Four months after accepting possibly the worst job in American medicine, Dr. Marguerite Hays has made progress toward restoring trust in the disgraced veterans hospital in West Los Angeles.
The 69-year-old nuclear medicine expert stepped in as the hospital's research chief when Department of Veterans Affairs officials in Washington abruptly shut down the facility's $45-million research program in March because of failures by hospital administrators to follow regulations safeguarding patients in studies.
Under her guidance, the 1,056-bed medical facility--the largest in the VA health care system--is slowly recovering from the unprecedented sanction, which so shocked researchers that one internal executive memo describes the center as suffering from "post-traumatic stress syndrome."
Hundreds of complex research projects have restarted, scores of newly diagnosed patients are being enrolled in studies, sunken staff morale is on the rise. And if proposed ethics measures take hold, a hospital only recently excoriated by Congress for violating patients' rights may soon be on the forefront of protecting them. The measures include:
* Forming a special safety panel,
one of the few of its kind at a public hospital, to closely monitor studies involving patients with mental illnesses.
* Reducing the use of placebos, or dummy pills, in studies involving sick people who need treatment.
* Cutting back on research sponsored by drug companies, which sometimes have rules that conflict with the hospital's protections for research subjects.
"It sounds as though the medical center is doing innovative things that should be closely watched by other institutions around the country," said Jonathan Moreno, head of the bioethics program at the University of Virginia and author of a new book, "Undue Risk: Secret State Experiments on Humans."
"But how the measures play out and whether they become part of the routine of doing research there is the issue," he said.
Hays, who is on leave from the Palo Alto VA Medical Center, said she hopes to develop "a model program that other VAs could imitate."
Dr. Dean Norman, the medical center's acting chief of staff, credited her with "turning around our research program."
But reform can bring discontent and some West L.A. researchers whose projects remain on hold said in interviews that patients' needs are being shirked for merely administrative reasons. Others predict a "brain drain," saying the already difficult job of advancing medical knowledge has become yet more onerous. A couple of researchers complained (anonymously) of a "witch hunt" atmosphere.
