universe) that they could not let it go out the door without keeping a big piece of it for themselves.
9
Profit and greed rule again. Disappointing at the not-for-profit institution lack of transparency. Agree that current technology and staff costs are significant, but, this whole deal could have been done much more professionally. If I were a patient or had been Kettering would be in trouble.
5
I can barely imagine
how disturbing this
must be to patients
and their families
who are presently
going through the
ordeal of cancer.
I hope that every
physician, researcher,
board and staff member
of cancer institutions
will read these reports
and vow to dedicate
themselves to their
mission to help not harm.
6
There is a more subtle nuance at work here that we are all missing.
Traditionally our most famous inventors and discoverers never get to reap the giant rewards that come from medical and technological advances unless they own the patent. If you work for a big academic institution like MSK, they usually get to own your discovery. Most often, when a discovery is made, it is big Pharma that walks away with the technology and monetizes the bejesus out of it.
Why should top flight academic institutions and famous teaching Hospitals not be able to derive profits from their own discoveries and advances? I think they should.
A system, as we have, that privatizes and monetizes everything always leads to this type of outcome.
We should stop deluding ourselves that our present health care system cares about the patients. It is about making advances that can be monetized to the maximum that the market car bear.
If we don’t like the system, then we should try to make it more like what England or Germany or France have.
Now you can scream.
7
Office of Technology Development (OTD) at MSK is responsible for commercialization of discoveries made at MSK.OTD reports to Eric Cottington, Senior Vice President, Research and Technology Management. It looks like the director of OTD, Greg Raskin, and Eric Cottington knew and approved the formation of this startup and did not see any conflict of interest. Greg Raskin was hired by current CEO of MSK, Craig Thompson, who was also sued for failing to dislose his discoveries.
Greg Raskin comes from Wall St. He has raised money for and invested in biotech companies. How does he justify raising money from board of directors of MSK because no other sophisticated investor would put money in this venture? Maybe those investors saw the potential conflicts of interest and decided not to be involved and this did not raise red flags for Greg Raskin? How did the in-house counsels at MSK approve this deal? Also "We were desperate to raise money" does not project a lot of confidence to the market.
It looks like either Greg Raskin does not understand his responsibilities or is in this for personal gains.
MSK CEO Craig Thompson, Director of Office of Technology Development Greg Raskin and Eric Cottington, Senior Vice President, Research and Technology Management should be removed from their positions immediately.
17
People need to calm down. I really don't think the level of malicious intent is as severe as every ProPublica driven article purports. Yes, these leaders need to be corrected, and guided back to a more transparent path. But I wouldn't presume for a second that Dr. Klimstra in fact would want to intentionally abuse his own pathologists or MSKCC patients. What if in fact he really does want to develop an improved diagnostic rubric for the betterment of cancer patients? What if private industry in whatever form is the only reliable source of funding in a climate of science deniers from the POTUS on down? Please. Whomever is trying to tear down MSKCC is shooting themselves in the foot. There are thousands of talented employees at MSKCC with world-class expertise. Dr. Klimstra is one of them. Sure he should divest; sure he made mistakes about how this relationship with Paige.IA went down, but do not equate poor business acumen with intentional malice against patients. The man is a trained pathologist. Patients need him and people like him to continue to advance the field.
37
@glorynine That is beside the point. The point is about a research culture and leadership ethos (this is where Dr. Klimstra's role intersects with the point vis a vis leadership) that could allow something like this to exist. I refer you to the top Reader's Pick comment from a sister of a patient at MSKCC who notes that the patient did not consent for her material to be used this way. It is about consent and, beyond that, the expectation of privacy in all its forms, including whether a deidentified part of you, digital or otherwise, is out there, out of your control, even out of your knowledge. It is about honoring this, and being a good steward of that information using a bar that is higher than any specific legal standard if that standard proves to be ethically insufficient as part of a whole view of the situation.
7
@glorynine This reads like a piece written by an MSK PR person.
8
This situation is obviously fraught with conflicts of interest and it does not take an MBA to see it. Treating these executive doctors like they have no business sense is incredibly naive. They all know what they are doing and any hesitation they might feel is clouded by potential returns.
2
I don't doubt that MSKCC provides excellent life-saving care for many patients but they are an unabashedly money-making enterprise that wants to protect their status as premier cancer center, attract big donations, and reap financial benefits for select staff. That a handful of staff and wealthy board members stand to profit from a proprietary database of 25 million tumor slides obtained from unsuspecting patients is a terrible conflict of interest and actually slows the pace of discovery in cancer research. As a non-profit entity, instead of commercializing this valuable trove of tumor genetic information, MSK should provide access to these samples to researchers all over the world as they pursue new breakthroughs in cancer diagnosis, treatment and personalized medicine.
8
We've had our issues with MD Anderson, part of the public University of Texas system and considered the best cancer center in the world. President after president has had conflicts of interest. Seems that the "wall" between a non-profit and for profit is very porous at best. Services there are so darn expensive that it caters to rich Middle East oil and other wealthy foreign patients under the guise that they help subsidize the services for the (very few) poor...
2
Simply said, the moral hazard is too great. The result will be "perverted" and eventually either be even more disturbing than it sounds or fail in a grand fashion. These things are predictable, just like, and because of human behavior.
2
Medicare for all. Medical research for all.
6
Sick and unethical. All of this data should be part of the public forum for scientists anywhere in any country to use. Hoarding the data for profits is slowing the progress of science toward better treatments and cures for millions of suffering and dying people all over the globe.
Gone are the days when Salk refused to patent the polio vaccine.
11
Mr. Sloan and Mr. Kettering were chief players in the push to put lead in gasoline. Responsible scientists knew that this was a very bad pollutant that causes brain damage especially in children.
This poisoning was not caused by ignorance, but by greed. Lead was used to prevent "engine knock" in car engines. There were other solutions to this problem that did not poison the public. Of course they made a huge profit.
Fast forward... it became unlawful to put lead in gasoline.
We should not be honoring this two men.
4
Go figure. Another sign that elites cannot be trusted.
3
The War on Cancer is a fraud, a scam, a road to nowhere. We are pouring biillions into the pockets of researchers, with little to show for it except for the researchers' high-flying lifestyles. End this madness.
And the war on Alzheimers is going the same route, raising billions for research while doing next to nothing for patients and their families.
1
Is this a Henrietta Lacks repeat?? I read the book and was horrified to learn of another major medical institution’s attempt to use a patient’s sample (in MSK’s case, millions of patients and samples) without permission and with no financial benefit to the patient’s family.
I have been a patient at MSK with mixed experience. I am fortunate to have a legal and medical background so am able to read between the lines. Not all is as it should be not all is disclosed. Institutional Review Boards in and of themselves can sometimes represent conflicts of interest.
On the positive side, MSK has saved many lives and increased quality of life for many patients. But buyer beware.... MKS used to be ‘the only game in town’ but now there are many other fish in the sea.
6
Rule no 1: There is no such thing as a non-profit entity.
2
Gosh, I just started streaming "The Resident" which is the first show I've seen where it isn't just the hospital administration that is money hungry and corrupt. There are physicians who are rampantly greedy.
Does that mean we've finally turned a corner on the false idea that all physicians are in medicine to simply care for others?
Maybe, we would really make significant progress in developing better treatments and even cures for cancer if institutions like MSKCC shared information instead of seeing it as a gold mine for a select few.
4
Universities long ago sold their souls to the great god $.
It is standard operating procedure for professors to spend only a perfunctory amount of time at the school while pursuing lucrative speaking engagements, commercial ventures outside. Their professorial chairs simply provide a merit badge to peddle to drug companies, foundations, think tanks. This happens extensively at private institutions and now at state schools.
Professors peddle their credentials and now even Harvard peddles 9 month degrees on line. Step right up--get your crimson diploma right here.
MSK is just the smoke which has caught the attention of the press, which has failed to expose the seamy underside of American academia.
3
Deborah Estrin, associate dean and professor at Cornell Tech in NY and one of the scientific advisors at Paige.AI specializes on handling of electronic health records. How did she not see the conflicts of interest here?
Director of Office of Technology Development at MSK,Greg Raskin is also on the board of another MSK startup Samus Therapeutics who lists Larry Norton Senior Vice President and Medical Director, Evelyn H. Lauder Breast Center at MSK as medical advisor. Do Greg Raskin and Larry Norton own stock at Samus Therapeutics? If so, will they disclose it publicly?
6
I want to know why MSKCC President Dr. Thompson is exempt from the Dollars for Docs project (https://projects.propublica.org/docdollars/). As others have said, I think we've only seen the tip of the iceberg with the hospital.
It's just so disheartening. I worked there in the early 2010s, and there are so many employees (doctors, all the way down) doing great things for patients. Is the recent news a deserved stain? Time will tell. In the meantime, as if cancer patients need any other blows to contend with, now they're being forced to question the ethics of the institution tasked with saving them from their disease.
9
Because, of course, nothing could go wrong with sharing personal medical information ....
2
Let's see ? New York's governor is corrupt ( endorsed by the NY TImes), Wall Street ( goes without saying) and now Sloan Kettering. The home of Trump and Clinton,
Enough as the conscience of everyone else.
Here's the problem yet again: No one is going to prison for this behavior. And, big surprise: the rich get richer off of all of us. Now it's our tissue samples. These greedy men should be ashamed of themselves but they are not, I'm sure.
2
This story echoes the story of Henrietta Lacks, whose cancer cells were used by researchers to create an "immortal" cell line, still in use today. She was never told that the cells from her biopsy were being used, and she died from cervical cancer. She and her entire family lived and died in extreme poverty while the doctors who used her cells to create the "HeLa" line, made millions. It's sickening, it goes against everything that doctors are supposed to stand for, and these doctors who started this pathetic company should be drummed out of medicine. To extend the metaphor, they are cancerous cells.
3
What a shame that such a fantastic idea, tapping the potential in all those tissue samples, would turn into such a slimy bit of self-dealing by individuals who are still trying to sell the absurd notion that there was no better deal available for the benefit of the world's patients, the institution, and those whose tissue is being exploited.
