This Podcast Will Kill You
Special Episode: Dr. Carl Elliott & The Occasional Human Sacrifice
23 Jun 2026
Transcript generated automatically by AI and may contain errors.
Chapter 1: What is the focus of Dr. Carl Elliott's book on medical ethics?
This is exactly right. Your husband is not who you think he is. Your body is not what you thought it was. Your identity is formed by a secret history. I'm Dani Shapiro, and these are just a few of the stunning stories I'll be exploring on the 14th season of Family Secrets.
He kind of shoved me out of the way and said, move. And he went out the front door and he jumped in a car and drove off. And that was the last time I saw him.
Listen to season 14 of Family Secrets on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.
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Hi, I'm Erin Welsh, and this is This Podcast Will Kill You. You're tuning in to the latest episode of the TPWKY Book Club, a series where I bring on authors of popular science and medicine books to chat about their latest work.
Through this series, we've gotten to cover some fascinating and eye-opening topics from animal senses to John Calhoun's rat experiments, the history of the pelvic exam to the story of refrigeration. These episodes really run the gamut.
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Chapter 2: What motivates individuals to blow the whistle on unethical medical practices?
To check out the full list of all the books we've covered on this series so far and to get a sneak peek for what's on the horizon, head over to our website, thispodcastwillkillyou.com, where you'll find a link to our bookshop.org affiliate page under the Extras tab. Once you're on Bookshop, you'll see a bunch of TPWKY-related book lists.
including one for this book club, as well as the Kids Book Club, put together by Erin Updike and posted on our socials. So if you're not already following us on socials, what are you waiting for? As always, we love hearing from you all about these book club episodes, about our other episodes, your thoughts, your book or topic suggestions. We love it all.
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Make sure that you're subscribed to the Exactly Right Media's YouTube channel so you never miss a new episode drop. The Tuskegee Syphilis Study, the Willowbrook Hepatitis Study, medical experimentation at Holmesburg Prison.
If you've ever taken a bioethics class, or if you're a regular listener of the podcast, these cases are no doubt familiar to you as just a handful of the most infamous examples of unethical medical experimentation. We learn about these studies, the victims, the perpetrators, the circumstances that allowed them to happen, so as to prevent history from repeating itself.
Like, this is why we have patient protections such as informed consent.
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Chapter 3: How does Dr. Elliott's personal experience shape his views on whistleblowing?
This is why we have these rules and mechanisms such as institutional review boards. But often missing in the telling of these stories is the person or persons who fought to expose these wrongs and bring them into the light, the whistleblower. What does it take for someone to speak out, especially when speaking out can lead to tremendous professional and personal costs?
In The Occasional Human Sacrifice, Medical Experimentation and the Price of Saying No, author and bioethicist at the University of Minnesota, Dr. Carl Elliott, explores the moral dimensions of whistleblowing and how the resulting fallout leads to a long-term, almost existential crisis.
For Dr. Elliott, this is a deeply personal topic, as he tried for years to uncover harms carried out in a study at his own university, harms that led to a patient losing their life. His experience serves as backdrop and crucial context for the other stories of whistleblowers that he shares throughout this book, at the heart of which is a question. Why do whistleblowers do what they do?
It's tempting to imagine that if each of us were placed in a situation with unethical medical experimentation, we would stand up for what's right. But research shows that's rarely the case.
Whistleblowing is a complex action guided by moral concepts such as shame and honor, and learning the stories of whistleblowers alongside the abuses they sought to expose adds tremendous value and insight into human nature itself.
Through Dr. Elliott's compassionate storytelling and contemplative analysis of whistleblowing as a moral dilemma, The Occasional Human Sacrifice is truly a must-read, and it will stay with me for quite some time. I do want to mention that this discussion includes descriptions of self-harm, so please listen with discretion. We'll take a short break here and then get started.
Dr. Elliott, thank you so much for taking the time to chat with me today.
Well, thanks for having me.
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Chapter 4: What are the consequences faced by whistleblowers in medical research?
I appreciate it.
In your book, The Occasional Human Sacrifice, you seek to answer how unethical experiments are carried out and why blowing the whistle is so difficult to do. And as you describe, this is a personal issue for you with you having firsthand experience as a whistleblower.
Would you mind sharing the impetus for writing this book and how it led you into a broader contemplation of whistleblowing in medical research?
Failure is basically how it led me into the book. So... I guess for me, the story begins back in 2008 when I first learned about the suicide of a young man named Dan Markinson in a research study in our Department of Psychiatry here at the University of Minnesota. The circumstances of that were so gruesome and so horrific and so sort of blatantly exploitative and unethical.
that I felt as if it needed an external investigation, partly because of the circumstances of his death, but also to ensure that the same thing had not happened to others in our Department of Psychiatry. And so I spent the better part of the next seven years basically trying to get that external investigation.
So Dan Markinson was a young man in his 20s who had become psychotic and delusional and dangerous as a result of a psychotic episode in the summer of 2003. And his mother, after seeing him deteriorate over a period of months and seeing the kind of alarming things he had,
called the police, and he was eventually brought to Fairview Hospital, which is the teaching hospital here at the University of Minnesota. And he was seen by the head of our schizophrenia program here, who thought he was psychotic, delusional, dangerous, admitted him to a locked ward, had him placed under a civil commitment order,
and fairly soon began to recruit him into an industry-funded study of antipsychotic drugs that he was doing.
