The Trouble with Medical Journals

It is a turbulent time for STM publishing. With moves towards open access to scientific literature, the future of medical journals is uncertain and unpredictable. This is the only book of its kind to address this problematic issue. Richard Smith, a previous editor of the British Medical Journal for twenty five years and one of the most influential people within medical journals and medicine depicts a compelling picture of medical publishing. Drawn from the author's own extensive and unrivalled experience in medical publishing, Smith provides a refreshingly honest analysis of current and future trends in journal publishing including peer review, ethics in medical publishing, the influence of the pharmaceutical industry as well as that of the mass media, and the risk that money can cloud objectivity in publishing. Full of personal anecdotes and amusing tales, this is a book for everyone, from researcher to patient, author to publisher and editor to reader. The controversial and highly topical nature of this book, will make uncomfortable reading for publishers, researchers, funding bodies and pharmaceutical companies alike making this useful resource for anyone with an interest in medicine or medical journals. Topic covered include: Libel and medical journals; Patients and medical journals; Medical journals and the mass media; Medical journals and pharmaceutical companies: uneasy bedfellows; Editorial independence; misconduct; and accountability; Ethical support and accountability for journals; Peer review: a flawed process and Conflicts of interest: how money clouds objectivity. This is a unique offering by the former BMJ editor- challenging, comprehensive and controversial. This must be the most controversial medical book of the 21st Century John Illman, MJA News Lively, full of anecdote and he [Smith] is brutally honest British Journal of Hospital Medicine * Please note that the reference to Arup Banerjee on page 100 of this book should be to Anjan Banerjee. We apologise to Professor Arup Banerjee for this oversight. *

Richard Smith, Chief Executive, United Healthcare Europe. Former Editor of BMJ and Chief Executive of BMJ Publishing Group

Introduction Introduction: medical journals are probably a force for good but need considerable reform The nature of medical journals Why bother with medical journals and whether they are honest? What and who are medical journals for? Can medical journals lead or must they follow? What are and what should be the values of medical journals? The processes of pubishing medical research The complexities and confusions of medical science Peer review: a flawed process at the heart of science and journals Problems in publishing medical research Research misconduct: the poisoning of the well The death of the author and the birth of the contributor? Publishing too much and nothing: serious problems not just nuisances Conflicts of interest: how money clouds objectivity Editorial misconduct, freedom and accountability: amateurs at work Important relationships of medical journals Patients and medical journals: from objects to partners Medical journals and the mass media: moving from love and hate to love Trying to stop failing the developing world Medical journals and pharmaceutical companies: uneasy bedfellows The highly profitable but perhaps unethical business of publishing medical research Ethical accountability of researchers and journals Relations between research ethics committees and medical journals: guarding the probity of research Ethical support and accountability for journals: an ombudsman, an ethics committee, and next? Libel and medical journals: proper constraint or against the public interest? The case that concern with ethical issues in publishing medical research is overdone The future Ethical manifestos for four different futures for medical publishing References

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