Bioethics News

Bioethicist alleges “publication bias” at NEJM


For a fascinating behind-the-scenes view of how a major medical journal can trash heterodox views, it is hard to beat Ruth Macklin’s saga in the Indian Journal of Medical Ethics (IJME).

Dr Macklin, a prominent bioethicist at Albert Einstein College of Medicine, in New York, disagreed strongly with a battery of articles published in the New England Journal of Medicine about treatments for extremely premature newborns.

The medical issue is complex. Basically the so-called SUPPORT study compared oxygen levels given to newborns in order to determine the optimal level. A lot is at stake; wrong levels can result in blindness and death. One vocal critic of the SUPPORT study, Peter Aleff, has a brain-damaged and blind son whose disabilities he attributes to problematic oxygen levels. He has described the SUPPORT study as “even more unethical than the syphilis studies in Guatemala and Tuskegee”.  

After the results of the SUPPORT study were published in the NEJM in 2010, the Office of Human Research Protections (OHRP) rebuked the University of Alabama for the inadequacy of its informed consent forms. The NEJM came out with all guns blazing in defense of its editorial judgement and launched four counter-attacks on OHRP: an article by two leading bioethicists; an editorial by the NEJM editor, Jeffrey M. Drazen; a long letter signed by 46 bioethicists and paediatricians; and an article by three officials at the National Institutes of Health, including its head, Francis S. Collins.

Dr Macklin and two colleagues studied the forms at the centre of this controversy.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.