Richard Smith: Is the New England Journal of Medicine anti-science? @Richard56 @Medici_Manager @pash22

4 Jul, 13 | by BMJ Group  http://bit.ly/18FaJ9j

About once a year a furious researcher writes to me complaining that the New England Journal of Medicine won’t publish a letter that strongly criticises, even demolishes, an article the journal has published. They write to me out of frustration, not because I have any influence over the Bostonian paragon, but because I’ve dared to criticise it in print a few times.

What my correspondents can’t understand is why the journal won’t publish their letter when electronic space is infinite and free. Why can’t the journal have rapid responses like the BMJ and many other journals?

I don’t know why the New England Journal of Medicine doesn’t publish electronically all the letters it receives, but I can hypothesise. The Bostonian paragon is unashamedly elitist and committed to excellence and virtue, just like their colleagues in the city teased by Henry James in his novel The Bostonians. Presumably the editors of the journal don’t want to overload their readers with what they see as ill informed criticisms, but want to present them with the quintessence of comment, beautifully edited of course.

But surely this behaviour is anti-science.

Medical journals are either explicitly or implicitly following the theory of science proposed by Karl Popper: scientists develop a falsifiable hypothesis and then test it to destruction. They never arrive at truth, but hypotheses that have survived the destructive fire serve as our best substitute for truth.

It follows that a very important part of science is giving everybody, the hoi polio as well as the blessed, the chance to scrutinise the hypotheses, methods, data, and conclusions of studies and present their criticisms. We can be much more confident in the findings of a study that has been exposed to tens of thousands of critical eyes than we can in one that has been viewed only by the chosen few, particularly when those few are of the same mental bent as the authors of the study.

Always in this kind of discussion I’m driven back to quoting the blind poet, republican, and regicide John Milton: “Truth was never put to the worse in a free and open encounter…. It is not impossible that she [truth] may have more shapes than one…. If it comes to prohibiting, there is not ought more likely to be prohibited than truth itself, whose first appearance to our eyes bleared and dimmed with prejudice and custom is more unsightly and implausible than many errors….”

The editors of the New England Journal of Medicine must think of themselves as superior people (and they are superior to most of us, and certainly to me) capable of distinguishing truth from error, but could they be making a mistake? I urge them to follow the advice of Rudolf  Virchow, the great German doctor and intellectual, who insisted that “Everybody is free to make a fool of himself in my journal.”

Competing interest: RS admires the New England Journal of Medicine but has several times published criticisms of the journal; and he is passionately committed to open access and sees the journal as an important barrier to complete open access.

Richard Smith was the editor of the BMJ until 2004 and is director of the United Health Group’s chronic disease initiative.

 

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