Censorship: How the medical journals deny academic freedom by Miguel A. Faria, MD

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Saturday, December 16, 2017

Science requires an ambient of academic freedom that entails the free exchange of ideas, ideas that can be tested in the laboratory and eventually rejected or accepted by the rigorous scientific method. But how can dissenters be heard when medical journals have established a monolithic wall of censorship, excluding ideas different from those espoused by the smug leaders of “organized medicine” and the medical editors appointed as the guardians of truth? Difference of opinions and the freedom to express them are essential to intellectual discourse. But academic freedom is perverted and scientific truth is replaced Medical Journalsby political ideology when only one side of an issue is allowed to be heard. This is essential what has happened over several decades with intolerance of opposite views by the public health establishment and the practice of censorship by the major medical journals in the debate over firearms. 

Unlike the criminological literature that have compiled data on both sides of the gun and violence debate, the public health establishment and the medical journals, have never published, to my knowledge, one major study or review article discussing the beneficial aspects of gun ownership. This is true for Journal of the American Medical Association (JAMA) and The New England Journal of Medicine (NEJM) in the U.S. and for The Lancet and the British Medical Journal (BMJ) in Great Britain. Medical dissenters would be very fortunate if they are able to get a short letter to the editor published. Most of the time, their material — i.e., studies, articles, even letters to the editor — are rejected. This has been the case since at least the early 1980s, and in the ensuing years nothing has changed. Consider just two personal professional examples from my documented correspondence with NEJM and Lancet, spanning a period of nearly two decades. (I could have used the correspondence of numerous other physicians who have experienced the same treatment, all of whom failed to penetrate the monolithic wall of censorship of the medical journals, but decided to use my own.)

February 2, 2000

Dear Dr. Faria,

Your letter to the editor regarding the Wintemute article of November 19 has been accepted for publication in edited form in a forthcoming issue of the Journal and sent to the authors for their comments...Gregory D. Curfman, MD, Deputy Editor, NEJM

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March 7, 2000

Dear Dr. Faria,

I regret that we will not be able to publish your letter to the editor in response to the article to Wintemute et al. Because of other space priorities, we are unable to print the letter. I am sorry that we must change our decision...Gregory D. Curfman, MD, Deputy Editor, NEJM

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March 14, 2000

Marcia Angell, MD, 
Editor, NEJM

Dear Dr. Angell,

When you ascended to the post of Interim Editor of The New England Journal of Medicine (NEJM) following the resignation of Dr. Jerome Kassirer, I applauded your promotion because, among other things, you had also courageously breached the wall of junk science being built around the issue of silicone implant litigation. Moreover, under Dr. Kassirer, when it came to the topic of public health and gun control, and to a lesser degree, Medical Savings Accounts (MSAs) and private medical care, NEJM took a decidedly liberal perspective, whereby only one point of view was promoted. 

The other side was ignored or, let us say it, censored. More recently, the mainstream press has been critical of NEJM because it had violated its own policies on conflict of interest ethics. When on November 22, 1999, I sent a letter to the editor (addressed, incidentally, to you), responding to Dr. Wintemute et al's article, "Mortality Among the Recent Purchases of Handguns" in N Engl J Med 1999;341(21):1583-9, and after passing editorial review, was accepted for publication, I was particularly delighted and grateful for its acceptance in your esteemed journal (Correspondence #99-3859). I was delighted because as a Hispanic (and the NEJM has promoted diversity), it seems that NEJM was also now promoting diversity of intellectual views.

Unfortunately, my hopes came tumbling down. Yesterday, I received a letter from Gregory D. Curfman, M.D., Deputy Editor, NEJM. He stated: “I regret that we will not be able to publish your letter to the editor in response to the article by Wintemute et al. Because of other space priorities, we are unable to print the letter. I am sorry that we must change our decision.” 

...Given the content of my letter, I must assume that like the refrain says, “The more things change, the more they stay the same.” Intellectual freedom and social progress can only thrive in an atmosphere where there is a free and open exchange of ideas and information — not censorship. I hope you can use your moral authority to reverse this decision. I remain hopeful that you can decidedly end this resurgence of lack of professionalism and ethics — and return of censorship... 

Miguel A. Faria, M.D.

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March 27, 2000

Dear Dr. Faria,

Thank you for your letter to Dr. Angell dated March 14. Regarding the correspondence on the Wintemute article, when we finally assembled it all, it was clear that we did not have sufficient space to explore all of the topics raised by that article. The central issue of your letter, that "guns are not the cause of suicide," is an interesting point, but one that we could not commit the space to assess in depth. Thank you again for your interest in The New England Journal of Medicine.

