Richard Smith: No case for retracting Lancet’s Gaza letter

richard_smith_2014 In 1973 about 280 000 scientific articles were published, but there were no retractions.  When I became an editor in 1979, retractions were rare and of little interest to anybody. Now we have moved to a point when somebody passionately objects to an article in a scientific journal they call for it to be retracted. The BMJ earlier this year had a group spend weeks deciding whether a paper on statins should be retracted (it decided against, in case you can’t remember), and there have been repeated calls for the Lancet to retract An open letter for the people in Gaza published in July  There is no case for retracting the letter.

The open letter was published during the recent bombing of Gaza in July and August. The whole world, including many Israelis, were horrified by what was happening. The Lancet letter was signed by 24 authors, all of whom “have worked in and known the situation of Gaza for years.” These authors sympathised much more with the plight of the Palestinians in Gaza than with the Israelis experiencing rocket attacks and worried about suicide bombers emerging from Gaza, and their letter is highly emotional.
In the same issue the Lancet published a letter from “1234 Canadian physicians,” pointing out that the 24 authors had declared that they had no competing interests when they clearly did.  I’ve long believed that it’s best to declare every possible competing interest, which is why I declared the death of my pet rabbit when writing an editorial on animal research and why some of my competing interests have become Proustian: if you do a lot of stuff you have a lot of competing interests. There’s no shame in having them, and having them does not mean that what you say is invalid. The 24 authors responded that they had no financial conflicts of interest, itself a debatable assertion, but both Richard Horton, the editor of the Lancet,  and Wisia Wedzicha, the Lancet’s ombudsman (although a woman), agree that the authors should have declared competing interests. Mind you, the “1234 Canadian Physicians” did not declare their competing interests, a stupid omission that undermined their complaint. The competing interests would, of course, amount to a small novel and taken a week to collect.

The “1234 Canadian Physicians” also objected to the authors of the open letter, writing that because only 5% of Israeli academics had signed a petition opposing the bombing “We are tempted to conclude that…the rest of Israeli academics are complicit in the massacre and destruction of Gaza.” There is an argument that if you don’t explicitly object to the status quo then you support it, but I find the “tempted to conclude” annoyingly coy—and I suspect that most Lancet readers, all smart people, would probably not agree with the open letter. But if everybody agreed with everything in the Lancet there would be no point in publishing it.

The open letter created a storm of both opposition and support. A petition called for Horton to be sacked. The Lancet seemed surprised by the extent and power of the storm, but with children being killed, passions high, and divisions longstanding, intractable, and bitter it wasn’t surprising. I have learnt in my 25 years as an editor and 40 years as a loudmouth that almost whatever you write in such circumstances will evoke strong reactions. The BBC found the same in covering the conflict in Gaza, being accused of being hopelessly biased towards both the Palestinians and the Israelis. The BBC was trying to be neutral, but the Lancet made no such claim about the open letter. Journals have no moral obligation to be neutral, but they will be better respected (and enjoyed) if they give space to opposing views—and the Lancet has done that.

Horton was also “horrified” to find that two of the 24 authors “had forwarded a vile and offensive video” that expressed a “clearly anti-Semitic world view.” Journals cannot be expected to know the sins of all of their authors, but they should be expected to expose them when they are discovered and relevant to what the journal has published. The Lancet has done that.

Before I explain why I see no case for retracting the open letter I’d better make my position clear. I was an editor at The BMJ, a competitor of the Lancet, for 25 years, and I was the chief editor for 13. I left The BMJ in 2004. I was also the chief executive of the BMJ Publishing Group for those 13 years, and I was one of the people who appointed Wisia Wedzicha as editor of Thorax. I’ve known Richard Horton for some 30 years, and we have written and spoken together. I went to his house for dinner recently, but we have also had times of disagreement.

I’ve never been to Gaza or the West Bank, but I visited Israel some 15 years ago. An important discovery for me was to learn how close the Holocaust felt to people in Israel, and in a probably very shallow way I felt that that might explain what looks to me, and many others, like disproportionately harsh treatment of the Palestinians. I’ve also visited many Arab countries. I don’t claim to be neutral, but I do recognise the discomfort of both Palestinians and Israelis.

But perhaps more importantly, I am passionately in favour of free speech. When editor of The BMJ, I believed strongly that we should post every rapid response to an article that wasn’t obscene, libellous, or incomprehensible. One consequence was that we published many rapid responses from people who thought that HIV was not the cause of AIDS. Nature took me to task for publishing such nonsense, and many other people, including my employers, accused me being “tabloid” and publishing rubbish.

I would always respond with one of my very favourite quotes—from John Milton’s Areopagitica:

“Give me the liberty to know, to utter, and to argue freely according to conscience, above all liberties…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 come 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….Where there is much
desire to learn there of necessity will be much arguing, much writing,
many opinions; for opinion in good men is but knowledge in the making.”

The disappearance of the idea that AIDS is not caused by HIV is an example of truth not being put to the worse in a free and open encounter.

Horton quotes an American correspondent voicing similar thoughts: “The answer to speech we do not like is more speech, not the silencing of writers (or editors) whose opinions we do not agree with.”

he best guidance on retraction comes from the Committee on Publication Ethics (COPE).  Horton and I were founders of COPE, but I was not involved in writing the guidance on retraction. This is what the guidance says:

“Journal editors should consider retracting a publication if:

• They have clear evidence that the findings are unreliable, either as a result of misconduct (e.g. data fabrication) or honest error (e.g. miscalculation or experimental error);

• The findings have previously been published elsewhere without proper crossreferencing, permission or justification (i.e. cases of redundant publication);

• It constitutes plagiarism;

• It reports unethical research.”

The Lancet open letter doesn’t meet any of these criteria. It was passionate, overstated in parts, inflammatory to some, and one sided; and the authors failed to declare competing interests and two of them had acted in an objectionable but not illegal way. But none of these are grounds for retraction. They do, as COPE recommends, need to be recorded in the journal, and they have been. If we start retracting every article that is one sided, inflammatory, inaccurate, and even plain wrong in important statements (as with The BMJ‘s statin article) then retraction will become meaningless. It needs to be kept for articles meeting the criteria defined by COPE—and intended mainly for research studies.

Finally, I take a historical view of all this. The Lancet was made the great journal it is by Thomas Wakley, the founder and first editor, publishing articles that were so inflammatory that his critics burnt his house down. That radical tradition has not always shone brightly in the nearly 200 years since, but Horton has restored it strongly, establishing the Lancet as a world leader in global health, speaking truth to power and giving a voice to those who are not heard (like the children of Gaza). It’s against that radical tradition and leadership that the Gaza open letter must be viewed. It should and has been disputed, but it shouldn’t be retracted.


Competing interests: These are declared in the blog.

Richard Smith was the editor of The BMJ until 2004. He is now chair of the board of trustees of icddr,b [formerly International Centre for Diarrhoeal Disease Research, Bangladesh], and chair of the board of Patients Know Best. He is also a trustee of C3 Collaborating for Health.