Deer  British Medical Journal  Wakefield

The Full Monty: a Review of Brian Deer and British Medical Journal’s Competing Interests in the Wakefield Affair

Artwork by Adriana Gamondes

By John Stone

The following observations are in response to Media Scholar’s query about Brian Deer’s competing interests ( Age of Autism Comment by Media Scholar).

Deer does not disclose the support he received from MedicoLegal Investigations (an outfit allied to the Association of the British Pharmaceutical Industry which specialises in getting doctors before the GMC) in 2003-4 (MedicoLegal Investigations ).

It also looks as if BMJ (with its annual pharmaceutical award ceremony) has begun to take a relaxed view on hospitality. I suspect this goes back to policy decisions made in 2008 when a senior BMJ editor Tony Delamothe wrote to me:

"I can see why you think the sponsorship of his award is relevant, but it's hardly Goldacre's fault that an outfit that has made the award has pharma sponsorship. The BMJ Group is about to start an awards programme of its own and some of the awards will be sponsored by pharma companies. If we were to give you the Medical Communicator of the Year Award (let's say, for the point of argument, sponsored by Novartis) it wouldn't bring everything you've said into question."

But only a year before they had published an attack by Goldacre on such patronage and allowed comment (BMJ Goldacre comment). The first 2009 BMJ awards took place without pharma patronage, but it is clear from Delamothe’s email that the they were already in August 2008 making plans for the 2010 awards which included sponsorship from Merck and GlaxoSmithKline. It is against this background that they refused to post correspondence from me earlier this year pointing out that Deer was a guest at a pharma/GSK sponsored conference in Baltimore last November: no doubt he was a key-note speaker (GSK Conference Features Brian Deer and actox.org Brian Deer).

After much argument and a certain amount of circumlocution Deer does disclose his dealings with the GMC in 2004-6. BMJ editor-in-chief, Fiona Godlee, to her discredit refused to take action on this non-disclosure last year but seems to have bitten on the bullet in January, but of course the problem remains that he did not disclose the conflict to Sunday Times readers and Channel 4 viewers at the time  – obviously a case of  “what the journalist didn’t tell you” (Age of Autism Godlee Must Go ).

Deer’s funding from BMJ is disclosed, but not as a competing interest. Furthermore, while BMJ quietly acknowledged its competing interests regarding their award ceremony (BMJ competing interests, BMJ Wakefield Article with correction and BMJ correction to Godlee) their disclosure still doesn't acknowledge BMJ's business partnership with Merck via BMJ Learning and Univadis. And quite outrageously none of this information is available to anyone visiting Deer's articles on-line, although it is plainly relevant information.

Then, of course, there is the issue of Harvey Marcovitch as BMJ editor signing the journal's allegations of fraud against Wakefield, on the basis that he was not doing it in his capacity as head of GMC panels and also not mentioning his association the United Kingdom Research Integrity Office (UKRIO) (Age of Autism Harvey Marcovitch ).

Lastly, mention should be made of  editor Fiona Godlee's long term commitment to suppressing debate on vaccine safety about which she declared her colours just prior to being appointed to her  editorship of BMJ in an address to British National Formulary (Age of Autism Fiona Godlee Has an Agenda )

It seems to me that BMJ not only fail in the detail they completely fail in the spirit of disclosure.

This is the text of Deer’s disclosure from January (BMJ Deer disclosure):

'Funding: Brian Deer’s investigation was funded by the Sunday Times of London and the Channel 4 television network. Reports by Deer in the BMJ were commissioned and paid for by the journal. No other funding was received, apart from legal costs paid to Deer by the Medical Protection Society on behalf of Andrew Wakefield.'

'Competing interests: The author has completed the unified competing interest form at www.icmje.org/coi_disclosure.pdf (available on request from him) and declares no support from any organisation for the submitted work; no financial relationships with any organisation that might have an interest in the submitted work in the previous three years; BD’s investigation led to the GMC proceedings referred to in this report, including the charges. He made many submissions of information but was not a party or witness in the case, nor involved in its conduct.'

'Provenance and peer review: Commissioned; externally peer reviewed.'

John Stone is UK Editor for Age of Autism.