Gregory D. Curfman, MD, Deputy Editor, NEJM

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Let’s move forward to 2017, an age in which medical journals publish print as well as online editions, consequently “space considerations” are not as much of a concern, giving readers more leeway at least online to participate in the exchange of ideas and provide critical opinions about the material being published. Thus, in response to an editorial, I submitted a letter to Lancet, paying close attention to all the editorial requirements.

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Flawed Biased Gun Studies by Public Health Researchers 

Your October 19, 2017, editorial disingenuously implied that the U.S. has a high suicide rate because of gun availability. Why not compare international suicide rates by all means? According to the World Health Organization, suicide is the second leading cause of death “among 15-29 year olds globally, and 78% of suicides occurred in low- and middle-income countries in 2015.”(1) We should add that where most countries have strict gun laws, the people substitute other methods and commit suicide at even higher rates than the U.S.(2) The 2015 figures show that the Japanese commit suicide via hanging, suffocation, jumping in front of trains, and Hara-kiri at a rate of 19.7 per 100,000, much higher than the United States. Americans rank 48th and the rate is 14.3 per 100,000. Norway, Sweden, Belgium, Hungary, and many other European countries have higher rates of suicide than the U.S., and they all have stricter gun laws.1 Once again, you are taking aim (pun intended) at an object while failing to address the more important point, a lack of access to mental health services. As for the rural suicide studies cited, they were debunked as biased and poorly designed.(3) 

I was one of the four experts(4) who testified to the Congressional Committee that imposed the restrictions on the CDC in 1996. The “abhorrent and nonsensical” state of affairs isn’t with common sense legal restrictions but with flawed, biased and politicized gun studies carried out by the public health officials at the CDC. 

Miguel A. Faria, M.D. 

References

1. World Health Organization (WHO). Mental health—Suicide data, 2017. Available form: http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/

2. Faria MA. Gun statistics—Should they be tortured or gently cross-examined? HaciendaPublishing.com, October 17, 2017. Available from: http://haciendapub.com/articles/gun-statistics-%E2%80%94-should-they-be-tortured-or-gently-cross-examined-miguel-faria-md

3. Gift T., Langmann C. Firearms and rural suicides. Doctors for Responsible Gun Ownership, August 24, 2017. Available from: https://drgo.us/firearms-and-rural-suicides/

4. U.S. Department of Labor, Health and Human Services, Education, 1996, pp. 944-946. Available from: https://archive.org/stream/departmentsoflab071996unit#page/944/mode/2up

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December 5, 2017

From: “The Lancet Peer Review Team”

Dear Dr. Faria,

Thank you for submitting your Letter to The Lancet. Having discussed your Letter with the Editor, and weighing it up against other submissions we have under consideration, I am sorry to say that we are unable to accept it for publication. Please be assured that your Letter has been carefully read and discussed by the Editors. Thank you for your interest in The Lancet, I hope this decision does not deter you from considering us again in the future. Yours sincerely, Elizabeth Zuccala, Senior Editor, The Lancet

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Addendum (And We have just heard from JAMA)

Date: Monday, December 18, 2017 12:32 PM
From: leted@jamanetwork.org  
To: Dr. Miguel Faria
Subject: JAMA17-9746 Decision Letter

December 18, 2017

Dr Miguel A Faria
Surgical Neurology International
Re: Letter to the Editor

Dear Dr Faria:

Thank you for your recent letter to the editor. Unfortunately, because of the many submissions we receive and our space limitations in the Letters section, we are unable to publish your letter in JAMA. After considering the opinions of our editorial staff, we determined your letter did not receive a high enough priority rating for publication in JAMA. We are able to publish only a small fraction of the letters submitted to us each year, which means that published letters must have an extremely high rating. You are welcome to contact the corresponding author of the article, although we cannot guarantee a response. We do appreciate you taking time to write to us and thank you for the opportunity to look at your letter.

Sincerely yours,

Jody W. Zylke, MD
Deputy Editor, JAMA
Letters Section Editor
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December 8, 2017

To the Reader in conclusion:

As we have seen, “The more things change, the more they stay the same.” These are the type of medical editors and medical politicians who pay lip service to the “free exchange of ideas” and “academic freedom” and who brazenly accused the U.S. Congress of legislating against science. In the case of The Lancet, its editors charged Congress with keeping “the USA ignorant of the true toll of its gun violence.” And in the case of JAMA, its editors accused Congress of “placing limits on science” and “suppressing research.”  Perhaps, they should look in a mirror. The medical editors are the censors, who are perverting science by limiting the free exchange of ideas and instead promoting junk science, based on expediency and political ideology. Congress acted correctly when in 1996 it restricted the bogus, faulty, self-serving gun (control) research conducted to reach pre-determined conclusions — and saved taxpayer money in the process. --- MAF

