Saturday 25 February 2012

David Magnus Defends the New Managerial Solution for AJOB as Udo Schuklenk Resigns from the Editorial Board

At last, there is word directly from the bench of the accused in the recent controversy regarding the new managerial solution for the American Journal of Bioethics after the Glenn McGee resigned as editor in chief to join a rather dodgy private stem cell company [since Slate retracted the article linked to here, apparently following threats of lawsuits from McGee, this link is now broken. Thanks to Nature, the background on the murky business of CellTex is still around, however] as full-time adviser/lobbyist/expert. My former posts on this matter are here: 1, 2, 3, 4 and 5. Today, I learned that another heavy resignation from the board of editors following these events has occurred: Udo Schuklenk has announced that he steps down from this position, preferring to keep his exact reasons confidential with reference to being being part of the editorial management of a competing journal, Bioethics.

David Magnus, one of the two newly appointed editors in chief – the other being Summer Johnson McGee, whose appointment I have criticised – addresses the rather rich variety of critical reactions to the new AJOB order, as well as its background, in a post at AJOB's adjunct blog. Given the amount of criticism that I have been mounting, I think it is only fair to cross post what David writes in its entirety (my comments can be found below, after the post):

David Magnus Corrects the Record Regarding AJOB

Over the past couple of weeks, a great deal of drama has played out regarding changes at the American Journal of Bioethics. While we appreciate all of the support we have received from our Editorial Board and much of the leadership in the field, a number of misleading or false claims have been made about which I feel obligated to respond.
  1. It has been claimed that the Editorial offices of AJOB were relocated to Celltex. This is false. It is a matter of public record that the offices of the journal have been and continue to be based at 3030 Post Oak Blvd. #805 in Houston, Texas. These are not the offices of Celltex and Celltex housed no AJOB editorial office or AJOB activity on their premises.
  2. It has been claimed that Glenn McGee took the job at Celltex and planned to continue to serve as both EIC of AJOB while working at Celltex until bloggers and twitter revelations forced a hasty change in plans.  In fact, when Glenn first decided that he was likely to move to the private sector, he decided it would be best to resign from AJOB. Transition plans began then—and this can be attested to by a number of leaders within the field of bioethics, since a number of them were aware of the transition plans.
  3. Most of the attacks fail to acknowledge that Glenn had already been working to transition out of his role at AJOB as soon as he accepted his new position. During the transition he had no role in the oversight or acceptance of manuscripts for the journal. Failure to acknowledge that he was in the process of transitioning out of AJOB and that conflict of interest provisions had been put in place is a misleading rendition of events.
  4. Charges of nepotism have been raised against the appointment of Summer Johnson McGee as the co-EIC of AJOB. This charge is false. It was my idea (not Glenn’s) for Summer to be proposed as co-EIC. It was up to Taylor and Francis (not Glenn and not me) to make the final decision to sign her to a long-term contract as co-EIC.  This is one of the more offensive charges, since it fails to acknowledge the reality that Summer is a scholar in her own right and that she is in fact the backbone of the journal. Anyone familiar with the workings of the journal knows that Summer has taken on more and more responsibility for the journal over the past several years—unfortunately while getting little recognition for her contributions.
  5. There has also been a charge that Summer is too conflicted to serve as co-EIC or that her COI cannot be managed or mitigated. This issue has already been addressed, but to reiterate: conflicts of interest are ubiquitous among journal editors. What is unusual in this case is that one of the sources of spousal COI is actually known. In contrast, most of us know very little about what, if any, COI issues exist regarding spouses or other family members of most bioethics journals (for the record, my wife is a public librarian). As we have already stated, Summer will have to recuse herself from any possible COI, including those that may arise out of the fact that her husband works for a stem cell company.  I do not believe that this will be hard and knowing the range of manuscripts that we typically review, it will be a minority of submissions. I will personally review all manuscript submissions (as will Summer) and no editor will be involved in manuscripts for which they have a COI. Since we have two co-EIC’s and two new Associate Editors, we believe that it should be relatively easy to divide any labor. To improve our management of COI issues and to update our now 10 year old COI policy, we are shortly going to be looking for volunteers among the three Editorial Boards to create a standing COI committee and charge them with helping to create guidelines and processes for better managing COI’s. We have actually been successfully managing conflicts of interest among ourselves for a long time (for example, an article was recently accepted that was written by one of my faculty) and there is no reason to believe that recusing Summer from reviewing the manuscripts where a COI exists can not be accomplished.
Going forward, Summer and I have a lot of exciting plans for AJOB. We plan on creating several committees (not just a COI committee) to explore ways of improving and expanding the journal and bioethics publishing generally. We also look forward to instating a business meeting for our Editorial Board at ASBH each year, a working meeting where we will update our board members on the state of AJOB, solicit their opinions, and hear reports from the committees we have created. These are but two ideas among many that we plan to institute. We have two new Associate Editors who have agreed to join us (we will send an announcement about this shortly). And we are excited about the opportunity to lead AJOB—the most cited journal in the field.
 David Magnus, PhD
Now, of these sorts of criticism, I have wielded only one, the fifth and last one, although I did point out in my initial post that the handling of the publication of the transition, its procedural steps and its background has been far from as open, professional and clear-cut as one would have expected from the leading journal of a flourishing field of research. Apart from not appreciating the impact on trust of the many serious mistakes that has been made in this process (by the former and/or the new management, by Taylor & Francis, and so on), David, I think, addresses several of the points of criticism fairly well. However, I do think that his take on the fifth still leaves much to ask for. What he says in so many words is this:

