In this public response to the smear campaign and
personal attacks on Richard Horton, The Lancet Editor-in-Chief, Lancet Complaint to Reed Elsevier, we assert:-
1. Richard Horton is highly regarded as an exceptional
leader in global health and as a campaigning Editor of The Lancet in the
best traditions of the Journal.
Richard Horton – Editor under attack from Zionists
2. Politics is intrinsic to many health issues and a
legitimate subject for health commentary and debate, especially in the world’s
leading global health journal. Controversy is an inevitable and healthy aspect
of public discourse on political issues.
This is what the Zionist Professors & Doctors are Happy With
3. The “Open letter to the people of Gaza” addressed an
important topical issue, the main points of which have been substantiated by
subsequent, independent, reports of what happened in the Gaza Strip in the
summer of 2014, of which it is possible that some of the complainants are
Richard Pepys is Knighted for Devotion to Mass Murder
4. To describe the Open letter as ”stereotypical
extremist hate propaganda” is inaccurate and unhelpful hyperbole.
5. The Lancet provided equal coverage of views
for and against the letter in subsequent published correspondence, reflecting
the ratio of letters received by the Journal and allowing a healthy debate to
6. The Lancet Ombudsman’s review of the issue was
balanced and fair, highlighting the strengths and weaknesses of the letter and
how the controversy was handled, for all to see. She was not persuaded that the
letter should be retracted.
7. The Committee on Publication Ethics (COPE) is best
placed to judge whether its Code of Conduct and Best Practice Guidelines have
been breached. A previous Chair of COPE has written that the Open letter should
not be retracted.
8. The heavy-handed attempt to force The Lancet
to withdraw the Open letter is the latest in a series of attempts to stifle
media coverage of the Israel-Palestine issue and should be resisted.
9. In the light of reports by Physicians for Human
Rights-Israel, Amnesty International, Human Rights Watch, the United Nations
and others, the “unfinished business” of Operation Protective Edge is to
determine whether and by whom, from either side of the conflict, violations of
international human rights and humanitarian law were committed.
15 April 2015
Scroll down to read the full response.
Professor Graham WattMD,
FRCGP, FRSE, FMedSci, Professor of General Practice, University of
Sir Iain ChalmersDSc,
FFPH, FRCP Edin, FRCP, FMedSci, Coordinator, James Lind Initiative,
Professor Rita GiacamanPharmD, MPhil, Professor of Public Health,
Birzeit University, occupied Palestinian territory
Professor Mads GilbertMD,
PhD, Professor of Emergency Medicine, UiT The Arctic University of
Norway, Tromsø, Norway
Professor John S YudkinMD, FRCP, Emeritus Professor of
Medicine, University College London, UK
Professor Emeritus Jarle AarbakkeMD, PhD, Former President (Rector) UiT The
Arctic University of Norway, Tromsø, Norway
Professor Adel Afifi MD, MS, Professor Emeritus, Carver College of Medicine,
University of Iowa, USA
Professor Rima Afifi, PhD, Faculty of Health Sciences, American University of
Professor Neil Arya MD, CCFP, FCFP, D Litt, Assistant Clinical Professor Family Medicine,
McMaster University, Adjunct Professor Family Medicine Western University,
Adjunct Professor Environment and Resources Studies University of Waterloo,
Professor Rajaie Batniji MD, DPhil, Clinical Assistant Professor of Medicine, Stanford
Professor Robert Beaglehole DSc, FRS(NZ), ONZM, Professor Emeritus, University of Auckland, New
Professor Espen Bjertness PhD, Head, Section of Preventive Medicine and
Epidemiology, Department of Community Medicine, University of Oslo, Norway
Professor Rolf Busund MD, PhD, Professor of Cardiothoracic and Vascular Surgery, UiT
The Arctic University of Norway, Tromsø, Norway
Professor Simon Capewell DSc, MD, Professor of Clinical Epidemiology, University of
Professor Phil Cotton MD, Professor of Learning and Teaching, University of
Professor George Davey Smith MD, DSc, FMedSci, Professor of Clinical Epidemiology, University of
Professor John A Davis MD, FRCP, FRCPCH, Emeritus Professor of Paediatrics, University of
Dr. James Deutsch, MD, PhD, FRCPC, Department of Psychiatry, University of Toronto, Canada
Judith Deutsch MSW, Faculty, Toronto Psychoanalytic Institute, Former
President Science for Peace (2008-2012), Canada.
