Is the BMJ trying to redeem itself? 

The Rapid Responses are worth the time

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Censorship or self-censorship in the mainstream media, if not to say paid government propaganda, has been very clear for all to see. But reading the comments at the bottom of online articles can give a more encouraging picture of the views of the readership.  Perhaps the most classic was Michael Gove’s It’s time to explore the need for Covid certification’  appeal to the readers of the Telegraph to ‘help us find common-sense answers’ to this issue. The Telegraph eventually closed the comments. The Daily Sceptic reported some sample comments and they were NOT supportive.

The concerns about the influence of Big Pharma on major medical journals has also been raised and is in some ways even more serious, as covered in a review article in the BMJ in 2022 entitled ‘The illusion of evidence based medicine’.  HART member, Professor Norman Fenton is one such author who has found that even the preprint server medRxiv who had routinely published his work in the past, have since 2021 rejected every submission. He also wrote an invited short article for the Lancet which they then refused to publish.

Professor Carl Heneghan has raised similar questions about delays in publication of the 2020 Cochrane Review on Physical interventions to interrupt or reduce the spread of respiratory viruses and the subsequent senior editorial statement about the 2023 update. 

For a while, it seemed as if the British Medical Journal was trying to provide more balance, but an opinion piece in May entitled We need a gold standard for randomised control trials studying misinformation and vaccine hesitancy on social media seems to have put paid to that. The author completely missed the possibility that much of the information re covid vaccine harms published on social media is correct and being posted by authors trying to redress the lack of balanced information in the legacy media. Moreover ‘vaccine hesitancy’ for the covid vaccines might now look more like common sense. There was a discussion in the only two published rapid responses, on whether the term ‘vaccine hesitancy’ was preferable to ‘antivaxx’. Meanwhile another rapid response setting out how poorly designed Covid-19 vaccine trials provided ‘a classic example of how to increase vaccine hesitancy’, was rejected by the BMJ, only appearing in the HART bulletin.

In August, a BMJ news item entitled: ‘Covid-19: Lockdowns and masks helped reduce transmission, expert group finds’ gave completely uncritical support to the Royal Society’s overview. But at least they did publish a highly critical rapid response from Roland Salmon, who questioned,

‘what exactly is the reader to make of the role of “the then UK Government Chief Scientific Adviser, Sir Patrick Vallance, in helping the Society to refine the concept of this report and ensuring it has value for future science advisers and decision makers”(p 2)? Would Patrick Vallance have really conceived that measures for which he was an active protagonist were no use? Given this, he could hardly be criticised if he thought that the most useful thing for future science advisors and decision makers was a compendium of evidence that this stuff had worked.’ Salmon’s response concluded, ‘Canonical authority is never a good basis for public policy. The BMJ ‘s readership would have been better served by a more questioning account of this Royal Society report’  

Another rapid response from Noel Thomas pointed readers to the Cochrane Review mentioned above.  The pithiest response from an Emergency Medicine Physician from Idaho seems to sum up the whole of the last three years perfectly,

‘Dear Editor, I fail to understand how there can be any success in a global pandemic in which literally everyone caught the virus despite precautions and vaccination. I would argue that lockdowns not only had detrimental mental health effects, but also prolonged the pandemic. We now have an endemic virus and are reaping the long term educational and economic harmful results of lockdowns across the world. Hardly successful or beneficial.’

Another August opinion piece included a letter from BMJ Editor in Chief, Dr Kamran Abassi, ‘Royal colleges must be more transparent on payments from industry’. This produced several rapid responses including one from retired GP Dr Peter Selley, entitled How can doctors share concerns?’. He pointed out,

‘Your Journal, of course, depends on income from the similar sources to the tune of over 3£M a year’. Thirty years ago an ordinary doctor, like me, could pen a letter to the editor of the BMJ, fairly sure it would be published. This might be about an ethical issue, a clinical finding, or an adverse event on a drug, of which BMJ used to publish two per issue on average. Nowadays your Journal will not accept a letter in the form of a rapid response (like this) unless it is hooked onto a published article. Your headline stories are mostly written by your editorial staff (3) and your opinion columns offer predictable views.’  

Retired consultant physician Timothy Moss continued on this theme, suggesting:

Perhaps this process was a valuable component of Continuing Medical Education that was free from commercial interests? ….a wider and/or earlier awareness of adverse prescription medication events might be achieved were such a medical journal platform to become available once more?’ 

Both these letters missed out the dreaded ‘v’ word. And again it is the letter that the BMJ rejected which speaks volumes about the influence of Big Pharma. This was the letter written by a HART supporter, referred to the Counter Disinformation Unit for his troubles. 

Dear Editor

As a retired physician, I welcome the BMJ’s exposure of the opaque funding of the Royal Colleges by the pharmaceutical industry [1] and your latest open letter [2].  The large donation from Pfizer may explain the Colleges’ reluctance to tackle the issue of the subtle censorship of their members. 

I, along with around 50 other health professionals and academics, signed a detailed fully referenced letter to the MHRA in May 2021 cautioning them against approving mRNA covid vaccines for use in children [3].  Not surprisingly, they went ahead anyway without answering any of the concerns raised.  But perhaps more shocking was that the Department of Health and Social Care forwarded all our names to the Counter Disinformation Unit, where they remain to this day. This only came to light almost 2 years later after a detailed investigation by Big Brother Watch [4].

My letter to the President of the Royal College of Physicians, asking for support in questioning this approach to raising medical concerns, produced the extraordinary reply that “as the letter was open and published, I suppose that is to be expected.” If the letter had been an invitation to a child pornography or terrorist website then referral to the CDU would be entirely appropriate, but surely not for a fully referenced scientific letter highlighting potential harm to patients.

Dr Geoffrey Maidment, MD, FRCP, retired consultant physician

In another September opinion piece by regular BMJ writer Dr Helen Salisbury, ‘Covid booster chaos’ reasonably chronicled the chaos for GPs caused by reduced payment levels and changing dates for autumn booster schedule. The article bemoans the lack of information about the new Pirola variant that has led to the date change and concludes:

‘Clearly, it would be sensible to get the “best guess” vaccine into as many arms as possible, beginning with the most vulnerable patients’.

Dr Fatou Mbow, a practising GP, wrote in her rapid response:

‘I wonder how doctors came to consider “sensible” an action they know nothing about, let alone “get the “best guess” vaccine into as many arms as possible” when such promoted action is on healthy individuals (“healthy” with regards to an infection a vaccine is usually expected to prevent). The “do no harm” principle really seems to have been forgotten in this Covid 19 epidemic, for reasons unclear to me. I sincerely hope this oversight isn’t in relation to the financial considerations at the very heart of this article

Given the discussion around the funding of the Colleges and indeed of the BMJ outlined above, it is hard to find reassurance. 

Meanwhile, Dr Salisbury is a Senior Medical Education Fellow at the University of Oxford – extremely worrying that such uncritical thinking is being taught to the next generation of doctors.

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