Medical Hypotheses to be Falsified?

Free speech is a fun problem. If we believe in it, then we have to accept that people will sometimes write or say something we think is not just wrong, but that we find offensive.
To what extent is there free speech in the science literature? Obviously there are some limits: we are restricted by the subject matter, of course. And there is also some limit on quality: one of the jobs of peer reviewers is to say when a submission fails in rigour. But there is also a grey area, where the subject is deemed not important enough, or just too wacky (i.e. it’s suggesting ideas very different from what we currently think). The latter sort of paper presents a conundrum: many way-out ideas are flat-out wrong, but a few could actually be right and paradigm-changing, even if this is not apparent. Should we not give these views an airing too?

These questions have been brought into sharp relief by the journal Medical Hypotheses.This journal has, well, a reputation. The editor in chief, Bruce Charlton, has taken a deliberately different approach to the journal. Its aim is set out in its guidelines to authors:

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.

The journal has a reputation for publishing some weird stuff, including AIDS denialism. Charlton has a deliberate policy of selecting articles because they raise radical ideas, rather than because they look correct. Obviously, he’s asking for some controversy, and now he’s got it. The Scientist reports: Journal editor facing axe.
Elsevier, Medical Hypotheses‘s publisher, has apparently told Prof. Charlton that he must either implement a series of changes or be let go:

In addition to instituting a peer-review system, an external advisory board assembled by Elsevier also recommends that articles on controversial subjects, such as any that support racism, not be considered for publication.

To be honest, implementing a peer-review system doesn’t sound too bad: it would still allow the editor to have final control over acceptance, but it might help improve some arguments. But telling the editor that he can’t publish articles on controversial subjects surely goes beyond what the publisher should be allowed to do to control a journal1.
Medical Hypotheses raises questions about what we should tolerate in our scientific communication. Much that is published in it is probably largely wrong. But the journal deliberately publishes this sort of material, and its reputation is well known. To change the journal as the publisher wants would be to strike at its raison d’être. It would also mean censorship of the scientific literature. Is it right to do this?
I think for most of us there are two issues at stake: there is the technical quality of the articles that Medical Hypotheses publishes (i.e. whether the arguments are logically sound, or all of the evidence considered). But there is also how radical the ideas are that are presented. I think there is a good argument for allowing radical ideas some leeway in the evidence for them when they are first presented (of course, they still speculative, but a lot of ideas have problems when they are first presented: think Darwin and his blending inheritance). Obviously a balance has to be found, and we might not agree with where Charlton has placed it.
It is clear that some ideas presented in Medical Hypotheses look morally suspect, to say the least. But morals are no reason to reject scientific ideas. And essentially this is what Elsevier are saying should be stopped. I find this wrong – even if I find the moral implications of some of the papers Medical Hypotheses publishes to be distasteful. I think we need freedom to expound on scientific ideas, even if they are wrong, and if they might make some people uncomfortable.
There is another aspect to this – why are Elsevier doing this? They’ll have difficulty claiming the moral high ground: last year it was discovered that they had published six fake journals. I can only assume it’s the bottom line they’re worried about.

1. an exception clearly has to be made if the journal is publishing something that would not be legal, e.g. defamatory material&#8617.

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21 Responses to Medical Hypotheses to be Falsified?

  1. Stephen Curry says:

    That’s an interesting post, Bob. I tend to your view but the paper that you link to, which is titled Down subjects and Oriental population share several specific attitudes and characteristics seems to be a fairly hopeless hypothesis. Is anyone seriously going to test it?
    I don’t think the journal should shy away from controversial topics but only if there’s a bit of substance to the hypothesis. I guess a touch of peer review would solve that.

  2. Lee Turnpenny says:

    Very interesting, and I’m with you that ideas should have such a forum. I mean, come on – the clue is in its title! Odd, in that this journal has been around for some time, with Charlton, who can be, err, stimulating, at the helm for the last seven years. I wonder why, and where the pressure on Elsevier has come from? From within the scientific community, some of whose members may have been offended by Charlton’s opinion of them, perhaps? I might be wrong, of course: just a hypothesis.