This deal should be killed and a better one negotiated.
4
This Is The Main Reason Cancers' Cures Are Delayed And Denied To Americans - The Monetizing of Cancer Research Results - By A Few Insidious Insiders - Despite Our Taxes Supporting The Research at MSK, NIH, M. D. Anderson Cancer Center, etc. (M. D. Anderson's Proton Beam Therapy Center Is Owned 53% by China's Concord Med Holdings Ltd, ?% by Hedge Funds, %? by Texas Insiders and little % by MD Anderson - Despite MDA's Claims to Be A "Univ. of Texas" ("State") Facility.
Only Harvard/Mass. Gen'l Hospital keeps proper, ethical separation between [A] The Public's Interests and [B] Self-
Interested Short-Sighted Promoters and Grifters as pictured here.
It is No wonder Why Most Cancer-Patients' Families Must File Bankrutcy.
2
you sound like the Harvard PR dept. Harvard and the Broad Institute are even more corrupt than MSK.
2
So much sleaze coming from MSK these days. Time for Craig Thompson to go. The unethical behavior is jeopardizing the efforts of the many fine and decent people who work there. Signed former employee 1981-1990
5
Anyone who hasn’t read The Immortal Life of Henrietta Lacks should do so. It’s a compelling read. The author Rebecca Skloot addresses similar ethical concerns.
From the author’s web site: Henrietta’s cells have been bought and sold by the billions, yet she remains virtually unknown, and her family can’t afford health insurance. ... (The book discusses) the legal battles over whether we control the stuff we’re made of.
3
I want to bring something to the attention of the authors of this article. In short, my sister who has been under the care of MSKH for more than 40 years has a complex condition in which she has three separate types of cancer. She has some small metastases....she wanted to get a second opinion but Sloan Kettering Oncologists have a policy of no internal second opinions. If you want want another opinion you have to stay with this doctor. This is unprecedented and unethical. I am an academic vascular surgeon at UmassMed...the story is worse. I believe self-centered egotistic rule is consistent with the lack of values that you have uncovered in your outstanding reporting. I hope you will be willing to, at least, hear me and my sister out.
Louis M Messina, MD
6
This is yet another blatant exhibit of the unethical culture plaguing MSKCC in recent years. Have we had enough of so many scandals, ridiculous excuses, and kneejerk responses from one institute? Are we seeing the beginning of the end of a corrupted era at MSKCC? Who are responsible and are we ready to cure the “Cancer of Greed” at MSKCC? It all began with the ROBUST program that has been in place at MSKCC for years, telling employees, trainees etc. to turn a blind eye when witnessing unethical issues because it is OK because we “MSK” are corporate and corporate (executive, personal) interests are above ethics. Under this hypnotizing self-deceiving lullaby, the CEO (Craig Thompson) at the very top likely had endorsed his physician-in-chief (Jose Basalga) and the Pathology chairman (David Klimstra), and misled the board members onto this unfathomable entrepreneurship, i.e. “donations and patients” entering MSKCC turns executives’ entitled self-indulging inventions. Hence, if people don’t agree and cooperate with the leadership, they have to leave. It is time for the incumbent ROBUST program to implode and for the search of new outside leadership with high ethical standards to restore the esteem leadership role of MSKCC in cancer patient care and research as a TRUE NON-PROFIT organization. Finally, we would all echo what stated in the recent NYT editorial “Medicine’s Financial Contamination”: leaders more than rule books set the example that others will follow.
7
Behavior and decisions are consistent w/ the previously reported issues w/ Dr. Baselga ( CMO at MSK). This is both a profound failure of leadership at the highest levels, and another profound failure to behave w/ decency and ethics. Shame upon you, Board members and Physician leaders at MSK.
3
Anyone who thinks Sloan Kettering is a charity should check with their billing department - very uncharitable.
8
Hey, as a one-time resident of MSKCC and a Cancer survivor, how do I become an investor? Maybe Mrs. Kravis will give me some of her winnings? Mr Druckenmiller?
1
Think of HeLa on this one.
2
Nothing quite as disgusting as someone making a profit off of suffering. Do they steal the gold from the deceased too?
3
This is worse than a scandal - it is a shanda
2
Very fine reporting by Charles Ornstein and Katie Thomas. I’d like to see the business plan (if there is one, heh) for the Paige.AI venture. This would (ideally) clarify the actions of the Sloan Kettering partners. But if there is no detailed business plan, it could indicate a shoddy approach to executing this venture.
Suspicion arises when we look at the specious arguments from participants in the deal. VP Dr. Rankin states: “We feel this is a really valuable and important technology to get developed,” which is a diversion from the discussion about the deal’s legality. And Dr. Fuch’s echoes the typical naive, or disingenuous, techie response, “Computer scientists like myself very seldom get the chance to really help patients,”. His statement could have been issued by Uber or Facebook.
Regardless of the outcome of this deal, it appears that it was a poorly executed effort by several wealthy, powerful people who leveraged their privileged positions to effect the venture. If they attempted to fly it under the regulatory radar, then they are complicit; if they weren’t aware of the business requirements, then they are inept.
6
@Charles Excellent analysis, very well written.
Don't you love it when someone with his hand in the cookie jar exclaims that the problem is not stealing cookies! The problem is that the thief inadequately "communicated" about cookies!
This reeks to high heaven. Bid-rigging, treachery, rapacious greed, hypocrisy when caught... it's all here.
I would love to know why these entrepreneurs at Sloan Kettering chose to privatize the profit from this venture for themselves. At least one of them realized how horrible this looks. Thank you, NYT and Pro Publica.
38
No wonder greed is near the top of the seven cardinal sins.
2
Time to axe the “leadership” of this great, but sadly diseased, organization. Despicable.
3
Greed, greed and more greed among the Doctor class. Disgusting.
2
Universities and other ostensibly "publicly funded" institutions are institutionally milking the public. Taking the money from pain, suffering and generosity and funding the profits of big Pharma.
Cancer research, the longest running scam in history. Part of the great American greed ethic, screw the sick, milk the rest. Keep the money flowing.
2
This hospital and virtually every other hospital that has a lab has a trove of data sitting in some storage system. Using it locally, dependent upon the accumulated skill of a particular physician, is a societal waste. The skill of the doctor disappears when they die. The data is there and should be used to benefit society as a whole. If someone has the skill to develop a process to analyze that data and advance the treatment of the cancers that kill many of us each day go for it. If they make some money on their development of a research process so what. The individual data item by itself is useless beyond the person afflicted that generated the slide or data item. The governing board should take another look at how the "benefits" are distributed for the good of all and medicine. Some of the benefits should go to those who had the initiative to get the process started and then reinvest the rest it in the hospital and society to improve cancer treatment across the world.
8
At this point, it seems clear that this is a 'catastrophic' failure of leadership for MSK.
1.The overseeing Board members failed in their duties ( to the Institution)
2. The non-Physician top executives failed in their duties ( to the Institution and to the hard-working and ethical Physicians and Nurses involved w/ patient care)
3. The involved Physicians failed in their duties ( to their patients, the staff in their research labs, to practicing Physicians like me who read their published papers in journals such as NEJM and Lancet, assuming them to have integrity)
Shame upon all of you. ( Harvard Business School:
Will you make this a case study for your students, please!).
11
If the non-profit MSK wanted to maximize the public benefit of its data, it would make it freely available to all researchers. I'm sure it could find a foundation to fund such as effort. Instead, it limits the data to one for-profit company. It can brag about the results of the one company, but how many treatments will not be discovered and how many people will die because MSK won't allow other researchers to also use the data, so that it can get profits from the one chosen company?
12
There seems to be a lot of hedge fund folks with seats on Sloan’s board. It’s hardly surprising that they seek to monetize their position by the use of information that really doesn’t belong to them, like Facebook and Google and the others. Isn’t that the American way?
9
In my opinion, I’m not sure the article adequately explained the risks of bringing any “invention” to market. Most inventions and startups fail. The odds are this one will fail too and investors will lose all their money.
Capitalism rewards risk and punished failure.
I don’t see how this violates that basic rule, except if it is a success, not only will those who took the risk benefit, but society and the public as well.
5
Capitalism rewards success, not a risk, because risk very often ends up in a failure. In this particular case , granting the license to one company means to give this company an advantage compare to other companies which amounts to gaming the system. Excluding other companies increases risk of failure for society, because it puts resources in one basket
5
The real issue here is not the financial arrangements of the staff and hospital board members - which are fundamentally improper, unprofessional and hopefully illegal. The REAL issue is blocking access of all researchers to the tissue slides. These are not the property of MSK; they are the critical result of 60 years of research and treatment across multitudes of patients, physicians and scientists. At a minimum they are property of the human race; MSK is only the custodian of that body of knowledge to ensure its unhindered availability to improve the lives of all.
32
Agree. As Salk said when he refused to patent the polio vaccine, “how do you patent the sun.”
This is just an excuse to own the rights to this invaluable catalogue of data. The key to life for thousands that is locked up except to the highest bidder.
3
It is quite possible to enlist talented bioinformaticians to work on such big data issues without having to compromise integrity. But it does require funding from either federal funding, or non-profit foundations.
If, in the worst case, it is necessary to enlist commercial group, then everyone with a stake in the venture, which includes all researchers,patients, the NIH , should have a share in any profits, instead of limiting gains to the few in power at the time of the agreement. Otherwise they are robbing researchers, patients and taxpayers who paid with federal research funding
4
How do we want research done?
That's the prime question... we've cut national funding for independent (and publicly-owned) research to the bone. We've created a lost generation of researchers who face absurdly low chances of obtaining funding for independent research.
The current trend seems to be to privatize research. Privatizing research means finding venture capital. Finding venture capital means offering the chance for profit. Offering the chance for profit in biomedical research means accepting fairly low odds of success. Accepting fairly low odds of success means expecting a substantial payout for success. Yes, this feels oily, sleazy, and slimy, but before we clamor too much, we need to answer the question:
How do we want research done?
23
Complicated.
Now that many of us have freely donated our or our family's data to a for profit corporate entity, who will be able to use the technology that results from this research and what will we be charged?
