The Department of Veterans Affairs routinely disseminated false information about the health of America’s veterans, withheld research showing a link between nerve gas and Gulf War syndrome, rushed studies out the door without taking recommended fixes by an independent board, and failed to offer crucial care to veterans who came forward as suicidal.
These are the allegations of Steven Coughlin, an epidemiologist who worked at the VA’s Office of Public Health until he resigned last year, citing “serious ethical issues.” On Wednesday Coughlin will testify at a congressional hearing on the health of Gulf War veterans.
“What I saw [at VA] was both embarrassing and astonishing. I couldn’t stay any longer,” says Coughlin, who left the VA in December, just four and a half years into the job.
Coughlin was previously associate professor of epidemiology and director of the program in public-health ethics at Tulane University and is a former chair of the writing group that prepared the ethics guidelines for the American College of Epidemiology.
In an interview with The Daily Beast, Coughlin said that whenever he spoke out about any alleged unethical activity, his bosses “intimidated and admonished” him. He says they first tried to silence him after he spoke out about a major health study of 60,000 Iraq and Afghanistan veterans. Coughlin believed that the nearly 2,000 subjects who self-identified as suicidal should have been checked up on afterward by mental-health clinicians. Instead, he says, the researchers interviewed them and moved on.
Coughlin says his supervisors also frequently “obscured the facts” about the impact of toxic exposures on troops in Iraq and Afghanistan and the causes of Gulf War illness.
“Many of those veterans are now homeless or deceased,” he says. “It’s very unfortunate. My supervisors did all they could to block my efforts.”
After getting nowhere with his superiors, Coughlin says, he contacted the chairman of the VA’s Institutional Review Board and the VA inspector-general to request that the study be put on hold until his supervisors could identify clinicians to call back suicidal veterans.
“That’s when all hell broke loose,” he says. “My supervisors tried to remove me from the study, and I received a written admonition. It was shocking. All I was trying to do was help ensure the safety of the veterans participating in our study.”
Coughlin says he was unsuccessful in getting OPH to address the problem in the study of Iraq and Afghanistan veterans, but he managed to incorporate clinician callbacks in a separate Gulf War survey, and he says those calls “saved lives.”
The VA declined to comment specifically for this story, but in a statement released Wednesday, it said the department has a "decades long history of conducting world-class research studies that meet accepted and rigorous scientific standards." The statement, which noted that "all allegations of malfeasance are taken seriously and are investigated fully," also said that the Obama Administration in 2010 recognized nine new diseases as associated with Gulf War Illness.
"VA agrees with Gulf War veterans that there are health issues associated with service in the Gulf War," the statement read. "That is why Secretary (Eric) Shinseki formed a Task Force to conduct a comprehensive review of VA's programs to help improve the care and services we provide to Gulf War Veterans. We will continue to learn and examine ways to improve treatment, process claims, and better care for these veterans.”
Coughlin says his supervisors also frequently “obscured the facts” about the impact of toxic exposures on troops in Iraq and Afghanistan and the causes of Gulf War illness, which afflicted as many as 250,000 veterans, according to the Institute of Medicine.
While the cause of Gulf War illness has been debated for years, a number of peer-reviewed scientific studies have concluded that it is a neurological condition caused by exposure to nerve gas, pesticides, and other toxic elements.
However, says Coughlin, “the people I worked for refuse to release any information to the public that reaches that conclusion. They insist on holding on to the outdated theory that Gulf War illness is psychosomatic.”
He says there is VA data on adverse health consequences of toxic exposures in the Gulf War that “the public has never seen, and I’m sure will never see.”
He says his supervisors paid the Institute of Medicine $1 million to review the latest literature on Gulf War illness, but the first five outside experts they invited to the IOM committee all reported that it was psychiatric and not neurological. “This understandably outraged Gulf War advocates,” Coughlin says. “It was so obviously biased.”
Anthony Hardie, a Gulf War veteran and advocate who will also be testifying at the congressional hearing, tells The Daily Beast that Coughlin’s story “only confirms what Gulf War veterans have believed all along: this cabal of federal bureaucrats and contractors who continue to obfuscate, manipulate, and lie remain a serious obstacle to ill Gulf War veterans’ legitimate quest for treatments and justice.”
Coughlin says the OPH’s 2009–10 National Health Study of a New Generation of U.S. Veterans, which targeted 60,000 post-9/11 veterans, cost $10 million, plus the salaries of those who worked on it. He says 20 percent to 30 percent of these veterans were also Gulf War veterans, and the study produced data regarding their exposures to pesticides, oil-well fires, and pyridostigmine-bromide pills.
OPH never released any data from the study, or even the fact that it exists, Coughlin says. The VA’s official position on pyridostigmine-bromide pills, which the Department of Defense says Gulf War veterans took as protection against nerve gas, did not cause Gulf War illness. But a 2008 study by Beatrice Golomb at the University of California, San Diego, “thoroughly, conclusively shows that this class of chemicals actually are a cause of illness in Gulf War veterans.”
Coughlin also says the OHP released a major survey on Gulf War veterans without fixing it as recommended by the Research Advisory Committee on Gulf War Veterans’ Illnesses, which was mandated by Congress in 2002. Coughlin says his supervisors told the VA that implementing the fixes would cost the government $1 million and delay the study for a year or longer.
“None of this was true. It would not have cost nearly that much to restart the study,” Coughlin says. “But as a result of the false statements made by my supervisors, the chief of staff ordered the survey to proceed without the changes.”
Coughlin says he’ll ask Congress to initiate legislation to cure the “epidemic” of ethical problems at the OPH and urge the committee to direct the VA to identify procedures to ensure that veterans who participate in large-scale epidemiologic studies receive appropriate follow-up care to prevent possible suicides.
“The VA is the nation’s largest health-care provider, and these large studies cost taxpayers tens of millions of dollars and are so important to veterans’ health,” says Coughlin, who is currently looking for another job. “My only motivation for coming forward is to help veterans. That’s the only reason I paid for my own flight to come to Washington. I think the attention from the House committee and the media will lead to positive changes. It will hopefully help veterans.”