Elsevier to Medical Hypotheses editor Bruce Charlton: Enough is enough

These days, I’m having a love-hate relationship with Elsevier. On the one hand, there are lots of reasons to hate Elsevier. For example, Elsevier took payments from Merck, Sharp & Dohme in order to publish in essence a fake journal designed to promote its products, and then got caught doing it again. On the other hand, Elsevier owns both The Lancet and NeuroToxicology. The former recently retracted Andrew Wakefield’s original 1998 Lancet paper that launched the latest iteration of the anti-vaccine movement in the U.K., as well as a thousand quacks, to be followed by the latter, which withdrew Andrew Wakefield’s unethical and poorly designed monkey study of the hepatitis B vaccine. These decisions go a long way–although not all the way by a long shot–towards balancing the harm that Elsevier has done over the years.

Perhaps the most persistent atrocity unleashed upon science by Elsevier has come in the form of a journal. It’s a journal I have written about before called Medical Hypotheses. MH is a journal that describes itself and its requirements thusly:

The purpose of Medical Hypotheses is to publish interesting theoretical papers. The journal will consider radical, speculative and non-mainstream scientific ideas provided they are coherently expressed.

Medical Hypotheses is not, however, a journal for publishing workaday reviews of the literature, nor is it a journal for primary data (except when preliminary data is used to lend support to the main hypothesis presented). Many of the articles submitted do not clearly identify the hypothesis and simply read like reviews.


So far, there’s nothing inherently objectionable or anti-scientific in the concept behind MH. I can easily see a role for a journal that publishes speculative biomedical papers. The problem is that the editor of this journal has over the years allowed MH to be seriously abused by cranks and quacks, turning it into, in essence, a vanity journal that will publish almost anything, no matter how much it goes against established science. For example, Mark Blaxill published pseudoscientific speculation that vaccines cause autism, and the anti-vaccine movement trumpeted Blaxill’s paper for the next several years as “evidence” in a “peer-reviewed journal” (more on that later) that vaccines cause autism. It worked, too, because most lay people can’t distinguish between a highly speculative scientific article and a scientific report based on sound data from well-designed experiments and/or clinical trials, with solid scientific reasoning leading to its conclusions. Nor do most people–even scientists– have any idea of some of the other amusingly (and not-so-amusingly) wacky “hypotheses” published in MH, such as ideas that masturbation is a treatment for nasal congestion, a paper linking high heeled shoes to schizophrenia, a meditation on the nature of navel fluff, and truly offensive speculations about “mongoloids.”

Perhaps the worst debacle suffered by MH came to pass last summer, when it published an article by HIV/AIDS denialist Peter Duesberg that was so outrageously wrong and even downright racist. So bad was the article, that Elsevier administered one of the worst indignities imaginable to a scientist. It retracted his article from MH. Can you imagine the humiliation, to have an article retracted from a pseudoscientific, bottom-feeding crank journal.

As a result of this rather hilarious incident, a number of things happened. First, it became apparent that MH is not peer reviewed. Indeed, its editor Bruce Charlton showed up in the comments of my blog lamenting how mean I was to his journal and admitting that his journal is “editorially reviewed,” rather than peer-reviewed. In essence, Charlton picked the articles to be published and declared himself as “agnostic” as to the likely validity of any article he published.

Another consequence of the MH kerfuffle about Duesberg’s paper was that a group of scientists got together to complain to the National Library of Medicine, which is responsible for deciding which journals are listed in the MEDLINE database. Being listed in MEDLINE is critical to a biomedical scientific journal, and being delisted would have been a severe blow to MH. In their letter, the scientists explained their rationale, which was that MH does not meed the criteria for inclusion in MEDLINE. It’s very clear that it does not.

Another result, something that I had not heard about (and am rather puzzled why) was that apparently Elsevier started a review of MH and its editor Bruce Charlton. The result was that Elsevier issued an ultimatum:

The editor of the journal Medical Hypotheses–an oddity in the world of scientific publishing because it does not practice peer review–is about to lose his job over the publication last summer of a paper that says HIV does not cause AIDS. Publishing powerhouse Elsevier today told editor Bruce Charlton that it won’t renew his contract, which expires at the end of 2010, and it asked that Charlton resign immediately or implement a series of changes in his editorial policy, including putting a system of peer review in place. Charlton, who teaches evolutionary psychology at the University of Newcastle upon Tyne in the United Kingdom, says he will do neither, and some on the editorial advisory board say they may resign in protest if he is fired.

Elsevier’s move is the latest in an 8-month battle over the journal; it comes after an anonymous panel convened by Elsevier recommended drastic changes to the journal’s course, and five scientists reviewed the controversial paper and unanimously panned it.

