The JBI saga continues
Regular readers of this blog will recall my writing about a deeply unpleasant episode in which the Journal of Bioethical Inquiry wrote some unfounded allegations about unethical behaviour by Dianthus Medical, which, after extensive correspondence, they refused to correct. I first wrote about it here, and linked briefly here to a much more detailed account written by my friend Karen Shashok and published on the EMWA website.
The chairman of the editorial board of the journal, Paul Komesaroff, has now responded to Shashok’s article, and his response has been published on the EWMA website. Komesaroff’s response is not concordant with my own understanding of what happened. In this post, I shall explain what really happened with reference to the actual content of the emails that were exchanged, so that you can make your own mind up about the accuracy of what Komesaroff claims.
Komesaroff begins his response by saying “In science and scientific writing the first rule is to ensure that the facts you are reporting are correct”. On that point, at least, we agree. However, Komesaroff doesn’t have a good record of living up to that ideal, as he has consistently refused to correct the article that appeared in his journal which falsely accused us of ghostwriting.
Let’s look at some of the specific points Komesaroff makes. He makes a great many points, some of which are not particularly important, and if I attempted to respond to every single one this blog post would become unreadably long. So I’ll concentrate on the most egregious inaccuracies. Actually, this is going to be quite a long post anyway, but I hope you’ll bear with me, because I think it’s important to put the record straight.
In the introduction to his response, he says that I threatened to take legal action for libel and refused to withdraw that threat. While it is true that I raised the possibility of legal action in some of my earlier emails with Springer, the publisher of the journal, I subsequently make it perfectly clear that I had decided not to go down that route.
Once I realised that Komesaroff believed I was making legal threats (he didn’t actually tell me this himself, but I learned about it second hand as a result of correspondence between Komesaroff and Karen Shashok) and that he was using this as a reason not to correspond with me, I sent the following email on 18 July 2011:
Dear Dr Komesaroff
I think there may have been a misunderstanding here. I gather from correspondence with Karen Shashok that you are under the impression that I am threatening legal action, and that it is the threat of legal action that is inhibiting you from engaging in discussion.
I'm not sure why you believed that to be true, but I'm happy to confirm that I have no plans to take legal action.
Now that we've cleared that up, are you willing to discuss the article?
Kind regards
Adam
In the light of that email, I’m sure you can make up your own mind about the truth of Komesaroff’s claim that I made a threat of legal action which I refused to withdraw.
Moving on to the section of his response entitled “The facts of the matter”, point 6 says that the original article in JBI did not make any claims about unethical conduct by Dianthus Medical. That is rather disingenuous. While it is true that the article did not use the precise words “unethical conduct”, that was the clear implication of the article. We are accused of ghostwriting, and most people understand that to be unethical. Moreover, the description of ghostwriting in the paper leads the reader in little doubt that it is not a good thing:
“A ghostwriter includes messages to maximize the marketing power of the publication while one or more “honorary” academic authors lend their names, titles, and purported independence to the paper (Moffat and Elliott 2007). While the audience may look suspiciously on a paper with an all-corporate authorship line, the presence of an academic author lends the air of independence and prestige, making the article appear more credible. The academic authors may review an outline or draft, but typically perform little writing.”
In point 9, Komesaroff claims that I was asked which statements in the article needed to be corrected and that I “consistently refused to identify a single false, inaccurate, or misleading statement”. I disagree. Komesaroff emailed me on 19 July 2011 to ask what specifically I thought was wrong with the article. I replied to him the next day with the following email:
Dear Dr Komesaroff
I can assure you that I am most certainly genuinely interested in resolving my concerns, so I am happy to answer your questions.
The claims in Spielmans & Parry's article that I object to are in the section entitled "Writing firms", on the 6th page of the pdf version of the article.
The first paragraph of that section mentions my company specifically by name, as an example of the sort of company that indulges in ghostwriting. The following paragraph then states:
"The process is relatively simple: A ghostwriter includes messages to maximize the marketing power of the publication while one or more “honorary” academic authors lend their names, titles, and purported independence to the paper (Moffat and Elliott 2007). While the audience may look suspiciously on a paper with an all-corporate authorship line, the presence of an academic author lends the air of independence and prestige, making the article appear more credible. The academic authors may review an outline or draft, but typically perform little writing."
Although it's not explicitly stated that my company operates in that manner, by following the paragraph in which my company is mentioned with that statement there is a clear implication that that is how we write our papers. I'm sure that any reasonable reader would infer (assuming they believe the article to be accurate) that the description of ghostwriting given above applies specifically to my company.