Professor Abbas Elzein PhD, Associate Professor of Environmental Engineering,
University of Sydney, Australia
Sir Terence English KBE, FRCS, FRCP, Former President of the Royal College of Surgeons,
President of the British Medical Association and Master of St Catherine’s
College, Cambridge, UK
Professor Gene Feder MD, FRCGP, Professor of Primary Health Care, University of
Professor Olav Helge Foerde MD, PhD, Department of Community Medicine, UiT The Arctic
University of Norway, Tromsø, Norway
Professor Per Fugelli MD, Professor of Social Medicine, University of Oslo,
Dr. Miriam Garfinkle MD, Retired Community Physician, Independent Jewish
Emilio Gianicolo, Researcher of the Italian National Research Council,
Italy. Since September 2013, guest researcher at the University of Mainz,
Institute of Medical Biostatistics, Epidemiology and Informatics in Mainz,
Professor Gordon Guyatt PhD, Distinguished Professor of Clinical Epidemiology
and Biostatistics and Medicine, McMaster University, Canada
Professor Rima Habib PhD, MPH, MOHS, Faculty of Health Sciences, American University of
Professor Gudmund Hernes, Norwegian Business School, Oslo; Former Norwegian
Minister of Education and Research (1990-95), and of Health (1995-97), Norway
Professor Dennis Hogan PhD, Robert E Turner Distinguished Professor Emeritus
of Population Studies and Sociology, Brown University, USA
Professor Gerd Holmboe-Ottesen PhD, Section of Preventive Medicine and Epidemiology,
Department of Community Medicine, University of Oslo, Norway
Professor Anne Husebekk MD, PhD, Rector of UiT, The Arctic University of Norway,
Professor Tor Ingebrigtsen MD PhD, Hospital Chief Executive/CEO, The University
Hospital of North Norway, Tromsø, Norway.
Dr. Lars Jerden MD, PhD, Center for Clinical Research Dalarna, Sweden
Professor Jak Jervell PhD,Professor Emeritus, Honorary President,
International Diabetes Federation, Norway
Professor Ann Louise Kinmonth CBE, FMedSci, Emeritus Professor of General Practice, University
of Cambridge, UK
Professor Rebecca Kay PhD, Professor of Russian Gender Studies; Co-convenor
Glasgow Refugee, Asylum and Migration Network GRAMNET, University of Glasgow,
Professor Debbie Lawlor FMedSci, Professor of Epidemiology, University of Bristol,
Professor Jennifer Leaning MD, SMH,FXB, Professor of Practice of Health and
Human Rights, Director, FXB Center for Health and Human Rights, Harvard
Professor Emeritus Georges Midrè PhD, Department of Sociology, Political Science and
Community Planning, The Arctic University of Norway, Tromsø, Norway
Professor Alan Myers MD, MPH, FAAP, Professor of Paediatrics, Boston University School
of Medicine, USA
Professor Kaare Norum MS, PhD, Former president (Rector) University of Oslo,
Former Dean of Medical Faculty, University of Oslo, Norway
Professor Iman Nuwayhid PhD, Dean, Faculty of Health Sciences, American
University of Beirut, Lebanon
Professor Kate O’Donnell PhD, Professor of Primary Care Research and
Development, University of Glasgow, UK
Professor Ole Petter Ottersen MD, PhD, Rector of the University of Oslo, Norway
Professor Alison Phipps OBE, PHD, FRSE, Professor of Languages and Intercultural Studies,
University of Glasgow, UK. Co-Convener: Glasgow Refugee, Asylum and Migration
Professor Raija-Leena Punamaki PhD, School of Social Sciences and Humanities,
University of Tampere, Finland
Reem A Qadir MSW, RSW, A social worker with extensive work experience in
Individual and Family Therapy, Canada
Dr. Sara Roy PhD, Senior Research Scholar Associate, Center for Middle
Eastern Studies, Harvard University, Boston, USA
Professor Harry Shannon PhD, Department of Clinical Epidemiology and Biostatistics,
McMaster University, Canada
Professor Debbie Sharp PhD, FRCGP, Professor of Primary Health Care, University of
Dr. Angelo Stefanini MD, MPH, Scientific Director, Centre for International
Health. Department of Medical and Surgical Sciences, University of Bologna,
Professor Johanne Sundby PhD, MD, Department of Community Medicine, University of
Dr. George Tawil MD, Clinical
Associate Professor, Georgetown University Hospital, Washington DC. Past
president of the Medical Staff, Inova Alexandria Hospital, Alexandria,
Virginia. Past Chair, Medical Affairs Council, Inova Health Systems, Fairfax,
Professor Paul Wallace FRCGP, FFPHM, Emeritus David Cohen Professor of Primary Care,
University College London, UK
Professor Steinar Westin MD, PhD, Department of Public Health and General Practice,
The Norwegian Institute of Science and Technology (NTNU), Trondheim, Norway
Professor Salim Yusuf DPhil, FRCPC, FRSC, OC, Professor of Medicine, McMaster University, Canada
Professor Huda Zurayk PhD, Professor and previous Dean of the Faculty of
Health Sciences, American University of Beirut, Lebanon
The names of the 240 additional scientists, clinicians and
researchers who have co-signed this response since its publication can be
On 31 March 2015, 396 professors and doctors, led by Professor
Sir Mark Pepys, submitted a complaint to the Senior Management and Board of
Reed Elsevier concerning “egregious editorial misconduct at The Lancet
that is unacceptable in general and also gravely violates your own published
The signatories include 5 Nobel laureates, 4 knights and
a Lord. 193 (49%) of the signatories are from the US, 95 (24%) from Israel, 33
(8%) from the UK, 26 from France, 19 from Canada, 12 from Australia with
smaller numbers from Belgium (3), Brazil (3), Italy (2), Denmark (2), Mexico
(1), Panama (1), South Africa (1), Sweden (1) and Switzerland (1).
