Silence flows downstream
You might think that a scathing book review (of a book that had otherwise been mostly favorably reviewed) by someone with a potential conflict of interest would be a prime example of trying to "silence science". But you would be wrong. It was the critics of the review who were the bad guys, At least that is the message of Silencing Science, a new book by Steve Milloy (of the Junk Science home page) and Michael Gough (director of science and risk studies at the Cato Institute). Here is how the case was presented in the book (page 38):
In December 1997 the editors [of the New England Journal of Medicine] turned on Jerry H. Berke, the author of a book review that appeared in the Journal.
The book in question claimed that chemicals in the environment are responsible for an epidemic of cancer. Book reviewer Berke criticized the book's lack of science supporting these claims. But he was also the medical director for a large industrial company.
According to journal editor Jerome Kassirer as reported in the Washington Post (December 28, 1997), "It's laughable that Berke thinks he could write an objective review of the book given that he was an employee of W. R. Grace."
But Milloy and Gough left out or distorted many facts.
1. The name of the book. Living Downstream: An Ecologist looks at Cancer and the Environment, by Sandra Steingraber.
2. The tone of the review (NEJM, November 20, 1997, page 1562). The review begins with an attack on environmentalists: "An older colleague of mine once suggested that the work product of an environmentalist is controversy. Fear and the threat of unseen, unchosen hazards enhance fund-raising for environmental political organizations and fund environmental research, he suggested." It ends with an assault on the book "The objective of Living Downstream appears ultimately to be controversy." In between Steingraber is described as "obsessed" and her book "biased" and "an environmental polemic." I would think that the tone of the review alone should have caused its rejection.
3. It appears that it is Burke, not Steingraber, who lacked science. Steingraber looked at numerous studies, and even Berke remarked that she "has analyzed an enormous volume of data" and that "She has obviously put forth an enormous effort of scholarship in compiling this work." Berke, by contrast, relied on a single study and an accompanying editorial. And even this study supported Steingraber's claim that cancer rates are increasing.
4. The editors of the Journal did not suddenly tarn on Berke, as Milloy and Gough seem to imply. According to a story in the Providence Journal Bueliten, a reader of the review became incensed, and checked Berke's background. The reader notified Bill Ravanes, who in turn wrote an essay with Paul Brodeur entitled ``Can the New England Journal of Medicine be up to the same old and long discredited tricks?'' and dispersed it on the Internet. This generated a great deal of publicity, and numerous letters to the journal.
The Journal's official response was low key. They printed a single letter (January 22, 1998, page 268) From Dr. Howard Frumkin that began "The review of Living Downstream, by Berke, appears to have violated the Journal's policy concerning conflict of interest. Beneath the book review Dr. Berke is identified only by what appears to be a home address, a common designation for a practitioner without institutional affiliations. In fact, Dr. Berke is (or was until recently) a senior official with W.R. Grace company, a prominent chemical manufacturer." This was followed by Berke's response: "When I reviewed Living Downstream, I was medical director of W.R. Grace. I was asked by the company not to represent my opinion as that of W.R. Grace. My book review represented my personal opinion and was not influenced by my colleagues at W.R. Grace." The letter gave W.R. Grace as the address. for Dr. Berke. Last came a note Dr. Robert S. Schwartz, the book review editor: "The Journal asks book reviewers to attest that they have no association that would present a conflict of interest. Dr. Berke listed himself as a "Private Consultant, Occupational and Environmental Medicine" and signed our form. After his signature, he gave W.R. Grace as his address, but this escaped my attention, and Dr. Berke subsequently deleted that address in the galley proof of his book review. We regret our error in asking Dr. Berke to review the book."
5. The issue of bias and conflict of interest is a complex one, especially with the funding of scientific research switching from the government to private industry. (See Journal fuels conflict-of-interest debate in the Boston Globe). In the extreme, a company can prevent (or try to prevent) the publication of research they funded if the results are unfavorable. This is what Boots Pharmaceuticals tried to do after a study showed that its drug Synthroid did not work any better than rival drugs (Silencing Science, pages 28-29). The company refused to give permission to publish, which was required in a provision in the original research contract. Only after a story in The Wall Street Journal and considerable public outcry was the study published.
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Written by Jim Norton
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