You mention the letter that I published. There are three reasons why I don't believe that to be sufficient. First, the letter is not bibliographically linked to the original article via the journal's website. It would be perfectly possible for anyone to read the original article without being aware that my letter exists. Second, Spielmans and Parry wrote a reply to my letter in which they made further allegations, and the journal did not give me an opportunity to respond to those allegations. Thirdly, I think it's rather bad form of a peer-reviewed journal to publish a paper which makes up allegations on the basis of supposition, rather than evidence, and any journal with the word "ethical" in its title should surely wish to publish an apology in such circumstances.
What I would now like to happen is for the journal to publish an apology and a correction to the article, bibliographically linked to the original article, so that it would be clear from the article's web page that the correction exists. As I am sure you will have seen in previous correspondence, Spielmans and Parry agreed to some wording of a correction that they would find acceptable (I attach a copy in case you no longer have it to hand). When the authors themselves agree that a correction to the article is appropriate, I cannot see any reason why the journal would not wish to publish it.
I look forward to your response.
Kind regards
Adam
Komesaroff apparently does not believe that the above email identifies “a single false, inaccurate, or misleading statement.” I think that email was perfectly clear about exactly what I thought was misleading in the article. If Komesaroff thought that my email wasn’t sufficiently clear, he could have emailed me back to say so, but instead he emailed back to say that he was not prepared to engage in any further correspondence.
In the final paragraph of his “The facts of the matter” section, he states that I “admit that no errors have been committed”. Given the email I quoted above, I’ll leave you to make up your own mind about the truth of that statement.
This whole episode is bizarre. The journal published some unfounded allegations against us. That’s not hugely bizarre. Many papers containing statements that didn’t get thorough fact-checking are published in peer reviewed journals. What is bizarre has been the journal’s response when the error was pointed out. Surely a reputable journal would wish to publish a correction when it is pointed out that they have published a misleading article? This should be particularly true when the authors of the article themselves agreed that they had no evidence for the allegations and have agreed that a correction (although they preferred to describe it as a “clarification”) would be appropriate.
But instead, Komesaroff has invented a fictitious threat of legal action as a reason to break off any discussion of the article. That threat did not exist, as I have proved above. But even if it did, I cannot understand why it would make it OK for the journal to allow a misleading article to stand uncorrected. Surely the important thing is the accuracy of the published record?
Journal of Bioethical Inquiry and correcting the record
Background at http://www.emwa.org/Home/Webeditorial-7.html and http://www.emwa.org/Home/Webeditorial-8.html
Komesaroff and I do not agree on what the real issues are in this case, so further debate is unlikely to bring us any closer to agreement.
I respect Komesaroff’s point of view but feel he, the editorial board of JBI and Springer have used an issue that could easily have been resolved to everyone’s satisfaction in 2010 into an opportunity for him to give readers of his EMWA webeditorial a biased and willfully inaccurate account of my efforts (as well as Adam’s) to engage the journal and publisher in reasoned dialog.
The Komesaroff and Springer position is to insist that Adam was threatening them with legal action, which is not true. So Komesaroff's main argument --that the journal would not act under pressure from the threat of legal action-- is baseless.
Komesaroff has claimed that I misrepresented my correspondence with him, and has labeled as “facts” his personal understanding and interpretation of the events, along with his selective reporting of the events.
When Hendrik Jan Stoker, Springer’s legal counsel, asked me what I wished Springer would do, I asked him specifically if Springer could support JBI in 1) publishing a complete correction to the false and misleading information about Dianthus Medical Limited, and 2) clearly linking correspondence and other publications arising from Spielmans and Parry’s article. He did not respond to this question.
So much for Komesaroff’s claim that I could not say what I wanted them to correct. Although we disagree on the need to publish the second clarification, there is no question that the journal should link the two published letters to the original article. To date they have not done so.
Those are the facts as I see them.
Part of the email correspondence between Komesaroff and myself is pasted below. Please contact me if you would like copies of any other correspondence. Readers may use these documents to judge who has reported the facts more accurately on the EMWA website.
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On 16 July 2011 16:06, Karen Shashok wrote:
kate.cregan@monash.edu, michael.ashby@dhhs.tas.gov.au, leigh.rich@armstrong.edu, bronwenmorrell@gmail.com, Paul.Komesaroff@monash.edu, grant.gillett@otago.ac.nz, ian.kerridge@sydney.edu.au, margaret.otlowski@utas.edu.au, neil.pickering@otago.ac.nz
eric.merkel-sobotta@springer.com, Hendrik-Jan.Stoker@springer.com, Maja.deKeijzer@springer.com
Dear Colleagues,
Copied below FYI is my most recent reply to Dr Komesarrof (copied in, as you can see from the To line) regarding our views on editorial policy at Bioethical Inquiry. I hope it will stimulate some discussion among members of the Editorial Board and the publisher regarding the best course of action.