1. Yes, through Summer Johnson McGee's marriage to Glenn McGee, AJOB does have a clear-cut conflict of (vested) interest built into its editorial management, but that may very well be the case with other journals too!  

This hardly needs comment, does it? Imagine a prosecutor arguing thus: I have clear evidence to prosecute person P for the crime C, but since there are possible other individuals that might have been possible to prosecute for other crimes, had I only had the evidence, prosecuting P for C is out of the question. Case closed.

2. AJOB will be beefing up its organisation for handling the actualisation of the COI of Summer Johnson McGee (and other COI's that may appear) in particular cases, so that it does not wholly depend on the subjective judgement of the person attached to the COI, or other people of the editorial management, alone, but another three people recruited from the editorial boards of all AJOB journals.

This seems like a necessary minimal step given 1, but is it sufficient? Well, in the end this comes down to trust, doesn't it? My position here is rather like the one voiced by John Lantos: In the face of a journal that prefers to house and attempt to "manage" a serious COI in the midst of its highest management when it is quite possible to avoid it in the first place, I do not feel a tingling buzz of increased confidence and trust, rather the other way around. I, as I suspect most of my colleagues do, ask myself the obvious question: why does David Magnus make this far from necessary choice that seriously threatens the credibility of the journal? Why, for instance, does he not start with a clean editorial slate and manage the practicalities of the transition by engaging both McGee and Johnson McGee in temporary advisory capacities to this effect – naturally, rewarded to the extent that their high qualifications and competence require? The point here is not that there may be answers to these questions and that the string of follow-up questions and subsequent answers may go on for a long time. The point is that, from the point of view of the best interest of the journal, there are obvious strategies to avoid having these questions being actualised in the first place. Not choosing these from  the start undermines trust, and trust is what David Magnus above asks of all of us who care for the integrity of AJOB and the field of bioethics research. It doesn't add up, simple as that.

4 comments:

  1. I would suggest that there is not a "serious" COI issue facing the AJOB management, and that the steps necessary to managing a fairly normal transition of editorial responsibility are not particularly fraught nor would they normally require extensive public scrutiny. The current debate is a manufactured controversy over matters that would not ordinarily pose a problem.

    Whatever one may think about the propriety of Glenn McGee's relationship with CellTex, that is a matter for him to decide for himself. Its relationship to AJOB, or the supposed conflict it creates, is minimal. The number of articles the journal is likely to publish regarding CellTex is vanishingly low, and regarding commercialized stem cell technology in general is likely low as well. The simple process of referring editorial review of such articles to editors without familial connections to the industry, as Magnus describes, is both standard practice and easily manageable. To claim that Summer McGee is irredeemably compromised regarding any possible editorial role simply by being married to someone in the biotech industry is both unrealistic and unfair.

    I didn't understand Magnus's observation about the ubiquity of COI on journal boards to be a defense of COI in the case of AJOB. It merely frames the issue in a realistic way by pointing out that COI is common and handled as a matter of course in other venues, and that there is no reason to think it can't be so handled at AJOB. Taking his observation to be a claim that COIs should never be addressed is uncharitable.

