Paul Carlson MD
Program Director of the General Psychiatry Program at the U of Utah
Paul J. Carlson, MD, is a psychiatrist and Associate Professor of Psychiatry at the University of Utah, where he serves as the Program Director of the General Psychiatry Residency Program. He is affiliated with the Huntsman Mental Health Institute and specializes in adult psychiatry, with particular focus on mood and behavioral health disorders. Dr. Carlson trained at Baylor College of Medicine and completed his residency and chief residency at the University of Texas Southwestern Medical Center, later pursuing research at the National Institute of Mental Health. In his role as Program Director, he oversees the education and professional development of psychiatry residents within a large academic and clinical training program serving the Mountain West region.
When Doing Nothing Isn’t Neutral: Leadership, Responsibility, and Ethical Duty
Throughout the events described on this site, the author had intermittent but meaningful interactions with Paul Carlson, MD, Program Director of the University of Utah General Psychiatry Residency Program and a senior faculty member at the Huntsman Mental Health Institute. Dr. Carlson is widely regarded within the institution as a thoughtful educator and leader in psychiatric training. The author experienced him as a steady and respected presence within the residency program, and she continues to view him as an individual of intelligence, professionalism, and personal integrity.
At the same time, the author’s account places Dr. Carlson within a broader institutional context in which multiple concerns regarding safety, professional conduct, and alleged harm were raised over time. According to the author, Dr. Carlson was present during the June 7, 2021 incident that she experienced as a public hazing event. She further reports that, in August and September of 2021, concerns were communicated indicating that Parth Gandhi, PhD, may pose a risk of serious harm, including potential violence. Additionally, the author reports that prior to the Generations Conference, communications were shared that she interpreted as indicating potential sexual risk.
In the author’s view, these events represented opportunities for intervention, escalation, or further inquiry. However, she perceived that meaningful intervention did not occur at those times. While the specific decision-making processes and context for these responses are not fully known, the author experienced these moments as instances in which risks were not addressed in a manner she believed was warranted.
The author does not attribute malicious intent to Dr. Carlson. Rather, she situates these experiences within a broader ethical question regarding the responsibilities of leadership in academic medicine—particularly in environments where trainees may be vulnerable and dependent on institutional protection. As Program Director, Dr. Carlson occupies a role that carries both educational and ethical responsibilities, including the duty to foster a safe training environment and to respond appropriately to concerns raised by trainees.
This raises an important ethical consideration reflected in a widely cited statement attributed to Albert Einstein:
“The world will not be destroyed by those who do evil, but by those who watch them without doing anything.”
Within the context of medical ethics, this principle can be understood as a reflection on duty to act, particularly when credible concerns of harm are raised. Ethical frameworks within both the American Medical Association and the American Psychiatric Association emphasize the responsibility of physicians to report and respond to colleague impairment, misconduct, or potential risk to others. In training environments, this responsibility is further heightened by the power differential between faculty and trainees.
The author reflects that her experience raised questions about how such duties are operationalized in practice. Specifically, when concerns are ambiguous, evolving, or difficult to interpret, what threshold must be met before action is taken? And how do institutional dynamics—including loyalty, uncertainty, and reputational concerns—shape those decisions?
These questions are not unique to this case, but are central to the ethics of medical training and leadership. The author’s account suggests that, in her experience, the balance between caution and intervention may not have fully aligned with the level of risk she perceived at the time.
Importantly, the author makes no definitive moral judgment about Dr. Carlson. She continues to regard him as a good man and a respected educator. His inclusion in this narrative reflects not an accusation, but his position as a leader within the system in which these events unfolded.
The broader ethical inquiry remains:
At what point does inaction, even if well-intentioned, contribute to harm?
And how should leaders in positions of authority respond when concerns are raised that may carry significant implications for safety?
These questions are left to the reader.
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