The Drug Trial: Nancy Olivieri and the Science Scandal That Rocked the Hospital for Sick Children

David Bennett is the national director of the Department of Workplace Health, Safety and Environment at the Canadian Labour Congress in Ottawa.

The hereditary blood disease thalassemia requires frequent blood
transfusions. These cause elevated levels of iron in the blood, which in
turn requires treatment if patients are not to suffer debilitation or
death. The two main drugs used to reduce iron levels are Desferal
(deforoxamine), the administration of which is painful, and L-One
(deferiprone).

Dr. Nancy Olivieri is a physician, blood disease specialist, and
researcher at Toronto’s Hospital for Sick Children. She was under
contract with a manufacturer of L-One, Apotex, to do research on the
drug. Olivieri became convinced, first, that L-One was largely
ineffectual and, second, that it was toxic to the liver. When Apotex
refused to renew Olivieri’s contract, she was prohibited, in unusually
severe contract clauses, from disclosing her results either to her
patients or to the research community.

The heart of the controversy that ensued was that the requirements of
private sponsors of research are incompatible with academic freedom and
with citizens’ rights, since people are patients as well as the
subjects of research. The dispute escalated, involving personality
conflicts, professional behaviour, medical ethics, the faculty union,
and the role of the hospital, with Olivieri and her supporters pitched
against the administration and several of her medical colleagues.

The story is multi-faceted, with a complex interplay of many
scientific, medical, social, and political factors. This was a challenge
to author Miriam Shuchman, who concludes that no party was clearly and
unequivocally in the right. While Shuchman is intermittently and
forcefully critical of Olivieri, she also establishes that at key
points, Olivieri was clearly wronged by the company, the hospital, and
her colleagues, in one case outrageously. Since Shuchman assigns both
merit and fault in the visceral conflict, the book is likely to please
no one without reservation. It would be hard to query Shuchman’s
credentials, however; she’s a medical scientist, an ethicist, and an
experienced medical journalist.