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November 25, 2020

Reconsidering Named Honorifics in Medicine—the Troubling Legacy of Dermatologist Albert Kligman

Author Affiliations
  • 1Division of Dermatology, Department of Internal Medicine, Dell Medical School, The University of Texas at Austin
  • 2Associate Editor, JAMA Dermatology
  • 3Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA Dermatol. 2021;157(2):153-155. doi:10.1001/jamadermatol.2020.4570

Recently, a series of police killings of unarmed African Americans has renewed attention to the history of abuses and institutional racism in the United States. This national conversation has led to institutional name changes (eg, removing Woodrow Wilson’s name from the Princeton University School of Public and International Affairs) and removal of monuments (eg, John C. Calhoun in Charleston, South Carolina) whose namesakes supported white supremacy. In medicine, named lectureships, professorships, and other honorifics are used to solidify the legacies of individuals deemed important. In a moment with calls for diversity, inclusion, equity, and anti-racism, physicians can use this as an opportunity to reflect on who is honored and whether they speak to current values. One such example is the legacy of dermatologist Albert Kligman.

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3 Comments for this article
To come clean the institution has give back the money or repurpose it, and the name is complicated
Joerg Albrecht, MD, PhD | Cook County Health
The editorial by Drs Adamson and Lipoff is timely, well written, and thoroughly researched. Like the authors, I am in awe of the width and creativity of Dr Kligman’s work, and I share their discomfort.
Dr Kligman violated current fundamental research ethics, and having his name on lectureships, laboratories and fellowships is troubling. Clearly the profession has to come clean, but we should hold modern institutions to higher standards than individuals who acted within the norms of their times. Dr Kligman’s research was carried out not just in view, but within the American legal system. What better represents the
lived values of a society than its legal systems and its prisons?
Dr Kligman and the university that employed him profited handsomely from his research.(1) Given that the University of Pennsylvania received money, it has to own up to ethical violations of the research in its name. It cannot disavow Dr Kligman without also disavowing the money it earned from him. Sacrificing only Dr Kligman’s name falls short – and would be hypocritical.
Removing Dr Kligman’s name also risks erasing an uncomfortable history. An asterix may indicated controversy,(2) but given both the history and undisputed achievements of Dr Kligman, perhaps the more educational solution is to combine names. One possibility may be Leodus Jones, who was the most prominent organizer of the Holmesburg inmates and one of the few to receive a settlement.(3) A Kligman-Jones named lecture, laboratory, or fellowship could encourage a dialogue and thought-provoking memorial to history. Jones and the other inmates are integral part of the immensely successful Penn research history.
Penn owns the tretinoin patent,(1) and Dr Kligman at least donated $15 Million.(4) It sits atop the former site of Philadelphia General Hospital (PGH), a public hospital closed in 1977. There are many ways who the university could do good with the money it received. Philadelphia still has no public hospital, and its public clinics no, or weak dermatology services. Kligman’s funds could be used to provide an endowed free clinic with the appropriate resources, including subsidized medications to help the descendants of those who were used for research.
Penn’s mission includes a lofty commitment to “outstanding patient care throughout the world.”(4) Instead, Penn could use these funds to assure that Philadelphians have easier access to decent care. That would be a fitting way to serve Penn’s core values and to “learn from our history, (and) take responsibility for the future…”(5)

1. Fried S. Facing up to Retin-A. Philadelphia Magazine. 1996(April ):102-107, 149-155.
(this reference could probably be omitted to match the maximum number of references:
2. Heymann WR. Charlottesville, Anzio Beachhead, Eponyms and Roger Maris. https://www.aad.org/dw/dw-insights-and-inquiries/medical-dermatology/charlottesville-anzio-beachhead-eponyms-and-roger-maris. Updated 08/18/2017. Accessed 12/16/2020.)
3. Samantha Melamed. Leodus Jones, 74, bore witness to Philly's grisly Holmesburg prison experiments. https://www.inquirer.com/philly/news/pennsylvania/philadelphia/leodus-jones-74-bore-witness-to-phillys-grisly-holmesburg-prison-experiments-20180213.html. Published 02/13/2018. Accessed 12/06/2020.
4. Calvert S. U. settles suit over Retin-A. https://www.thedp.com/article/1992/03/u-settles-suit-over-retina. Published 03/06/1992. Accessed 12/06/2020.
5. University fo Pennsylvania: Mission and History, https://www.pennmedicine.org/about/mission-and-history. Accessed 12/06/2020.
Adding to the list
Daniel Krell, Family Medicine | Retired PCP
All specialties should identify and purge their specific honorifics named for people or institutions with histories of unacceptable behaviors. One of the most egregious histories is that of J. Marion Sims (think "Sims speculum"), whose practice consisted of performing repeated and experimental gynecologic surgeries on naked, unanesthetized slaves, over many years.*

*Washington, Harriet, 2007, "Medical Apartheid"
Remembering the "institutionalized" in our own training...
Harald Aanning, MD | Retired general surgeon
More than 40 years later, I have come to regret my participation in the following: as a first year surgical resident rotating through OB-GYN clinic we practiced pelvic exams on women waiting for their birth control prescriptions; during our 2-month anaesthesia rotation we were given one-on-one responsibility for passing gas on retarded children undergoing orthopedic procedures; we spent four months (as 4th year residents) as the surgeon at a reservation hospital doing hernias, C-sections, cholecystectomies, and similar operations on Native Americans; and rotations at the VA hospital through five years of residency were noticeably less supervised by staff surgeons...

Looking back, I simply followed others before me and never looked back - until recently with articles such as this by Drs. Adamson and Lipoff...