“The Lancet” on Health and Climate Change: A Tale of Editorial Bias

By Professor Timothy Florin and Dr Wes Allen

The public has every right to expect that scientific medical journals should impartially quest after truth. However, even the respected journal, The Lancet, has difficulty with maintaining impartiality when it comes to the subject of climate change. Who would have expected this?

We lay before you a tail of apprehended bias by its Editor-in-Chief, supported by an impotent ombudsman.

The story begins with a 35-page document on health and climate change, The Lancet Commissions (2015), which Dr Allen critiqued and sent to the lead author, Nick Watts. The Lancet has since published annually a Countdown Report on health and climate change.

In response to the November 2018 Countdown Report, Prof Tim Florin and Dr Allen wrote a letter to the Editor in December 2018, arguing that the authors of the Report lacked objectivity and rigour, and failed to properly apply the Precautionary Principle that they so lauded.

Our letter must have had some merit because it was accepted in January after a peer review process.

The fun and skulduggery by The Lancet was about to commence.

It is normal to publish a topical letter and author’s reply in one of the ensuing weekly issues of the journal. However, while the publication proof was approved by The Lancet shortly after acceptance, the letter was not published until 1 June. It apparently took that long for the Countdown Report authors to exercise their right of reply.

Of more concern, the approved proof for publication was altered without consultation by The Lancet: 16 numbers in the text, which pointed to references in the approved appendix, were removed for the eventual publication. This should never occur with ethical publishing.

While our short letter conformed to The Lancet’s required size specification for a topical letter, the Countdown authors’ right of reply was nearly twice the length of our letter, spurious and defensive, quoting Dr Allen’s earlier critique out of context, identifying Prof Florin and Dr Allen as members of Saltbush and quoting that out of context.

That this is a travesty of editorial practice, by what was once possibly a leading journal worthy of its proud name, is hardly contestable. However, there is more.

We raised our issues in a letter to the journal’s ombudsman, 6 June 2019. The final paragraph of the letter stated:

“It is of interest that the main thrust of our letter was to suggest that The Lancet’s high standard of objectivity was being compromised. This suggestion is now amply confirmed by the hatchet handling of our letter and the Report authors’ reply. Incidentally, the authors’ reply did little to address the main thrust of our arguments but focused largely on ad hominem attacks with regard to the related subject of climate change. The authors also quoted out of context (currently unpublished) work from one of us, clearly with a view to besmirch his name. Most of the large wordage of the letter in reply was neither directly relevant to the Report on health and climate or our points about lack of academic balance on that matter.”

22 June, we received: “I am the ombudsman’s liaison at The Lancet, and I’m writing to confirm that we have registered your concerns. In the first instance these are to be addressed with the Correspondence editor, and I understand you are in correspondence with her. Please do be in touch again with the ombudsman if your concerns are not resolved.”

A specialist editor with The Lancet, responded the same day:
“Thank you for your email. Please do submit a reply to the letter by Watts and colleagues, and the Editor in Chief and I shall read it carefully.

This looked like redress. A wrong was to be righted.

We followed instructions and submitted a second letter “Climate change and health: scientific rigour and the precautionary principle”. Then several weeks later, 8 September, we received the following:

“… the Editor in Chief has been on long-term sick leave. Richard Horton is now back, and after discussing your letter yesterday, we have agreed on a plan.

We will be inviting Nick Watts and colleagues (again) to respond formally but briefly to your letter, and we’ll publish the two together as soon as possible. … we are very concerned that your letter ends with a long list of un-referenced claims about the “radioactive pollution from producing neodymium from wind turbines”, and the “psychological damage, especially to young and vulnerable minds, from the use of fear…”. Rather than adding in these references – the existing ten references already exceeds the usual limit by far – I’d strongly recommend you remove these claims and form your final paragraph from the first and last sentence of that paragraph.”

In a spirit of true constructivism, we shortened our letter and kept references to the existing ten. We submitted the following letter –

“We appreciate the opportunity to respond to the Authors’ reply to our earlier letter1 in which we expressed concerns that the Climate Countdown Report 2018 compromised The Lancet’s high standard of objectivity by focusing entirely on the negative impacts of climate change on health.

“Rather than allaying our concerns, the reply reinforced them by ignoring our main points: the well-documented health benefits of a reduced diurnal temperature range due to warmer winter nights and the Gasparrini et al studies in The Lancet showing cold exposure to be far more lethal than heat exposure globally, and likely to remain so in most world regions, even without mitigation, adaptation or demographic changes.

“While advocating “objectivity and scientific rigour”, the reply sadly resorted to quoting unpublished material out of context, appealing to higher authorities such as the Bank of England, and ad hominem argument to impugn motives. It extolled “cheap renewable energy” to solve grievous fuel-poverty, but ignored the expensive infrastructure required to support intermittent sources; countries with the most have the dearest dispatchable electricity.2

“The authors’ “overwhelmingly negative” bias is evident in their statement that “any CO2 fertilisation effect will eventually be outweighed by heat stress, drought, and . . . a negative effect on grain quality.” Many studies show that higher CO2 levels mitigate heat stress3 and drought, 4 and improve some food qualities, 5 with most such studies employing 450-700 ppm. Negative impacts can be offset by varietal selection6 and nitrogen fertilizer.7 The authors seized on stalled wheat yields in Australia, due to drought, but ignored sequential record global yields8 and the IPCC statement that “there is low confidence in attributing changes in drought over global land areas since the mid-20th century to human influence”.9

“We acknowledge a human influence on climate but worry that the Report applies the precautionary principle without carefully weighing all pros and all cons in an objective and comprehensive cost-benefit analysis. We believe that we share the authors’ deep concern for the health of the environment, but a narrow focus on CO2 reduction policies has already resulted in air-pollution from the post-Kyoto push for diesel, deforestation for the production of biomass and biofuel, and significant environmental and social costs associated with the manufacture and life-cycle of some resource-intensive renewables and battery storage,10 as well as other negative impacts beyond the scope of this letter.

