Steven Coughlin, the former Department of Veterans Affairs (VA) epidemiologist who as I reported back in March for The Daily Beast blew the whistle on the VA for its alleged lack of care for suicidal veterans, is not satisfied with the agency’s review of his complaints. Coughlin, who worked at the VA’s Office of Public Health until he resigned last year, says the VA, which contacted Coughlin today via email, has not adequately addressed the problems he outlined during his testimony at a Congressional hearing.
In an exclusive interview with The Reno Dispatch, Coughlin said, "I remain concerned about the measures taken in many ongoing VA-funded studies to assist research participants who are suicidal. It does not appear to me that they have done enough to address this serious situation."
Coughlin told Congress six months ago that VA routinely disseminated false information about Veterans’ health, withheld research showing a link between chemical weapons and Gulf War Illness, rushed studies out the door without taking recommended fixes by an independent board, and failed to offer crucial care or even provide a call back to veterans who came forward as suicidal.
|VA Secretary Eric Shinseki|
On the same day that Coughlin was testifying before Congress, VA Secretary Eric Shinseki (right) ordered the VA Office of Research Oversight to investigate these allegations. The "final" report has been under review internally at VA for months and is now complete, but has not been released to the media or the public.
Coughlin says that in May, he received a draft copy of the VA’s final report, which, he notes, “did not discuss what steps the VA planned on taking to protect vulnerable research participants in the National Health Study for a New Generation of U.S. veterans and other large-scale epidemiologic and clinical studies who self-report suicide ideation.”
Coughlin, who notes that every year, hundreds of thousands of men and women are surveyed by VA researchers, says it is "essential" that Congress, investigative journalists, and experts in such fields as epidemiology, psychology, medicine, bioethics, and scientific integrity "continue to draw attention to the need to afford better protections to research participants who are experiencing suicidal behavior."
Coughlin notes that in some large-scale, ongoing epidemiologic studies of veterans and military service men and women, validated scales for assessing major depression have been modified by omitting the item that asks the respondent whether they are having thoughts about their being better off dead or of harming themselves or others.
"This protects the investigators and the institution by not collecting self-reports about suicidal ideation or intent," he says, "but it does nothing to assist vulnerable research participants who may be thinking of killing themselves."
In response to an email today sent by VA to Coughlin informing him that the final report was now available, if he submitted a Freedom of Information Act (FOIA) request, Coughlin wrote the following:
“In order to request a copy of the report, it would be helpful to know its exact title. As you are aware, the issue that I was most troubled about was the lack of call-backs for veterans who participated in the National Health Study for a New Generation of U.S. veterans who self-reported that they were having thoughts that they would be better off dead.
Coughlin continued, “Can you please tell me, has VA required the investigators to contact any of those research participants to see if they can be assisted in some way? I am very interested to know whether my Congressional testimony and the special review requested by Secretary Shinseki prompted any improvements in the way that the VA Office of Research Oversight requires VA investigators to protect the rights and welfare of veterans participating in large-scale epidemiologic or clinical studies who self-report suicidal ideation, suicide plans, or suicidal behavior.”
Coughlin concluded, “In the Tuskegee Syphilis Study, which as you are aware is internationally accepted as a paradigmatic case in biomedical research ethics and public health ethics, vulnerable research participants were deprived of appropriate health care and some of those people died prematurely from a preventable cause of death. Simply put, they were treated as means to an end. When the whistleblower first reported his concerns and government officials examined the situation, he was unable to get the Agency (the U.S. Public Health Service) to improve the situation. Before too long, that whistleblower left government service. Here we are four decades later and similar events have occurred (in the Department of Veterans Affairs) despite the plethora of federal regulations and VA policies concerning the protection of human subjects.”
Coughlin told me back in March that his only motivation for coming forward was “to help veterans. That’s the only reason I paid for my own flight to come to Washington. I think the attention from the House committee and the media will lead to positive changes. It will hopefully help veterans.”
Members of the VA team responsible for the report did not respond to my emailed requests for comment.