If this is another phase of concierge medical care only for the rich and the resulting tests and procedures that result from this are only for the rich that is pure exploitation.
The government could fund this kind of entity and make it available for public use at a lower cost since the profit motive could be different.
6
I am a cancer survivor. Recently, I received an email from a cancer society about a research project. They were requesting access to my records. The records would be "scrubbed." The idea was to pool records from around the country to help with diagnosis. Now I wonder if someone will profit from my records.
7
@mabeans They will, of course. It's the only motive at work here. Additionally, cancer research and new drugs are not really extending our lives or curing cancer. A quote from JAMA "Overall cancer survival has barely changed over the past decade. The 72 cancer therapies approved from 2002 to 2014 gave patients only 2.1 more months of life than older drugs."
Also, see: https://www.usatoday.com/story/news/nation/2017/02/09/new-cancer-drugs-d...
Patients are not getting cured at the rate that they should be getting cured considering the amount of money that is poured into cancer research. Diagnosis is also a huge business. There's something very, very wrong in the medical industry.
15
@Joanna Stelling
I completely agree with you, and yours is a point that needs to be emphasized more often and more loudly. And if the ultimate causes of cancer were to be determined, the many for-profit companies that make and distribute cancer-causing pollutants would take a financial hit, so the web extends beyond the medical industry. There's money to be made at every step along the way.
"Dr. Fuchs had previously worked for NASA developing algorithms that would teach the Mars rovers to navigate terrain, and has said some of the same algorithms can differentiate cancerous tumors from benign ones"
Does NASA/US Federal govt. have something to say about this? Who owns those algorithms--Fuchs or the US taxpayer?
7
The courts have ruled that pure algorithms, on their own, are not patentable.
3
@Jacob
That's a simplification. An AI algorithm that allows a computer to produce a useful result certainly is. See, for example, Enfish v Microsoft.
@Jacob
Goldman Sachs chased down Sergey Aleynikov for theft of trade secrets. It's not quite the same, but shows how much gray area there is.
Mathematics cannot be patented, such as "2+2=4" or "pi = circumference/diameter". But a non-obvious sequence of mathematics (algorithm) can be.
1
Ever since the rise of the billionaires in Silicon Valley, all major academic medical centers have been looking for ways to commericalize their most valuable asset - patient data. These money grabs would be easier to swallow if they included mechanisms for funneling the profits back to the institution in some form of corporate philanthropy rather than to enrich the privileged few at the top.
14
Obviously, no individual, group, or entity, should benefit, unless express permission is given, for the specific use, from the use of material and or data, mined from human tissue, whether that human be dead or alive; in cases where the tissue is from a deceased person then the estate has control.
That said, AI through the creation of algorithms, especially predictive algorithms, and specific predictive groups imbued with autonomous ability, with unfettered access to data and cloud computing, will, in the not so distant future, provide solutions which will peel away the limitations of the human intellect, and light the way to a better future.
AI can do some very curious things, such as developing it's own language variant, in an attempt to prevent human interference, so its "thinking" may remain inviolable, the kind of thing that caused Steve Hawkins to wonder and worry.
Humanity is only now peeking out of its cave, and we all need to put aside the innate tribal instinct, and work together to insure this nearly invisible grain of matter we cling to, continues to exist.
3
That's nonsense — no present AI has a will of its own; there's no evidence any have ever deliberately obscured their processing from observation by their human programmers.
@Jacob
None "you" are aware of ...
Taken to the extreme, this situation at MSK could be repeated at ANY health care institution. But it generally doesn't happen because the sharing of medical records and biological samples from patients is subject to stringent laws and ethical requirements that generally prevent non-essential parties from having access. Certainly no access to private, for-profit industry unless they are directly responsible for the data creation. This is even true if the said corporation has "good intentions". MSK may also (likely) have IP associated with their acquisition, interpretation, and management of the data and samples that they could and should protect. It seems that full disclosure of the PAIGE plans should have been made to all impacted parties by those MSK select Board Members and Investors, and you can be sure that they knew it a priori. They didn't do that. This could represent a major breach of ethics and law.
10
Leaving aside the commercialization issue here we should be very careful not to overprotect de-identified patient data such as diagnostic images or pathology slides because this would be an onerous restriction on education and research and have a very real negative effect.
6
What a mess MSK has on its hands. Greed greed greed treed. I wonder how much personal attention patients are geting from these physicians?
8
Not much, in my experience. They completely dropped the ball with my partner, who died of liver cancer — much sooner than he might have if they’d been paying more attention. Our questions and concerns were mostly ignored; it was often impossible to get anyone’s attention. We also got repeatedly conflicting information from doctors who were supposed to be working together on his so-called team, downright wrong and dangerous information from another one, and a medication error from his lead oncologist, with disastrous results that shortened his life and made his last few months on this earth much more miserable than they had to be. My lasting impression is that, at the end of the day, if a patient doesn’t qualify for one of MSK’s clinical trials, that patient falls through the cracks. This is not my view alone — I’ve heard this same story from other patients and their families. MSK is not all it’s cracked up to be, at best. I wouldn’t send anyone there, especially given these most recent disclosures.
9
@Ali T
It is sad that many compassionate doctors working now getting these poor comments. It is the leadership who sets bad examples for people to follow. Those people are responsible. People at MSK are responsible for not speaking up against the Cancer of Greed.
The *physicians* aren't the ones possibly at fault here. It's the *management* (and it's cozy relationship with new venture) that's being questioned. Did you not read the actual article?
1
Expect this is just the tip of the iceberg
9
@islandbird
Absolutely, many more have been covered up and neglected from the very top.
1
GREED.
Medicine is BIG business.
You will be allowed to die...AFTER you pay out every last penny you possessed for drugs or treatment to some billionaire and have no money left for you or your children. These deals are just designed to ensure the direction of the money flow.
9
This is another disturbing example of greed intruding in health care in this country and should nudge concerned citizens into advocating loudly and consistently for profit to be removed from the system. Why should the chair of pathology and members of the board profit from the work, intellect, talent and dedication of the pathologists?
Why should these same individuals essentially profit from the patients whom these staff physicians diagnosed and treated?
Sure, "artificial intelligence" and statistical analysis may have a place in medicine....but the end goal here is to reap a profit, replace the pathologists and "leverage" the MSKCC data. Klimstra should be removed and the board members should be forced to step down. But that won't happen, because MKSCC doesn't want to lose its influential benefactors and Klimstra is entrenched. He cares for the department as much as he does for his family? That doesn't say much for his family.
As for "informatics" specialists in medicine and the computational analysts....those are the individuals who can't cut it in clinical medicine. Can't diagnose their way out of a paper bag and they should be in another line of work.
The MKSCC pathologists should be in an uproar. Rampant dishonesty and poor leadership. Klimstra should do the right thing and step down.
92
@A doctor in the Americas That attitude toward informatics/statistics is disappointing coming from a doctor. We need all the help we can get solving the problem of cancer; so far it appears to be solvable only with high-scale data and computation. They have not just a role but an absolutely critical role in this line of work. The pathologists should be in an uproar over the ethical shadiness of this move, agreed, but we should be honest about whose jobs are in the crosshairs of advanced computational methods: pathologists.
Let's make sure that we give people the credit they deserve - informaticians, pathologists and clinicians alike - and take the shortest path to the cure. It will involve statistics, I promise.
5
@A doctor in the Americas
Just a post script here...I’m a physician and a cancer survivor. I have first hand experience of both sides of the equation .... the angst and stress of treatment, decisions, medical costs. The worry...
And I am fortunate to have a pathologist in my family who is capable, conscientious and always focused on doing everything he can for the patient and the patient’s clinicians. And he happens to work at a stellar institution fighting the kind of erosion of integrity this MKSCC episode exemplifies.
This MKSCC scandal is a travesty and outright greed which should not be tolerated. It besmirches all the other physicians focused on doing the right thing all the time.
8
@March of technology
You are right - "informaticians" have a place and statistics are important. (Full disclosure, I am a physician working in clinical medicine who also has a PhD and MPH so recognize and give due credit to biostatisticians.) That said, informatics is the flavor of the decade in medicine and an astounding amount of dollars are being spent on "informatics" in medical institutions - wasteful spending which emanates from the top down and provide "directors" of this and that. The clinicians who can have an impact can work together with the biostatisticians who can have a impact - and their synergy can lead to great discoveries. The lack of true teams and translational efforts is the problem...and I can assure you, I don't see any way pathologists, radiologists and anesthesiologists are going to be replaced by robots or artificial intelligence in the foreseeable future. It is the hubris and greed that is driving this engine. You may think that pathologists are in the crosshairs but I believe you don't understand enough what these physicians do. You can train a monkey to do certain jobs or replace some with computational analysis....this is not one of them.
1
A majority of profits from the start-up, Paige.AI, should be devoted to the direct care of patients at MSKCC.
Investors could still be able to recoup their initial investment, with a reasonable profit but the lion’s share should be “re-invested” in caring for persons with cancer.
9
I just want to remind people that MSKCC's groundbreaking work to save lives eclipses any unseemly alliances.
6
@DCBinNYC Could you explain the groundbreaking work and how it saved lives? My friend who was treated at MSK for breast cancer, did not have a good experience there. Just curious about what they've done to increase cancer survival rates, not diagnoses. We have too many diagnostic tools and not enough tools to cure people.
2
Does it, though?
No, no it does not.
1
This issue wouldn’t be so obscene if medical care wasn’t so obscenely expensive.
10
The Chairman Selby says, "we were desperate and could not find investors" and Fuchs says it is the culmination of a life work.. Hmm. Someone is lying. This is a dreadful conflict and breaches trust in the very institution in whom we place it for our own lives and the lives of our loved ones. All of these people should be asked and the transactions ( exclusive use ) should be valued in the open market. Stan understands this as do all the others.. greed and nothing else... an insiders deal. Lets get a read on all the emails and texts between individuals so we can understand their excitement win the deal that could not generate any "interest"...
