A right royal spat
Authors: Geoff Watts
Journal: BMJ (2005)

Does the editor of a learned journal have a right to comment on the policies and actions of other bodies operating in his field? In a free society surely the only point of issue is over the word “right”—critical appraisal is not so much a right as an obligation. The principle, then, is clear. The practice may be a bit messier.

The Lancet of 21 May carried a leader article entitled “What is the Royal Society for?” The question, it argued, was one that the society's new president, Martin Rees, should be asking himself. By way of guidance the Lancet offered Sir Martin some thoughts to be going on with: that Britain's national academy of science has become “a lazy institution resting on its historical laurels” and that it is now “little more than a shrill and superficial cheerleader for British science.”

The Royal Society's contributions to medical science, it declared, are woeful: “Its marbled cupboards are largely bare.” During the past six months, the leader continued, “it has produced little of public value,” just “meagre morsels of endeavour.” Compare this “astonishingly weak intellectual output” with the far richer offerings of the US Institute of Medicine. “The Royal Society,” it concluded, “represents an idea that is too important to let wither. Yet withered it surely is.” Ouch!

The manner in which Nature, some years ago, poured scorn on the work of the French immunologist Jacques Benveniste shows that even learned journal editors are not above the odd dollop of showmanship if it serves to raise the profile. So, in having a go at the Royal Society was the Lancet's editor, Richard Horton, simply trying to create a bit of a buzz and some cheap publicity? A group of fellows of the Royal Society seem to think he was.

One of them, Professor Mark Pepys of the Royal Free Hospital, London, drafted and circulated a letter defending the society. With the endorsement of 30 or so other fellows he dispatched it to the Lancet. Part of the letter is devoted to a vigorous attack on Horton and his editorship. This “once pre-eminent academic medical journal,” it claims, has suffered the consequences of Horton's “remarkably poor editorial judgment” and the “desperate headline-seeking tone of his editorials.”

The Lancet declined to publish on the grounds that it had already accepted two other letters from fellows who were more directly involved. The Pepys letter then found its way to the Times, where the science editor, Mark Henderson, wrote a story headlined “`Scaremongering' Lancet accused of causing harm to health and wasting millions.”

Although the attack on Horton was only the subtext of the Pepys letter, Henderson, as a good journalist, rightly perceived that Times readers would be more interested in this than in the issue that had prompted it. He focused on the anti-Lancet comments and added further details of Horton's alleged editorial misdemeanours. These, of course, include the decision to publish research by Arpad Pusztai and Andrew Wakefield, reports that fuelled the rows over genetically modified crops and the measles, mumps, and rubella vaccine, respectively.

Anyone reading the Times would have formed the impression that the eminent fellows had simply lost their collective rag and responded to Horton's criticisms by irrelevantly kicking him where they thought it would hurt most. In fact, as already pointed out, this personal attack was only a small part of their letter, which has since been seen in full by the BMJ.​.




Figure 1





The gloves are off

Credit: MEPL




But why had Horton chosen to criticise the Royal Society? “It wasn't some frivolous attack,” he insists. “It's part of a deeply serious long term project... about how science can have an impact at government level.”

He argues that the Royal Society should have a major role in influencing policy. “Having lived in the United States for a couple of years and seen the Institute of Medicine and been very impressed, it's my model of how the Royal Society could work.”

Unfortunately, the positive and constructive intentions of the Lancet editorial were less apparent than its immediate criticisms. Horton responds that his intentions would be clear to regular readers—and in support of this he lists some of the editorials and articles he's recently published on policy matters. But not everyone, of course, is a regular reader.

Pepys doesn't dispute that journals have a right to comment on august professional bodies. And if this same leader had appeared elsewhere? “We would of course have rebutted it in the same factual terms.” It's the source of the criticism that stings him and that accounts for the personal tone of the letter. “I don't have a high regard for him [Horton],” he told me. “He might be a good journalist for the Daily Mirror or the Sun or something, but using the Lancet as a pulpit to up the circulation... it's not what a reputable journal should be about.”

Kamran Abbasi, lately deputy editor of the BMJ and now editor of the Journal of the Royal Society of Medicine, offers another view. “I thought it was classic Richard [Horton] because he was being provocative, he raised an issue, and also because he's pushing one of his pet theories, that we need an independent body giving out advice about health care.

“He sort of missed the mark and allowed himself to be easily criticised by comparing it [the Royal Society] with the US Institute of Medicine. But I think he was right to ask what the Royal Society is for.”

Readers can make up their own minds about this spat by applying a criterion that should satisfy both Pepys and Horton: the Wakley test. Would the radical founder of the Lancet approve the editorial written by his radical successor?