Dr Ben Goldacre argues scientists must be able to critique drugs and medical devices without the risk of losing their home in an expensive and time-consuming libel case
It’s common for lawyers to be dismissive of any special pleading for science in the libel reform movement: if you want to step out and make criticisms, they explain, you should be aware of their implications, and ready to defend them. It must be easy to assume, if you’re a lawyer, that everyone understands the rules of the game. Perhaps it all feels easier when you get a large cash sum for every six minutes you spend playing.
But in science, the assumptions and traditions are different, and with good reason. In science and medicine, criticising each others’ ideas and practices isn’t an aberration, or a special occasion: it’s exactly what you are supposed to do, all of the time, and with very good reason.
Medicine is almost unique among all human activities in that it’s possible to do enormous harm even when you set out with the absolute best of intentions, and there are many examples of this, even in mainstream healthcare. On paper, for example, it made perfect sense to give antiarrhythmics preventively, to everyone who’d had a heart attack, rather than just the people who had abnormal hearth rhythms: within a couple of years, to everyone’s surprise, it turned out that this practice had killed more Americans than died in the whole of the Vietnam war.
In medicine, when you make a mistake about whether something works or not, it’s possible to cause death and suffering on a genuinely biblical scale.
That’s why we have systems to try and stop us making such mistakes, and at the heart of all these lies mutual criticism: criticising each others ideas and practices. This isn’t something that’s marginal, or tolerated by the profession. It’s something that is welcomed and actively encouraged. More than that, it’s institutionalised.
Every week, in every academic institution in the country, you’ll find a “journal club”, where research past and present is laid bare and torn apart by eminent professors and first year students alongside each other. Almost every hospital in the world has a “grand round”, where a consultant and their medical team present a difficult case, to the entire hospital, and everyone debates what went wrong and why. The questions after a research presentation at an academic conference are often a blood bath, but this isn’t taken personally, because it’s normal, like some strange kind of consensual intellectual S&M: we do it because we know it’s good for us, and nobody threatens legal action.
In this BBC World Service documentary — made with the BBC Radio Science Unit, rather than Current Affairs – we explain why science is different, and why it is dangerous to have laws that restrict the everyday scrutiny of each other’s ideas and practices that scientists and doctors necessarily engage in.
Under the current libel laws, reading about cases like Peter Wilmshurst’s, Henrik Thomsen’s, Simon Singh’s and my own, scientists and doctors are increasingly aware that every utterance could have bizarre and unpredictable legal consequences; that even if you’re proved right, a case may still take years of working every evening and weekend, unpaid, and hundreds of thousands of pounds you cannot spare.
In science and medicine, mutual criticism has a massive societal benefit, because we all benefit from the way it makes medicine safer, but the burden of libel is shouldered entirely by individuals who are unprepared and often unprotected. You cannot reasonably expect scientists to be experts in the details of libel law as well as their own field, and you cannot reasonably expect people to constantly and unpredictably put their families’ homes at stake, just for doing the job we expect of them.
In my view, as a society, we have to choose. At the moment, we expect scientists and doctors to speak out when they see problems with other people’s ideas and practices, and unthinkingly, not even in the melodramatic sense of a whistleblower: it’s simply the job.
But with the law in its current state, doctors and scientists might be wiser simply to stop giving any view about any drug or health-related product that is marketed for commercial purposes, in any forum, and make it clear that from now on, decisions and utterances about efficacy should be made solely by the manufacturers, or only on very rare occasions, under tightly controlled circumstances, and after extensive legal review.
If that’s what we want, then we should leave the law unchanged, and communicate this fact clearly to all doctors and scientists: because we cannot expect them all to be expert defamation lawyers, and we cannot expect them to shoulder the burden of a law that is expensive, long-winded, unclear, unpredictable, and could destroy you in a moment.
Ben Goldacre’s documentary Science and Libel airs this morning at 10.32 on BBC World Service and is repeated later in the week
Goldacre is a doctor and scienctist, visit his website, Bad Science where he unpicking dodgy scientific claims made by scaremongering journalists, dodgy government reports, evil pharmaceutical corporations, PR companies and quacks.