The complaint makes brief mention of The Lancet’s
publication of the paper by Wakefield, linking MMR vaccine to autism, which was
shown subsequently to be fraudulent, but is chiefly concerned with The
Lancet Editor-in-Chief, Richard Horton, and his alleged “persistent and
inappropriate misuse of The Lancet to mount a sustained political
vendetta concerning the Israel-Palestinian conflict, to promote his own well known
personal political agenda”.
The centre of the complaint concerns “An open letter for
the people of Gaza” by Manduca and 23 others, which was published online by The
Lancet on 22nd July and in hard copy on 2nd August 2014, 14 days into
“Operation Protective Edge”, Israel’s 50 day attack on Gaza.
The complainants consider that this letter, and The
Lancet’s handling of the controversy it aroused, breached both the
Journal’s own policies and the Code of Conduct and Best Practice Guidelines for
Journal Editors issues by the Committee on Publication Ethics (COPE).
The complaint ends by requiring “Reed Elsevier to behave
ethically by retracting the Manduca letter, apologizing for its publication and
ensuring that any further editorial malpractice at The Lancet is
Chronology of events
8 July 2014
Israel began a major military assault on the Gaza Strip,
the fourth in eight years. It lasted 50 days and was more devastating than
previous offensives. 2,220 Gaza residents were killed, of whom at least
70% were civilians, including over 500 children. More than 17,000
residents were wounded and over 100,000 made homeless (UN OCHAopt, 2014).
According to Israeli official accounts, 73 Israelis were killed: 67 soldiers
and 6 civilians, including one child and one migrant worker. 469 Israeli
soldiers and 255 civilians were wounded (Bachmann et al. 2014).
15-22 July 2014
A report cited by the Sunday Telegraph newspaper
records that 125 children were killed during the week 15-22 July 2014,
including 59 on 20th July.
22 July 2014
On the 14th day of Israel’s 50-day assault ‘An open
letter for the people in Gaza’, co-authored by 24 signatories from Italy, the
UK and Norway, was published by the medical journal The Lancet,
initially online and subsequently in print (Manduca et al. 2014a). One of the
signatories provided eyewitness accounts of the medical consequences for the
civilian population, while working clinically at the largest trauma centre in
Gaza during the first weeks of the assault. The letter was endorsed online by
more than 20,000 signatories.
9 and 16 August 2014
The Lancet published 20
letters in hard copy editions, divided equally between authors criticising and
supporting the Open Letter. Some correspondents declared that medicine
“should not take sides” and that those who speak out against the consequences
of war for civilians incited hate or introduced politics “where there is no
place for it” (see, for example, Konikoff et al. 2014). Others described the
letter as “anti-Jewish bigotry, pure and simple” (Marmor et al. 2014), although
at least one of the authors of the ‘Open Letter’ was Jewish, and the word
“Jewish” did not appear in the letter. Similar charges were made in the lay
press, both within Israel and elsewhere (see Simons 2014, for example).
One of the letters published in response to the ‘Open
Letter’ was co-authored by seven Jewish health professionals in South Africa
(London et al. 2014). They suggested that “remaining neutral in the face of
injustice is the hallmark of a lack of ethical engagement typical of docile
populations under fascism”. They had witnessed and exposed some of the
worst excesses of state brutality under apartheid, and had been harassed,
victimised or detained for being anti-apartheid activists. They pointed out
that they did not have the opportunity to air their views in their national
medical journal, which suppressed public statements made by concerned health
professionals and labelled such appeals for justice and human rights as
They expressed support for The Lancet’s decision
to permit a discussion of the professional, ethical, and human rights
implications of the conflict in Gaza, emphasizing that it is appropriate for
health professionals to speak out on matters that are core to their
30 August 2014
After 20 responses to the ‘Open Letter’ had been
published, its authors accepted The Lancet’s invitation to reply
(Manduca et al. 2014b). They denied any financial conflicts of interests, as
had been alleged, and listed the variety of experiences and affiliations that
had led to their support for Palestinian society.
They noted that the allegations by the Ministry of
Health in Gaza that gas had been used by the Israeli military would need to be
tested by an independent Commission of Inquiry set up by the UN Human Rights
Council. They ended by recalling the context in which they had written their
letter: during the preceding two days one Palestinian child was being killed,
on average, every two hours, and the UN had made clear how serious the
situation had become:
“The huge loss of civilian life, alongside credible
reports about civilians or civilian objects (including homes) which have been
directly hit by Israeli shelling, in circumstances where there was no rocket
fire or armed group activity in the close vicinity, raise concerns about the
principles of distinction and proportionality under international law.”
