Whistleblowing in Medicine
The editorial in the last issue of Prometheus discussed retractions and announced that 40,000 journal papers a year were now being retracted according to the Retraction Watch blog. Ivan Oransky, its editor, has been kind enough to inform me that the annual figure is actually about 12,000 and I have been contrite enough to thank him and apologise for taking total retractions in the Retraction Watch database to be an annual figure.
This issue contains three research papers with themes central to the purpose of Prometheus. The first of these is an analysis of commercial stem cell clinics in the UK. This is a paper whose authors – doctors and researchers in the field – are concerned less that the private sector is profiting from stem cell technology than that the technology’s exploitation by private-sector clinics poses a danger to the public. One might ask why the paper’s authors, Megan Smith, Kate Goodheart, Claudia Fryer, Tomas Balcytis, Peter Wilmshurst and Patricia Murray, should choose Prometheus – hardly a medical journal – to express their concerns, but there are few obvious medical outlets for a paper analysing the exploitation of stem cell technology by private clinics. Medicine and medical organisations are surely dedicated to improving public welfare, and yet medicine offers the very conditions in which private benefit can be gained at public cost. As Prometheus has found, the cult of the expert is particularly powerful in medicine: what is correct is determined by the discipline’s experts and may not be challenged except by those same experts. It is perhaps not surprising such disciplinary compliance attracts modern managers able to contribute to medical authority all the values of the business school.
The paper’s corresponding author, Patricia Murray, professor of stem cell biology and regenerative medicine at Liverpool University, has previously written in such periodicals as the Telegraph and Private Eye about the inappropriate use of stem cell technology . She is a whistle – blower and has just been awarded the 2024 HealthSense Award for years of voicing her concerns over the misuse of stem cell technology, often by private-sector entrepreneurs with the complicity of the public sector. While one cannot help but admire the tenacity and sacrifice of whistleblowers, should they be encouraged? Why should what seems right to an individual be taken more seriously than the strategy of a whole organization? Why should an individual risk all by standing up to the organization?
The new book by Carl Elliott, The Occasional Human Sacrifice , sets whistleblowing in a medical context and its message is terrifying. We long to trust the organizations on which we depend. Where our trust proves unjustified, we look to regulation to control organizational behaviour, and then to government to control the regulators when they too fail. The system is cumbersome and often breaks down, driving whistleblowers to despair and ultimately to act, often with little prospect of changing anything and at great personal cost. Prometheus has had much to do with such whistleblowers over the years and our editors are well aware of what they go through: the organization seeks to squash resistance with bullying and ridicule; the whistleblower’s allies flee from trouble to express their loyalty to the organization; mediation is introduced not to resolve, but to punish and extinguish any lurking dissent; the continual threat of legal action depresses as it is supposed to do; and isolation fans self-doubt in the whistleblower. Isolation also denies the whistleblower the ability to discuss and argue. Academic publication, geared to produce metrics for private benefit rather than argument for public good, generally abandons whistleblowers, leaving them without an academic outlet for debate. Prometheus does what little it can to compensate for this deficiency.
Iacob Postavaru, Emilia Bunea, Crina Pungulescu and David Stolin undertake what many would consider an impossible task. They seek to use humour to teach economics. Not for nothing is Economics considered the dismal science, the very antithesis of humour. Nothing daunted, Editorial.pdf Prometheus 6 our brave authors have surveyed participants trapped in an Economics conference. They have asked participants to compare two short passages from each of three Nobel prize winners in Economics, one straight (and Economics has no trouble being straight) and the other rendered humorous by artificial intelligence. Does the injection of humour render Economics more interesting and thus more memorable? Well, yes, but not by much. Do have a look at ChatGPT’s three efforts to make the best in Economics fun. The best humour is often subtle: let loose on Economics, ChatGPT may be intelligent, but subtle it is not.
Gilles Grolleau, Naoufel Mzoughi and Marie Stadge enter the world of social responsibility initiatives. Much as commercial organizations admit to a responsibility to act in the interests of their communities, so universities (many of them also commercial entities, of course) are acknowledging their own social responsibility. Commercial organizations may see commercial advantage in promising to be socially responsible. Is this also the case with universities? While it may seem that universities have every incentive to make much of their service to the community, this paper suggests that they should think at least twice. The greatest danger would seem to be that their efforts will be perceived as greenwashing, particularly if they actually are greenwashing. But there are other dangers peculiar to universities, the most obvious being that attempts to serve the community may be at the cost of neglecting their core activities, teaching and research.
We also have a review essay in this issue, Emilio Mordini reviewing Anthony Elliott’s Algorithmic Intimacy: The Digital Revolution in Personal Relationship. Our reviewers are encouraged to adopt whatever style they find most comfortable in their reviews. Mordini has preferred to chat with Elliott, putting the reader in the position of bystander, or even eavesdropper. The effect is striking: the reviewer is no longer judge, but rather an equal of the author, and the reader is simply listening in to the exchange and making what he or she can of a conversation. Why, asks Mordini, or perhaps Elliott, are people normally protective of their privacy, but do not mind publishing almost anything about themselves online? Who could resist listening in on that? Brian Martin’s review of Sarah Landam’s Data Cartels: the Companies that Control and Monopolize our Information also takes an uncommon approach. Landam uses organizational examples to show what happens when so much information is controlled by so few: Martin adopts the same style by giving the example of (would you believe?) this journal. Prometheus has often been at the mercy of the information rich and powerful, but Martin is far too glowing in his tribute. He also agrees with Landam that the problem now extends beyond a cartel of publishers to a more powerful cartel still, one which collects, processes and sells information with little interest in the information itself or the use to which it will be put. Metrics is metrics, and metrics is money.
Lastly, we are to have a special issue titled Reimagining the Critical in Innovation Studies . We have not had a special issue in ages and this one looks particularly promising. The venture is being organized by Thanos Fragkandreas, Helen Lawton Smith and Theo Papaioannou. Details in the call for papers at the end of this issue.
Reference
Elliott, C. (2024) The Occasional Human Sacrifice: Medical Experimentation and the Price of Saying No , Norton, New York.
Stuart Macdonald
General editor
Prometheus Volume 40, Issue 1