Written by Dr. Miguel Faria

Miguel A. Faria, M.D., Associate Editor in Chief in socioeconomics, politics, medicine, and world affairs of Surgical Neurology International (SNI). He was appointed and served at the behest of President George W. Bush as member of the Injury Research Grant Review Committee of the Centers for Disease Control and Prevention (CDC), 2002-2005. His website is www.haciendapub.com

This article may be cited as Faria MA. Censorship: How the medical journals deny academic freedom. HaciendaPublishing.com. December 16, 2017. Available from: http://www.haciendapublishing.com/articles/censorship-how-medical-journa...

This article was also published in The Macon Telegraph on December 15 and in Doctors for Responsible Gun Ownership (DRGO) December 19, 2017.

Copyright ©2017 Miguel A. Faria, Jr., M.D.

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Comments on this post

“The more things change, the more they stay the same.” So true!!

I just can't seem to find it, but I recall reading a British medical journal from 1970 where I spotted a gem in the editorial section.

It was reported that Ted Kennedy's family holed the murderous Democrat up after he left Mary Jo Kopechne to drown, but made sure he was breathing oxygen on dry land. Now, this journal's editors had somehow found out that when the drowning occurred, the chief medical examiner was out of town, and the far less experienced deputy was left to oversee the office. After cursory external examination of the body, he strongly felt there was indication for an autopsy. Something he saw worried him enough to conclude he had better make sure this was an accident. I can't remember which, but the Royal family either bribed or threatened the deputy ME into not doing the autopsy and releasing the body.

They then said that it was only because they were writing from Britain could they say any of that, and because it was 1970, just after the "accident" occurred, that nobody should expect much reaction from any American medical journals. I believe they were right.

Yet, when I first read that it made me laugh, because there was an editorial in JAMA in 1882 which proclaimed loudly that Charles Guiteau, convicted and executed assassin of President Garfield was insane, and should have been placed for life in a state hospital, but never should have been hung. After extensive searching I cannot find it. I have made it no secret in the past that I think JAMA is nothing but a leftist rag, but it really makes you think that it could have been one at least as early as 1882. They sure didn't write any editorials on Kopechne's need for an autopsy as early as 1970.

Part of the past sentiment concerning Guiteau I feel was due to the father and son team of late 19th and early 20th century neurologists, the Spitzkas. The elder Spitzka testified as to Guiteau's insanity in court for the defense, but in 1882 at least juries weren't buying it, so he ended up doing Guiteau's autopsy shortly after his conviction.

The younger Spitzka holds the distinction of performing the autopsy on Leon Czologsz, who assassinated President McKinley in September 1901. Justice was still swift, and if the convicted smoked a bit in the electric chair, nobody noticed. He was already in possession of the brain of Czologsz by October 1901. Czologsz said why he shot the president at the trial in September, but that did not deter the younger Spitzka from trying to prove his brain one of an insane man nonetheless.

McKinley's autopsy (published in full by JAMA in late 1901) demonstrated in part why you do not want an obstetrician to perform surgery to repair a bullet wound in the stomach by sunlight. The case was nowhere near hopeless.

It is interesting that the convicted were the only two people put on trial out of the four presidential assassins in our history, but things never really do change. The more insidious forms of liberalism are not a recent import to this country.
--ARB

Academic intolerance!

via email---Academic Intolerance

Hi Miguel,
Very nicely written. I think it will bring to light the important and significant discrimination going on by the various liberal publications / censors.

You'd predict that it would strike a raw nerve of our "media," but they recognize an agenda when they see one, and unfortunately support this bias. Keep up the excellent work, and thanks for all you do,

John Wipfler, MD, Indiana, December, 12, 2017
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Hi Miguel,
I am glad you are exposing once again the prejudice and hypocrisy of the medical journal editors. There seems to be more public suspicion of "experts" at places like JAMA and NEJM these days, and I believe your tireless work in exposing them is at least part of the reason. Merry Christmas to you and Helen!