(OCHA oPt 2014)
22 September 2014
Some were dissatisfied with The Lancet’s handling
of the Open Letter. Two medical academics at University College London
registered complaints with The Lancet Ombudsman (Simons 2014). One of
them, Professor Sir Mark Pepys, was quoted in The Telegraph as having
written that “The failure of the Manduca et al. authors to disclose their
extraordinary conflicts of interest… are the most serious, unprofessional and
unethical errors…The transparent effort to conceal this vicious and
substantially mendacious partisan political diatribe as an innocent
humanitarian appeal has no place in any serious publication, let alone a professional
medical journal, and would disgrace even the lowest of the gutter press.”
Pepys suggested that the behaviour of Dr Horton, editor
of The Lancet, was “consistent with his longstanding and wholly
inappropriate use of The Lancet as a vehicle for his own extreme
political views, which had greatly detracted from the former high standing of
the journal.” (quoted in Simons 2014).
The article in The Telegraph also alleged that
two of the authors of the Open letter – one of them Chinese – have sympathies with
the views of “an American white supremacist” (Simons, 2014), following the
mistaken forwarding of emails, for which both individuals subsequently
When one of the authors of the ‘Open Letter’, the
Norwegian doctor Mads Gilbert, who has worked clinically in Gaza during every
Israeli assault on the Strip since 2006, was voted “Norwegian Name of the Year”
in a national poll in December 2014, Pepys and eight other doctors wrote to the
largest Norwegian newspaper, VG, to complain about his silence on the
‘loathsome hatred and racism’ of his co-authors. They asked for his national
award to be reconsidered (Cohn et al. 2015).
17 October 2014
The Lancet Ombudsman
published her report online on 17 October (Wedzicha, 2014). She said that she
had received many emails and letters, some supporting and others opposing the
position expressed in the ‘Open Letter’, and that some of them had been
inappropriate in tone and of a personal nature. She stated that it was
“entirely proper that medical journals and other media should seek to guide and
reflect debate on matters relevant to health, including conflicts”.
She was not persuaded by calls for retraction of the
‘Open Letter’, “I do not believe that sufficient grounds for retraction have
been established, and this would make other letters referring to the
publication in question difficult to interpret”.
The Ombudsman went on to address allegations of bias
among the authors of the ‘Open Letter’. “Given the shocking images and
statistics reported from Gaza at the time, the use by Manduca and colleagues of
emotive language, in description of the ‘massacre in Gaza’ for example,
can be understood. Where the letter is less successful is in its portrayal of
the armed element of the conflict on the Palestinian side. Given the authors’
close association with the region they will have been aware that several
thousand potentially lethal rockets and mortars were fired from Gaza into
Israel during the conflict, leading to loss of life.”
The authors were criticised for not having disclosed at
the time of submission “any financial or other relationships that could be
perceived to affect their work”, and she indicated that she would be asking the
journal’s editors to put a policy in place as soon as possible to rectify this.
The Ombudsman criticised the authors for not referencing in their original
letter the source for their statement about the possible use of gas in Gaza.
The Ombudsman’s most serious criticism of the letter was
the “regrettable statement” that, because only 5% of Israeli academics had
supported an appeal to the Israeli government to stop the military operation in
Gaza (Gur-Arieh 2014), the authors had been “tempted to conclude that…the rest
of the Israeli academics [had been] complicit in the massacre and destruction
“In summary”, the Ombudsman concluded, “the letter by
Manduca and co-authors was published at a time of great tension, violence and
loss of life. Given these circumstances the letter’s shortcomings can be
understood, as a measure of balance has been achieved by the publication of
further letters from both sides of the debate.”
3 November 2014
The Ombudsman’s decision to reject calls for the letter
to be withdrawn from the public record was supported by Dr Richard Smith,
former editor of the British Medical Journal, former chair of COPE and
author of COPE’s Code of Conduct for Editors (Smith 2014): The Lancet
letter was “passionate, overstated in parts, inflammatory to some, and one
sided; and the authors failed to declare competing interests and two of them
had acted in an objectionable but not illegal way. But none of these are
grounds for retraction.”
He ended his commentary on an historical note: “The
Lancet was made the great journal it is by Thomas Wakley, the founder and first
editor, publishing articles that were so inflammatory that his critics
burnt his house down. That radical tradition has not always shone brightly in
the nearly 200 years since, but Horton has restored it strongly, establishing
the Lancet as a world leader in global health, speaking truth to power and
giving a voice to those who are not heard (like the children of Gaza). It’s
against that radical tradition and leadership that the Gaza open letter must be
viewed. It should and has been disputed, but it shouldn’t be retracted.”
Contrasting views of journal editors
Editors have disagreed on whether political issues
should be addressed in scientific journals.