7
MSKCC is a corporate juggernaut holding itself out as a charitable institution. It is the Amazon of cancer care. If you look at the MSK network of satellite medical centers, which is ever expanding, where are they? They are strategically placed in locales surrounded by affluent towns/communities, with well-insured residents. There are many excellent medical centers practicing state of the art cancer medicine just a stones throw away from these MSK satellites. MSK's business strategy is not surprising, given that it's board members seem to be a bunch of hedge fund managers. If one tries to find information on what % of their patients are uninsured or Medicaid, you will have a difficult time. Have you or a loved one ever tried to get an appointment there? Easy enough if you are well-insured, otherwise good luck. When the rank-and-file oncologists at MSK are calling out their department chairs, you get a feeling this is a pervasive culture of greed. Why does the pathology/AI/genomic database need to be privatized in a "non-profit" institution? Other medical centers have banded together to form consortiums to address large clinical and research questions. Oh wait, this would dilute MSKCC's brand. I wouldn't want the board members to miss out on a great investment opportunity. Hey, I'm sure they on the board out of pure altruism in the first place. And the dept. chairs deserve something for their years of toil at the top of the medical hierarchy (gagging noise).
25
@JBJ Yes, your point about getting an appointment there is well taken. My friend, who is not on Medicaid or Medicare, just a normal middle-aged woman who had breast cancer - had to go to a friend who went to a friend, etc. etc. in order to get an appointment. Just calling them, as you would call a regular doctor's office, is totally useless. So, I'm sure if she was a Medicaid patient, she wouldn't be seen at all.
3
The website of PAIGE and Dr. Fuchs' LinkedIn profile are asthonishing. His primary presentation is as Chief Scientific Officer of the company and there does not seem to be a separation of his work for PAIGE and for MSK. I am not sure why this is permitted by MSK and Weil Cornell.
13
@UB
It is at least permitted by the CEO.
2
Similar to my thoughts on ALL companies with ties or formed at a nonprofit .... yes FB and Google ... when you use a nonprofit’s environment and data to help make $ and no matter how noble the cause, the majority of $ needs to go back to the nonprofit. Not just a small percent.
I highly doubt people donating bodies to science or giving a swab of issue when being tested agreed to do so t allow a for profit company to get rich.
Disgusting even if the mission is to cure cancer.
11
Everything in America is for sale. Greed prevails throughout. Started before DJT's election, enhanced by his control of our country that he exercises wantonly.
It seems this was not presented to a Human Studies review for approval; if it was presented and was approved, the review board failed miserably in protecting current and former patients. A horrendous ethical failure either way.
17
Mskcc needs to take better care of its staff nurses. They dont respect them or treat thme fairly. They rule with intimidation and are always last to give them any pay raises especially when their competers are putting nurses first. The nurses might not be curing cancer as stated by their human resources officer at a meeting, but are the front line in patient care and the heart of the insitution. Every year the cost of living goes up from parking to health care cost but any raise we get is eaten up by this. We are expected to work 2 hours without overtime because they say we are salary workers and professional but dont ever abide by state law governing requirments for professionals. They steal the nurses overtime and retaliate if you say anything about it. The state needs to investegate mskcc on labor laws or we need a union to come and help us workers.
5
Either take away their nonprofit status, or they shut down the deal. Appointing a task force is a delaying tactic and means they intend to stay involved. Complete corruption.
14
I was going to offer some erudite commentary like many of the well written commentary’s prior to mine on this article. But at this late hour in the evening all I can think of is that I want to vomit.
14
It is sad, such a great institution. But unfortunately, doctors like this exist. Even at Sloan Kettering.
Another doctor here was also in the news. While voting against a new therapy, Dr. Howard Scher's family's hedge fund according to this SEC document was heavily invested in Cancer/Chemo stocks:
http://www.secinfo.com/d12kd8.ue.htm
https://www.nytimes.com/2007/06/04/health/04drug.html
7
Cancer survivor here. Two hospitals have my biopsy samples. At a certain point in my treatment I wanted the slides to pass by another pathologist for a second opinion. I was up against a major surgery or risking just chemo, my doctor almost quit my case because I was questioning the process. I was also about to loose my insurance so time was of the essence. The records department treated me as a problem, the hospitals like they were doing me a favor. I was sick as a dog and dying. Things didn’t get better, I lost everything, house savings, family but I’m alive. The idea that health is a business only bennifits people who control money. I put them in the same camp with people who take girls and sell them - against their will - for sex. We are all slaves to finance. It’s getting worse. Not even my tissue is mine.
120
@Slo Congratulations for being a cancer survivor. But I can't believe there is a pathologist or a radiologist in the U.S.A. who wouldn't mail out pathology slides or X-rays for a second opinion of your choice. Considering there are two lawyers for every doctor in this country ( annual law school admissions is 40,000 and medical school admissions is 20,000 approximately), your experience is very unfortunate.
MSK's "lack of communications" with their pathologists does not surprise me. As an MSK patient I constantly faced their "lack of communications" about my surgery and post surgery quality of life. Their billing department told me "we are NOT a non profit" (really!) so they could demand my $85,000+ payment within 60 days.
Saying it's a "lack of communications" is just a nice way to coverup their culture of deceit to keep their cancer patient assemblyline profitably humming along.
10
I'm agnostic but thank God for the failing NYT. If I recall correctly Elizabeth Rosenthal of the NYT a few years ago did some outstanding reporting on some terrible things happening in healthcare in the USA. Definitely, Pulitzer worthy! But as far as I know nothing happened. The swamp was not cleared. Now, the swamp has never been more pestilent. The various people involved in this AI venture now declare their good intentions - then, why was it all kept secretive, no disclosure, apparently no legal opinions sought.
I started medical school 1970 and if I am not totally deluded, I viewed it as akin to a vocation, I am sure I never viewed it in monetary terms (I confess I was likely aware that it was unlikely I would become homeless, penniless!). I am curious if people posting especially physicians, nurses consider my naive notion of our professions are now extinct.
10
@Branagh Ms. Rosenthal's book, "An American Sickness," is fantastic, It provides so much good information on how to negotiate this corrupt system of medicine that we have. But the book has so much more. I bring it with me to every doctor's appointment. An interesting side note: doctors don't like seeing patients who ask informed questions, and who don't treat them (the doctors) like gods. Imagine that. The collective medical profession is like the wizard of Oz. We really need to pull back that curtain.
According to the Salk Institute, "In the two years before the vaccine was widely available, the average number of polio cases in the U.S. was more than 45,000. By 1962, that number had dropped to 910. Hailed as a miracle worker, Salk never patented the vaccine or earned any money from his discovery, preferring it be distributed as widely as possible."
These cancer hospitals do great work. It's too bad their research and knowledge create breakthroughs that can only be accessed by the privileged. Today's world seems to be one of greed not service.
10
But what about the people needing an accurate diagnosis? Don't stop this work. Find a way to make it transparent and ethical and share it universally. Sloan Kettering is bad. Cancer is far far worse.
3
"As one digs deeper into the national character of the Americans, one sees that they have sought the value of everything in this world only in the answer to this single question: how much money will it bring in?"
Alexis de Tocqueville
8
What are two hedge fund managers doing on the board of a non-profit medical institution??
17
@keb
I think you know the answer to that one...
During one of my appointments with my oncologist -pre mastectomy, I was asked if I would agree to donate tissue from my tumor to add to the hospital research “library.” I signed a form granting permission without the least hesitation. I certainly would not have liked the idea that my tissue would end up enriching a few individuals without my knowledge.
13
This article is like reading a Michael Crichton novel. Board members and heads of department in an internationally famous hospital with a long history, all profiting in a 'non-profit' way. Great reporting!
11
@carolz These two reporters are amazing.
1
Greed has sullied the reputation of what had been one of the most highly esteemed medical institutions in the country. Although a family member was treated at Memorial in the past, I think I would hesitate to refer anyone there in the future. How could one ever know that the treatment protocols being recommended weren't also lining someone's pockets? Sad and disgusting news indeed.
10
Something smells very rotten in this deal and should be halted immediately. The board members should be investigated and the hospital should not be allowed to do this. Whether or not the slides and pathology reports are anonymous, there should be an immediate stoppage. Their motivation is nothing more than greed. How much is enough?
7
I am stunned that anyone here is surprised, shocked, appealed by this.
Of course you sell exclusive rights to invaluable medical samples, of you course you give patents for living organisms and newly discovered aspects of living tissue. This is what we in Americas choose.
If there's money to be made, profits to be inflated, investments to be rewarded, human life is meaningless. Unless it needs to be saved by the latest medication you're peddling.
This is the very definition of for-profit medicine.
And it is almost exclusively American, where healthcare is big, big business practiced by "foundations" rich enough to buy up huge swaths of real estate and pay their executives millions upon millions of dollars.
If you can afford to live, live. If you can't, pay for what you can then go away and die quietly.
Its why corporations and investors don't take the Hippocratic Oath. Unless they're doctors, of course, and then there's big problem.
6
This is so wrong as to be indescribable. Most of the research done by the MSK pathologists would have been funded by the federal government. Much of the clinical care given to the patients whose specimens are being used would have been paid for by Medicare and/or Medicaid. For MSK to turn this into a profit making venture is completely inappropriate.
Full disclosure: I am a cancer researcher at a different institution.
11
Wow, the who's who of greed
9
Takes the concept of an “inside job” to new levels. They were “desperate for investors,” but just gave (only) their rich friends the opportunity to get richer, and used hospital senior staff to seal the deal. I, too, am an MSK patient. Why not ask patients if WE want to invest? Definitely Henrietta Lacks redux.
8
If all the rules of privacy are followed, any effort towards the goal to eradicate cancer is one that should be funded. Allowing only one research group, Paige AI in this instance, to have access to the MSK slides reveals the short-sightedness that exists in so much scientific research, not to mention greed. If the archive of a non-profit cancer center is to be opened for research, it seems only right that all worthwhile research groups should have access to it. If all research groups were allowed access to the archive, and in exchange were required to share their findings with each other, imagine how the landscape of cancer research may change.