With best wishes,
Karen
- - - - - - -
16 July 2011
Dear Doctor Komesaroff,
Thank-you very much for copying over the correspondence. Dr Jacobs had also sent me full copies of both of your emails and his correspondence with you, which I have read.
I believe part of the problem is that everybody --not just me, but you yourself, Dr Jacobs, Dr Cregan, and perhaps others-- have "already made up (our) mind(s)" about the incident. You felt that I had not seen all the relevant evidence, and now that I have seen the correspondence between you and Dr Jacobs, my feeling is this:
1. The public record regarding the professional practice and ethics of Dianthus Medical Limited has not been corrected in accordance with current professional guidelines for editors about the most transparent, ethical way to correct published errors.
2. Whether lawyers in different parts of the world disagree on whether the published article is or is not defamatory has no effect on what the readers of Bioethical Inquiry have actually interpreted from the published article, and hence no effect on the potential damage to Dr Jacobs' business or reputation.
3. I do not feel that Dr Jacobs had "threatened" the journal with legal action. He has simply stated how he plans to proceed in the future.
In any case, his frustration is entirely understandable. The journal's unwillingness to proceed with publication of a more explicit correction raises questions about editorial ethics, and the journal's failure to link related publications expliciltly to the Spielmans & Parry article deprives readers of relevant information and perpetuates the error in the published record. Given Dr Jacobs' leading role in efforts to improve professional ethics among medical writers, it is extremely distressing to see such utterly misleading information about his professional practices published in a journal about ethics.
4. Rather than months of arguing, my feeling is that all this could be put to an amicable, ethical end (in which everybody's reputation as a "good guy" could be enhanced) if Bioethical Inquiry would move beyond lawyer-talk, leave its editorial pride behind, and simply publish a full correction, as Dr Jacobs has been requesting for many months now. Morerover, all publications arising from the error in the Spielmans & Parry article should be linked correctly, in accordance with the guidelines of the International Committee of Medical Journal Editors, the World Association of Medical Journal Editors and the Committee on Publication Ethics (which is re-examining its procedures in the light of the controversy their decision regarding this case has triggered). I am sure Springer has the resources to enable this.
With best wishes,
Karen
At 21:15 19/07/2011, you wrote:
Dear Karen,
When I agreed to enter into discussion with you I stated clearly that I carry responsibility for all correspondence in the matter of Mr Jacobs and that despite our readiness to engage in reasoned debate the journal will not respond to threats or pressure.
I am surprised and dismayed that instead of pursuing the course of reasoned discussion you have sent a letter to the editors of the journal and to members of the editorial board which can only be interpreted as an attempt to exert pressure on them to provide a favourable response to Mr Jacobs' demands. I regard this as a flagrant breach of faith and an indication that you are not in fact interested in finding an amicable resolution to his concerns.
Accordingly, I am no longer prepared to engage in discussion with you. I will reply to Mr Jacobs one more time but hereby advise you that the journal's correspondence with you is closed.
Sincerely,
Paul Komesaroff
20/07/2011 9:32
Dear Doctor Komesaroff,
Thank-you for your views on this. Whether the other colleagues I copied my email to would interpret it as "an attempt to exert pressure on them to provide a favourable response to Mr Jacobs' demands" is not something you or I can know. Each reader's reaction may be different.
This is precisely the point I have tried to make regarding the misleading information published in Bioethical Inquiry. You and other editors (including, apparently, some people at COPE) may feel it was not such an issue, but other readers may get a very negative impression regarding Dianthus Medical.
Secrecy in this case serves to no good purpose, and I feel it is not fair to the other members of the editorial board or to the publisher to keep them in the dark regarding my views.
The issue of potentially damaging and misleading information about Dianthus Medical and the journal's refusal to publish an appropriate correction remains, unfortunately, unresolved. I regret that you have decided to terminate our correspondence, and will be happy to hear further from you if you change your mind.
With best wishes,
Karen
*************************************
Komesaroff repeats the argument that the article that triggered this controversy contained no errors of fact. Nonetheless, the article juxtaposed information in a way that would lead most readers to answer “Yes” if asked if Dianthus was a ghostwriting business. The statements themselves, considered separately, may have contained no falsehoods. But when read in the context of the article, their connotation and implication are misleading. Spielmans and Parry themselves recognized that readers might misunderstand their meaning, which is why they wished to publish their second clarification.
