Editor of the BMJ to take up new post
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7451.1276-a (Published 27 May 2004) Cite this as: BMJ 2004;328:1276All rapid responses
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I am not entirely clear what Joseph Watine means by my ‘style,’ but I
would entirely agree with him that Richard Smith has done a splendid job
of encouraging free speech by making BMJ an excellent 'open all hours'
global discussion forum. However, he does this much to the chagrin of
those who think that open discussion of health issues somehow comprises an
affront to the dignity of the profession.
Though I agree with Joseph Watine that it is a good principle to
encourage free speech, I have to disagree with him that this somehow
confers upon Richard Smith the cache of being a ‘principled man’ in any
wider sense.
Without wishing to belabour the original point, it would be hard to
regard as ‘highly principled’ a person who knowingly published--and paid
someone to write--the Horrobin obituary, who then refused to apologise for
the upset that obituary caused, who refused to withdraw it, who still
employs the same obituary writer on BMJ, and who dithered enormously over
whether to resign a professorship when Nottingham University was accepting
tobacco money. Quite simply, a more highly principled person would not
have done these things.
A highly principled person puts influence and reputation and concern
for the sensitivity of others above their own self-interest; they have to
weigh the impact of their words and deeds upon the people they serve.
Such a person would have resigned their professorship much quicker;
would never have touched such an obituary with a barge pole; would have
swiftly apologised for publishing the obituary, as a genuine error of
judgement, amended it or withdrawn it; would never employ such an obituary
writer again [unless they apologised too], would have freely and openly
acknowledged the error...etc. These seem like the reliable hallmarks of a
more principled person.
What seems to have appalled people most is that here was a man in a
responsible and influential post, who was not prepared to do these things,
not prepared to rectify their past mistakes, unwilling to show any
contrition or even acknowledge that they were responsible for an error of
any kind. Surely, these are all self-evident aspects of this tragic case?
Perhaps the only good thing that flows from all this is that people
do recognise that an error was made and are able to freely discuss it; and
we can thank Richard Smith for that.
When Dali once said that it is very often the mistakes, between paint
and brush, which are of greater interest to the artist than the skilful
strokes that were imparted deliberately to the canvas, he perhaps implied
that true progress only occurs through accidents: “mistakes are almost
always of a sacred nature. Never try to correct them - on the contrary:
rationalize them, understand them thoroughly - after that, it will be
possible for you to sublimate them.”
However, it is hard to see how Richard Smith might apply this advice
in the field of medical journalism.
And I find there is always room for agreement with Herbert Nehrlich
on most matters.
Competing interests:
None declared
Competing interests: No competing interests
Having read Peter Morrell’s short letter, I find it difficult to
understand why Richard Smith would not be a “principled” man.
One thing is clear however: in accepting to publish Peter Morrell’s
short letter, Richard Smith demonstrates that he is very open to
discussion and to free speech, which is a very good principle. Therefore,
in my view, Richard Smith is not an “unprincipled” man.
Competing interests:
I like Peter Morrell's style very much.
Competing interests: No competing interests
My first DILEMMA of the season. I like both Peter Morrell and
Richard Smith.
I have long ago forgiven the latter's inept handling of the David Horrobin
obituary and have not seen any other 'faux-pas' worth fretting about.
I think that most of his comments were informative, pertinent and timely,
many were clear proof that the author was -for lack of a better word-
surprisingly, very human.
I had always thought that it would take no less than a cold, stuffy, nerdy
and inflexible person to play editor to a Medical Journal but found out
differently.
I am sorry to see him go, for reasons having to do with the above
observations as well as with the old wisdom about the 'Devil you know'.
Why begrudge him a better position?
In closing, I was wondering about the bike.
Did you, Dr. Smith, take my recommendations about a vehicle change to
heart as yet? If not why not?
You won't be able to show up on a bike working for the Yanks! Instant
salary reduction and status demerit points.
The model is a 6.9......!
Competing interests:
None declared
Competing interests: No competing interests
Well said, Peter Morrell and the author of the David Horrobin
obituary is still writing for the BMJ.
I begged Richard Smith to publish our informative paper on zinc
deficiency and dyslexia in 1989. Humbly, I said, I thought it was one of
the most important papers he would ever receive. He agreed to publish, but
only 200 words and only 5 references and none of the graphs which
explained the different results with sweat, hair and serum assessments in
zinc deficiency.1 The seminal findings which highlighted the importance
of zinc for brain development and function, and how zinc deficiency can be
reliably and accurately assessed, have been ignored. Unnecessary
confusion over zinc deficiency tests remain to this day. This is a tragedy
for humanity and for millions of children and parents. The Lancet is soon
to publish my letter of protest because their recent Seminar review of
dyslexia did not mention preconception care prevention, or medical
treatment of dyslexia, for example by using low allergy diets, zinc and
EFAs to improve impaired brain function.2
However, Richard should be congratulated for setting up Rapid
Responses which have been a brilliant way to communicate "hard to get
published" anti-establishment ideas and information and to point out the
obvious flaws in otherwise unchallenged studies.
