{"id":2901,"date":"2015-04-30T22:10:50","date_gmt":"2015-04-30T21:10:50","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=2901"},"modified":"2015-10-01T02:40:23","modified_gmt":"2015-10-01T01:40:23","slug":"how-can-journal-editors-fight-bias-in-polarized-scientific-communities","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2015\/04\/30\/how-can-journal-editors-fight-bias-in-polarized-scientific-communities\/","title":{"rendered":"How Can Journal Editors Fight Bias in Polarized Scientific Communities?"},"content":{"rendered":"

By Brian D. Earp<\/a><\/span><\/span><\/p>\n

In a recent issue<\/a> of the Journal of Medical Ethics<\/em>, Thomas Ploug and S\u00f8ren Holm point out<\/a> that scientific communities can sometimes get pretty polarized. This happens when two different groups of researchers consistently argue for (more or less) opposite positions on some hot-button empirical issue.<\/p>\n

The examples they give are: debates over the merits of breast cancer screening and the advisability of prescribing statins to people at low risk of heart disease. Other examples come easily to mind. The one that pops into my head is the debate over the health benefits vs. risks of male circumcision<\/a>\u2014which I\u2019ve covered in some detail here<\/a>, here<\/a>, here<\/a>, here<\/a>, and here<\/a>.<\/p>\n

When I first starting writing about this issue, I was\u00a0pretty \u201cpolarized\u201d<\/a>\u00a0myself. But I\u2019ve tried to step back over the years to look for middle ground<\/a>.\u00a0Once you realize<\/em> that your arguments are getting too one-sided, it\u2019s hard to go on producing\u00a0them without making some adjustments. At least, it is without losing credibility — and no small\u00a0measure of self-respect.<\/p>\n

This point will become important later on.<\/p>\n

Nota bene! According to Ploug and Holm, disagreement is not the same as polarization. Instead, polarization<\/em> only happens when researchers:<\/p>\n

(1) Begin to self-identify as proponents of a particular position that needs to be strongly defended beyond what is supported by the data, and<\/p>\n

(2) Begin to discount arguments and data that would normally be taken as important in a scientific debate.<\/p><\/blockquote>\n

But wait a minute. Isn\u2019t there something peculiar\u00a0about point number (1)?<\/p>\n

On the one hand, it\u2019s framed in terms of self-identification, so: \u201cI see myself as a proponent of a particular position that needs to be strongly defended.\u201d Ok, that much makes sense. But then it makes it sound like this position-defending has to go \u201cbeyond what is supported by the data.\u201d<\/p>\n

But who would self-identify<\/em> as someone who makes inadequately supported arguments?<\/p>\n

We might chalk this up to ambiguous phrasing. Maybe the authors mean that (in order for polarization to be diagnosed) researchers have to self-identify as \u201cproponents of a particular position,\u201d while the part about \u201cbeyond the data\u201d is what an objective third-party<\/em> would say about\u00a0the researchers (even if that\u2019s not what they would say about themselves). It\u2019s hard to know for sure.<\/p>\n

But the issue of self-identification is going to come up again in a minute, because I think it poses a big problem for Ploug and Holm\u2019s ultimate proposal for how to combat<\/em> polarization. To see why this is the case, though, I have to say a little bit more about what their overall suggestion is in the first place.<\/p>\n

<\/p>\n

Polarization as a conflict of interest <\/strong><\/p>\n

Ploug and Holm\u2019s major\u00a0suggestion is this: the polarization of a scientific community can generate conflicts of interest for particular researchers. Specifically:<\/p>\n

[T]he threat is that a polarised group may nourish an interest in advancing the position and views of the group, and that this interest may come to be a main criterion and goal for the choice of methods, the reporting of findings and the provision of policy advice. This interest may well be based on an honest conviction that one is right and thus not be in any way morally reprehensible, but even honestly held convictions can introduce potential biases in research and reporting.<\/p><\/blockquote>\n