6
A deal to profit from the tissues and research of others? Ok, sure. An exclusive deal? No one else can profit or benefit? No one can validate the results? No patient can profit? No check by the market on rampant greed? No, not good, not worthy, not moral, not acceptable.
6
In accordance with its not-for-profit mission, MSK should be making this data freely available to all legitimate researchers -- perhaps with a modest fee sufficient to cover costs associated with providing the data.
10
Yes, either available to all or no one. This is straight up corrupt.
4
When any institution is given a tax exempt status by a state or the Federal Government, essentially the public is subsidizing it. That means the good people of New York and the United States have been subsidizing the work and operation of Sloan Kettering.
Now the snake of profit has entered the garden and board members and others seek to profit from work that has been given a tax exemption all these years. If one cannot see that such an action is wrong, they do not belong on the board or in leadership of a not for profit institution.
10
Putting asides the general disdain for industry endemic to the Times and its readers, this is a thorny issue of how data should be used. AI is still an approach yet to yield much benefit (ie see IBM's Watson) which is likely why no experienced biotech investors participated in formation of the company, and why the entire enterprise is speculative. Patient privacy is always paramount, but if it is true as the article notes that these slides lay fallow for decades, why such hostility to innovators who had an idea how to deploy them in a way that might benefit patients, and in a manner overlooked by the majority of the hospital staff who only now want a piece of the action ?
6
"Gimme a break! Those pathologists have already been paid for their expertise and slide interpretation.."
Average NYC pathologist salary according to Glassdoor.com $60,435/yr. Top pathologists at MSK likely earn something more than that, but those who choose to work in academia typically earn far less than those in the corporate for-profit world.
Average board member/hospital executive salary?
8
max, I was a staff nurse at MSKCC and when I left nearly 30 years ago, my salary was nearly $60k. The pathologists are well compensated.
2
@Max you don't know what you are talking about. Those pathologists make more than you imagine
As a professional consultant and board member on a non-profit, I have always thought the foundation of good governance was to avoid conflicts of interest or THE APPEARANCE OF CONFLICTS OF INTEREST at all costs, no matter how good you think a cause is. Your role as a board member in guiding any institution is to set that example for all levels of management.
Reading these events at MSK I can only conclude one of two things:
-the board members and leadership are unqualified for their job and something systematic at MSK has allowed for this error;
-the board members at MSK knew their job, but decided to do something in their self interest, clearly in violation of self dealing and conflicts, and perhaps in violation of US tax law.
The comment from the replacement lead physician also shows poor judgement--they see this as a one off problem of "being put under the micro scope". Sorry, that is a poor excuse, you should be under a microscope and you must own the responsibility of running your center to the highest standards.
Clearly MSK is not living up to the highest, or even high standards. They are better at making excuses (and money for themselves).
In either case, it is time to clean out MSK.
139
@Bob
This is yet another blatant exhibit of the unethical culture plaguing MSKCC in recent years. Have we had enough of so many scandals, ridiculous excuses, and knee jerk responses from one institute? Are we seeing the beginning of the end of a corrupted era at MSKCC? Who are responsible and are we ready to cure the “Cancer of Greed” at MSKCC? It all began with the ROBUST program that has been in place at MSKCC for years, telling employees, trainees etc. to turn a blind eye when witnessing unethical issues because it is OK because we “MSK” are corporate and corporate (executive, personal) interests are above ethics. Under this hypnotizing self-deceiving lullaby, the CEO at the very top likely had endorsed his physician-in-chief (Jose Basalga) and the Pathology chairman (David Klimstra), and misled the board members onto this unfathomable entrepreneurship, i.e. “donations and patients” entering MSKCC turns executives’ entitled self-indulging inventions. Hence, if people don’t agree and cooperate with the leadership, they have to leave. It is time for the incumbent ROBUST program to implode and for the search of new outside leadership with high ethical standards to restore the esteem leadership role of MSKCC in cancer patient care and research as a TRUE NON-PROFIT organization. God Bless MSK.
1
@Bob
A search for new leadership from outside academic institutes with high ethical standards to restore the esteem leadership role of MSKCC in cancer patient care and research as a TRUE NON-PROFIT organization is the imminent must first step.
1
I think the main problem is the conflict of interest presented by MSK management and directors having a financial interest in Paige.AI. As financial custodians of MSK what have they done to maximize the value of the information they have conveyed to Paige.AI? Were there discussions with multiple entities or exclusively with Paige.AI "one in a burgeoning field of start-ups that are applying artificial intelligence to health care"? Count me as a skeptic when it comes to venal interests of people in a position to funnel information from a nonprofit hospital to a for profit venture that they themslves have financial interest.
93
I cannot agree more. In response to the Dr. Baselga revelations, I mentioned in a comment at that time, that not declaring his interests and equity in start-up biotech ( which he felt was not necessary) that competitors who may be better, could be injured if he purposefully was inappropriately critical of their work. Furthermore obtaining the necessary material to validate a test is very expensive. Can we have full exposure as to what costs to the company this was? There should be the full accounting of the costs to the company from MSK and their employers, along with money received from the raised capital directly paid for roles. Digital Pathology is an exciting area of development. Why can not these specimens be made available to others in the field to determine which platform is best? Instead, they are at a decided disadvantage to find the needed specimens to validate a competitive approach
There are many thorny close calls in medical and professional ethics.
This is not one.
Without the consent, they shouldn’t release the slides to an outside entity.
And privacy isn’t the only issue at play here. You can’t exclude from consideration the rights and interests of the pathologists whose work created this mountain of data.
There is, though, a long term future solution: ask patients on admission to sign releases allowing future use of their tissue sample.
78
@Horace Dewey
I agree that a release segment should be added informing patients that the data, slides and conclusions could be used in cancer research. Few people would object in my opinion as long as their privacy is not breached.
As for the pathologists. Were they not paid to do their work? In almost all cases where a process is conducted on company time it belongs to the employer. If their work produces an innovative solution to a problem the employee usually compensated with a bonus and in this situation perhaps a nomination for the Nobel Prize or some other recognition.
I am though troubled by the incestuous way the company was formed to use this information and market it. With the only stock holders being persons medical and non-medical who are the managers it presents a conflict of interest situation that should be monitored by an outside agency. Even if no conflict arises there needs to be assurance to those outside the corporation that controls are the reason they aren't. I think we all know that nonprofits aren't always nonprofit but depend on accounting practices to make them look like they are.
@Horace Dewey And compensation to the patients for use of the sample. Signing release forms is like signing a non-disclosure agreement. Once you sign, you have to keep your mouth shut for the rest of your life. Once you "release" your personal data, it goes out to the world. If it's medical data you're releasing, I can picture the day when HR directors will fire or hire you based on that data. I can see financial analysts browsing that data and telling you that you're not a good candidate for a loan, at age 36, because you'll be dead in three years from a heart attack. People tsk, tsk this theory but from the way these doctors behave and the amount of leeway they are routinely given to treat patients like nothing more than specimens for research, I have no doubt that money, as always, will triumph.
I am a practicing pathologist in a community hospital. Every pathologist (whether in academics or the community) knows that there is a trove of untapped data in the tissue samples sent and stored in the lab. Most pathologists wouldn't know how to go about hacking and profiting off these specimens. So, we don't. If you want to make the big bucks, then you can always leave academia to chase the next big thing in industry. The decision to leave may not be easy but it is the right thing to do. This story smacks of tunnel vision, greed, and entitlement. It is not ok that those in charge conflated MSKCC's reputation with license to behave recklessly.
156
MSK saved my life when I went there for a second opinion and the doctor recommended a more aggressive treatment plan based on his study of thousands of similar tumors and treatments. So I feel that if my tissue and anything else related to my care can be used to advance the knowledge that can help other patients — please use it! But make sure that the people who are providing the care, in its many aspects from pathology to PT, can justly feel they are integral to MSK’s mission and not cogs in a machine that may be creating wealth for a few insiders.
112
My brother Tommy died at Memorial Sloan Kettering hospital in 1972 after nearly seven years of battle with leukemia. He was thirteen years old. Our family was shaped indelibly by his illness and death, as were his classmates, friends and neighbors. That anyone other than patients and their families might reap benefits- financial or otherwise- from their suffering speaks of a malignancy of ethics at MSK.
Physicians and researchers eager to use AI to speed up their investigations should certainly be supported, their labs funded, but NEVER ever should any physician or researcher be motivated by the prospect of financial gain; it is appalling that the research community would allow this. What population represents a more “vulnerable” subject pool than the dying, the dead, and their families IRB?
Sincerely,
Kathleen M. Corley, PhD
44
My feelings precisely. The motivating impetus here is financial gain, period. As a physician my goal is to treat patients kindly, compassionately , always with competence and integrity. I was assistant chief resident at MSKCC in 1986, and part of my responsibilities included teaching residents these core values.
I am appalled by what has transpired at MSK. Make no mistake, the sole purpose for this arrangement is financial aggrandizement, not to benefit patient care.
7
@Dr Michelle Steffers Yes. Were ( are) they still teaching Interns and residents the core values, w/ Dr. Jose Balega as CMO?! I as a practicing Physician too, am appalled.
In addition to an obligation to obtain each patient's permission to share their medical information and data with an outside interest such as described here, MSK and other institutions are obligated to state upfront how the data will be used and for whose benefit. It should be required that the institution state both to the internal Institutional Review Board and to all those from whom permission to use data will be obtained (in the consent form) whether or not the database will be public: To easily be available to all persons including other researchers and physicians outside of MSK. I fear there is a proprietary aim in the project described in this article. Unfortunately, most investors and sponsoring institutions want a share of the payoff on any money they invest and a share of the intellectual property rights on any of the findings.
The business world of academic medical centers is as competitive as other kinds of business. Just listen and watch the advertising claims, often over-generalized. These centers struggle to keep their patient flows high to survive in the expensive world of medical science and clinical research, especially in times of limited federal funding.
7
This is probably just the "tip of the iceberg". The Press needs to delve deeper and farther back to see what they might find in their investigations of the Sloan Kettering! Money corrupts absolutely!
18
There’s not way a law firm could evaluate the financial terms of a deal. The legal terms, yes. The valuation, no.
