The Dark Side of Peer Review

“Peer review” is the process in which manuscripts describing research findings are critiqued by other scientists in the relevant field to see whether the work is of sufficiently high quality to be published.  There can be little doubt that peer review can be a useful method for intercepting inferior quality data and for offering advice on the key experiment or experiments that the research team need to perform in order to substantiate their story.

For a long time, however, there have been concerns within the scientific community that the process is open to abuse by unscrupulous scientists exploiting their role as reviewers to further their own research. In recent weeks these concerns have spilled into the general press and generated alarming headlines.

First, there was the “Climategate” scandal in which leaked e-mail exchanges within the Climate Research Unit at the University of East Anglia brought into doubt the veracity of some of the evidence for global warming. The details of the science itself are not relevant to the discussion here, and many of the original accusations against the CRU look considerably less damning in the wider context in which they were written (see, for example, the interesting video Climate change: those hacked e-mails). Nevertheless, one feature of the memos was the insinuation that peer review could be manipulated.

Added to this, we now have the spectacle of leading stem cell scientists complaining that their work has been ‘slow-tracked’ by major journals in favour of other research being carried out by rival teams (for details see the BBC report Journal stem cell work ‘blocked’ or listen to the audio Stem cell research ‘biased’ (Today programme, 2nd February 2010).

In truth, there are lots of different issues at play in this story. One is the rivalry between research teams for prestige. Coupled with this there is the rivalry for research money. As the clip from the Today programme makes clear, research funding is related to a scientists track record in publishing in major research journals, those with a high “Impact Factor” (this also has a huge bearing on research ‘league tables’ as the same criteria have been key aspects of the Research Assessment Exercise (RAE) by which the relative merit of similar departments at different Universities are compared. Publication in a major journal such as Nature or Cell can be make or break for successful receipt of the next grant, a decision which Austin Smith says may be worth half a million pounds.

Journal publication is a business venture, so editors have a vested interest – it is alleged – in trying to make sure the work published there has topicality that will boost their Impact Factor and hence their esteem, their advertising revenue, etc. Some of these pressures might be alleviated by changes in the publication model (i.e. by a shift to more open access journals) but the fundamental difficulties of personal rivalry remain a flaw in the peer review process, even if the financial implications are negated.

In the absence of other methods for evaluating the quality of research, the peer review system is unlikely to be replaced in the near future. There is, however, an onus on editorial boards, and on the reviewers themselves, to see that the greatest possible integrity is maintained in ensuring that decisions about the merits of a paper for publication are made on the right grounds. The importance of virtue ethics comes into play here, with the character of the individual being a significant determinant in their actions.

UPDATE: This link goes to the contents of the Open Letter to Senior Editors.  There was also a second interview from the Today programme, with Sir Mark Walport of the Wellcome Trust. As suggested above, he emphasises the need for quality control and the potential to put the peer review documents on-line too so that the process is more open. He suggests that the reviewers need to remain anonymous so that they do not need to pull their punches.

The science and ethics of stem cells (audio)

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In March 2009 I was interviewed by SuperSonic FM, a Leicester school radio station, as part of their National Science Week activities. A recording of the interview (27.5 minutes) has recently been added to their website and can be accessed via this link.

DNA – The Promise & The Price

Narrator Bill Paterson: "A child born in 1953, the structure of DNA has just been discovered. 1989 and this baby's genetic fingerprint can be identified. The first single gene for Huntington's disease has been discovered. 2003 this child's entire genetic code can now be read and faulty genes in his DNA can be adjusted. Another birth, but this time no ordinary miracle. The baby's sex and eye colour were decided before she was conceived; also her hair, the shape of her nose and her intelligence. The date of her birth? Perhaps only a few years from now. She's born from a revolution in genetics. A revolution where each new step brings new questions of ethics and responsibility. And as the promises of the science gets greater, so do the questions for all of us get bigger."

DNA – The Promise & The Price provides an excellent resource for discussing the ethical implications of advancing genetic research, focusing on; gene therapy, stem cells and cloning. The documentary examines the frontiers of genetic science, revealing how researchers attempt to fulfil DNA’s potential to help cure and prevent disease. It also questions how some aspects of these novel technologies may have significant consequences for individuals and society. Bill Paterson: “Much is promised by genetic science, the manipulation of our genes. But can it deliver? And if it does are we ready to take responsibility for meddling with the very fabric of life itself: our DNA”.

Professor Steve Jones: "When it comes to medical research, any medical technology that works, it is very quickly accepted by the public. Ethicists may not like it, scientists may not like it, but the public, if they believe it works they will accept it, and the legislation will always follow. Ethics has always followed science, it's never led it and I don't see any reason why genetics is going to be any different. Ethicists would love to tell geneticists what to do, but I'm afraid the geneticists are not going to listen."

