No place for this

No place for this

Now everyone knows that Diabetic Investor isn’t shy when it comes to getting in the middle of controversy. For the past 20 years we have witnessed some truly wacky things happen and have done our best to provide all sides to a story. A perfect example would be when Avandia came under attack by our good friend that crusading cardiologist Dr. Steven Nissen. Like it or not this attack prompted the FDA to make major changes to how they approve diabetes medications. Like it or not this attack also has changed the very nature of diabetes management.

Yet this attack on Avandia for better or worse did prompt some very serious discussions in the diabetes community among all stakeholders.

However the Avandia controversy doesn’t hold a candle to the latest diabetes controversy, a controversy that honestly has no place in the wacky world of diabetes. For reasons only known to The Lancet, a highly respected medical journal, the editors decided to publish a letter on the most volatile subjects the Israeli Palestinian conflict.  (

Now before everyone gets on their high moral horses a few quick thoughts. Diabetic Investor by no means would suggest that this conflict should not be addressed. Had this letter appeared in the New York Times, Wall Street Journal or London Times we would not have an issue. Whatever one’s feelings are on this tropic this is America and people have fought and died so we can have something called Free Speech.

What Diabetic Investor does not understand or forgive is why The Lancet decided to publish this letter. Why would a highly respected medical journal become embroiled in such a passionate issue which has nothing to do with medicine.

Making matters even worse was the very one-sided nature of this letter. Had the authors presented a balanced perspective, one that gave the Israeli point of view then The Lancet might, and that’s a very small might, have a leg to stand on. The authors concluded their biased letter with the following paragraph;

“We register with dismay that only 5% of our Israeli academic colleagues signed an appeal to their government to stop the military operation against Gaza. We are tempted to conclude that with the exception of this 5%, the rest of the Israeli academics are complicit in the massacre and destruction of Gaza. We also see the complicity of our countries in Europe and North America in this massacre and the impotence once again of the international institutions and organisations to stop this massacre.”

Perhaps the authors missed the point and the reason only 5% of their Israeli colleagues signed the appeal was that the 95% who didn’t sign believed that physicians should stick to practicing medicine and leave politics up to the politicians. While we have no problem with physicians speaking out on any issue we have a huge problem when a publication endorses a biased unbalanced view which is exactly what The Lancet did when they decided to publish this letter.

Polite thanks but no thanks would have been the correct course of action. The Lancet could have easily said there is no place for unbalanced biased letters in a medical journal. Using the convoluted logic of the authors of the letter we could state that The Lancet holds the same unbalanced biased views as the authors.  That this once respected medical journal agrees with these views and wanted to provide the authors with a broader forum to express them.

Over the weekend Diabetic Investor received an email from Dr. John Buse, one of the most respected diabetes researchers on the planet, a man who has an impeccable reputation. Dr. Buse writes: “Over a month ago I wrote to Elsevier, the publisher of The Lancet to encourage them to develop an editorial policy that avoids the entanglement of their science journals in political issues as it is by nature divisive while science seeks to be integrating.  Science journals are not Time or Newsweek.  There are more appropriate venues for political discourse. And news magazines do have editorial policies about balanced treatment of issues and I suspect most would not have published that letter. Similar requests to Elsevier have been pressed by many colleagues before and since and on numerous occasions by me in the last weeks. There has been no public action by Elsevier. Politics outside of health and science policy simply has no place in science and medicine. “

He goes onto to state the following;

“Though it pains me greatly, in order to make the point as clearly as I can, today I have:

1)      resigned from the editorial board for Diabetes Research and Clinical Practice,

2)      resigned from the editorial board for Lancet Diabetes & Endocrinology,

Further, I pledge with regret that until this issue is resolved to my satisfaction:

1)      I will not subscribe to, submit articles to or review articles for any of Elsevier’s 2952 journals (list available here:;

2)      further, I will try not to reference articles published in their journals in my future writing;

3)      I will withdraw my name from publications under review with their journals and encourage my coauthors to withdraw the publications from review; and

4)      I will not purchase any of the ~25,000 Elsevier books, complete the book chapters that I have in process (specifically the Williams Textbook of Endocrinology) or agree to participate in other books published by Elsevier.

I would encourage you to:

1)      contact Mr. Reller, Vice President for Global Corporate Relations at Elsevier (copied here), and

2)      reach out to your friends and colleagues to make sure that they are aware of this issue and suggest that they also consider at least communicating their concerns if not acting.”

Diabetic Investor not only agrees with Dr. Buse we applaud his actions and encourage others to do the same. The simple fact is there is no place for non-medical political issues to appear in any medical journal. As Dr. Buse notes there are better more appropriate forums for this highly charged debate. Neither Dr. Buse nor Diabetic Investor believes that public debate of these issues should be censored, quite the opposite. However The Lancet has no business in politics and should follow the lead of the 95% of physicians who did not sign the appeal.  Leave politics to the politicians and get back to practicing medicine.