Update (September 20): The Cochrane Collaboration issued a statement yesterday (September 19) stating that the board’s decision is “not about freedom of speech” (emphasis Cochrane’s). Instead, “it is about a long-term pattern of behaviour that we say is totally, and utterly, at variance with [Cochrane’s] principles and governance.” In accordance with the organization’s rules, Gøtzsche for now remains a member, and has seven days to make a written response. “We will report back to you about the outcome as soon as we are able to,” the statement says.
The Cochrane Collaboration, a respected medical organization that conducts systematic reviews of research and helps guide clinical practice, has expelled one of its governing board members, Danish physician and Cochrane cofounder Peter Gøtzsche, STAT News reported yesterday (September 16). The grounds for the decision, which led to the resignations of several other board members who had voted against the move, have not yet been made public, but the resulting controversy has cast a cloud over the organization’s 2018 annual meeting, now underway in Edinburgh in the UK.
Gøtzsche, also the director of the Nordic Cochrane Center, has suggested that the decision was motivated by Cochrane’s disapproval of his challenges to the pharmaceutical industry and frequent criticism of the vaccines it manufactures. “As most people know, much of my work is not very favourable to the financial interests of the pharmaceutical industry,” he writes in a letter published online on Friday (September 14). “Because of this Cochrane has faced pressure, criticism, and complaints. My expulsion is one of the results of these campaigns.”
In July of this year, he and two colleagues published a critique of a recent Cochrane review of multiple human papillomavirus (HPV) vaccine trials. The organization’s review had concluded that prophylactic vaccines were safe and effective at preventing cervical precancer in young women. Gøtzsche and his colleagues argued in their paper that the review had failed to include key clinical trials, and was skewed by several sources of bias.
According to Hilda Bastian, another of the Cochrane Collaboration’s founders, Gøtzsche’s critique was itself flawed, STAT reports. She called the article “a hatchet job by people with several axes to grind,” in a blog post last month. “I would be surprised if Cochrane’s investigation and update resulted in changed conclusions.” Cochrane later issued its own statement supporting the original review and disputing Gøtzsche and his colleagues’ criticisms.
The expulsion of an elected member of the board has created heated debate among scientists, both within and outside the organization. Of the 13-person board, six voted in favor of Gøtzsche’s expulsion and two did not vote, STAT reports. According to a statement published on Saturday (September 15) on Cochrane’s website, four board members have since resigned as a result of the decision.
“We consider the Board’s use of its authority to expel Peter from Cochrane to be disproportionate,” wrote the four members in a statement, Science reports. “We believe that the expulsion of inconvenient members from the Collaboration goes against Cochrane ethos and neither reflects its founding spirit nor promotes the Collaboration’s best interests.”
In an email thread among experts in evidence-based medicine, Allen Frances, chair of the department of psychiatry at Duke University, writes that the debate has “nothing to do with freedom of speech,” STAT reports. “At least in psychiatry, Peter is anything but impartial,” he continues. “He consistently expresses the most extreme views in the most dramatic and misleading way. . . . As an individual, Peter has total freedom to express extreme opinions, but he has no inherent right to cloak them with Cochrane’s hard won mantle of neutrality.”