3
How can they use tissue samples without patient permission?
6
I bet you don't know that pathology labs must store tissue blocks and slides for 10 years after the diagnosis is rendered. A place like MSK would prepare more than a million slides a year. Over ten years they need to keep this material sorted and stored so it can be recovered and used by the patient's oncologists, usually within 48 hours. Do you know how much infrastructure is needed to do that? It is enormous. It is also uncompensated unless you believe it can be covered by the $45 bucks paid on a normal biopsy for dissecting, processing, staining, transporting, and transmitting the diagnosis back to the clinician. If they use the decades old material to promote science and reimburse some of their costs more power to them.
9
Seems they think the lesson of Henrietta Lacks, and no doubt many others, wasn't absorbed. Data counts along with cell samples. Good for the protesting pathologists. As former patient whose data was collected by MSK for almost 20 yrs of follow-up, I find this a huge violation of trust for both patients and the public supporting large nonprofit hospitals.
Patients have lost enough; now this too?
30
@Motownie
Hmmmm .... maybe if Henrietta Lacks was white they would have paid more attention.
I persuaded my mom who is diagnosed with cancer to go to MSK for the best care and I also raised money through cycle for survival for MSK. The ones in power are just benefiting from the powerless ones.
I feel sick reading this.
48
It would be very different if their findings were to be posted in the public research domain for others to test and expand on. Then it would seem that the real objective is find the best methods for early detection. Here it seems the primary goal is to personally profit off patient suffering.
96
If this is true non-profit venture, which it should be, all excess proceeds should be donated to past and present surviving patients, and not merely those whose primary profession and motive was and is business and finance, as is the case here.
Further, this should include MSKCC scientists physicians, and other MSKCC professionals who are directly and indirectly involved with this venture!
13
This isn't a swamp, it's a ___sty.
Example:
"Mr. Beattie said the hospital relied on some investors to set a value for licensing the slides, with guidance from hedge fund leaders on its board. A law firm, which he did not identify, evaluated the documents and said it was a good deal."
So the future investors set the price for what they would buy. then had - the classic ! - third party, a law firm they no doubt also paid, provide the "third party cover" for the deal. No doubt if this was discovered years after the fact the third party law firm would be blamed. And that firm would then say they were only "Providing advice, not a legal opinion".
"Kathryn Martin, the hospital’s chief operating officer, said the cancer center did not anticipate the pathologists’ objections. “I think we could have done a better job communicating it,” she said"
Yes if everything had been better communicated, all would be fine. That always absolves every fault in this society.
Everything in America is run from the inside these days.
50
@John McGlynn
Everything in America is for sale. Greed prevails throughout. Started before DJT's election, enhanced by his control of our country that he exercises wantonly.
These problems could be eliminated by making it a non-profit. These are already wealthy people and will continue being wealthy after their donation (investments). Just do it for the benefit of everyone. Poor people in poor hospitals in poor countries get cancer too.
2
". . . a for-profit venture that could be lucrative for a few leading researchers and board member" on the backs of cancer patients. Such incredible gall and greed on the part of these individuals is as despicable as it is appalling and egregious.
Shame on each and every one of these individuals who profited handsomely.
55
They hide behind their tax exempt "non-Profit" status. They hold fund raising benefits and parade around like a charity. Now the curtain gets pulled and we can get a glimpse of what really goes on. They should cut the nonsense and reorganize as a for-profit company and pay their employees accordingly. This is theft on many levels.
8
We have made annual donations to Sloan Kettering over the years, but we will stop donating until the obvious conflict of interest is resolved.
14
Did we not learn from the outrage over the history of the HeLa cells? Apparently not. Thank goddess for journalists holding every institution accountable to the people.
28
Maybe some patients and families should band together and hit and paige.AI and MSKCC with a class action suit. No better way to punish poor leadership and self dealing. They will all just walk away and make money anyway, so make them pay through the courts.
33
When President Ulysses Grant had throat cancer, a group of wealthy New Yorkers got together and started a cancer hospital which ultimately became Memorial Slaon Kettering with additional donations from Rockefellers and General Motors executives (Sloan and Kettering).
I think it is time for the billionaires of silicon valley to come into the picture, and make Paige.AI a non-profit entity. It should really be Paige.AI-NP (Pathology Artificial Interlligence Guidance Engine Non Profit).
21
@R Murty K Yes, but would it be NP-complete?
1
I think we have seen this before.
So did they read “The Immortal Life of Henrietta Lacks”? On the hand, maybe they did.
28
Exclusive access to the data for the profit of insiders. That is what rankles. Why is it a benefit to the public for just these MSK/PaigeAI guys to have access? (hint: it's not) Why would patients allow access to their tissue for research purposes For the profit of these guys? (another hint: they wouldn't).
I have donated tissue for the advancement of medical science to help others. NOT so some guy can make a buck off it. This is an outrage.
19
Simple. Revoke their non-profit status.
46
I spent time as a consultant for MSK. There are many good people doing important work, as in the rest of the healthcare industry.
This is too far. I’m disgusted. These executive administrators and physicians are smart enough to develop new treatments for cancer, but they are too blinded by greed and some lawyer saying “it’s not technically illegal” to use that intellect to realize blatantly unethical behavior. And even with no moral compass, an economic view of this shows that exclusivity on patients’ tissue is massively undervalued and it is unfair to MSK (the non-profit) at 9%. Not to mention the patients who had CANCER and paid for treatment are cut out altogether.
Here’s a quick litmus test for the next wave of capitalist curers: if 3 hedge fund investors join, it’s probably unethical. Vultures in cahoots with greed-blind executive doctors.
37
"Is there someway we can make a ton of money off other people's misery?" asks Sloan Kettering.
After all, in the U.S. today, death and misery are top money makers, and real political gold. Just ask Donald "I'm the biggest victim of Puerto Rico's hurricane" Trump.
15
When full page ads for Sloan Kettering were appearing in the New Yorker a few years ago, it seemed odd for a nonprofit to be marketing itself so enthusiastically. Red flag?
8
It is entirely clear to me that the secret to unraveling cancer in any dimension—cure, treatment, vaccine, cause, etc.— is the use of tissue samples in conjunction with computer analysis. So, the tissue samples are pure GOLD. If the patient is found not to own their own tissue sample, how on earth can MSK claim it owns them and has the ability to sell them to a profit making endeavor with presumably “altruistic” goals? Wake up NIH, NCI, ACS, and all cancer-related advocacy groups and get a consensus now on the use of these samples before someone claims singular rights to a mass of data that perhaps ought to be in the public domain for the benefit of researchers around the world IF in fact the endgame really is to save lives. I feel compelled to give a shoutout to all researchers who truly passionately love science for the intellectual challenges it presents. Please don’t be demoralized because I firmly believe the secrets to cancer are going to be found through the love of life and the excessive amounts of curiosity each of you has - not by a cancer treatment factory. Lastly, I object to the use of the term “greedy” to describe a patient who seeks control over their tissues for whatever reason they wish -money, principles, privacy, etc. If the patient is “greedy,” what shall we call the group of for-profits benefitting from the tissues?
55
As a data science strategist with non-profit and for profit experience and a nascent angel investor, my main concern is that the alleged improprieties will prevent the value of this data from being unlocked.
Artificial Intelligence (aka Machine Learning) has the potential to exponentially increase the pace of the race for a cure. This incident and another poor execution at MD Anderson also covered by the Times jeopardize access to crucial data from non-profits, an astoundingly risk averse group.
The worst case is that all such institutions make a binary negative decision to stay away from data licensing for fear of ending up on the front page of the Times in a negative way.
The losers in this scenario are patients who are clinging to life hoping for breakthroughs.
As to the ethics, first of all it is naive to think that non-profits are not big financial enterprises. They are enormous revenue generators paying big salaries to highly skilled senior executives.
Second, the best way to structure public-private partnerships is through a for-profit subsidiary or foundation. The Mayo Clinic does an excellent job of partnering with startups without raising conflict of interest issues for itself or its clinical and administrative employees.
Third, it is arguable that an exclusive deal is better from a data security perspective than the non-exclusive Facebook/Google approach.
Fourth, there is a need for cost benefit analysis of privacy concerns. In cancer, benefit>cost IMHO.
26
This should have been your wake up call. "Get Well in the RNAi Way-RNAi, A Billion Dollar Baby in Therapy (2015).
George Church et al used NIH funded research to support their claims and patented naturally occurring RNA interference, which is about to become most effective for prevention and/or treatment of all virus-driven pathology.
More than 77,000 published/indexed work on PubMed support that claim. Search for "microRNA" and watch as more than 1000 new publications are added each month.
2
If this was primarily for patient benefit I would suggest that Dr. Klimstra and others who work in MSK and the board member should pledge that they donate all the profit from this project to research and patient care at MSK . I am certain they doing this to be come super rich with million if billion dollars pay off in the near future. Greed and nothing else.
11
Earlier today, a colleague observed that we humans have a way of making the same old mistakes with new technologies. The leadership of MSK offers a perfect example.
Someone waves his hands and tells folks in authority that this new idea will “transform the way we diagnose cancer!” Outside investors aren’t so sure, and no one seems to have looked around too much to see what’s what. But, whatever! The folks invest, hoping to make millions while ignoring obvious conflicts of interest, not to mention how cancer patients, pathologists, and pretty much the public might feel about all this. Talk about tone deaf.
American society’s overzealous quest for profit is destroying science and medicine (well, not just those two things). It leads to exaggerated claims, like unproven ideas transforming diagnosis — if only we raise a king’s ransom first. Surely, there has to be a more ethical way to test an idea.
15
This is a rather discouraging story. My wife was a cancer patient there in the early 1970's. I think that the corporation needs to solicit our permission to use the samples, and pay us for them. Or, with patients' permission the samples could be sold with our permission and the monies received be made a charitable donation to the hospital.
In no instance would we allow her slides, results, etc. be given to the for profit corporation.
76
This is disheartening and infuriating. Two unintended consequences may be: (1) In larger and larger numbers, patients of Sloan Kettering will start refusing to give permission for their data and tissue to be used for research; and (2) Sloan will lose some excellent pathologists to other cancer centers that would love to have them work there.