The topics found in DNA – The Promise & The Price include: genetics; genetic diseases; gene therapy; transplantation; stem cells; and cloning can all be found in the UK National Curriculum. Please note all timings mentioned  include advertisement breaks – (00:04:51 – 00:08:00, 00:25:31 – 00:28:40 and 00:46:50 – 00:50:00) 

Could human reproductive cloning be a “Godsend”?

The fictitious "Godsend Institute", from which the film takes its name

(Warning: contains plot spoilers!) The film Godsend stars Robert De Niro as a maverick fertility expert who has perfected a technique for human reproductive cloning. Following the death of their son Adam, on the day after his eighth birthday, Dr Richard Wells (De Niro) offers his services to the Duncan family telling them “you can have him back” (00:11:27). Although Godsend’s convoluted plot is entertaining, it must be noted that the science is both inaccurate and misleading. Nevertheless, there are a number of clips that highlight some of the bioethical issues, not only around human reproductive cloning, but also in terms of the links between what is legal, what is moral, and what science can do.

To ‘Opt in’ or ‘Opt out’? – Organ Donation in the UK

NHS 'Transplants save lives' website

Organ donation is one of the miracles of modern medicine; the ability to transplant tissue from one person to another without rejection has brought dramatic improvements in the day to day lives of thousands of people, in many cases it is literally life-saving.

At present, however, the sad reality remains that demand outstrips supply. According to the Transplant Activity in the UK report for the financial year 2007/2008: 3235 transplant operations took place, but 7655 people were waiting for a transplant (up more than 6% from previous year), and 506 patients died while waiting for an organ transplant, (it is thought that this number could actually be as high as 1000 per year).

The debate that surrounds organ donation is fuelled by society’s moral obligation not to allow these people to die needlessly. When a person dies and they are not on the Organ Donation Register (ODR) and/or their family do not grant permission for their organs to be donated, then none can be used to help those suffering on the waiting lists.

The UK Government is desperate to improve the number of organs available for transplantation. In 2006 this led to the establishment of the Organ Transplant Taskforce, chaired by Elizabeth Buggins, in order to ‘identify barriers to organ donation and recommend actions needed to increase organ donation’.  Their most recent report The potential impact of an opt out system for organ donation in the UK, published 17th November 2008, has received widespread media coverage. With the aim to increase the number of people on the organ donation register, they examined potential benefits and the viability of a move from the current ‘opt in’ organ donation system, to a ‘opt out’ system where by every citizen in the UK is automatically registered to donate their organs when they die unless they actively decide not to.  

This post highlights relevant and useful online clips whilst briefly discussing the central ethical arguments presented by the report. It also complements this with suggested questions to use while discussing the topic.  

Superdoctors – Miracle cures

Robert Winston introducing the programme

Commenting in the second episode of the three part Superdoctors series that “one of the most exciting frontiers of our age is stem cells“, Robert Winston goes on to ask “how will these cutting edge technologies change the way that you, and I, and are children are treated?” (Start – 00:04:02). Stem cell therapy is at the beginning of its expected transition from the laboratory to the clinical application. The programme seeks to distinguish the hype from the genuine developments and to examine some of the hard decisions that need to be taken. Several of the key ethical issues associated with stem cell research have been considered in posts about other programmes (see for example Are hybrid embryos an ethical step too far? – The Big Questions and Bioethics Briefing – Stem cells). This episode, however, is particularly useful for consideration of two issues:

• Public understanding of science and the management of expectations
• Clinical trials and “therapeutic misconception”

More tricky decisions – Inside the ethics committee

Visit the Inside the Ethics Committee homepage at BBC Radio 4

The fourth series of BBC Radio 4’s bioethics programme Inside the Ethics Committee began on August 6 2008, and discussed some of the ethical issues involved in the creation of ‘saviour siblings’ (first broadcast on BBC Radio 4, at 20.00, August 6 2008 and repeated on August 9 2008, at 22.15). Vivienne Parry and a panel of experts discuss the ethical issues around real-life medical cases, on this occasion the dilemma involves a young child, Catherine, and her medical treatment. Previous BioethicsBytes posts have noted the utility of this series (see the post Making tricky decisions – Inside the ethics committee), and this episode is no different.

Shortly after she was born Catherine was diagnosed with Diamond Blackfan Anaemia (DBA). DBA is a rare blood disorder caused by a genetic mutation. In general, its treatment is “gruelling” (00:02:27) and the prognosis is poor. As in several previous cases (notably, the Whitaker, Fletcher and Mariethoz families), Catherine’s parents were offered the option of using preimplantation genetic diagnosis (PGD) for tissue typing alone in order to create a ‘saviour sibling’ whose umbilical cord blood could be used to treat Catherine’s DBA.

