The War against The Lancet

When Medicine and Politics Mix

Hate, disgrace, and pitiful editorial standards.  Are these the terms to be ascribed to The Lancet, which, bar a few blemishes, has shown a distinguished pedigree in the world of medical research?  Stroppy academics have made an argument that an open letter published within its pages last year be denounced and withdrawn. “An Open letter to the people of Gaza” triggered a furious reaction within the magazine, with complainants suggesting that the publication has sided with the forces of “anti-Jewish bigotry”.

The letter itself (July 22, 2014), authored by Paola Manduca, Iain Chalmers, Derek Summerfield, Mads Gilbert, Swee Ang on behalf of 24 signatories, spoke of the “ethics and practice” of being “doctors and scientists” which made them denounce “what we witness in the aggression of Gaza by Israel.  We ask our colleagues, old and young professionals, to denounce this Israeli aggression.  We challenge the perversity of a propaganda that justifies the creation of an emergency to masquerade a massacre, a so-called ‘defensive aggression.’”

The Ombudsman’s report on the letter, authored by Wisia Wedzicha, conceded “that wars and other serious conflicts, and their grave consequences for health, are appropriate subjects for discussion in medical journals.”  The report did chide the authors for not being more open about affiliations with organisations that might have had a stake in the “situation in Gaza”, something The Lancet editors were recommended to rectify in due course.

Some language was also taken to task – that a mere 5 percent of Israeli academics who had pleaded with the government to halt aggression in Gaza implied that “the rest” were “complicit in the massacre and destruction of Gaza” was deemed extreme.

The editor Richard Horton, reflecting on the episode in an October piece last year, suggested “new guidance” in the matter, that editors would have to “from time to time, be faced with submissions that lie at the difficult intersection of medicine and politics.” Care would be needed, he reflected, on publishing pieces that “might unnecessarily polarise, or foster or worsen political division.”  The open letter certainly did not require withdrawal.  Not even a previous Chair of the Committee on Publication Ethics (COPE) felt that it needed to be.

The issue would have been dead and buried but for the continuing attempts to force the issue with Horton and its publisher.  A group of protesting doctors numbering over 500 signatures, led by Professor Sir Mark Pepys, sees the journal as having been the subject of “grossly irresponsible misuse” for political ends.  The letter, they argued, constituted “stereotypical extremist hate propaganda”, itself a peculiar confection oddly favourable to the overwhelming use of force that claimed over two thousand Palestinian lives.  “Medical concern,” they argued in this case, was merely a “hypocritical disguise”.

The doctors, in turn, argue that they will boycott the journal if the publishing group Reed Elsevier does not “enforce appropriate ethical standards of editorship.”  Reed Elsevier, they argue, profited “from the publication of dishonest and malicious material that incites hatred and violence.”  The entire swathe of 2,000 scientific journals will also be the subject of the academic cold shoulder.  “None of us is under any obligation to submit and review material for publication in their journals or to serve on their editorial or advisory boards.”

A closer reading of the website concernedcademics.org suggests how aggressive the grouping has been in targeting The Lancet.  It features a report by NGO Monitor arguing that The Lancet has been “a political platform for NGOs”.  The Lancet, argued the authors, had taken “a highly politicized course in the Israeli-Palestinian conflict” something which duly “ostracized, and to a large extent, demonized Israel and the Israeli medical community.”

The statement is palpably absurd, given repeated efforts on the part of Horton and the magazine’s team to establish Palestinian-Israeli bridges in the medical domain.  That aspect of the curriculum vitae has been removed from view.

The Lancet, however, has friends.  Handsoffthelancet.org comprises some 300 doctors, led by Professor Graham Watt of the University of Glasgow. It has its own counter-petition which is gaining steam.  “The heavy-handed attempt to force The Lancet to withdraw the open letter is the latest in a series of attempts to stifle media coverage of the Israel-Palestine conflict and should be resisted.”  Last Wednesday, the journal’s international advisory board comprising 19 professors, wrote to Horton expressing their “unreserved support” for his position.

The Lancet has seen this before.  Its founding editor, the notable social reformer and surgeon Thomas Wakley, faced more than a fair share of editorial attacks for his stances, notably against the rotten core of the medical establishment.  Having survived that, the publication has gone on to stir the pot of medical discussions, with editors like Horton reviving a radical tradition.  The awful effects of conflict on civilian populations deserves a spot in its volumes. The complaining academics have already missed the train on this one, embracing a spurious form of objectivity that merely apologises for a brutal status quo.

Binoy Kampmark was a Commonwealth Scholar at Selwyn College, Cambridge. He lectures at RMIT University, Melbourne and can be reached at: bkampmark@gmail.com. Read other articles by Binoy.