“1 Florin TH and Allen DW. Health and climate change. Watts N, Gong P, Campbell-Lendrum D. et al. Authors’ reply. The Lancet 2019; 393: 2196-97 (1 June)

“2 Mills MP. The “New Energy Economy”: an exercise in magical thinking. Manhattan Institute 2019. https://www.manhattan-institute.org/download/11934/article.pdf

“3 Gutiérrez del Pozo D, Gutierrez E, Pérez P. et al. Acclimation to future atmospheric CO2 levels increases photochemical efficiency and mitigates photochemistry inhibition by warm temperatures in wheat under field conditions. Physiologia Plantarum 2009; 137 (1):86-100. DOI: 10.1111/j.1399-3054.2009.01256.x

“4 Fleisher DH, Timlin DJ, Reddy VR. Elevated carbon dioxide and water stress effects on potato canopy gas exchange, water use and productivity. Agricultural and Forest Meteorology 2008; 148:1109-1122. https://doi.org/10.1016/j.agrformet.2008.02.007

“5 Levine LH, Kasahara H, Kopka J. et al. Physiologic and metabolic responses of wheat seedlings to elevated and super-elevated carbon dioxide. Advances in Space Research 2008; 42: 1917-1928.

“6 De Costa J, Weerakoon WMW, Chinthaka KGR. et al. Genotypic variation in the response of rice (Oryza sativa) to increased atmospheric carbon dioxide and its physiological basis. Journal of Agronomy and Crop Science 2007; 193:117-130. DOI: 10.1111/j.1439-037X.2007.00255.x

“7 Sultana H, Armstrong R, Suter H. et al. A short-term study of wheat grain protein response to post-anthesis foliar nitrogen application under elevated CO2 and supplementary irrigation. Journal of Cereal Science 2017; 75:135-137.

“8 Lyddon, C. Another record-breaking harvest. World-Grain.com 2016 (11 November) http://www.worldgrain.com/articles/news_home/Features/2016/11/Another_record-breaking_harves.aspx?ID=%7BF66FAB2BAE1E-40B6-95F7-A7F92CD9B379%7Dandcck=1.

“9 Bindoff NL, Stott PA et al. Detection and Attribution of Climate Change: from Global to Regional. In: Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA. Chapter 10: 871. https://archive.ipcc.ch/pdf/assessment-report/ar5/wg1/WG1AR5_Chapter10_FINAL.pdf

“10 Dominish E, Florin N and Teske S. Responsible Minerals Sourcing for Renewable Energy. Report prepared for Earthworks by the Institute for Sustainable Futures, University of Technology Sydney 2019: 38-43. https://www.uts.edu.au/sites/default/files/2019-04/ISFEarthworks_Responsible%20minerals%20sourcing%20for%20renewable%20energy_Report.pdf

17 September 2019, we received this reply.

“Thank you for the opportunity to consider your further submission relating to The Lancet Countdown on health and climate change.

After careful consideration, the Editor in Chief is not minded to publish this further exchange, and your letter is therefore declined.

I appreciate that this may be disappointing news; however this decision is final, and no further discussion will be entered into.

Best wishes,.. (signed the specialist correspondence editor)”

What can one say? What homily can this story deliver for the benefit of our society? The tale that we have told appears to demonstrate unethical behaviour by the long-serving Lancet Editor In Chief, Richard Horton. It would seem that the correspondence in this instance supports the aphorism that ‘the fish rots from the head down’. Reading between the lines, one can feel sympathy for the senior corresponding author.

The Lancet, which had a reputation second to none for lancing untruths, has demonstrated what can happen when a scientific journal becomes politicised.

Professor Timothy Florin (University of Queensland) holds an honorary position at the Translational Research Institute in Brisbane, Australia. Before retirement, he was an NHMRC Practitioner Fellow, Head of the IBD Service, and co-Leader of the Infection Immunology Inflammation Program at the Mater Research Institute, and Senior Staff Specialist at Mater Hospitals in Brisbane, Australia. He remains active in medical research.

Dr Wes Allen is a GP in northern NSW, a member of The Saltbush Club and the CO2 Coalition. He has published papers in the Medical Journal of Australia and Australian Family Physician, letters in The Lancet, and has critiqued publications on both sides of the climate debate, including The Weather Makers and Slaying the Sky Dragon. He produced a White Paper on Climate Change and Health for the CO2 Coalition. He has both PV solar and solar HWS on his home and no vested interests in any energy-related companies. He cycles to work and elsewhere but has no illusions about saving the planet with a low carbon footprint.

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