The third shoe drops

Brian Deer's third and final installment on the Wakefield affair is out, and this time it's not about Wakefield -- it's about the editor of the Lancet, which published his fraudulent research, and executives of the Royal Free Hospital, where it happened. You can read it for yourself but the bumper sticker version is simple enough: when Deer confronted them with evidence of Wakefield's fraud, their immediate and only response was to deny the whole thing and cover it up.

That Wakefield perpetrated a fraud in order to get rich is not strange. People do that. But The Lancet's behavior, beginning with the editor at the time, Richard Horton, and continuing after his tenure, has been strange, in my view. They did not retract the article until the UK's General Medical Council completed its investigation in 2010, 6 years after Deer had first confronted Horton with his findings. They have had nothing more to say about it since. All of this discussion is taking place in rival journal BMJ, whose editor, Fiona Goodlee, has quite properly taken them to task. As of this moment, The Lancet has issued no comment.

In case you didn't know, The Lancet is arguably the world's oldest medical journal, founded in 1823, and perhaps the most prestigious. Responsible editors would have immediately responded to Deer's allegations with a full investigation and aggressively and forthrightly disclosed the results. Deer was ultimately found to be correct in every particular by the GMC, and The Lancet editors and Royal Free College dean could have established that for themselves quite readily just by looking at the medical records of the children in the fraudulent study. Instead, they let Wakefield investigate himself and pronounce himself innocent.

The Lancet was the victim in this originally, and could have earned respect and commendation for responding appropriately. Instead, they crossed over and became co-conspirators. Oh, by the way -- The Lancet has been owned by a for-profit corporation, Elsevier, since 1991. Not that there's anything wrong with that.