Liz Price and I were also grateful to Richard for publishing our
review letter of breast cancer risks with HRT in 1996 in a Table with more
than the usual allowance of references.3 This was because the BMJ had
printed a string of letters claiming that HRT did not increase breast
cancer risks, as we had claimed.4 The quoted studies did not stand up to
close scrutiny and now the WHI results have confirmed the higher risks of
breast cancer with progesterones than with oestrogens alone. My graphs of
the registration data showing the rise, fall and huge rise in the
incidence of breast cancer, with matching changes in hormone use are easy
to see in electronic rsponses.5
Mostly, I thank you Richard and wish you well.
1 Grant ECG, Howard JM ,Davies S, Chasty H, Hornsby B, Galbraith J.
Zinc deficiency in children with dyslexia: concentrations of zinc and
other minerals in sweat and hair. BMJ 1989;296:607-9.
2 Grant ECG. Developmental dyslexia and zinc deficiency. Lancet 2004
in proof
3 Grant ECG , Anthony HM, Myhill S, Price E, Steel CM .Breast cancer
and hormone exposure. Lancet 1996;348:682
4 Price EH, Little HF. Women need to be fully informed about the
risks of hormone replacement therapy. BMJ 1996;312:130
5 Grant ECG.Increases in breast cancer incidence
http://bmj.com/cgi/eletters/328/7445/921#55298, 1 Apr 2004
Competing interests:
None declared
Competing interests: No competing interests
A ‘man of principle’ would not depart the editorship of a British and
enormously prestigious medical journal to join a massive American
healthcare company intent on scavenging money from the NHS.
Is this what Peter Morrell is trying to say? By way of attack, is
that not a tad ‘ad hominem’, just a touch snide, just a little
unprincipled?
I feel sure that Richard Smith has a broad back and a ducks back -
from which water runs…….. but the Americans??
Competing interests:
experience of recent humiliating dressing down for playing the ‘ad hominem’ game against the BMJ (and the Americans)
Competing interests: No competing interests
Well said,Peter Morrell.
Competing interests:
Race Discrimination claim involving BMA and Dr Smith at the EAT
Competing interests: No competing interests
When Alex Scott-Samuel refers to the editor of BMJ as “the previously
principled Dr Smith” [1] then perhaps he should weigh his words with
greater care.
This is afterall the same Richard Smith who dithered rather longer
than a “principled” person would about whether to resign his professorship
at Nottingham University over some tobacco money.
It is also the same Richard Smith who published the most disgraceful
obituary [to David Horrobin] in the history of BMJ and then consistently
refused to apologise for the upset he had caused.
How can such actions be construed as anything approaching those of a
“principled” man? Principled by whose definition? While Alex Scott-Samuel
implies by the rather snide title of his post--every man has his price--
yet it is not principles that have been sold down the river as there were
none there in the first place.
[1] Alex Scott-Samuel, Sold down the river, BMJ e-letter, 28 June
2004
http://bmj.bmjjournals.com/cgi/eletters/328/7451/1276-a#64566
Competing interests:
None declared
Competing interests: No competing interests
Could I voice what many in the NHS are currently saying - that BMJ
editor Dr Richard Smith and Tony Blair's number 10 health adviser Simon
Stevens have sold the NHS down the river for a pocketful of United Health
Group dollars.
While the actions of the previously principled Dr Smith could merely
be regarded as foolish and misguided, those of Mr Stevens are much more
serious. In committing himself to
leading United Health Group's opportunistic takeover bid for Primary Care
Trust commissioning, he is taking advantage of a market imbalance
explicitly created by his own policies.
Had Stevens remained as the PM's adviser he would resumably have
sought to correct the 'commissioning imbalance' by promoting PCT mergers
or by shifting responsibility for
commissioning to a more appropriate level such as the Strategic Health
Authorities.
If United Health Group and others like them realise their objective
of dominating NHS commissioning, we will have a second 'Private Finance
Initiative situation' whereby NHS funds are used to generate private
sector profit for undertaking work that the NHS should be doing - in the
former case, local commissioning of services; in the latter, obtaining
public sector funds for capital expansion. And UK taxpayers will
effectively be funding Smith and Stevens' six-figure salaries.
Yours sincerely, Alex Scott-Samuel
Competing interests:
None declared
Competing interests: No competing interests
Dear BMJ,
As a young researcher from India, I would forever remember Prof. Richard
Smith for the following:
* Real-time theme issues (including 'Health in South Asia' and 'How
electronic communication is changing health care')
* Completely revamped and updated BMJ online
* Straightforward Editorials on variety of issues
While BMA is grateful to him for 'creating a flourishing business',
readers are grateful to him for reshaping and providing the prestigious
medical journal online.
Competing interests:
None declared
Competing interests: No competing interests
Re: principles
Peter Morrell, what I meant when I wrote that I like your style very
much, is not only that your English sounds very good to me, but also that
you do not fear to write what has to be written, remaining always polite.
Your arguments may seem to be a little bit of a caricature sometimes,
but these caricatures of yours are also part of your style, and I like
them very much too.
By the way, the caricature you made of Richard Smith reminds me of
Mr.Pickwick. Quite fun!
Competing interests:
None declared
Competing interests: No competing interests