For example, the American Diabetes Association issued a
statement, signed by several editors of leading diabetes and endocrine
journals, indicating that they “will refrain from publishing articles
addressing political issues that are outside of either research funding or
health care delivery” (American Diabetes Association 2014).
In response, a commentary signed by the current and two
previous editors-in-chief of the European Journal of Public Health, one
of whom has longstanding and very extensive collaborations with Israeli
colleagues (McKee et al. 2015), voiced strong support for The Lancet,
arguing that medical journals cannot ignore the political determinants of
health, including those arising from conflicts. They noted, “It seems strange
that it was the diabetes community that feels it necessary to take this
decision,” noting how the global epidemic of diabetes, fuelled by forcing
markets open to energy-dense food, reflects a policy identified primarily with
Republicans rather than Democrats in the United States.
Following the Ombudsman’s Report
Soon after Israel’s 2014 assault, Physicians for Human
Rights-Israel (PHR-Israel) assembled a medical fact-finding mission (FFM) of 8
international medical experts, unaffiliated with Israeli or Palestinian
parties. Four had expertise in the fields of forensic medicine and pathology;
four others were experts in emergency medicine, public health, paediatrics and
paediatric intensive care, and health and human rights. The FFM made three
visits to Gaza between 18 August and November, 2014.
The principal conclusion in the report of the FFM
(Bachmann et al. 2014) is as follows: The attacks were characterised by heavy
and unpredictable bombardments of civilian neighbourhoods in a manner that
failed to discriminate between legitimate targets and protected populations and
caused widespread destruction of homes and civilian property. Such
indiscriminate attacks, by aircraft, drones, artillery, tanks and gunships,
were unlikely to have been the result of decisions made by individual soldiers
or commanders; they must have entailed approval from top-level decision-makers
in the Israeli military and/or government.
The FFM (pp 98-99) listed many examples “suggestive of
several serious violations of human rights and international humanitarian law”,
including disproportionality, attacks on medical teams and facilities, and
denial of means of escape. They also reported (pp 53-55) evidence which
suggested the use of anti-personnel weapons and gas during the conflict.
These accusations have also been made in reports by
Amnesty International (Amnesty, 2014), Human Rights Watch (Human Rights Watch,
2014), B’Tselem (B’Tselem – The Israeli Information Centre for Human Rights in
the Occupied Territories, 2015) and the United Nations (OCHA, 2014, 2015).
The FFM called on the UN, the EU, the US and other
international actors to take steps to ensure that the governments of Israel and
Egypt permit and facilitate the entry of investigative teams into Gaza,
including experts in international human rights law and arms experts, and noted
(in January 2015) that this had still not been done, months after the offensive.
Specifically, the UN Commission of Inquiry has been denied entry to Israel, the
West Bank and Gaza (See: United Nations Independent Commission of Inquiry on
the 2014 Gaza Conflict).
The FFM recommended further urgent and rigorous
investigation into the impact of this war, as well as the previous armed
conflicts, on public health, mental health and the broader social determinants
of health in Gaza, adding that, in its assessment, the implacable effects of
the on-going occupation itself would have to be taken into account.
There have been subsequent accusations by Amnesty
International of war crimes committed by both sides of the conflict (BBC 2014;
Further calls for retraction of the Open Letter
Dissatisfied with the Ombudsman’s report, critics of the
Open letter continued to call for it to be withdrawn and for The Lancet
editor to apologise for publishing it. In a new development, the authors of the
Open letter, and the journal, are being accused of being anti-Semitic. The
current complaint to Reed Elsevier now refers to the Open Letter as
“stereotypical extremist hate propaganda, under the selective and hypocritical
disguise of medical concern”. On 24 February 2015, its lead author Professor Sir
Mark Pepys wrote to 58 Israeli academics (Pepys, 2015):
The Lancet under the editorship of Richard Horton has
published, for more than the past 10 years, many disgracefully dishonest and
unacceptable articles about Israel. Horton has made no secret of the fact that
these pieces express his own very strongly held personal views which he has
published elsewhere in detail.
Last July, at the height of the Gaza war, The Lancet
published a piece by Manduca and others which was at an unprecedentedly low
level. It combines outright lies and slanted propaganda viciously attacking
Israel with blood libels echoing those used for a thousand years to create
anti-Semitic pogroms. It completely omitted the Hamas war crimes which
initiated and sustained the conflict. There was no historical or political
background. Crucially there was no mention of any conflict of interest among
the authors despite the fact that Manduca and all the co-authors have long
participated enthusiastically in not just anti-Israel but frankly Jew hating
activities. All these individuals are close colleagues and collaborators of
Many of us have been trying as hard as we can since the
Manduca publication to get it retracted, to get an apology for it and to
convince Elsevier, the owners of The Lancet to both sanction Horton and to
prevent any repetition of such shameful and unacceptable behaviour. So far
there has been no satisfactory response. Indeed Horton continues to stand by
the Manduca piece and refuses to accept that it is not factual and correct.