    As to how open the AJOB editors should have been about their process of transition, that seems a rather strange accusation. Does the appointment of a journal editor normally require public comment? Journal management made their own decisions within their own areas of responsibility, came up with a workable solution, and announced it. Every informed comment indicates that the process was well-planned and coordinated. I don't see that anyone else is in a position to demand the right of review or approval.

    This would not be a controversy at all except for the fact that some critics have chosen to create one. Several academics and bloggers have made a concerted effort over the past couple of weeks to heavily criticize CellTex and Glenn McGee's relationship with it, then to use that issue to cast aspersions on the former and current editorial management of AJOB. Some have dragged in questions regarding deaths of patients in other countries using materials from CellTex's Korean supplier - an important issue, but irrelevant to the question of the editorial management of AJOB. Others have re-opened grievances regarding the infamous dexamethasone controversy that erupted in the journal in 2010, piling that onto their criticisms of McGee in the current instance. Whatever controversies one may perceive in the past, or involving outside institutions, should have no relevance to questions of the assignment of editorial responsibilities at AJOB – questions that in ordinary circumstances would be seen as minor and easily managed.

    Glenn McGee is a bioethicist of widely-recognized talents, and an even more widely-recognized propensity for attracting controversy in his managerial roles. But it seems evident to me that the current controversy, at least as respecting AJOB, is largely spillover from criticisms of McGee's behavior in avenues outside AJOB itself, and possibly not even recently. The only issue facing the journal is whether its management is capable of handling the various challenges to responsible decisionmaking that arise in the editorial role. All evidence indicates they are already doing so in the normal, and reasonable, manner. I don't think anything else is required, or should have been expected. That so many people are eager to heap so much abuse on the involved parties over what are actually fairly ordinary management issues and processes is testimony to how inflamed the incident has become.

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  2. As I said, it's a matter of trust. Your trust remains, Kevin, mine don't - as don't that of at least two rather heavy names on the AJOB editorial board.

    As I read it, you're one of those that wouldn't mind having a senior consultant of Merck or Pfizer as Editor in Chief of NEJM or Lancet - or their spouse, either, to use John Lantos analogy. That's where we disagree.

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  3. I don't think an issue of trust can fairly be raised here. Nothing has actually happened so far, other than the orderly transition of editorial responsibility. There are no grounds for withholding of trust.

    Glenn McGee has - on his own initiative - removed himself from the AJOB editorial staff; nothing involving his ongoing professional roles reflects on that organization. I think it's very unfair to presume that Summer Johnson McGee and the extended AJOB editorial board will not handle potential conflicts involving her husband's work with CellTex, or stem cell research generally, in the appropriate manner, similarly to the way such conflicts are handled in many cases in scholarly settings. And it would put an unsupportable burden on scholars whose spouses are involved in industry to insist that they are thereby unqualified for all positions of responsibility.

    As for the analogy you cite, Merck and Pfizer routinely sponsor research that is cited in major medical journals; CellTex to my knowledge does not and is unlikely to do so. The rare direct conflicts that may arise are easily manageable. At any rate, in this case, no officer of CellTex is involved with AJOB. The wife of such a person is, but that is another matter.

    This whole thing seems to me to consist of people repeatedly demanding to impose standards or principles that they have made up, which are not recognized in the field, to a situation in which nothing has actually gone wrong. The new AJOB editors are declared unfit on the basis of definitions of "conflict" that have not previously been applied in such a setting, absolute bans on participation are called for on the ground of particular, minor, and hypothetical conflicts in very limited cases, and demands for "transparency" are made by people who are not part of the AJOB management and would not be expected to be consulted on its doings.

    In actual effect, everything seems to be OK so far, and a policy has been announced for dealing with potential conflicts in the standard manner. That ought to be enough.

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  4. Well, Kevin, I don't think that anyone have made an argument in terms of fairness when trust has been mentioned in this case. People have simply declared that they have lost or lack trust, as a matter of fact. You may, of course, try to argue – for instance, by claiming the financial ties created by marriage to be "another matter" and thereby declare COI's to disappear via arrangements with spouse - that distrusting someone due to the existence of vested interests is unfair. Or that distrust with regards to arrangements taken to manage such a COI is unfair. However, in the case of an operation that depends on being trusted that is not very helpful in the face of actual distrust. I think that David Magnus' post also reflects this insight, although I believe that he does not draw the logical conclusion.

    So, unfair in your eyes or not, I think that you will have to live with the fact that in the eyes of several other people than yourself, some of which (now former) members of AJOB's editorial board, "everything" does definitely not "seem to be OK".

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