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Chapter 5: What historical examples of unethical medical experimentation are discussed?
His mother objected. She didn't want him in a study. She felt he could not consent to the study, that he was psychotic and incompetent, and that the circumstances, the civil commitment order, which essentially legally bound him to do whatever his psychiatrist was telling him to do,
prohibited him from being enrolled ethically, and she objected, but she was told, you know, sorry, he's an adult, he signed the consent form, he's in the study. She then spent the next four months trying desperately to get him out of the study. He had been discharged to a halfway house. She could see him getting worse, becoming increasingly agitated, and she was afraid, violent,
She called, she sent emails, she went to the Department of Psychiatry. She wrote to the chair of psychiatry again and again, expressing her worries. Eventually left a voicemail message for the study coordinator saying, does he have to kill himself or somebody else before anybody is going to do anything?
And three weeks or so after she left that message, his body was found in the shower of a halfway house where he was staying. And next to his body was a note that said, I went through this experience smiling.
When did you learn about this and what happened after? Like, when did this become public knowledge? When did this become something that was a news story?
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Chapter 6: How do societal norms influence the decision to whistleblow?
Not for another four years. I read about it in the St. Paul Pioneer Press in, I believe, would have been May of 2008. I was actually on sabbatical at the time. I was in South Africa. A friend of mine who was one of the reporters who did that, Paul Tosto, had sent me links to it.
I found it so alarming that when I got home a few months after that, I started asking around and trying to find out what had happened. Because it's actually my area of work. I mean, I work on research ethics. I work on psychiatric ethics. I had been on the Institutional Review Board at the university for several years.
I knew people in the Department of Psychiatry, and yet this grisly death, I had heard nothing about it. And when I started to ask around, it just felt as if no one was as alarmed by it as I was. Not people in the Department of Psychiatry, not people in the Bioethics Center, not administrators.
And eventually it became clear to me that it was going to take some kind of pressure from the outside to get the university to act.
Chapter 7: What challenges do whistleblowers face in getting their voices heard?
And so I got in touch with Mary Weiss, Dan Markinson's mom. She was not happy to hear from me, obviously. She had a lot of suspicions of the university. She agreed to talk to me, and then after we talked, she agreed to let me have access to everything I wanted, court records, medical records, Dan's diaries, anything that would be useful.
And so I wound up writing about it in a sort of larger backdrop to it, which was a sort of scandal about research integrity involving the sponsor of the study, AstraZeneca. And eventually wrote about it in Mother Jones magazine, sort of hoping that having exposure in a national publication would shame the university into acting. But that, again, was a complete failure.
I mean, it really accomplished nothing at all except to make the entire academic health center very angry with me.
As you write, whistleblowing is incredibly isolating and disillusioning, and that kind of flies in the face of a lot of popular media representations or stereotypes about whistleblowers or stories that feature whistleblowers.
They might be brave and bold or bitter and disgruntled, but they tend to follow this certain narrative arc, which you describe or you label as Vonnegut's man-in-a-hole narrative. Can you tell me more about this narrative, what it fails to capture, and what it's really like down in that hole?
Kurt Vonnegut described the man in the hole story as somebody gets into trouble and gets out again. And he said, you know, we love this story. The Wizard of Oz, Dorothy kills the Wicked Witch and returns to Kansas. The prodigal son, Robinson Crusoe, David and Goliath.
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Chapter 8: What reforms could support whistleblowers and improve medical ethics?
The reason we like these stories is that they sort of reassure us that the world has a kind of moral sense to it, that the universe is a fair and just place. And if you watch, you know, whistleblower movies or TV shows about whistleblowers, they usually follow some version of that men and all story. The whistleblower takes down the corrupt organization.
What I found when I started looking deeper into these stories, actual whistleblower stories, is that they usually don't follow that sort of narrative arc. I mean, they usually don't have happy endings. And the whistleblowers themselves usually come out of the experience with these sort of very deep moral wounds.
It's almost as if it's a kind of existential disorientation because everything that they thought about how the world works is upended.
I mean, they just assume, everybody just assumes, if they've gotten to the point where they feel like there's nothing else to do, they assume that the rest of the world is going to be as morally outraged by what they have found and what they're trying to reveal as they were when they found it out. And then when they blow the whistle, it turns out that that's not the case.
They think the authorities are going to do something, that they're going to leap into action and rectify the injustice, and then that doesn't happen. And they think their friends are going to stand by them, and then that doesn't happen.
Even if they have some measure of success, they very often come out of it with a kind of almost obsession with what they've been through, an inability to get over it and put it behind them because it's so disruptive to the way that they had always seen the world.
Right. They're never truly free of that hole or of the feeling of what it was like down in that hole.
Right.
Yeah. I mean, being in the hole is a very dark place and it tends to turn people inward. And in the hole, you can't really think about anything other than yourself and what this is doing to you and how you get out of the hole. I mean, I can remember talking to the whistleblowers in Sweden in the Paolo Macchiarini scandal and hearing from them just how obsessed they became
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