Medical Ethics

"Medical journals are immoral, a former BMJ editors tells Sarah Boseley...

"Richard Smith thinks that the way the medical journals make their money, by publishing scientific papers, is immoral. He also says that they are little more than a marketing tool of the drug companies. That's harsh talk from anybody--but even more remarkable from Smith, who was editor of the British Medical Journal for 25 years until his departure last summer.

"Smith is writing a book about publication ethics. He started compiling a list of incidents where the publication of a paper in a medical journal had raised ethical questions, as with the alleged link of MMR, the measles, mumps and rubella vaccination, to autism and the flawed study in 1990 which suggested that women who attended the Bristol cancer help centre were just as likely to die as those who did not.

""It was as I began to think about these things that this started to bother me," says Smith. "I'd always known medical journalism wasn't about the truth, and I tried to write that at least once a year. It's partly because of the nature of science--it's about provisional truths"..

"But another thought," he says, "was that this whole business of sending original research to doctors is kind of crazy. When you talk to ordinary doctors, they are not scientists, and yet here we are sending them this mass of complicated information that most of them are not equipped to critically appraise. They haven't got the time."...

""Peer review is a very flawed practice," he says. "It is slow and expensive, a lottery, and prone to abuse and bias. Much of the time it doesn't pick up errors."

"Before the Internet came along, scientific papers had to be published in journals. But now, he believes, journals should give up what are in effect immoral earnings. Instead, he says, all research should be published in one large free database, with access for all. Smith has joined the board of directors of the free access online Public Library of Science" (Sarah Boseley. "A question of ethics." Guardian Weekly, July 8, 2005: 19).

Colby Glass, MLIS