Has the BMJ become a captured organisation? 

DURING the Tony Blair era it became common for politicians to tell us they ‘were passionate’ about their chosen issues of the day, a habit which grated upon many of us who try and approach difficult problems in a dispassionate way. 

Of course, we too are human and often fail to use purely dispassionate thought when arriving at opinions, but if we are to count ourselves as scientists, we need to be constantly aware of our feelings, biases and errors. We should also be open to changing our opinions on matters of fact whenever new data becomes available, or when better interpretations of data change the reading of it.  

On matters of human values and ideals we must, though, be free to hold and express opinions on what it means to live healthy, fulfilled or even happy lives. During the Covid-19 era it has become obvious that passionate, as opposed to dispassionate, thought has guided decision making by governments around the world.  I would argue that dispassionate scientific debate has been crushed during these times – and I passionately regret it.

The BMA states it represents, supports and negotiates on behalf of all UK doctors and medical students and that it is member-run and led, fighting for the best terms and conditions as well as lobbying and campaigning on the issues impacting the medical profession.  It is the pre-eminent trade union for the medical profession in the UK, as reflected in its name. But I wonder for how long?

A servant cannot serve two masters, but the BMA gives itself not only two, but multiple goals, international and national, and aims to influence policy. Unless it carries the majority of subscription-paying doctors with it, the crusading aspect of its work may alienate many of its current members. Most of these do not work in public health and many may disagree with population level restrictions which public health policymakers have called for, such as lockdowns, because they see more clearly the effects on individuals’ mental health, childhood development, loss of medical contact, et al, which I believe marks out these interventions amongst the greatest public health policy disasters in history. 

I now regard them as such for dispassionate scientific reasons – they did not work, but I was also passionately opposed to them in principle because they were experimental in a modern industrialised society and the precautionary principle should have precluded such experimentation.  

They also undermined the very respect for autonomy which most of us in the West have recognised as contributing fundamentally to quality of life and which many uniformed countrymen are still prepared to fight and die for. Its recognition is the basis for every medical intervention, after all. However, some recidivist but influential groups still call for more of these coercive lockdowns and appear to wish to co-opt the BMA and its daughter journal, the BMJ to support them.

The BMJ has committed to following the advice of the International Committee of Medical Journal Editors, which states that journal owners should not interfere in the evaluation, selection, scheduling, or editing of individual articles either directly or by creating an environment that strongly influences decisions. For the BMJ editor, Kamran Abbasi, to schedule a number of articles with Martin McKee, President of the BMA (the owner of the BMJ) who also happens to be a member of Independent SAGE, ­is therefore highly problematic.

While it is the prerogative of Independent SAGE to hold views on matters of principle, neither it nor the BMA should seek to suppress proper debate on Covid-19 policies by controlling the output of the BMJ.  As people, authors from Independent SAGE have a right to passionate political views, but it is dangerous, unwise and questionable to mix the BMA and Independent SAGE together. Mr McKee, a man who according to a BMJ article makes, ‘commentaries … infused with crusading zeal and a sense of social justice that brook no opposition’ also uses the BMA website to state his own political position on Brexit. As President of the BMA this is surely out of place?

Furthermore, on matters of fact, the BMJ must recognise that as it represents the voice of scientists, it will not be damaged by accepting lockdowns have been catastrophic for the lives of millions upon millions, if that is what data show. On the contrary, as a body providing a voice for scientists the BMJ can be damaged if it does not accept it should allow for open and honest debate. 

Ironically, however, Mr McKee has stated a personal pet hate includes ‘sycophantic interviewers who fail to hold them (i.e. politicians) to account’ while he also wishes to encourage those who seek to challenge the establishment. So, without any sycophancy Mr McKee, I am not the first, nor will I be the last, perhaps, to ask you to get your own house in order.

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Ian Comaish is a British trained ophthalmic surgeon with a keen interest in medical ethics and a strong desire to reduce suffering because quality of life is paramount.