Censorship in Medical Journals Is Harmful, Also for Patients
By Professor Peter C. Gøtzsche, MD
August 10, 2020
It has become increasingly difficult to publish articles in medical journals that are critical of drugs or the drug industry, or that expose fraud and other wrongdoing committed by doctors. It is also difficult to publish articles documenting that the status quo in a medical specialty is harmful for the patients even though such articles should be warmly welcomed. Particularly in psychiatry, it has been amply documented that guild interests are far more important than the patients’ survival and well-being.1,2
For top general medical journals, e.g. Lancet and New England Journal of Medicine, the conflicts of interest are obvious, as the revenue from drugs ads and selling reprints of trial reports constitutes a substantial proportion of their income.3 Top specialty journals have similar conflicts. In addition, they usually have part-time editors who are keen to protect the specialty’s guild interests and prevailing dogmas.
Another problem is the threat of litigation. The BMJ has an insurance that mandates the editors to adhere to their lawyers’ advice; otherwise, the insurance won’t cover the costs of a libel lawsuit.
The corruption of our most prestigious medical journals has been exposed by current or previous editors-in-chief of the top journals, e.g. BMJ, Lancet and New England Journal of Medicine.4
Aggravating the situation is the fact that big publishers buy smaller enterprises all the time. This means that there are fewer players on the market, which are therefore easier to corrupt than if there had been many. The five big publishers are Reed-Elsevier, Springer, Wiley-Blackwell, Taylor & Francis and Sage. They published more than half of all academic papers in the peer-reviewed literature in 2013.5 In 1973, the five largest publishing houses controlled 20% of scientific papers published, but by 2006, that number had already risen to 50%.5
Not surprisingly, there has been increasing concern that journals may be censoring scientific research and stymieing debate, and there are many examples of gross violations of publication ethics and even of journals violating their own rules.2,4,6-8
The HPV vaccines
A particularly egregious recent example was when a Springer journal refused to publish two papers from my research group9,10 even though its editors had accepted them after peer review, and we had paid the fees for open access. Researcher and medical reporter Maryanne Demasi described these events in an article from 13 July 2020.4
By using clinical study reports we had obtained from the European Medicines Agency, we found evidence suggesting that the HPV vaccines in rare cases may cause serious harm.9 This finding contradicts the official reassurances that there is nothing to be worried about but agrees with other independent research, e.g. from the Uppsala Monitoring Centre,8,11 which is a WHO collaborating centre that accepts reports of suspected harms of vaccines and other drugs.
Our systematic review of the HPV vaccine trials9 is much more reliable than the 2018 Cochrane review as we based it on clinical study reports and not on journal publications. It was accepted for publication in Systematic Reviews on 6 March 2019.8 However, a year later, it had still not been published although the journal promises publication within 20 days of acceptance. Our email correspondence took up an astonishing 74 pages,4 and we had been given a total of 20 apologies and a variety of odd, contradictory and implausible reasons why our paper had not been published. One of the excuses was that the journal lacked staff to publish our papers, which was clearly not the case, as Systematic Reviews had published 309 papers during that year.
On 16 February 2020, we wrote to Springer that it seemed they deliberately delayed the publication and highlighted that, “If this is the case, it is scientific censorship that borders on scientific misconduct and fraud. We have a big network with renowned scientists, many connections with the international media, and a strong social media presence. If Springer Nature, BMC and Systematic Reviews fail to publish our papers before 1 March 2020, we are obliged to alarm our fellow scientists and the international and social media about Springer Nature’s, BMC’s and Systemic Reviews’ editorial practices. We will also involve the Nordic Cochrane Centre’s and the Danish taxpayers’ legal teams if the 1 March 2020 deadline is not met.”
This caused Springer to publish our review with record speed, only 12 days later, on 28 February, during which time we checked the proofs and corresponded several times with a high-ranking person, William F Curtis, PhD, Executive Vice President Journals, Medicine & Life Sciences, Springer Nature. We had clearly made Springer nervous.