  3. Austin Elliott says:

    Reading between the lines of what has appeared in the blogosphere, the pressure on Charlton seems to result from his publishing the HIV-is-not-the-cause-of-AIDS stuff. The difference between these papers and a lot of the other left-field ideas printed in Medical Hypotheses is said to be that a lot of the stuff in the HIV articles was plain wrong (e.g. misrepresenting other folks’ work in the literature) and had been extensively debunked elsewhere. And it was not felt to be new either – rather a re-rehearsal of the well-known line that comes from Peter Duesberg et al. This is the general tenor of the comments from people in HIV research that have leaked out onto, or been paraphrased on, the forums or blogs.
    Med Hypotheses nominally/officially has “editorial peer review”, i.e. by Charlton or someone else on the editorial board. But that then raises the question of whether there is anything they wouldn’t take? (see the post, and Stephen’s comment) Anyway, it is the apparent lack of quality control / filtering, specifically WRT the HIV stuff, that seems to have done for Charlton’s regime.

  4. Lee Turnpenny says:

    … which is irresponsible and, in seeming contravention of his own organ’s guidelines, incoherent. (It might also suggest an anti-science agenda?) He could, of course, retract (not being the first journal to errantly publish a piece of crap), and apologise for any blatant misrepresentation. But if he gets the boot, then, rather than installing a replacement with the freedom to continue the journal’s remit – in a responsible manner – the publisher is going to dictate what can and can’t go in, then what does it become?

  5. Austin Elliott says:

    Yes, in some ways the outcome is rather sad, since the journal does seem to serve a need. Of course, in the age of the Interwebz there are many other ways to get your “radical” ideas out, like simply posting them online. But there would seem to be a place for a journal that gives a forum to non-paradigm ideas, provided they are substantiated by some kind of evidence.
    What all the fuss suggests to me is that Charlton was not the best choice as Editor. The word going around seems to be that the love of controversy for its own sake, and the consequent attention, came to be rather too important in the scheme of things. But as Lee says, the outcome as we are now getting it seems to be that the original purpose of the journal will be lost.

  6. Eva Amsen says:

    I used to be an editor for Hypothesis , and we’d often get the same (kind of) submissions that also went to Medical Hypotheses, but actually reviewed all our submissions to make sure they properly cited all their ideas and statements, and made logical sense. What was left could still be considered controversial/new, but put in context rather than an off the cuff letter. It’s possible to present a controversial idea and still cite references, be coherent, and suggest ways that your idea might be tested.
    (And for good measure, a disclaimer: I’m no longer associated with Hypothesis, and my comments are mine and not any past or present employers/affiliations.)

  7. Åsa Karlström says:

    Intersting post Bob. Hadn’t seen all of that before. (For example, I thought it was only one journal-looking-publication-on-behalf-of Merck)
    I like Eva’s comment abut logical sense “It’s possible to present a controversial idea and still cite references, be coherent, and suggest ways that your idea might be tested” . I do think that it is good for science and others to have a place where to vent some more “out there” ideas. Although, I guess it is mainly since I think you should be able to argue against wackaloo ideas with logic to disprove their arguments.
    [somewhere here I end up realising that sometimes it might not be good to give "out there ideas" places to be read by all.... naivite and all]
    Good of you Bob to remind up that darwin wasn’t popular at first.. or second… think there is a good argument for allowing radical ideas some leeway in the evidence for them when they are first presented (of course, they still speculative, but a lot of ideas have problems when they are first presented: think Darwin and his blending inheritance)

  8. Eva Amsen says:

    Asa, you could think about ideas that are totally unfeasible for ones own lab to work on. “If only we had ten elephants, a large hadron collider, and access to a rocketship, we could test hypothesis X.” It could still be a good idea, and you could publish it in case someone else does have access to all that, and then they can test it and cite your hypothesis.

  9. Åsa Karlström says:

    Eva> I like those types of hypothesis. It’s when I realise that other types (read non logical stories about vaccinations or other proven and published diseases ) that I flinch. sometimes it is hard to argue with someone when their arguments are too far out.

  10. Bob O'Hara says:

    Thanks for your comments, folks. I’m currently in a workshop, so I haven’t had time to really follow the discussion. And now beer awaits…

  11. Maxine Clarke says:

    Even Nature publishes Hypotheses. Only about once a year, though ;-) And we peer-review them.

  12. Austin Elliott says:

    Heh. I know one radical hypothesis you could publish, Maxine. Might have AFH in apoplexy, though!