If this clarification, reproduced in both my own and Komesaroff’s EWMA webeditorial, had been published in JBI as requested by Spielmans and Parry in 2010, the issue would have been quickly resolved to everyone’s satisfaction. But it appears that Cregan abruptly changed her mind about publishing it, for reasons that remain unclear.
It is unfortunate that COPE decided that JBI had done all it should have done in this case. According to the journal and its publisher, this decision exonerated them from taking further action. The reasons why I feel strongly that COPE’s decision was misguided are explained in my EMWA webeditorial.
JBI’s abrupt about-face appears to have been motivated in part by unfounded legal concerns. If legal concerns can stop journals from complying with COPE’s code of conduct for editors, we have a serious problem.
Another possible factor in Cregan’s decision to reject the second clarification may be Komesaroff’s personal views regarding the medical writing profession. This possibility is supported by Komesaroff’s insistence in bringing the debate on ghostwriting and medical writing into his EMWA webeditorial.
Ghostwriting is being debated in many other places in print and on line, and although I can understand how easy it is for Komesaroff (like others) to scare readers yet again with the bogeyman argument (“All med writers are ghostwriters, therefore all med writers are evil, corrupt, and will bring about the end of the human species”), medical writing ethics is not what this debate should be focusing on.
The focus should be editors’ responsibility to correct the record (specifically, by publishing clarifications submitted by the authors themselves), and now, perhaps, on COPE’s responsibility to critically examine what it does and how it can support people who want to do something about editorial misconduct.
I remain troubled by the possibility that the information JBI and Springer provided to COPE may not have been complete. An additional concern is the lack of information about COPE’s procedure for handling “complaints”, and the growing perception among researchers that COPE is likely to be biased in favor of editors and to be less sympathetic to people who feel they have been on the receiving end of editorial misconduct. The lack of information in the public domain remains an obstacle to understanding out how COPE reached its judgment in this case.
Komesaroff concludes his version of the facts with a series of questions. I’ll answer them here for myself. Adam has provided his own answers on his blog.
1. “Why did Jacobs and Shashok refuse to engage in reasoned dialogue?”
I did not refuse. It was Komesaroff who broke off our correspondence. My numerous attempts to engage people at JBI and Springer in reasoned debate are listed in the timeline at the beginning of my EMWA webeditorial.
2. “Why have they made repeated claims of “errors” and the need for “corrections” when they themselves admit that no errors have been committed?”
This is explained above and in my EMWA webeditorial. The issue is not one of “factual error”. The issue is what conclusions readers would have drawn from the original article. Spielmans and Parry realized that their words could be misinterpreted and realized that a second clarification was in order. JBI declined to publish their second clarification.
3. “Why have they concealed the fact that that the Journal has repeatedly offered them the opportunity to engage in scholarly dialogue about the important issues involved?”
I have not concealed any facts. Readers are welcome to contact me to obtain copies of documents relevant to the issue.
My correspondence with Komesaroff started off well. I will provide copies of these emails on request. However, it ended badly. I left the door open for further dialog, but Komesaroff never knocked again.
4. “Why, instead of entering into respectful debate do they resort to tactics and allegations seeking to apply pressure or bully their way to an outcome they seek?”
I sent many respectfully worded emails to many people whom I felt should take some action. Copies of these emails will be provided on request. This correspondence, as explained in the EMWA webeditorial, was not fruitful. It is now clear at last that the reason JBI declined to take further action was because they feel COPE’s decision exonerated them of any further responsibility.
It is regrettable that Komesaroff believes my efforts to constitute “applying pressure and bullying”. Readers may decide for themselves.
5. “Why do they refuse to acknowledge – even when the independent arbiter chosen by themselves has said so – that the Journal’s approach and behaviour has been beyond reproach?”
The reasons why I disagree with COPE’s exoneration are explained above and in my EMWA webeditorial. Whether readers believe that JBI’s “approach and behaviour have been beyond reproach” is a decision readers may make for themselves.
I've followed this saga with interest, but I think you might be missing a key point here. As far as I can tell from other articles that Komesaroff has published on this issue (eg, MJA 2002; 176: 118-121), he seems to be of the opinion that anyone who is paid by Big Pharma will always be tainted by their commercial evilness and unable to act ethically.
Your position is even more reprehensible in this respect because you are knowingly being paid to lie... er... write for Big Pharma, rather than just accepting gifts and expenses as do doctors who attend conferences.
He probably feels that he has already given you an extravagant amount of flexibility by even allowing you to respond to the article in the first place. Fortunately JBI is not a well-known journal. Therefore Komesaroff probably wonders why you are so upset, given that none of your potential clients are ever likely to go near a journal that is concerned with ethics anyway!
Is that fair?