UC Davis muzzles professor for speaking out about excessive PSA testing

When UC Davis announced a seminar on men's health back in October 2010, it sounded like a typical educational event.  But UC David professor Michael Wilkes investigated and learned that the seminar was primarily a sales pitch about the prostate specific antigen (PSA) test, and that its main message was that men should get tested regularly beginning at age 40.  However, the weight of scientific evidence suggests that regular PSA testing is not a good idea, and it may do more harm than good, as I wrote recently.  In a major report issued earlier this year, the U.S. Preventive Services Task Force recommended that men should not get routine PSA screening for prostate cancer, stating explicitly that

"the benefits of PSA-based screening for prostate cancer do not outweigh the harms." 

Prof. Wilkes, an expert on prostate cancer screening, came to the same conclusion almost two years ago.  In response to the UC Davis seminar, he and USC professor Jerome Hoffman wrote an opinion article for the San Francisco Chronicle.  They made basically the same argument that the USPSTF made in their lengthy, thoroughly researched report: that the PSA test often does more harm than good.

The story would end there, if not for what UC Davis then did to Prof. Wilkes.  Within a few hours of the publication of the newspaper article, the Executive Associate Dean at the UC Davis medical school informed Wilkes that he would be punished in two ways.  First, he would lose his position in the doctoring program, and second, he would lose the funding support for a Hungarian student exchange program that he organized.  Dr. Wilkes, it is worth noting, was recruited to UC Davis from UCLA because of the innovative program in doctoring (how to be a doctor) that he developed.

Apparently the Executive Associate Dean (where do they get these titles?) was angry over what Dr. Wilkes wrote in the newspaper.  He later admitted that he read Dr. Wilkes' article just before he wrote his threatening email.  All of this is documented in a report issued this past May by the UC Davis faculty Committee on Academic Freedom and Responsibility (CAFR).  Many additional details were reported on UC Davis Professor Jonathan Eisen's blog in June.

When challenged about these threats, the university lawyer David Levine said, in essence, what threats?  My goodness, he said in a letter to Wilkes, I'm just giving you a few helpful facts:

"I am simply pointing out that there are numerous errors of fact in your article, that they were injurious to the University interests and reputation and thus potentially actionable under the law of defamation."

But heavens no, we're not threatening to sue you or anything like that.  Just pointing out some things that we're sure you will want to know.  The university's lawyer's explained further, in a letter to CAFR this past February, that

"The administrative action … was simply to provide information to Dr. Wilkes regarding … the potential legal exposure for broadcasting false information that is injurious to reputation."

I'm sure that Dr. Wilkes found all of this information very helpful.

This summer, the UC Davis faculty senate voted 52-0 that the university had violated Prof. Wilkes' academic freedom, and called for the university to apologize and withdraw its threats, which UC Davis has not yet done.  An academic freedom watchdog group, FIRE, wrote to UC Davis chancellor Linda Katehi with the same requests.  Chancellor Katehi replied in a letter, dated July 17, that she and Provost Ralph Hexter have "assembled a small team of independent subject-matter experts" to review the case, and that they will have more to say by August 31.

What the heck do you need a committee of experts for?  Even if Prof. Wilkes' article was wrong (and it's not - he is spot-on accurate), he has every right to express his opinions.  So it doesn't really matter if PSA testing is good for you or not.  Yet after almost two years, UC Davis still has not withdrawn the threats made by its lawyers and by its Executive Associate Dean against Prof. Wilkes, and by extension against any other professor who might disagree with something the university is doing.

At this point, merely withdrawing the threats is not enough.  Chancellor Katehi should clearly and unambiguously affirm Prof. Wilkes' right to speak his mind, and she should also punish the Executive Associate Dean, the university counsel, and any other administrators who have been involved in this outrageous assault on free speech and academic freedom.  Otherwise they or others might very well just do it again, the next time they read an Op-Ed piece that annoys them.

The perfect hamburger, spoiled

20 years ago, we cooked hamburgers the way we liked them.  If you wanted your burger medium rare, well, good for you.  A thick, juicy burger, seared on the outside and just a bit pink on the inside, was the centerpiece of any good summer cookout. That was a more innocent time.

In 1993, a deadly outbreak of E. coli infections hit the northwestern U.S., sickening hundreds of people and killing four children.  The outbreak was traced to undercooked ground beef from a hamburger chain called Jack in the Box.

Fortunately, we live in a highly educated, advanced society, where the citizenry understands that its health depends on having bacteria-free food.  The unsanitary conditions that allowed E. coli to enter the food supply, including assembly-line slaughterhouse practices, were quickly halted.  New government regulations assured that any factory that shipped contaminated beef would be shut down.  Inexpensive, accurate DNA testing now detects almost all bacteria at a neglible cost.  Food-borne outbreaks of bacterial infections have been rare ever since.

Ha ha ha ha ha!  Just kidding!  Of course we can't have government regulators getting in the way of efficient food manufacturing!  Consumers ought to know that it's their fault if they get sick.  We must cook our burgers until they're as sterile as a Martian landscape.  That's simply the trade-off we must make to have such cheap food these days.

It's not that we don't check for any bacteria at all.  In fact, the U.S. Department of Agriculture recently announced that it would begin testing beef for six different deadly strains of E. coli.  Until now, it has only tested for the O157:H7 strain, which was behind the 1993 outbreak.  I guess this is progress.  However, the USDA will not be testing for salmonella bacteria or for any other nasty microbes.

The beef industry is opposed to any efforts by the government to test its products for bacteria.  For many years now, it has been remarkably successful, through lobbying efforts in Congress and through lawsuits, at rendering the USDA powerless.  As one example: twelve years ago the USDA tried to shut down a beef plant in Texas that failed its salmonella tests.  The beef industry challenged the USDA in court and won, and the USDA still doesn't have the power to shut down a plant for salmonella contamination.

We have the technology to detect all the bacteria that keep turning up in beef and chicken.  DNA testing technology has gotten much faster, cheaper, and more accurate in the 20 years since the Jack-in-the-Box outbreak, but we still don't use it on our food.  The meat industry won't say why it opposes DNA tests for contamination, but no one knows how consumers might react if they knew how much bacteria was really in their meat.

The USDA does test for E. coli O157:H7.  In the first half of this year, it tested 6,427 beef samples.  Out of those, 470 (7%) tested positive, which is pretty startling, considering that this is just one strain out of six known to be deadly to humans, and considering that we've known about this one since 1993.

(Chicken, by the way, has similar problems, with most raw chicken (organic or not) being contaminated by salmonella or campylobacter bacteria.  It helps that no one likes chicken cooked rare.)

Where does all this bacteria comes from, anyway? You may already know the answer: poo.  Beef and chicken production facilities aren't very good at keeping the (ahem) waste material separated from the meat.  Changing the way our beef is produced would cost more, undoubtedly. But is it unreasonable to ask a food producer to deliver safe food?

Luckily, if you cook meat long enough, it can't hurt you.  It might not taste as good, but hey, we all make compromises.  So broil those burgers through and through, and if they're a bit dry, well, that's what ketchup is for.