The goal of the attached protest to Elsevier document is
to get the [‘Open letter’] retracted. I hope that all of you will sign
it. Meanwhile colleagues at the Rambam Hospital have, as you know, invited
Horton to Israel and shown him the reality of Israeli medicine, as opposed to
the vicious anti-Semitic fantasy he has promoted. They have engaged in long
discussions with him. Despite his refusal to either retract or apologise for
his publications some colleagues are apparently convinced that Horton has
reformed. Others, including Professor Peretz Lavie, the President of the
Technion, who met with him for one and a half hours, were unconvinced by Horton’s
presumed change of heart.
My view is that the Manduca piece was written by
dedicated Jew haters, though some choose to mask this by being overtly
passionate only about hating Israel. But they all agree that a Zionist/Jewish
lobby or power group controls the world and its destiny and must be brought
down. The Manduca piece would have made Goebbels proud and Streicher would have
published it in Der Stürmer as happily as Horton published it in The Lancet……
anybody who was not a committed anti-Semite would firstly not have published
(the Open letter), and secondly would have retracted instantly when the first
author’s long track record of blatant anti-Semitism were exposed. In Horton’s
case he already knew and liked her and her co-authors well, fully aware of all
their vicious anti-Israel and frank, overtly anti-Semitic backgrounds.
Pepys’ text was distributed widely beyond the Israelis
to whom the initial text had been sent, including, on 30 March, to over 150
academics with the subject line amended to:
‘DO NOT CITE The Lancet in your work – Their content
includes fraudulent data’ (Lewis 2015).
As a result of this correspondence, 396 people have
co-signed the complaint, including the statement “The collaboration of the
academic community with Reed Elsevier and its journals is based on trust in
their maintaining high ethical and scientific standards. None of us is under
any obligation to submit and review material for publication in their journals
or to serve on their editorial or advisory boards”.
The long history of pro-Israel suppression of medical freedom of
The heavy-handed escalation of the dispute and the use
of ad personam charges of anti-Semitism to suppress freedom of expression in
medical journals are not new.
In 1981, a short article in World Medicine
informed medical readers who were considering attending the ‘medical olympics’
in Israel that the event was going to be held on the site of a massacre ordered
by the then prime minister of Israel (Sabbagh 1981). The pro-Israel protest led
eventually to the demise of the journal (O’Donnell 2009).
In 2001, pro-Israel objections to the historical
background in an article on ‘The origins of Palestinians and their genetic
relatedness with other Mediterranean populations’ published in Human
Immunology (Arnaiz-Villena et al. 2001) led Elsevier to remove it from the
In 2004, an article entitled ‘Poverty, stress and unmet
needs: life with diabetes in the Gaza Strip’ (Tsapogas 2004) published in
Diabetes Voice was expunged from the public record and the editor resigned,
again because of charges of political bias.
In 2004, there was an outcry from pro-Israel doctors
when the British Medical Journal published a personal view entitled
‘Palestine: the assault on health and other war crimes’ (Summerfield 2004). The
editor received nearly a thousand emails, many of them personally abusive and
alleging anti-Semitism (Sabbagh 2009).
In 2009, commenting on several British Medical
Journal papers exposing and discussing these issues, a senior British
Medical Journal editor concluded that authors, editors, publishers,
advertisers, and shareholders should ignore orchestrated email campaigns
(Delamothe 2009). Citing another editor he suggested that the best way to blunt
the effectiveness of this type of bullying is to expose it to public scrutiny.
The “Open letter to the People of Gaza” was written in
deep concern and outrage during a military assault on the Gaza Strip, killing
large numbers of civilians, including women and children, on a daily basis. The
world was shocked and appalled. The content and tone of the letter were
controversial, as shown by subsequent correspondence in The Lancet, for
The Lancet Ombudsman
criticised aspects of the letter but neither she nor a former Chair of COPE
considered that it should be withdrawn.
The involvement of 396 senior researchers in a mass
effort to force Reed Elsevier to withdraw the letter is the latest in a series
of heavy-handed interventions to stifle media coverage of the Israel-Palestine
issue and should be resisted.
Richard Horton should be supported as an exceptional
editor of The Lancet, in the best traditions of the Journal.
The “unfinished business” of Operation Protective Edge
is not whether the “Open Letter to the People of Gaza” should be retracted, but
in the light of reports by Physicians for Human Rights-Israel, Amnesty
International, Human Rights Watch, the United Nations and others, to determine
whether and by whom, from either side of the conflict, violations of
international human rights and humanitarian law were committed.
Will the 396 signatories of the complaint to Reed
Elsevier give their support to that objective?
Professor Graham Watt MD FRCGP FRSE FMedSci
Graham Watt has long term academic links with the
Institute of Community and Public Health at Birzeit University; has
post-doctoral colleagues working at Birzeit University and the University of
Hebron; chairs the steering committee of The Lancet-Palestinian Health
Alliance* and is a Trustee of the UK charity Medical Aid for Palestinians. He
did not sign the Open Letter for the People of Gaza.