Well, well, well. Isn’t this interesting? Again, I don’t necessarily disapprove of a journal devoted to highly speculative, even radical hypotheses. My problem with MH is that it blurred the line between the speculative and apparently confused “speculative” with “making shit up.” Apparently the reviewers agreed:

Following the advice of an external panel whose membership has not been made public, Elsevier wrote Charlton on 22 January to say that Medical Hypotheses would have to become a peer-reviewed journal. Potentially controversial papers should receive especially careful scrutiny, the publisher said, and some topics–including “hypotheses that could be interpreted as supporting racism” should be off limits.

Elsevier also had its flagship medical journal, The Lancet, organize a formal review by five anonymous experts. The reviews, which have not yet been released publicly but were obtained by Science, were unanimously harsh–especially about the Duesberg paper, indicating that it is riddled with errors and misinterpretations. “It might entertain their friends and relatives on a cold winter evening, but it does not belong in a scientific journal,” one reviewer wrote. On 24 February, Elsevier wrote Duesberg that his paper–which had not yet been printed and had been taken down from the journal’s Web site in August–would be “permanently withdrawn.” Ruggiero received a similar letter 5 days later.

In the meantime, Bruce Charlton has been using every means he can think of to defend himself. Again, normally I’d be sympathetic to the idea of a journal devoted to weird and wacky hypotheses. I can even be sympathetic to some of the defenses of MH published by Charlton on his blog. I cannot be sympathetic to idiotic statements like this by Professors Lola J. Cuddy and Jacalyn M. Duffin:

If it emerges that Duesberg’s paper erred beyond his minority viewpoint to actual errors–be they deliberate or accidental, a signal comparison can be made to two leading medical journals. Medical Hypotheses would have been no less a victim or a wrongdoer than the distinguished entities The Lancet and the New England Journal of Medicine.

Earlier this month, Elsevier’s flagship journal The Lancet withdrew a 1998 paper by Andrew Wakefield et al. that helped foster the now discredited theory linking autism and MMR vaccines. No one has called for the alteration of Lancet. Indeed, the issue has drawn attention to the preeminent leadership role that The Lancet plays in the dissemination of knowledge and ideas.

Similarly, in 2000 the New England Journal of Medicine published a peer-reviewed paper that strongly supported the use of rofecoxib (known as Vioxx®). Later it emerged that the paper had suffered improper industry interference and failed to declare a treatment-related death. The drug was taken off the market in 2004. Considerable discussion surrounded the editorial responsibilites for the 2000 article when the flaws came to light in 2005. But no one called for the New England Journal of Medicine to be altered in any way. Jeffrey Drazen is still its editor-in-chief.

OK, maybe I’ll give Cuddy and Duffin that last bit, at least partially. On the other hand, it’s been well known that fraud is very difficult to detect through a standard peer review of a scientific paper, and most journals do not have good systems in place to detect undisclosed conflicts of interest. In any case, Cuddy and Duffin are demonstrating extreme ignorance at best or extreme disingenuousness at worst. There is a profound difference between journals’ peer reviewers missing examples of scientific fraud, which peer review tends to be ill-equipped to detect, and a journal editor just taking any ridiculous “speculative” paper that comes along and calling it science. Although an argument can be made that Wakefield’s paper should never have been accepted for publication because it was such thing gruel, the Vioxx paper at the time it was published looked like a perfectly legitimate and reasonable randomized clinical trial. It took years to discover the problems with both papers. In brief, Cuddy and Duffin are comparing apples and oranges, and, in essence, invoking the tu quoque fallacy.

Whatever the value of the concept behind a journal like MH, in the case of MH that value has not only failed to be realized, but has in fact been degraded and brought into serious disrepute. Charlton has, through his carelessness, arrogance, and his ideologically blind refusal to enforce even the most minimal minimal scientific standards on articles submitted to MH, has resulted in embarrassment after embarrassment falling upon his journal, from its abuse by the anti-vaccine movement to the latest debacle. The Peter Duesberg HIV/AIDS denialist paper retracted by Elsevier was merely the last straw. As a result, Elsevier decided that it had little choice but to order Charlton to impose peer review or to resign. By refusing to adhere to even a modicum of scientific rigor, Charlton has destroyed the aspect of MH that he apparently most values.

A journal devoted to cutting edge, even fringe scientific hypotheses might indeed be valuable, but because of his carelessness, Charlton guaranteed that Medical Hypotheses was not that journal and that it never will be. If there is to be a journal devoted to highly speculative scientific articles, it’s clear that Medical Hypotheses isn’t it and can no longer even attempt to be it. Bruce Charlton saw to that.