When a doctor is at center of political corruption scandal

Sheldon Silver was, until recently, Speaker of the New York State Assembly. This post made him one of that state's two or three most powerful political figures. He was forced to resign his post when indicted for corruption.

What, you may ask, is remarkable or newsworthy about a politician being accused of dishonesty? To me, the interesting aspect of this whole situation is the key role played by a physician.

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Robert Taub, MD, PhD, served for many years as director of the Columbia University Mesothelioma Center. From your days in medical school, you probably remember that this is truly a terrible disease. The doctor was researching better therapies for its victims.

According to news reports, Dr. Taub saw mesothelioma patients in his center and allegedly “gave their names” to one or possibly two law firms that handle asbestosis litigation. One law firm received more than 100 of his patients and the ensuing legal actions brought in hundreds of millions of dollars.

The referrals to these particular law firms, according to the reportage, was in return for “donations” from the law firms to a research fund overseen by the doctor. Dr. Taub asked Silver to encourage the firms to make these contributions.

Silver allegedly also arranged for a "grant" of hundreds of thousands of taxpayer dollars for Dr. Taub's research. Those public funds were supposed to pay for research into the health impacts of the Sept. 11 attacks on The World Trade Center. Also, at least one report says donations were made by the lawyers to a non-profit organization on which Dr. Taub's wife was a board member.

NEXT: Ethical considerations

In return for Dr. Taub's sending these mesothelioma patients to specific law firms, the newspapers say, public servant Silver personally received millions of dollars. It's more complicated in that Silver also is alleged to have received payments from other law firms related to real-estate deals.

According to the U.S. attorney's office, there was no legitimate legal work performed by the Speaker to earn these payments. At the insistence of junior-elected representatives of his party, Silver has resigned his position.

Ethical considerations

I don't know Silver or Dr. Taub, and have no knowledge of any of this beyond what I read in the papers. What seems unique to this situation (as reported) is that the spider at the center of this web is a doctor who, in return for research funding, steered his patients to certain law firms, to the great financial benefit of the law firms and Silver.

Silver is under indictment for criminal acts. Dr. Taub is, according to officials, cooperating and not subject to indictment.

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Is it ethical for a doctor to encourage or otherwise cause his or her patients to go to a particular law firm, as alleged?

If we give Dr. Taub the benefit of the doubt and presume he was 100% motivated to obtain support for research in order to help the people suffering from mesothelioma, was it ethical for him to take donations from these law firms while he was sending his patients to them? Were these funds that flowed to Dr. Taub's research from the law firms fully disclosed? Was Dr. Taub aware that the law firms he was sending patients to, at the request of Silver, in turn making payments to Silver?

I discussed this scandal and the ethics with some “normal” people (i.e., not physicians) over dinner. They thought it would be important to know whether Dr. Taub gave his patients a long list of reputable law firms with expertise in asbestosis claims or whether he only steered them to the two firms that were giving him “donations” for research.

NEXT: Conclusion

They also thought it would be important to know whether the physician disclosed that the law firms were financially supporting his research. They were not willing-based upon what has so far been printed in the newspapers-to conclude that the physician definitely behaved unethically. These are thoughtful and successful business people, so I take their perspectives very seriously. Maybe he was not acting unethically.

Columbia University is not amused by what was unearthed by the U.S. Attorney's office. Dr. Taub has "gotten the boot" and is no longer director of the mesothelioma center, and the center itself no longer officially exists as a distinct entity.

 No doubt some people who read these articles will reflect upon Dr. Taub's role and (like me) be very troubled to see a physician in the center of a major political corruption scandal.

My own belief is that full disclosure of financial support-be it for personal compensation or for research or other purposes-is certainly a good thing, for physicians and for politicians.