Sir Iain Chalmers DSc FFPH FRCP Edin FRCP FMedSci
Iain Chalmers was employed by UNRWA in Gaza in 1969 and
1970, and has returned there (self-funded) at intervals since, most recently to
help support the development of Evidence-Based Medicine. He was a member of the
steering committee for The Lancet series on Health and Health Services
in the occupied Palestinian territory, and serves on the steering committee of The
Lancet-Palestinian Health Alliance*. He has supported the Gaza Oxford
Brookes University Scholarship scheme financially, and makes regular financial
contributions to Physicians for Human Rights–Israel, Jews for Justice for
Palestinians, Jewish Voice for Peace, together with other charities supporting
human rights. He is a co-author of the Open Letter for the people of Gaza.
Professor Rita Giacaman, PharmD, MPhil
Rita Giacaman is a Palestinian faculty member at the
Institute of Community and Public Health, Birzeit University and a member of
the steering committee of The Lancet-Palestinian Health Alliance*.
Professor Mads Gilbert MD PhD
Mads Gilbert is a member of the Norwegian Palestine
Committee and co-founder of Norwegian Aid Committee (NORWAC); has received
funding from the Norwegian Government for medical work in Lebanon occupied
Palestine; and has travelled to occupied Palestine, including Gaza, on various
medical missions with paid or unpaid leave from the University Hospital of
North-Norway for WHO, UNRWA, NORWAC, and the Norwegian Palestine Committee. He
has worked as a clinician in Al-Shifa Hospital during recent Israeli incursions
(2006, 2009, 2012 and 2014). He is a peer reviewer for conferences and
publications of The Lancet-Palestinian Health Alliance*. He delivered
testimonies for the Report of the International Commission to enquire into
reported violations of international law by Israel during its invasion of
Lebanon, to the “Goldstone Commission” and to the current UN Independent
Commission of Inquiry on the 2014 Gaza Conflict. He is a co-author of the Open
letter for the people of Gaza.
Professor John S Yudkin
John Yudkin is a peer reviewer for conferences and
publications of The Lancet-Palestinian Health Alliance* and a member of
its steering committee.
*The Lancet-Palestinian Health Alliance (LPHA) is
a loose network of Palestinian, regional and international researchers who are
committed to the highest scientific standards in describing, analysing and
evaluating the health and health care of Palestinians, to contributing to the
international scientific literature and to developing local evidence-based
policy and practice. The principal activity of the LPHA is an annual scientific
conference, selected abstracts from which have been published by The Lancet.
Arnaiz-Villena A, Elaiwa N, Silvera C, Rostom A, Moscoso
J, Gómez-Casado, Allende L, Varela P, Martínez-Laso J (2001). The origins of
Palestinians and their genetic relatedness with other Mediterranean
populations. Human Immunology 62:889-900.
London L, Sanders D, Klugman B, Usdin S, Baldwin-Ragavan
L, Fonn S, Goldstein S (2014). Israel–Gaza conflict. Lancet 384:e34.
Manduca P, Chalmers I, Summerfield D, Gilbert M, Ang S,
Hay A, Rose S, Rose H, Stefanini A, Balduzzi A, Cigliano B, Pecoraro C, Di
Maria E, Camandona F, Veronese G, Ramenghi L, Rui M, DelCarlo P, D’agostino S,
Russo S, Luisi V, Papa S, Agnoletto V, Agnoletto M (2014a). An open letter for
the people in Gaza. Lancet 384:397-8. http://www.thelancet.com/gaza-letter-2014
Manduca P, Chalmers I, Summerfield D, Gilbert M, Ang S,
Hay A, Rose S, Rose H, Stefanini A, Balduzzi A, Cigliano B, Pecoraro C, Di
Maria E, Camandona F, Veronese G, Ramenghi L, Rui M, DelCarlo P, D’agostino S,
Russo S, Luisi V, Papa S, Agnoletto V, Agnoletto M (2014b). Israel-Gaza
conflict. Authors Reply. Lancet 384:746.
Marmore BM, Spirt BA (2014). Israel-Gaza conflict.
Lancet 384:491. 23
McKee M, Mackenbach JP, Allebeck P (2015). Should a
medical journal ever publish a political paper? European Journal of Public
One of the world’s oldest and most venerable medical journals is under
attack from an international group of more than 500 doctors over its coverage
of the humanitarian disaster caused by the Israeli-Palestinian conflict.
TheLancet and its editor, Richard Horton, have been
targeted over what the group claims is the “grossly irresponsible misuse of
[the journal] for political purposes”. The controversy was sparked by an
article deemed to be critical of Israel’s conduct in Gaza.