Tim Wheeler, MD, California
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Dear Miguel,

Excellent article and a much needed article and discussion. Beautifully written! Similar censorship occurs concerning a number of such protected sacred cows of the orthodox elite--such as fluoride, vaccination dangers, MSG, aspartame, pesticides and many more such subjects. Controlled communication and dispersal of information for public consideration or even fellow scientists, is the new norm. Most of this control comes from the collectivist left who reasons that some ideas are so dangerous to the public welfare and public emotional health they they cannot be allowed to be aired. I have had a number of scientists of impeccable credentials tell me that they were told that even though they had excellent scientific support for their viewpoint, for illusory and non determinable reasons their viewpoint had to be shielded from the public or from scientific consideration. We now see this openly expressed by the radical left when they say that all conservative ideas must be restricted because their ideas are so dangerous--that is, being fascist--ignoring the fact that one who defends individualism, limited government and a Constitutional rule of law cannot be fascist--only collectivists who endorse a powerful centralized government with all inclusive powers over the individual can be a fascist. But then common sense is the first victim of controlled debates and control over dissemination of other viewpoints. The leftist is looking in a mirror when they make such idiotic statements.—RLB.
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Thank you all for your feedback and read below!---MAF.

Dangerous academic misinformation in Science journal!

From: David Stolinsky, Monday, December 11, 2017, 9:30 PM
To: Science Editors Subject: Important error 
Dear Editors:

Please remove at once the image on your webpage, showing a man drawing a pistol with his FINGER ON THE TRIGGER. Yes, you are anti-gun, so publish anti-gun editorials. But do not teach habits that are potentially fatal. Ask anyone familiar with guns, e.g. police officers, military personnel, or firearm instructors. They will agree enthusiastically. David C. Stolinsky, MD
—————
From: David Stolinsky, Wednesday, 13 December 2017, 18:24
To: science_editors@aaas.org
FW: Important error
Dear Editors:
 
You have not responded to my email, either by replying or by removing the offending image. What am I to conclude? That teaching a dangerous habit is justified by furthering an anti-gun agenda? Or that you consider guns so dangerous that making them even more dangerous is a matter of no concern? I have difficulty explaining your indifference in a more generous manner.
 
We can argue about policies and opinions. But that drawing a handgun with your finger on the trigger is dangerous is an incontrovertible fact. I learned not to put my finger on the trigger until I was ready to shoot in high-school ROTC. Perhaps it is time that you learn it too. Please reconsider your position. Sincerely, David C. Stolinsky, MD
——————
From: Brad Wible, PhD
Sent: Thursday, December 14, 2017, 7:39 AM 
Thank you Dr. Stolinsky for reading Science, and for sharing your concerns. What you might see as “anti-gun” we and many of our readers instead see as “pro-rigorous-research” and “pro-inclusion-of-rigorous-research-evidence-in-policy-debates”. But difference in opinion and the freedom to express opinion are strengths of this country. I would like to believe, and this motivates our work at Science, that we could at least agree that a scientific approach has proven time and again how it is a uniquely powerful way to converge on some reliable understanding of how things are, and to update and refine understanding, so that despite differences in viewpoints, we could at least agree upon some basic facts.
 
Regarding the photo, as someone who took hunter safety classes in my youth, I don’t disagree that there is a right way and a wrong way to safely handle firearms. If the Science paper had been about gun safety techniques, then the image could have been misleading. But the fact remains that despite firearm safety efforts, far too many gun owners likely do not follow textbook gun safety practices. That was one of the fundamental realities underlying the argument in the paper: many people likely do not exercise adequate temperament, judgment, and skill to store, transport, handle and use guns safely, and people die and are injured as a result, and a growing body of rigorous research is documenting such phenomena. Thus, the photo suggested what, sadly, is seemingly all too common, with tragic results as explored by the authors. Again, thank you for reading Science, Brad Wible, PhD, Senior Editor, Science
—————
Dear Dr. Wible: 
Thanks for your reply. I guess to summarize the reply: good motives excuse bad actions. I disagree. Your photo is no different, intellectually or morally, from movie posters – which almost without exception show the hero with his finger on the trigger, and often pointing the gun at his buddy. The function of both is to attract attention. Neither the movie posters nor your photo convey in any way the message that something unsafe is being depicted. I should add that two letters to the Motion Picture Association regarding this problem evoked not even a mechanical reply, much less a response.
 
With regard to firearm research, when Science, or the New England Journal, or Annals of Internal Medicine publishes even one article or opinion piece by Dr. John Lott and his colleagues, then I will joyfully accept that what is being pursued is truth rather than an agenda. Until then, let us agree to disagree. Best regards, David C. Stolinsky, MD 
————— 
Now they insist on disseminating misinformation in illustrations, no less, endangering the lives of their own readers, who may be initiates to guns. Then the Science editor hypocrites, complain of accidental firearm shootings!

The Science editors should have read the book — Wheeler, Timothy W. and Wipfler, E. John, III. Keeping Your Family Safe:The Responsibilities of Firearm Ownership. (Bellevue, WA: Merrill Press, 2009).PAGES 27-31 — before they decided they are experts, so Dr. Dave C. Stolinsky, editor-at-large of haciendapub.com, has taken them to task with good cause! — MAF