The Journal of the American Medical Assn. recently published a very unusual article: a scientific study authored by a sitting president of the United States. That's never happened before.
In a sense, it's cool that President Obama cares enough about science to want to publish a paper in one of the world's leading medical journals. But JAMA has set a bad precedent. The article, on healthcare reform in the United States, is problematic not only in its content but in the threat it poses to the integrity of scientific publishing.
Let's set aside the debate on whether the specific numbers in the article are factual. (Of course, there is certainly room to question Obama's data. The president writes that "[t]rends in healthcare costs … have been promising," even though healthcare spending per capita continues to increase.)
Far more troubling is the president's tone, which is often self-congratulatory. "I am proud of the policy changes in the [Affordable Care Act]," he writes, "and the progress that has been made toward a more affordable, high-quality, and accessible healthcare system."
It would be difficult, if not impossible, to find another paper in any scientific journal in which a politician was allowed to subjectively analyze his own policy and declare it a success. This is a textbook definition of conflict of interest.
Moreover, despite the scholarly nature of this academic journal, the president seems incapable of resisting political rhetoric. He glazes over contentious details of the ACA with poorly substantiated claims. For instance, he writes, "For most Americans … Marketplaces are working." Are they? A majority of Americans want ACA repealed, while others would prefer a universal healthcare system.
Worse, when it comes to those who disagree with his ideas, Obama responds with petty jabs. After denouncing "hyperpartisanship," he then goes on to criticize Republicans for "excessive oversight" and "relentless litigation" that "undermined ACA implementation efforts."
One-sided commentary is perfectly fine for the campaign trail, but it has no place in a scientific journal, or in the scientific record alongside the discoveries of DNA and black holes. On the contrary, a good scientific paper devotes space to seriously considering the objections of other scientists. Failure to do so would often be grounds for rejection. Rather than ignoring or belittling opposing ideas, it is the author's job to convince his readers that his data and ideas are superior.
Obviously, JAMA held the president to a different, lower standard than it would an academic scientist. In fact, JAMA editor-in-chief Howard Bauchner admitted as much. In an interview with the Chronicle of Higher Education, he said that Obama's article was peer reviewed, but that he was allowed "a bit more flexibility because of who he is." He also acknowledged that "we don't fact-check every fact."
That's outrageous. Fact-checking is integral to peer review. Scientific publications earn their reputations by publishing only studies that hold up under intense logical and empirical scrutiny. The referees who administer this process will often reject an article outright or ask for months of painstaking corrections if they find even a small error.
It is neither ethical nor scientifically rigorous to bend the rules based on the identity of the author. Facts, not famous bylines, determine the quality and significance of a scientific study.
The bottom line is that the president of the United States patted himself on the back and mocked his political opponents in a highly prestigious scientific journal. No scientist or doctor would have been allowed to publish what he published. It is difficult to fathom what JAMA was thinking.
As a major voice in the medical community, it is within JAMA's best interest to stay out of politics. Otherwise, people, including doctors and scientists, may begin to tune out.
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