Another editor bites the dust
BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7205.272 (Published 31 July 1999) Cite this as: BMJ 1999;319:272All rapid responses
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Having read some of the “rapid responses” recently published in the
eBMJ [1-3], I and some other readers and writers were dismayed to see
conservatism and conformity taking hold of this web site. Are the
medically trained more interested in window-dressing than in acquiring
fundamental knowledge [1-3]? The merest hint of the editor flexing
previously invisible muscles [4], and the conformists go scurrying about
like cockroaches to translate his every word and whim into reality. This
strange herd-instinct of the medically qualified, this conventionality
reveals much about why medicine so often seems stuck in a groove,
unadventurous, unembracing of change, fearful of modernity and conformist
to a fault.
Nothing very controversial or shocking has happened here and yet we
see the clamps on freedom of expression being applied enthusiastically as
forms of punishment [2,3] - for what [5]? What crimes have actually been
committed that inspires the new "club rules" for rapid responses [4]?
These new rules [4] are going to inhibit free expression and healthy
debate, i.e. the free exchange of views, that once made this such an
exciting meeting-place [1]. Many will be tempted to fly the nest and seek
their literary pleasures elsewhere. That would be a sad disappointment.
Here would only remain clinicians parroting each other's polite, shallow
mutterings, going out of their way to be agreeable and uncontroversial. If
you call that a discussion then you might just as well call white and
black different shades of grey. Grey, grey and greyer blandness looks like
main course on the new menu with everybody agreeing with everybody else -
a diet of polite nothings for polite nobodies [2,3]. BMJ might sanitise
itself into mediocrity and eliminate all those that made it great [5].
[1] http://www.bmj.com/cgi/eletters/320/7250/1660/a#EL16
[2] http://www.bmj.com/cgi/eletters/321/7252/0#EL13
[3] http://www.bmj.com/cgi/eletters/319/7205/272#EL6
[4] http://www.bmj.com/cgi/eletters/320/7250/1660/a#EL5
[5] http://www.bmj.com/cgi/eletters/321/7252/0#EL2
Competing interests: No competing interests
Dear Dr Smith,
I refer to email correspondence to me (copied to yourself and others)
from a regular contributor to this page in response to my recent posting
"Drinking in the Last Chance Saloon" on 16/7/2000.
The intent of the posting was not to suppress freedom of speech.
Quite the opposite. I am a great fan of the rapid response facility and
enjoy reading the many and varied comments on all aspects of the BMJ's
publications.
Almost all of these are objective, rigorous and informative. A small
number, however, are not. They contain personalised remarks about the
Editorial team or BMJ contributors, sometimes with the clear inference
that conflicting interests are at work. In isolation each of these
postings is a minor discourtesy but taken together over time they erode
the trust between the BMJ and its readership.
In the last two years two leading editors of international medical
journals have been invited to leave their posts. G Lundberg was dismissed
by the JAMA on the slightly bizarre pretext of having published a paper
about American teenagers sexual habits. J Kassirer of the NEJM was unable
to reach agreement with his publishers on a business strategy.
Commenting on this matter in the Editorial " Another editor bites the
dust" (1) you refer to the importance of trust between Editors and their
stakeholders.
"Trust exists when each party holds certain expectations of the
other; expectations of competence, predictability and fairness".
The rapid response facility requires trust on the part of the BMJ by
allowing its readers a far greater freedom to speak their minds. It would
be ironic if, in exercising that freedom, the readership were to undermine
the independence of its Editor.
Dr John Hopkins
Parkplace Health Centre
Darlington DL1 5LW
(1) Another eitor btes the Dust R Smith BMJ 199 319:272
Declaration of interest: I produce a health news web site which has
hypertext links to the BMJ web site. No payment is made for these links.
Competing interests: No competing interests
I think you have made a rod for your own backs by adopting open peer
review. It makes more work for you .
There is no evidence base that it produces better reviews . Worst of all, it
erodes trust between reviewers and editors which, as Richard rightly says,
is always bad.
Of course your motivation for introducing open review (I use "your"
to signify the BMJ editorial establishment) could not be more exalted. You
wished to be seen to be absolutely fair and transparent in your judgement
of papers submitted to the BMJ - bully for you. However I think your
mistake was to take a too exalted view of what editing a medical journal
is all about. You see yourself as resembling a quasi-legal body somewhere
in the Royal Courts of Justice, bound by rules of due process, rights of
appeal, etc. etc. and finish up with a huge bureaucratic monster in which
trust has little part.
