Are Biomedical Ethics Journals Institutionally Racist?

So there’s this letter published in the Journal of Bioethical Inquiry that moots the idea that the top biomedical ethics journals might be institutionally racist.  In it, Subrata Chattopadhyay, Catherine Myser and Raymond De Vries point out that the editorial boards of a good number of journals are dominated by members who are located in the global North – countries officially listed as being high or very high on the development index, with only 1.3% drawn from countries classed as least developed.

Developing World Bioethics has the highest proportion of its editorial board located in the least-developed nations; but even there, the figure is only just over 11%.  On the face of it, this doesn’t look too good, especially given the proportion of the world’s population in general that lives in the poorest countries.  The JME, by comparison, draws 100% of its editorial board members from people located in highly and very-highly developed nations.

Still: this isn’t likely to be the whole story.  Udo Schucklenk – a founding editor of DWB, of course – takes issue with the letter on a number of grounds.  For one thing, he he suggests that Chattopadhyay et al might be performing a sleight of hand with their metrics; by lumping together countries ranked as high and very high on the development index, they’re lumping together the UK, Germany, and the US with Iran, Malaysia, and Jamaica.  Neither Iran nor Jamaica is a classic basket-case economy; but, still, “high” and “very high” development covers a vast range of income levels.  Treating all these countries in the same way obscures that there’s a huge range of locations from which editorial staff may be drawn.

I’ll come back to this in a moment.

Chattopadhyay et al also claim that

bioethics pays more attention to esoteric ethical problems facing wealthy nations than it does to issues such as poverty, hunger, and health inequities that are global in nature. Is this editorial bias (Lancet editor Richard Horton calls this institutional racism) mirrored in the editorial boards of leading bioethics journals?

What they don’t do is provide an answer to their own question, or evidence to suggest one.  I suppose that there might be institutional racism at work; but that isn’t the only explanation.  Here’s another: issues such as poverty, hunger, and health inequalities don’t get much attention in journals (or maybe, pace Udo, journals other than DWB) because they aren’t that ethically interesting*.  There’s not much scope to argue about whether poverty, hunger, and inequalities are good things.  The debate here is how to remedy them, not whether they should be remedied; and that kind of debate is perhaps better had in more general ethics journals, or those devoted to development, economics, or politics.  There is scope to ask questions about what global justice would look like – but that isn’t a uniquely biomedical question, and it might be better addressed elsewhere.

In other words, institutional racism, or Northern complacency, might explain the content of journals; but it isn’t necessarily the only explanation, and it isn’t necessarily the best.

As I noted a second ago, Chattopadhyay et al leave their question hanging; having raised it, they move on to look at the make-up of editorial boards, suggesting that

[the] severe underrepresentation of developing countries on editorial boards suggests that institutional racism also infects leading bioethics journals and is clearly a cause for concern.

Does it?  Again, it might; but there’s a range of other things we have to take into account.  Udo notes that all the journals considered are English-language:

Why should non-English speaking academics working in the global south submit content to English language journals that are not widely read in their home countries?  Are they doing wrong, in the eyes of our Letter writers, when they focus on journals in their mother tongue that are actually locally read by their fellow country men and women?

But there’re other things that need clarification, too.  First, the analysis is of the editorial boards is based on where their members are based.  It does not tell us anything about where their members are from, or their ethnicity.  Hence leaping to claims about racism quite so quickly doesn’t seem warranted.  Geography isn’t race.

Second, academia is very globally mobile – far more mobile than most other professions, I’d guess.  This allows talented people to move around the world in pursuit of ever-better jobs.  It’s reasonable to assume that the highest pay and the best quality of life will be found in the most developed countries; therefore the most talented people are most likely to gravitate towards those countries.  But since journals will want to draw their editorial boards from among the most talented, this means that those boards are likely to be drawn from the most developed countries.  At the same time, if you’re living in a less-developed country and are asked to join the editorial board of a journal, that could well be the sort of recognition that helps you get a job somewhere else.  Again, the location of editors doesn’t tell us a great deal that’s of any use; it’s not a sign of anything sinister.

Of course, we might think that there’s something unjust about a world in which the most talented people from the developing world leave to live and work in the developed world; but that’s a different matter entirely.

Third, the letter gives only a snapshot, and snapshots of phenomena don’t necessarily help us explain those same phenomena.  To see why, imagine that talented people are randomly and evenly distributed around the world, and that each individually has exactly the same chance of becoming an editor irrespective of where they live.  Maybe editorial posts are distributed among suitably talented people by lottery, for example.  In this picture, we’d expect that, over time, the composition of editorial boards would match world demographics.

However, that expectation could be unmet without it meaning that anything has gone amiss.  An unbiased coin – or a whole bag of them – might never come up anything other than heads; the selection of editors might never, as a matter of fact, yield any distribution other than the one we currently see.

For sure, if a highly unlikely distribution does occur across several journals, and remains for a significant amount of time, it does increase the chance that there’s something wrong.  But any distribution is only ever evidence for that – it’s not proof.  Merely pointing out that the distribution of editorial board members is thus-and-so is a starting point; it might require explanation; but – as I’ve just indicated, and Udo has indicated further – there’re explanations for the distribution that don’t require imputations of racism.

Is there a case for the journals to answer?  Well, there might be.  Chattopadhyay et al might have identified a problem.  But it’s not obvious that the case is unanswerable.


*UPDATE, 25.iii.13, 14:00: See the discussion in the comments.  By “ethically interesting”, I simply mean that there’s no real debate to be had about whether, say, poverty is a bad thing.  What is ethically interesting is what should be done about it – there’s a real debate to be had there.  However, it’s not the kind of debate that necessarily belongs in biomedical ethics journals – it would be at least equally at home in applied ethics, political philosophy, economics, development, or related journals.

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