A Lost Art

Almost two weeks ago news that seemed to challenge the ethical guidelines of the academic and medical communities ricocheted across the nation.

The public disclosure that three Harvard-affiliated doctors had written letters of recommendation for a colleague without mentioning his prior rape conviction prompted outcries from physicians and scholars, an investigation by the Massachusetts Medical Society, and a flurry of letters and editorials in papers across the nation.

Yet the two institutions most closely associated with the controversial incident refused to join the fray: For six days after the recommendations became public both the University and Brigham and Women's Hospital (BWH) maintained a puzzling silence.

Last Saturday President Bok broke that silence. In a statement that followed growing criticism within and outside of the Medical School faculty, Bok said he "deeply regretted" that representatives of Buffalo Children's Hospital were not informed of Dr. Arif Hussain's crimnal conviction prior to offering him employment.

Bok's statement-which came after a series of discussions between the president, the dean of the Med School, and the chairman of the BWH Board of Trustees-precipitated a flurry of similar statements from the hospital and the Med School dean.

On Monday, the hospital's executive committee met to consider possible action, and the following day Dr. William Hassan Jr., acting president of BWH, released a statement on behalf of the hospital's staff "acknowledging" and "regretting" deficiencies in the process by which letters of reference were written" for Hussain.

Although both Bok and Hassan mentioned the formation of a committee to draw up guidelines on letters of recommendation, they left the details of the plan to Daniel C. Tosteson, dean of the Med School. In a letter distributed Thursday to the Med School faculty, Tosteson outlined plans for the committee, which will have at least 13 members including representative from all sectors of the Med School faculty as well as a few outside experts. Nothing that the case raises "complex and serious issues that are important for the future of the Harvard Medical School, academic medicine and the medical profession," Tosteson charged the committee to draft guidelines for faculty members writing letters of recommendation. The Med School faculty and the Harvard Medical Center will review the recommendations and will form the basis for a written statement of policy that the dean will recommend to the president and Fellows.

Also this week, Tosteson appointed a fact-finding committee to put together an "official description" of the Hussain incident, and the BWH executive committee voted to recommend that Hussain be terminated from the hospital staff. He has been on an unpaid leave-of-absence since his conviction on rape charges last June.