Nine Questions For The White House Physician On The President’s Use Of Hydroxychloroquine
Reprinted with permission from JustSecurity
President Donald Trump's announcement on May 18 that he had secretly begun taking the anti-malaria drug hydroxychloroquine 10 days before coincides with the revelation that two senior White House aides tested positive for COVID-19 and the sudden initiation of a White House policy for staffers to wear masks. When press secretary Kayleigh McEnany explained the new White House Policy back then, she did not disclose, perhaps because she did not know, that the president was taking hydroxychloroquine. "I think it's good," Trump said on Monday. "I've heard a lot of good stories. And if it's not good, I'll tell you right. I'm not going to get hurt by it."
Trump has been touting the drug for more than a month as a remedy for coronavirus, despite medical research and clinical tests that taking it can have dire consequences. "What do you have to lose?" Trump said on April 6. In late March, the CIA warned its employees: "At this point, the drug is not recommended to be used by patients except by medical professionals prescribing it as part of ongoing investigational studies. There are potentially significant side effects, including sudden cardiac death, associated with hydroxychloroquine and its individual use in patients need to be carefully selected and monitored by a health care professional." On April 24, the Food and Drug Administration issued a statement that the drug has "not been shown to be safe and effective." In late April, the most complete study of hydroxychloroquine conducted by the Department Veterans Affairs found that 27 percent of patients who received hydroxychloroquine died.
Remarkably on Monday, the president suggested the Veterans Affairs study was wrong. Why? "The only negative I've heard was the study at VA, where people that aren't big Trump fans gave it," the president said. That's right. He thinks the study was performed by medical investigators in a way to hurt him personally.
On May 14, Dr. Rick Bright, the former director of the Biomedical Advanced Research and Development Authority in charge of vaccine development, testified before the House saying that had been fired because he refused to greenlight hydroxychloroquine, which he described as one of several "potentially dangerous drugs promoted by those with political connections."
In support of Trump's announcement that he was taking the drug, the physician to the President, Dr. Sean Conley, a Navy commander, issued a statement in the form of a memo to the press secretary: "After numerous discussions he and I had regarding the evidence for and against the use of hydroxychloroquine, we concluded the potential benefit from treatment outweighed the relative risks."
Dr. Conley's intercession of his medical authority to satisfy Trump's showmanship overrode the scientific advice of the FDA and the CIA and added further fuel to Dr. Bright's testimony that the administration has "no master plan," that the United States faces "the darkest winter in our history," and that in the absence of national leadership, "Our window of opportunity is closing."
Conley's predecessor as the White House physician, Dr. Ronny Jackson, saw Trump's nomination of him as Secretary of Veteran Affairs crash in 2018 when the report of the Navy inspector general exposed the "toxic" environment of his medical office and reports of his alleged abuses of dispensing drugs to favored friends and his own alcohol abuse. Now running as a Republican for a congressional seat from Texas, Jackson has recently raised the Trump promoted conspiracy theory of "Obamagate." "President Obama weaponized the highest levels of our government to spy on President Trump," Jackson said. "Every Deep State traitor deserves to be brought to justice for their heinous actions." As White House physician, Jackson declared him one pound short of the level that would be medically obese. "He has incredibly good genes," Jackson said, "and it's just the way God made him." The important point here is that Trump has a track record of attracting and supporting this sort of partisan loyalist without ethical guardrails as White House physician.
Dr. Conley's approval of Trump's use of the drug now thrusts him into the spotlight, as Dr. Jackson was before, and raises significant questions about his potential abuse of his office.
Nine questions for Dr. Conley follow.
1. Sean Conley, the chief White House physician, states that he has discussed hydroxychloroquine with Trump without explicitly saying that he has prescribed the medication. Is Trump's statement that he is taking the drug true?
2. If it is not true that Trump's is taking the drug, why has Dr. Conley lied in violation of FDA guidelines, medical standards, ethics and professionalism? Who instructed or encouraged him to lie?
3. The 25th Amendment was passed in part because the White House physician for President Franklin D. Roosevelt covered up his debilitating heart disease. Is Dr. Conley violating the spirit of that constitutional amendment?
4. What is the complete medical record of Donald Trump that might put him at risk of dangerous side effects in taking the drug? More specifically, does Trump have any history of heart trouble or disease, or any other medical condition that would make it dangerous for him to take this drug?
5. Conley's memo states: "After numerous discussions…we concluded the potential benefit from the treatment outweighed the relative risks." The use of "we" in this sentence is notable. Is Dr. Conley saying that he would not have recommended use of the drug? In other words, is Dr. Conley hiding that Trump's views outweighed the physician's sound medical advice of the risks? Why did it take numerous discussions?
6. If it is true that Trump is taking this drug, why has Dr. Conley knowingly prescribed a drug that the FDA and other authorities have determined is potentially fatal, and, moreover, whose beneficial effects on treating COVID-19 are unproven? Why has Dr. Conley prescribed a drug possibly risking the life of the president and in violation of FDA guidelines, medical standards, ethics, and professionalism?
7. The drug, in any case, even though unproven, according to its unscientific advocates is supposed to be given only to those suffering from COVID-19, not as a prophylactic. Does Trump have COVID-19?
8. Whether Dr. Conley has told the truth or lied–either way–will his actions be reviewed and held to account by the Department of Defense given that he is a military officer? Will he be brought before appropriate state medical boards that licensed him?
9. Medical researchers have concluded that hydroxychloroquine may cause neuropsychiatric symptoms, "including agitation, insomnia, confusion, mania, hallucinations, paranoia, depression, catatonia, psychosis, and suicidal ideation." Has Dr. Conley properly assessed his patient, President Trump, for his susceptibility to these symptoms? Since Trump has been taking the drug has Dr. Conley observed that it has produced or exacerbated any of these symptoms in President Trump?
President Donald Trump is flanked by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases while speaking about coronavirus vaccine development in the Rose Garden of the White House on May 15, 2020. (Drew Angerer/Getty Images)
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