Many of the ethical issues involved in this choice have been dealt with in past BioethicsBytes posts (see The Future of Our Families? and the extended commentary that accompanies that post), however this edition of Inside the Ethics Committee brings consideration of these issues up to date. Though the majority of the ethical issues raised are covered in our existing posts, some of the additional details noted here about DBA and the testing procedure introduce new complications into the ethical debate.

Exploiting Genetic Knowledge – Visions of the Future (2)

The Biotech Revolution, the second episode of the BBC4 Visions of the Future series, continues to describe ways in which humanity is making a “historic transition from the age of scientific discovery to the age of scientific mastery”. Presenter Michio Kaku suggests that unlocking the basic code of life will allow us to “predetermine the destiny of life itself” and to manipulate it at the most fundamental level (Start-00:02:00).

The programme begins with Kaku having his “medical future rather than history” diagnosed via a series of genetic tests for complex diseases such as heart disease, diabetes and Alzheimer’s. He describes this as an “owner’s manual” which will enable him to have greater control of his health, and to allow others to perhaps prolong their life by decades (00:02:20-00:06:20 and 00:20:05-00:23: 20). As a scientist, he is eager to discover what secrets his genome may contain however, as a person, he says “wait a minute, this could be a Pandora’s Box… I’m looking at a side of me I have never seen before, a side that has potential medical problems lurking there”.

Some of the issues raised here mirror those found in the ITV1 broadcast The Killer in Me, which illustrated particularly well the anguish associated with having such tests and the way actions could be taken in light of the results. In this programme, in contrast, there is greater emphasis placed on the potential impact on relatives and wider society that may result from taking the tests. “We really want to respect your privacy and the privacy of your relatives” the physician emphasises to Kaku.  Much of the future of this testing, if not the present, relies upon “the last great discovery of the 21^st century, the Human Genome Project”.  Kaku believes that this event holds such significance that we will look at the history of medicine in two eras, “before genome and after genome”. “Having unravelled the fundamental code of our biology the stage is set for us to manipulate it” he adds (00:06:25-00:09:20).

Are hybrid embryos an ethical step too far? – The Big Questions

Following the Human Fertilisation and Embryology Authority’s decision to approve the creation of ‘animal-human’ hybrid embryos, or “cybrids”, the inaugural episode of the BBC’s new ethics show The Big Questions (BBC1, Sunday Sept 9th 2007, 10 am) included a fifteen minute debate on the topic. The programme provides some useful material for discussing the issue.

This initial post outlines the thrust of the discussion.  Interested readers are strongly encouraged to look at the extended commentary Science and ethics of cybrids – reflections on some recent media coverage, which includes not only a fuller account of the exchanges on The Big Questions, but also draws upon a similar discussion on The Guardian’s Science Weekly Podcast of September 10th. The relevance of a number of recent scientific papers on the biology of stem cells is also considered.  You may also like to watch a BBC news report following the announcement – go to their News page ‘Human-animal’ embryo green light and follow the ‘Watch’ link on the right-hand side.

Introducing our “Extended commentaries”

As the number of resources on BioethicsBytes continues to grow, so too does the range and diversity of the materials we are offering.  We have recently launched a new genre, the BioethicsBytes Extended Commentaries.  As the name implies, these articles pick up on one or more theme arising from a book, film or programme but discuss the issue(s) in a broader context. The Extended Commentaries draw on a wider range of academic texts than would be usual for a standard BioethicBytes review. They will normally be linked to a shorter post on the main blog.

At present there are four Extended Commentaries on:

Transgenics and a world of “limitless possibilities” – concerning issues arising from the first documentary in the Animal Farm series (Channel 4, March and April 2007), including medical v non-medical applications of transgenic organisms, connections with the debate about genetically-modified (GM) food, and a consideration of what is ‘natural’

The “pharmaceutical farm” – discusses speciesism, identity and the ethical treatment of experimental animals, as prompted by the second episode of Animal Farm

Making “creatures that work for us” –  looks at the medical benefits from transgenic animals, the modification of animals for our pleasure (specifically the transgenic GloFish) and the development of animals specifically to counter mankind’s impact on the environment, all of which were issues arising in the third programme of the Animal Farm series

The future of our families? – a consideration of some of the ethical concerns about saviour siblings, including illustrations drawn from Jodi Picoult’s novel My Sister’s Keeper

Further Extended Commentaries will follow in due course.