The protesting doctors, including five Nobel laureates as well as Lord
Winston, the broadcaster and IVF pioneer, style themselves “concerned
academics”, and accuse the journal of publishing “stereotypical extremist hate
propaganda”. They also accuse the journal’s owner, the publishing firm Reed
Elsevier, of “profiting from the publication of dishonest and malicious material
that incites hatred and violence”.
The doctors threatened to boycott the journal if Reed Elsevier does not
“enforce appropriate ethical standards of editorship”.
Observers say it is the most serious threat to The Lancet and free
speech in academia since the journal’s first campaigning editor, Thomas Wakley,
faced a series of lawsuits after attacking the incompetence, nepotism and greed
of the medical elite shortly after it was founded 192 years ago.
The controversy has been triggered by an
article that appeared during the Israeli attack on the Gaza Strip in July 2014
Horton, who has edited The Lancet since the mid-1990s, has built it
into a widely admired beacon for global health. But his uncompromising approach
has made him enemies, especially among those who see him as a supporter of the
Palestinian cause. He established a Lancet-Palestine Alliance with academics in
the West Bank, to improve coverage of health issues in the region.
The trigger for the assault on his editorship was an article published last
July during the Israeli attack on the Gaza Strip, which included eyewitness
accounts of the medical impact on civilians but, controversially, did not
include an acknowledgement of Hamas’s role in the war.
“An open letter to the people of Gaza” provoked a fierce debate in The
Lancet’s correspondence columns, with some complaining it was “anti-Jewish
bigotry” and others that medicine “should not take sides”.
It later emerged that two of the signatories of the open letter had
circulated emails containing a video suggesting sympathies with an anti-Semitic
American white supremacist. Both apologised and Dr Horton also subsequently
apologised for the “offensive video” during a visit to Israel. But he did not
withdraw the article.
In October, the Lancet’s ombudsman investigated the complaints and
criticised the open letter but said this did not justify retracting it.
However, this did not satisfy the journal’s critics and the dispute has rumbled
The Lancet has been accused of using the
journal for “political purposes” (EPA)
In the latest and most serious development, the protesters, led by Professor
Sir Mark Pepys of University College London, mustered 396 professors and
specialists from around the world to sign a complaint which was submitted to
the board of Reed Elsevier last month. The complainants demand that the
publisher retract the open letter, apologise for its publication and ensure
“any further malpractice at The Lancet is prevented”.
They threaten an academic boycott of Reed Elsevier, which publishes over
2,000 scientific journals, if their demands are not met. “None of us is under
any obligation to submit and review material for publication in their journals
or to serve on their editorial or advisory boards,” it says.
A further 150 doctors have added their signatures since the complaint was
submitted on a website set up to co-ordinate the protest at concernedacademics.org.
In response, a rival group of 300 doctors, led by Professor Graham Watt of
the University of Glasgow, has rebutted the criticisms on their own website, handsoffthelancet.com.
They argue Richard Horton is “an exceptional leader in global health”, that
politics is “intrinsic to many health issues and a legitimate subject for
commentary” and dismiss references to “extremist hate propaganda” as “unhelpful
“The heavy-handed attempt to force The Lancet to withdraw the open letter is
the latest in a series of attempts to stifle media coverage of the
Israel-Palestine conflict and should be resisted,” they say.
On Wednesday, the Lancet’s international advisory board, comprising 19
professors, wrote to Reed Elsevier to express its “unreserved support” for Richard
Fiona Godlee, editor of the BMJ, which is to publish a commentary on the
dispute, said it had suffered similar attacks over its coverage of the
“Health is a deeply political issue. There is a long history, when
Israel/Palestine gets discussed, of the medium being attacked. I don’t think
that The Lancet should retract the open letter.
“Richard Horton has transformed The Lancet from a rather sleepy,
academic journal to put it at the heart of the global debate on health. Many
consider him heroic but in other respects he has upset people. This feels like
a settling of scores.”
No one from Reed Elsevier was available for comment.
Richard Horton has taken The Lancet back to its radical roots, speaking
truth to power, holding the powerful to account and giving a voice to those who
are not heard, like the children of Gaza. Most editors follow their readers,
but the way Richard has led on global health is extraordinary.
The 500 complaining academics remind me of the White Russians,
continuing to fight a battle that has been lost. The Committee on Publication
Ethics has ruled there are no grounds for retracting the open letter, as has
The Lancet’s ombudsman. Reed Elsevier, the journal’s owner, has sensibly stayed
silent to avoid compromising the editorial independence of The Lancet, its most
Have all the academics actually read the highly intemperate, sometimes
inaccurate letter they have signed? Academics should not be in the business of
stifling free speech and putting their name to such bad prose. Open and full
debate is fundamental to both science and politics, and the right response to
something that you disagree with is to encourage, not suppress, debate.
As John Milton wrote, “Truth was never put to the worse in a free and open
encounter… If it come to prohibiting, there is not ought more likely to be
prohibited than truth itself.”
Richard Smith is a former editor of the BMJ and a co-founder
of the Committee on Publication Ethics