64
@JenD Completely agree: huge damage will be done if patients who give their permission for their data and tissue to be used for research - when they are undergoing cancer care at a non-profit - find that it is being used this way. Legal judgements allowing the for-profit use of the data when it was originally gathered by non-profits for the purposes of research are also mistaken and not good for people & society.
5
The pathologists won't go anywhere as everyone else will do this too.
How can anyone believe that it is ok for board members of a non- profit to have a financial interest in a company involved in a profit making effort with that same institution? Especially when this involves the free use of the non-profit’s assets?
216
@bearsvilleboy
How can anyone believe it? Because it has become the norm. In both hospitals (and universities I might add).
It is not an exaggeration to call cancer research and treatment today the Cancer Industrial Complex. A significant number of scientists and doctors are making fortunes off cancer through start-ups to the extent that many who work in the field no longer believe cancer will ever be cured for this reason alone. Too much money in it.
To use patient samples for personal profit makes it particularly disgraceful, but the whole enterprise - while often not illegal - stinks to high heaven.
Many cancer patients struggle financially long after treatment ends. The MSK investors have already been paid handsomely for the treatments rendered to patients. Every cent that they have made from this unethical insider deal should be donated to funds that help patients get back on their feet.
141
I’ve dealt with this institution twice. 20 years ago it was a very decent and efficient treatment center with excellent professionals. By two years ago, a corporate mindset had descended over the place that was alienating and troubling to me. It isn’t just these greedy monsters who’ve been caught. It’s the whole culture there today of corporate expansionism, so that the place starts to be more ruthlessly profit-driven than a humane place focusing solely on the individualized treatment of patients should be. This is the inevitable problem with privatized medicine.
192
There is an unmistakable line that should separate bio-research and clinical excellence from selective profiteering by certain members of the organization that helped gave birth to a putative new technology. Objectivity tends to yield to the allure of wealth and accolades and if things aren't going well, concerns about developing a flawed technology are more easily assuaged.
Aren't we already seeing enough of this kind of behavior in our government and industries?
20
The issue reflects the tension between what is legal and what is right. In times past, the two coincided. This is often no longer the case as we lose our sense of ethics in the haze of monetary and non-monetary gains.
While what MSK creates might be construed as legal, many people clearly think that it is simply not right. And as law is in service to what is right (or a codification of it) the issue will remain for many unresolved long after the lawyers are through with it.
25
@Orthodromic. So the other legal alternative for MSK is to just discard this old material. A better choice?
I suspect many other leading cancer research institutions are starting to sweat (hint hint, what city do I live in). The conflicts of interest between clinicians, researchers and start ups are so endemic as to be an accepted part of the culture. They call it “synergy”.
47
Started and encouraged many years ago here by administrators who did none of the work but manage the profit. Also not positive for true and ethical medical-scientific research.
This is pretty amusing but hits close to home for all of us who live between academia and industry.
Actually, those old slides are currently pretty valuable and not just to little tiny start-up AI companies. There are much bigger companies trying to match up genomic analysis of cancer with "phenomics" (like how cancer looks and behaves). To make this all work, they need lots of high quality tissue and associated patient data. MSKCC has likely been giving up millions of dollars they could have gotten up front or over time from a bigger player to access and use these same data. Instead, they apparently offered a sweetheart deal to insiders. Not simply corrupt, but probably bad strategy. Given that this kind of computation is becoming pretty generic very quickly, the major value of buying Paige.AI may end up being access to these data and MSKCC is only getting a fraction of the net.
Ignoring what the IRS or the State of NY might say, members of the board will have to go for having a hand in the cookie jar, the tech transfer office should be cleared out, Klimstra will likely need to resign as chair of Pathology and others may need to give up their academic leadership roles. The senior leaders who signed off on this may need to follow Baselga's lead.
The issue is that non-profits like MSKCC are wholly different from for-profits like Cancer Treatment Centers of America and should stay that way.
123
@Steve I am beginning to wonder about the cancer treatment that three of my friends received at MSK. Two died, one is still alive. These people REALLY need to clean house and remember what they're supposed to be doing: healing the sick. I think back on my friend Barbara's treatment and death, and now I'm beginning to question whether the choices the doctors made for her treatment weren't tainted by profit motives, sweetheart deals, shelling for Big Pharma et al. Is this place really a hospital anymore?
8
I believe it is time for the IRS, independent of political influence and appointees and the lobbyists they are influenced by, to review the use of tax exempt status of hospitals. As a retired physician, who practiced in academic medicine nearly my entire career, I have witnessed firsthand the erosion of the importance of the practicing physician in the administration of hospitals. For a considerable amount of time the payroll of hospitals has disproportionately swelled with administrators. Physicians have become micromanaged in order to be more ‘efficient’. Patient advocacy among physician’s comes at a price in this era where physicians are, for the most part, viewed as ‘pork bellies’. I know firsthand since I was wrongly terminated for being a patient advocate. Hospitals are certainly under financial pressures. And opportunities should exist to increase revenues. Nonetheless, when senior administrators earn salaries in the mid to high six figuresand seven figure salaries, and questionable, if not unethical issues arise it is time to re-examine the not for profit status of institutions whose business practices warrant such determination.
103
Is it just a coincidence that the three board members who profited from the deal are all associated with prominent hedge funds?
219
Bingo. Or is there a coincidence that Robertson is on the board, in a position to be first in line for investments like this, because he and his family donated millions to create the Josie Robertson building at MSK?
1
Chickens have come home to roost for medical sciences in the era of exposing unethical conduct and sexual misbehavior. It was about time this happened.
30
MSK has lost its way.
Takes FOREVER ... and lots of good and hard work to gain a reputation as good as what they had.
Takes just a few short-sighted decisions ... and poof!
Hope there are some people with a brain - BESIDES THE DOCS and nurses - at MSK ... and they go for as aggressive a treatment of the cancerous culture as they would for a patient with a particularly virulent "strain."
35
Dr. Rashkin, while this might change and improve the way cancer is diagnosed, it does not and will never justify breaking the law.
10
In addition to a myriad of medical classes, symposiums, conferences, consultations, etc., Sloan Kettering needs to add one more course. Ethics 101.
70
Once a country has been growing for about 300 years, it falls over from the weight of it's lawyers because nothing important can get done before it's obsolete. So here. People are allowed to get rich. Think of the damage to those who cannot benefit from these breakthroughs while all the nattering goes on.
4
@alexander galvin It's not the weight of the lawyers that causes the fall. It's the weight of all the gold held by the few people at the top. It is imbalance and corruption that causes the fall. Lawyers are a symptom, not a cause.
"People are allowed to make money" means nothing relevant here. The question is: should people make more money simply because they have money? And: Should insiders of a non-profit be able to usurp the intellectual property of that non-profit for...their own exclusive profit?
I would say no, and no. OHH! the risk of investment! Without investors what would we do!?! Some people will think. Yawn. 1.VCs don't put themselves at risk over one investment. 2.Amazingly, it turns out there are all kinds of concepts for developing innovation that don't involve VCs. Many involve rewarding researchers while better contributing to the public well being.
I have a problem with patents in medicine. ALL research is based on previous research. Patents amount to a restriction of the public to access the benefits of discovery which, truly, is founded on the base provided by 'society'.
27
Work it out, folks, work it out. MSK provides a wonderful service. As a cancer survivor, I say work it out!
19
I disagree and I am a cancer survivor who has been treated as MSKCC.... it does not mean that we should tolerate unethical behavior and profit mongering. I am pretty sure that if the hospital had no financial incentive to, i.e., hang on to the torturous mammogram machines, they would explore the less invasive and cheaper options available to women in, of all places, INDIA!
2
I agree. As a two-time cancer survivor thanks to MSK, I hate to see its reputation tarnished or ruined by the unethical behavior of a few. Clean house, MSK, and get to your mission - providing treatment and care for people with a deadly disease.
8
This is probably legal-- I can't imagine Sloan Kettering did this without the review of their legal department-- and it probably does not violate any Health and Human Services rules about use of patients' samples-- but wow, is it ever wrong.
First, this is an obvious conflict of interest. What were these people thinking??
Second, this deal is a huge disservice to future research in general. Those of us who ask study participants to provide tissue or blood samples for future research, and who obtain their consent to use these samples (including for profit without their compensation), see the harm from these violations every day as participants refuse to give samples because of failures of ethics such as this.
SHAME!
90
The heart of the issue is price discovery and project success maximisation. 9% for exclusive access to what amounts to a treasure trove of data seems ridiculous. As a non-profit the hospital should have either open-sourced the data, licensed it to multiple players, or worse case held an open auction for limited time exclusivity to raise funds for its continued research.
It would be a travesty to see an extremely important project be derailed due to the brashness / incompetence of the people who brought the deal together.
9
Perhaps "do no harm" ought to be expanded to "do not profit from the suffering of others" in such places and times?
155
This is outrageous on so many levels one must stop counting.
Administrators , physicians, scientists and BOARD members all out for their share of the take.
Disgusting. And they raise funds as a charity????
Multiple government agencies including IRS, need to be involved
MSK was long known for not really caring about patients -- much more interested in prestige and status and physician and researcher needs. Now the public sees it too.
58
They have some of my tissue. When will I see my share of the profit?
9
I wonder if President Donald Trump can put this into the perspective of the patent for naturally occurring RNA interference and get the NIH involved, again.
See: RNA-guided human genome engineering (2015) and updates.
The intersection of cutting edge technology and academia should lead to rapid progress in healthcare. However the process if fraught with danger as evidenced by the latest MSKCC scandal.
It's a case of academia mimicking politics. The cover up is worse than the act. The lack of voluntary transparency from the board members and Chief of Pathology in a for profit venture is egregious. They should be held to the same standard as Dr. Baselga and made to resign to restore faith in ethical processes at MSKCC.
10
Appears that the rules do not apply to Memorial Sloan Kettering. No one is above the law, even in a noble pursuit such as finding a cure to cancer. The ethical lapses of Dr. Jose Baselga are just the tip of the iceberg.