That would be a serious problem. As Ploug and Holm explain, it could \u201cthreaten the objectivity of science, and may in turn bias public debate and political decision-making.\u201d<\/p>\n

So they are onto something really important. In fact, in many areas of biomedicine (as well as in other scientific fields), you often get the feeling that a particular group of researchers (whether they\u2019re direct collaborators or not) are ultimately more interested in scoring points for their \u201cside\u201d than in getting to the bottom of a genuine dispute.<\/p>\n

One situation in which this can happen is when you have a tricky moral (or political) question hanging in the balance\u2014so that individual studies start to look\u00a0like so many chess pieces. This definitely happens in the debate over male circumcision. Since it\u2019s a religious ritual for some groups\u2014and one that is at least prima facie<\/em> harmful<\/a>\u2014it has\u00a0become very\u00a0important (for some researchers)\u00a0to show that\u00a0\u201chealth benefits\u201d<\/a> can be ascribed to it, since these can then be used to mount a\u00a0“secular” defense of the practice.<\/p>\n

On the other side, you have moral<\/a> and even human rights<\/a> objections to circumcision, which are a lot easier “sell” if you can demonstrate\u00a0harm<\/a>.\u00a0This ends up resulting in a very strange cocktail of religion, science, and ethics in the circumcision\u00a0literature (which you start to figure out if you dig deep enough<\/a> into it). There is no such thing<\/a> as a “neutral” publication about circumcision.<\/p>\n

Of course, simple career interests can play a role here, too \u2013 like the need to save face by defending your prior work, or the work of your friends or ideological allies. There are many other factors as well. And these can apply to any contested topic in science or medicine.<\/p>\n

So polarization is a genuine problem. How do Ploug and Holm propose to resolve it?<\/p>\n

A simple solution? <\/strong><\/p>\n

Their basic suggestion is that researchers should self-report polarization as a \u201cconflict of interest\u201d on the standard forms they fill out when submitting their papers. They might end up writing something like this:<\/p>\n

    \n
  1. This article reports research in a polarised field.<\/li>\n
  2. The research group I\/we belong to generally believe that the intervention we have researched should\/should not be introduced in healthcare.<\/li>\n<\/ol>\n

    Is this a promising solution to the problem of polarization?<\/p>\n

    Probably not<\/strong><\/p>\n

    Imagine that you are a researcher with enough self-awareness and personal integrity to identify yourself as \u201cpolarized\u201d on a conflict of interest disclosure form (if in fact that\u2019s what you are).<\/p>\n

    How likely is it, in this scenario, that you are also<\/em> the sort of person who would conduct polarized research\u2014and write up polarized articles\u2014to begin with? I don\u2019t think it could be very likely.<\/p>\n

    Like I said before, once you realize<\/em> that you\u2019re getting too dogmatic about pressing a particular viewpoint (as in: failing to seriously engage with decent points from the other side), you can\u2019t just go on submitting the same sorts of papers, as though this realization had no force. At least, you can\u2019t if you have any sense of personal integrity\u2014which is precisely what (self) disclosure of conflicts of interest requires.<\/p>\n

    A role for editors? <\/strong><\/p>\n

    So what about shifting the onus to editors? It seems to me that any journal editor who is responsible for making a publication decision about a particular manuscript, should know at least<\/em> enough about the field in question to judge whether it\u2019s a polarized area.<\/p>\n

    I\u2019m not saying they have to be experts in every field.<\/p>\n

    But if they don\u2019t know enough about the subject of the manuscript they\u2019re handling to be able to assess if polarization is an issue, then I don\u2019t see how they could be qualified to make the other<\/em> sorts of important assessments that are needed to, say, make a recommendation about publication based on the referees\u2019 reports.<\/p>\n

    So, in practical terms, if they aren\u2019t sure about whether or not the subject is polarizing, they should probably recuse themselves from evaluating the manuscript and send it to an editor who knows more about the field. On the other hand, if they can<\/em> assess polarization\u2014and if the manuscript sits at one extreme pole\u2014they can choose from the following options:<\/p>\n