  13. Nathaniel Marshall says:

    I know Med Hypoth has a bad reputation for some of the stuff they have published but they have also published some good thought provoking stuff in sleep medicine. This is how I first heard of them through legtimate ideas in my field.
    But then the people writing the papers I read are legitimate scientists proposing new ideas not quacks trying to legitimize pseudoscience in a ‘peer reviewed journal’. The mission of Med Hypoth leaves it open to abuse by dishonest actors, I suppose? Can you fix that without screening out potentially good but as yet unsubstantiated ideas?
    And why in particular is elsevier picking on Med Hypoth? I’m sure they publish plenty of junk CAM journals so why pick on this particular journal with a clearly stated niche mission?

  14. Eva Amsen says:

    “Can you fix that without screening out potentially good but as yet unsubstantiated ideas?”
    They could add requirements for citations (i.e. not all ones own, minimum of X) to establish that the idea “fits in” somewhere, or require a suggestion for an experiment, and still publish unsubstantiated ideas. even if it’s a very crazy hypothesis, it’s still about something. If I were to say, to give a silly example, that all left-handed people like Brussels sprouts, you could ask me to back up this idea with references. I could cite papers showing that left-handedness is determined at birth (either genetically or not – I’m too lazy to look up the details right now) and fixed for life, and papers that show that not everyone experiences taste the same way, and a suggestion for experiments to test the hypothesis (population study, surveys, genetic tests), and what controls it would need. It’s still the same idea, but showing that something is testable in principle, and that you might want to test for genetic characteristics for example, makes it a whole lot less wacky. Then, once someone DOES the experiment, they can say “we carried out the experiments proposed in this paper, and found that Brussel-sprout-preference is unrelated to handedness” (if that’s what they find) and the wacky idea becomes part of a more methodological – scientific – discussion.

  15. Austin Elliott says:

    Of course, if you have “editorial peer review” (as Medical Hypotheses says it does), then I would have thought there was nothing to stop the editors soliciting extra “expert” peer review on an ad hoc basis in those cases where they feel it appropriate.
    I run a learned society magazine, which does not “expert peer review” submitted articles in the usually understood sense. However, we do have “editorial peer review”, in the sense that one or more of the editorial group read what comes in before it goes in the magazine. Of course, if we get something especially controversial /reeking of brimstone, then we might (and indeed have) ask one or more experts in the same field to look at it and tell us what they think (e.g. is the author bonkers).
    Of course, some people would argue (in the context of something like Medical Hypotheses) that this would constitute censorship, though I would call it common sense.

  16. Maxine Clarke says:

    Ha ha, Austin ;-)

  17. Nathaniel Marshall says:

    Again this requires honest actors to work. Anybody can cite anything they want to support a completely bat-shit insane argument. The citation in question may have nothing to do with, or may indeed completely refute, the argument. Getting people to police the dishonest nutjobs requires peer-review, which leads us back to the original ethos of Med Hypoth…
    Even in the world of legit science this happens. I have a paper that is only very rarely cited in a way that is appropriate to it’s actual conclusions. And that’s in proper peer reviewed journals.

  18. Bob O'Hara says:

    bq. And why in particular is elsevier picking on Med Hypoth?
    I’ve been told by email that there has been external pressure on Elsevier. Certainly, they’ve published some papers that Elsevier are probably embarrassed about, and which should maybe not have been published.

  19. Austin Elliott says:

    Re “external pressure”
    I would guess that the HIV research community in particular have been writing to Elsevier’s health journals management people.
    I would also hazard a guess Elsevier might be worried about more prominent/ respectable biomedical journals possibly jumping ship because the MH row makes them not want to be with Elsevier.

  20. Bart Penders says:

    Having an “expert peer review” system in place, means that each of the submission will be filtered using the status quo as a standard. After all, what constitutes proper evidence and valid claims is determined by the current status of science, in turn reflected in the positions of expert peer reviewers. One could argue that “peer review” is a practice of censorship of deviance from accepted conceptualisations of the current status of science.
    If you want to publish really new hypotheses, this filter is a handicap. Deviance from the status quo is however, very tricky in terms of credibility. That is probably what Elsevier is trying to regulate. The problem with credibility (or loss of it) is that it is transferrable. One Elsevier journal loses credibility, others may as well.
    That is bad for business.

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