44
I am a MSKCC patient and had no idea they were going to use my data in this manner. I signed a confidentiality agreement that did not state that my information could be used -or sold- in this way. I am upset and feel that my trust and appreciation for the treatment I have been given and the care I have received has been violated. It should have been explained to patients!
123
Hospitals and insurance companies sell anonymized (i.e., all PHI identifiers removed), aggregated patient health datasets all the time. Chances are that any interaction you've had with a health provider has been monetized to some degree, so this isn't really that surprising.
Greed and sleaze...
9
simply stated whatever happened to professionalism amongst positions?
7
Not ethical or transparent. Just like Henrietta Lacks' family never profited from the billions of cells Johns Hopkins generated from her ever growing cells and profited from, none of it redowned to the her family.
8
Sounds like HELA all over again. Henrietta Lacks died, and was buried in a grave without a headstone. Her descendants got no financial renumeration for how her tissue samples were used. Billions and billions of dollars in profits were made,Maithili no consent given. Statute of limitations ran out long ago.
People in research, are as greedy as the next professionals. Everyone is corruptable.
20
I agree. I just wrote a comment recommending the book about Henrietta.
Crooked and shameful. Hospitals are overcharging for EVERYTHING. Now, another money-making scheme with no ethics. Our healthcare system needs a makeover.
51
SK has infusion centers all across the metro area that's putting 10's of thousands of dollars of drugs into patients bodies every single day.
How much is enough?
9
@HL
Just so happens that these "10's of thousands of dollars of drugs" , many of which have been developed at MSK, are saving thousands of lives, including mine.
This comment is inappropriate and off subject.
3
Daniel-I know how hard chemo therapy can be. You deserve to put yourself in the hands of doctors who are ethical. Sloan is loaded with them. Sadly it's come to light that some are profiting greatly from deals which lack transparency and create division within the institution and may create doubt for patients.
If you're really concerned about drug development you should be aware that the Trump administration is diverting funds from NIH to FEMA and ICE. In the case of ICE some of that money was used to separate children from their parents.
State run Colleges and the NIH both using tax payer money are both exploited by the Pharma industry and apparently none profit clinics like MSK who are profiting greatly on the back end.
The courage and fear the cancer patients have to deal with requires equal commitment and ethical behavior on the part of the clinic and doctors providing treatment. If the goal is to improve outcomes the data should be open to all players in these new fields.
Shame on top of shame. A problem of serious and unrevealed conflicts of interest of a leading physician at SKM has now blossomed into an institution-wide culture of conflicts of interest. The only way to restore trust in this historically great institution is to replace most of the Board of Directors and senior administration and clinical leadership.
16
I have no problem when doctors and researchers from a non-profit move to a for-profit to get personally rich but I am concerned that the term “non-profit” is becoming meaningless when it is a fig-leaf for personal enrichment, especially when insiders leverage non-profit assets.
Non-profit researchers are typically allowed to spend 15% (or more) of their time beyond their ostensibly full time jobs on earning unlimited amounts of personal income from companies. Then the non-profit usually takes a cut of that income. Making yourself rich elsewhere is encouraged. It is not unusual to earn most of your money from companies while working “full time” at a non-profit.
NIH banned outside personal enrichment a long time ago for federal doctor employees. Kudos to doctors and AI researchers who choose to work at NIH, and to the many others who work transparently for the benefit of patients, including the many that continue to do so at MSK.
27
Gimme a break! Those pathologists have already been paid for their expertise and slide interpretation and do not own the slides. The non profit should be able to lease these slides to an exclusive lessee to help defray costs. The only question is one of arms length pricing of the lease so that insiders have to pay a fair market value for the lease. Should these slides be valued by an independent auditor? Perhaps but one cannot forget that the lessee is taking all the risk and the eventual value of the slides to them may be zero. I am not sure what they are worth but since they will be leased and not owned, probably only some fraction of the imagined financial potential of the venture. Don't forget, no one else wanted to fund the lease, so most people thought the slides were nerly valueless
9
@Matthew Carr "Don't forget, no one else wanted to fund the lease, so most people thought the slides were nearly valueless". You have only the insiders claim to go on. Slides with well-annotated clinical information are valuable. Arrangements selling access to pharmaceutical companies are common. I know. I work in the field. As for whether the pathologists have already been paid for their work, that would be true in a for-profit, but people work for a non-profit for the common good, almost always sacrificing potential income to do so. There would be no complaints if the money was being funneled back to the non-profit mission instead of being sold to a select group of insiders.
32
@Dnain I guess you didn't read the article except for the constant whining by pathologists who are free to invest btw, the Hospital has received a 9% equity interest as payment for the leasing of the slides. Therefore the hospital is sharing the risk with the other investors. If I were a hospital administrator, I would have asked for a better deal , such as a lease payment up front, but I am not involved (Alas) All those piling on MSK are very naive about how capitalism works
@Matthew Carr
Spot on!
It's starting to seem that every activity at Memorial Sloan Kettering is ultimately designed to make a very few people who run the institution very very rich.
This is a charity operation that pays certain physician leaders 1.5 million dollars annually in salary (Jose Baselga).
Financial incentives and interactions with industry have corrupted the moral fiber of our cancer centers. While everyone agrees that these interactions need to happen for innovation to occur, these investigations reveal that there is corruption on a scale that is only starting to be understood.
136
"They also questioned the use of patients’ data — even if it is anonymous — without their knowledge in a profit-driven venture." This is where I see problems too. Confidential information in today's world of hacking and data breaches has a habit of turning up and being used against people.
My other question is if the patients whose data is used for this will be compensated in any way. After all, they are providing "raw material". They are also paying for treatment or consultations and for the work done on their tissue samples.
31
@hen3ry
Exactly. Those patients paid for those samples and did not authorize the use of or release of their data for use in anything other than their own health care or research.
A for-profit venture is clearly not an authorized use. Patients should have a choice to opt out and those who stay in should be given some sort of shares in the company. At the very least, the new company should never be allowed to share or sell the data to anyone else.
8
It's always a problem when one company has exclusive rights to something. It also seems highly unethical that the work of the pathologists is being used without consultation or remuneration. Monopolies are not good for consumers.
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On the face of it this looks like some bad decisions. But the bottom line is that the company in question & others in the field are trying to stop this terrible disease. The ethics of equity participation may be questioned, but tarring the entire hospital, its staff and most importantly its unwavering goal to improve cancer treatment is the wrong result here.
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@Jack
Wrong. Ethics and how you do things are as important as what you are trying to achieve. That is what a makes a board position and a leadership position difficult, you must make hard choices.
Maybe we should just start using prisoners to test experimental drugs?
We must remember, it is how we live, and how we die that defines us, not that we did either of those things at all.
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@Bob
You're wrong and you're thinking holds up medical and clinical progress because of the barriers you would like to persist.
Patient's slides do not entitle them to profit nor fees and if SK (or other institutions) can generate income, even though they have a non-profit status, that's fine as long as it leads to better clinical outcomes and lower costs for health care services.
Let's make the health care system more efficient and stop whining!
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@wj
Bob is absolutely right, and what you are suggesting is exactly the root of the lack of ethics at MSK.
When just about every part of a society exhibits a lack of ethical judgment, we can only come to the conclusion that the society in question is in steep decline.
Every last problem this nation is experiencing, at the core, is a problem of ethics.
These people knew what they were doing is unethical. They did it anyway. This is the takeaway.
These are the kinds of people this nation's education system is producing. While there will always be unscrupulous individuals, the magnitude of the problems we are seeing across industries, our politics, judiciary, law enforcement, and our society as a whole, begs for rewriting our social and moral contract as a nation.
This can't be who we want to continue to be.
--
Dworkin's theory of equality
https://www.rimaregas.com/2015/08/04/ronald-dworkin-theory-of-equality-p...
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@Rima Regas- money makes the world go around. now before our eyes we see how that song about greed has penetrated even to the supposedly benevolent practice of health care.
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@Rima Regas
Bingo! Too bad that each of us is limited in up-voting Ms. Regas' thoughtful comments a single time.
1
My sister is a Sloan-Ketter8ng patient who gladly gave the hospital permission to use her tissue for research. I was with her when she signed the statement, and nowhere did it mention that her tissue would be used to benefit a for- profit organization. MSK had better think this over carefully; if they will profit from the use of this tissue, then my sister should profit as well.
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And even if they DO share the wealth, they ought to nix the exclusivity for Paige. The worst kind of "intellectual property" mindset (and they're all bad) is the kind that turns objects of nature into black boxes that only a couple cronies can peer in to learn from.
If this is indeed a "desperate" move in response to poor investor attention, they must end it as soon as that turns around, if not yesterday. To barrel on is a finger to scientific ethics and the journalists who outed Baselga's corruption, and a wink-nudge to Baselga (perhaps followed by cushy severance pay).
3
@Barbara Barran
That's ridiculous. Your sister didn't author the tissue slides and it has no value to her beyond its use to cure her disease. Does she want to get paid every time a medical student studies her slides to learn more about disease? Who is the greedy one here?
10
As a computer scientist I find the following statement pretty ridiculous: "Dr. Fuchs, the head of the computational pathology lab, defended his role in a separate statement. “Computer scientists like myself very seldom get the chance to really help patients,” he said."
I doubt most people take issue with Paige.AI's mission. Almost everyone in the world has known someone dear to them with cancer or had it themselves. The issue is clearly the way they handled acquiring the data and total lack of transparency regarding the business formation. Clearly, identifying cancer as early and accurately as possible is a noble mission, but the ends do not justify the means.
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@Oliver. I find it shocking that someone in an administrative position as important as Mr. Fuchs's would adopt the position that he did this because the job he so handsomely gets paid for at Memorial doesn't
really involve helping patients. I l wonder how many other administrators at MSK believe that they very seldom get the chance to really help patients.
6
In 2010, Sloan Kettering inadvertently shared sensitive data of patient data. In 2012, they found that they had shared information in 2005. This had gone undetected for around seven years. And now, they shared willingly?
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