11 September 2010

Another apparent case of trying to intimidate and censor an independent researcher who published an unpopular result

I am not quite sure what the full story is, because I am just going on what was written in an article in the Toronto local newspaper and I am a bit hesitant to ask the principal for an interview (the reason will become clear).  The article recounts how anonymous actors tried to harm the career of David Colby MSc MD, apparently because he wrote a couple of reports that declared that there was no health risk to local residents from Wind Turbines.  Colby's is the Medical Officer (a quasi-governmental appointment as part of the health system, but close to academia in terms of not taking away one’s independence) for a jurisdiction in western Ontario near Detroit USA.  He is also an associate professor at University of Western Ontario, though I am not sure if he is a "real" professor (he does not have a doctorate) or just one of the many clinical trainers at health science programs that get an academic title.  The point is not the specifics of his titles, though, but that he is an independent researcher who speaks only for himself, and thus has the right to do what research he wants and report whatever conclusions he honestly believes his research supports.

The newspaper article portrays the controversy about wind power following the usual mainstream media approach of trying to make complicated scientific and political controversies sound like football matches (or in this case a tennis match, because it portrays it as a one-vs-one battle with another Ontario professor who takes the other side.  (Bob McMurtry, the opponent in the tennis match, also reports hostile reactions to his conclusions -- which are quite similar to my own, and he has invited me to speak at a conference he is hosting on the subject -- but no apparent attacks on his scientific freedom.)  But the details of the article I can verify seem accurate, so I am inclined to believe what was reported.

Colby was the first author of the North American wind energy industry's major report on health risks, a report that I critiqued at some length.  Before that he did a similar analysis for local authorities in his area.  He also apparently accepted an honorarium to give a talk at an industry conference (a sum that was reasonable if he had to do much work for it, though generous if it was a reward for just showing up at a meeting -- the article does not make it clear).  In any case, there was nothing wrong with him doing it but, according to the article, it was this talk and honorarium that was the basis for "someone" -- presumably cowardly hiding behind a veil of secrecy since the article did not offer any further identification -- trying to cause his medical license to be taken away.  Of course, “someone” would not have cared at all about him giving a talk to people who already agreed with him or them paying him for it, and so was undoubtedly really trying to punish him for his published reports.

Fortunately the relevant committee dismissed that attack as groundless.  His cowardly attacker apparently filed an appeal, though, which is pending.  But, according to the article:
The committee did offer one caution that grates on Colby and has been seized upon by those opposing wind turbines: "Colby's expertise is in medical microbiology and infectious diseases, an area quite distinct from audiology or other fields related to the physical impact of wind turbines on human health. Thus, the committee wishes to remind Dr. Colby, going forward, of the importance of fully disclosing the extent of his qualifications in a field in which he has been retained as an 'expert.' "
I found myself absolutely appalled upon reading this, for several reasons.  Importantly, a belief that Colby and his coauthors did good work or genuinely have the expertise to have written what they did is not one of them.  When I was asked to evaluate the scientific quality and accuracy of the North American industry report, what I wrote is the type of thing that puts the word "savaged" in the critical review vocabulary:
It is notable that the Colby et al. panel did not include any population health researchers, even though the question they claim the report addresses is one of population health.  Their expertise seems to be limited to the relevant physical sciences and clinical medicine.  ....  Some clinicians are trained and qualified population health scientists, but there is no evidence that those who participated in the Colby panel have such expertise.  Unfortunately, it is often the case that physicians who may be quite skilled in their clinical abilities do not recognize that population science requires an entirely different set of skills.  ....  [The section that addresses epidemiology in] the Colby report exemplifies the lack of expertise in population health science.  It is difficult to make this clear without seeming petty, but this section reads like it was written by someone who took a single class on how to understand epidemiology, and half understood the material.
Nevertheless, someone trying to take away his medical license is very much like the intimidation and attempted censorship that I (for daring to question the anti-tobacco extremist orthodoxy) and Jim Enstrom (for two different bits of his work) suffered.  And the scolding from the medical committee is equally absurd.  Someone does not lose his right to become an expert on and provide analysis of another substantive area just because he knows something about infectious diseases.  (I speak from the perspective of a repatriated American, but even Canada protects free speech to this extent.)  By that standard, we would not have many people writing about tobacco harm reduction in North America since our original training includes infectious disease epidemiology (Heavner), as well as oral pathology (Rodu), information science (Bergen), and environmental economics (Phillips).  If someone wanted to assess on his merits whether Colby was not really an expert, that is fine -- I certainly did so -- but there is no evidence they did that.

