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"Slap suits": New threat
to doctors' free speech

THE PUBLIC LOOKS to the news media for health information. The media, at their best, turn for information to doctors, particularly specialists in teaching hospitals and government agencies. The job of public relations officials at these institutions is to facilitate this flow of medical wisdom.

When the process works as it should, the public benefits from the dissemination of knowledge from responsible, disinterested, unintimidated sources. This information flow now is threatened by litigation filed with the intent of hindering scientists from speaking out when their views threaten economic interests.

Several years ago a reporter at the Dallas Morning News contacted four university-based medical experts, including the former editor of the New England Journal of Medicine and an Alumni Trustee of Columbia University, Arnold S. Relman, M.D. The reporter, Jeffrey Weiss, asked the physicians about the claims and practices of an alternative medical cancer care company he was investigating for his newspaper. He sent the doctors information on patients and other material he had collected from this provider. The Dallas newspaper published Weiss' story, with the doctors' critical comments, in June 1992 under the head-line "Cancer unit ads called deceptive."

The treatment group sued--not Weiss, but the four doctors--for $24 million. The suit claimed the doctors' statements were "false, malicious, and libelous per se." The suit said in part: "Defendant. . . Relman is quoted in the article as stating: `This kind of advertising clearly implies they can do things others can't do. It's reprehensible. It's sleazy. . . . You can get testimonials for snake oil.'"

Relman and his colleagues all were indemnified and defended by their institutions, and the suit ultimately was dismissed. But exonerating the physicians took a year's worth of work by the institutions' lawyers and administrators. The total cost to the institutions, as estimated by one of the doctors, may have reached $100,000 or more. The anxiety of the four physicians has not been quantified.

The plaintiff's attorney said in a recent telephone interview that his clients got what they wanted. Monetary damages are not everything, he explained. One goal of libel and defamation suits is to stop the defendants from making further damaging statements.

One of the doctors has since died. One says he is yet uncowed. One refused to discuss the case with a reporter, on the advice of his institution's attorneys. Relman, chastened and chary, said he would continue to speak out--but only if he felt what he had to offer would contribute to public understanding.

"I think it is, in general, unfortunate that. . . [litigants] are able to fend off legitimate criticism by using their access to counsel, and by spending money in a way that individuals often are not able to match," the ex-editor and Harvard internist said. "They therefore are able to intimidate individual physicians who may know something important to the public interest and keep them from speaking out.

"This compounds the injury."

-- David R. Zimmerman

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