In contrast, as editor of EJCN, I see my spiritual home to be in Notting
Hill Gate, rather than the Strand. I identify with small independent
shopkeepers who buy and sell objet d'art. They try to maintain a good
window display to attract customers (=readers of EJCN) and make a modest
profit. When someone comes in with an offering (=authors of papers) they
ask the vendor to leave it for a while so they can get a valuation. To do
this they rely partly on their own opinion, and partly on advice of other
traders in the street (=reviewers) whom they trust to give good advice, as
the trader himself would do, if asked. They also bear in mind that the
goods may be faked, or stolen, and that they have a legal duty not to deal
in stolen goods, and that may be sued either by vendors or customers if
they deal dishonestly.
I think my perception of editorial function is better than yours. Notting
Hill Gate traders to not feel impelled to identify the sources of advice
on which they make an offer to buy incoming goods: if the vendor does not
like the offer he can always try another shop up the street and see if he
gets a better offer, just as authors can go to another journal if they do
not like the way I handle submissions to EJCN.
Open peer review enables authors to peek into the editorial back room
where decisions to accept or reject are made. This may, or may not, be a
good thing -your own research shows little benefit to the authors. However
it demonstrates a lack of trust between you as editor, and me as reviewer.
You imply that it is necessary to reveal my identity to the author to
restrain me from plagiarising his work, or to prevent me from bearing
false witness about the paper in order to further my own interests. That
is not a basis on which I wish to act as a reviewer for any editor,
however well-intentioned you may be.
John Garrow
Rickmansworth
Herts
Competing interests: No competing interests
It is a pity that Dr Kassirer leaves his position. The development of
BMJ to Internet openness is a direction which I salutate. But it not means
that all journals MUST behave the same. I believe that very special NEJM,
which image was shaped last years by Dr Kassirer efforts, has right to
exist.
Call for correct balance between obligations to person and to society is
OK, when cerrect balance is achieved. Is it more probable in temperate
English climate? We have lots of examples of incorrect balance, from
Tuskegee case to Socialism.
Dr. Kassirer preference of obligation to patient worth understanding as
well as his view of the NEJM. Who said that necessarily new NEJM-
publications will be better than old fashioned NEJM?
Competing interests: No competing interests
It is highly understandable that Dr. Kassirer cannot
sacrifice scientific standards for financial interests.
Traditions like peer-review of papers and open-minded,
sometimes provocative editorial work are essential for
setting high standards. These standards meet the needs of
the medical community to identify important achievements.
The increasing number of low-quality journals as well as the
often uncontrolled use of the internet for the exchange of
medical information deserves attention by us (and lacks it
so far). It is an unevitably upcoming challenge to find a
more ethical approach
Competing interests: No competing interests
Absolutely right, Richard. Medical publishing can no longer afford to
take an elitist, ex cathedra approach. The Internet has seen to it that
information belongs to everyone. In that regard, the BMJ is on the right
track; the NEJM was shunting itself into a siding.
David Woods
Competing interests: No competing interests
This is a worrying trend.However,the BMJ editor should not be
troubled by the happenings in the american society.The British judiciary
is in effect promoting the right of individual's free speech.Following
extract(1) just confirms that:
"Free speech included not only the inoffensive but also the irritating,the
contentious,the eccentric,the heretical,the unwelcome,and the
provacative,as long as such speech did not tend to provoke violence"
Whether the BMA would agree with such view,however,is entirely a
different matter.
REFERENCES
(1)Redomond-Bate v Director of Public Prosecutions;The Times,July 28
1999:QBD
30 July 1999
Competing interests: No competing interests
Re: Re: Freedom of speech on eBMJ?
Dear Dr Smith,
Joseph Watine's response makes the same points as his earlier e-mail
to you, myself and others.
Forgive the repetition but it is not my intention to argue for the
suppression of free speech.
The BMJ is, in part, a debating chamber in which a wide range of
views and opinions are expressed.
A good parallel is with the House of Commons ( whose proceedings are
now broadcast by the BBC).
Parliament too has its "regulars" and debate can get heated. However,
there are strict conventions which limit how far Members go in what they
say. They are not allowed to question each other's integrity in the course
of a debate and they refer to one another by their constituencies rather
than by name.
These conventions can appear arcane,even ridiculous but they serve a
purpose. They ensure that debate is essentially objective and impersonal,
that contributions are judged not by their emotional impact but by their
content and values.
It is tempting to ask if any of this matters, after all most of us
have other things to do than fret about the BMJ. But it matters because
the rapid response is a unifying force, bringing together doctors and the
public not just in Britain but around the world to share ideas.
Whether, as Watine says the facility is "grey, grey, grey" is a
matter of opinion. It is arguable, however, that postings which describe
other respondents as "scuttling cockroaches" add little to the debate.
Yours sincerely,
Dr John Hopkins
Competing interests: No competing interests