I have to admit some sympathy with the "stick to your own expertise" attitude.  But the real problem is not expanding one's area of topical expertise, but rather that when most physicians, regardless of specialty, are asked to comment on epidemiology (or at least any epidemiology that involves data that is more complicated than a simple clinical trial) they are wading into territory they are not expert in.  But because medical training includes teaching people to pretend certainty about everything they know a bit about, and they start to believe their own rhetoric, physicians seldom seem to know they are not experts.  On average they are probably better at epidemiology than the average educated person, but still only qualify as educated consumers of it, not able to produce quality research let alone evaluate the evidence.  But threatening their medical licenses because they are mediocre scientists makes about as much sense as trying to prevent me from doing scientific analysis because I did a bad job of applying a bandage or misdiagnosed why my shoulder hurts so much.  I am a mediocre medic and they are mediocre analysts of science -- that does not mean either of us is bad at what we are really expert in.

More generally, trying to punish someone for exceeding their officially-approved expertise is a very scary behavior.  Do we really want quasi-governmental authorities deciding who is qualified to carry out particular scientific analyses (and who is forbidden from doing so)?

This is especially true when the real solution is rather obvious:  First, the health press, regulators, and everyone else need to get a clue that most physicians do not have very much expertise in populaton science that is any more complicated than a randomized trial (and even then the average physician is pretty sketchy).  It is not their job to understand public health science, and they are generally not trained in it.  I suspect that the average field biology researcher would be better at it, and there is no doubt that the average economist would -- public health research looks a lot more like economics than it looks like clinical medicine.

[Note:  I apologizing for insulting my readers with this caveat, but I have a feeling someone is going to blow a gasket if I don't help them out with the logic:  This is not to say that there are not people who happen to be physicians who also happen to be educated in population science and have practiced it enough to be good at it.  Being a physician does not prevent someone from also being a good scientist.  There are quite a few good scientists among physicians, and the best of them are among the best epidemiologists I have known.  My experience is that medics who take the time to study epidemiology are generally much better than average students in the field.  It is just that most physicians are not scientists (beyond the engineering science that is part of clinical practice) and most of the best public health scientists are not physicians.]

Second, health science oriented reporters and regulators need to become educated enough to understand the difference between a genuine scientific critique and someone just saying "nuh uh! he's wrong because his side is evil!" (or retain some consultants who have that education).  To my knowledge, no one has ever written anything that is even a prima facie case disputing the legitimacy of Enstrom's controversial studies or any of my work on tobacco harm reduction.  I would like to think that any reporter or regulator, upon hearing someone dismiss our analyses, could ask "what is your scientific basis for that conclusion, and you must answer without using any phrase like ‘there is a general consensus that….’."  In Colby's case there would be a response to that (the detailed content of my report or others').  Perhaps at that point the questioner would be over his head and not be able to assess which of the competing analyses was right, but this is quite different from cases where there is not even a competing analysis.

It is kind of interesting that in all of the cases I have mentioned here, it is the self-styled enforcers of the health promotion orthodoxy that have tried to censor research.  You hear a lot about industry trying to intimidate and censor research it does not like, and I am sure it happens in some areas, but I have not heard of the tobacco industry (the Enstrom and Phillips cases) doing any such thing for decades, nor the diesel industry (Enstrom case) though I am not so familiar with that, nor the wind energy industry (Colby and Phillips cases).  Even though the wind energy industry has repeatedly tried to deny the existence of evidence it does not like, and has not actively supported the research that it is morally obligated to do (indeed, acting so unethically as to declare that research should not be done even as it asserts scientific opinions that could easily be tested), at least it has not launched any inquisitions.

In any case, should the opportunity ever present it, I would offer a fierce defense of Colby's right to do the work he did and present the conclusions he did, though I somehow doubt he is going to ask me for my support.

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