The Journal Ombudsperson:  A Step Toward Scientific Press Oversight FREE

AT THE 1994 Peer Review Congress in Chicago, Ill, Altman and colleagues¹ presented a bleak and disturbing assessment of editorial practice and called on medical journal editors to "explore possible procedures for allowing authors' grievances to be heard and for possible sanctions if complaints are upheld." They cited 3 instances in which editors had clearly breached accepted standards of behavior. In one case, an editor reprinted a complete article in his journal without seeking the author's permission. In a second example, an editor commissioned a review and sent galley proofs, but then published a similar review, with identical passages although different authors, several months later. Finally, an editor sent a paper reporting adverse events of a drug to a reviewer at the pharmaceutical company that manufactured the drug. The paper was rejected.

In turning their attention away from researchers, who usually receive much the worse blame for episodes of scientific misconduct, Altman et al focused on "actual dishonesty by editors towards authors." They identified "the secrecy inherent in the editorial aspects of scientific publishing" as a critical reason to explain why so few misdeeds by editors come to light. Altman et al proposed that an international scientific press council might enable authors to seek redress in an independent setting.

In July 1996, The Lancet appointed an ombudsman—Professor Thomas Sherwood, retiring dean of the medical school at the University of Cambridge and a former member of the journal's international advisory board—"to record and, where necessary, to investigate episodes of alleged editorial maladministration when a complainant remains dissatisfied with the journal's first response to criticism."² The remit of the ombudsperson is shown in Table 1. We guaranteed that we would publish his reports annually.

We modelled our ombudsperson on the UK Parliamentary Commissioner for Administration. The job description of this individual is well defined. He investigates complaints about government departments; he is independent; his investigations are confidential; he provides his services free; and he recommends redress if he finds a complaint justified. His concerns are "maladministration [that] has led to injustice."³ Maladministration is defined as avoidable delay, bias or unfairness, failure to give appropriate advice when asked, discourtesy or harassment, failure to follow proper procedures, failure to take account of representations, and mistakes in the handling of claims. In 1996 and 1997, for example, the UK ombudsman received 2219 complaints about the National Health Service.

Complaints to our ombudsman were made directly to him in writing without being seen by editors. His investigations involved reading correspondence and filing. When necessary, he interviewed the relevant editor, assistant, or other staff members concerned. Our ombudsman's final judgment was delivered to that editor, to me, and to the complainant in writing.

In contrast to the National Health Service, our ombudsman received 11 complaints during his first year (July 1996-June 1997), increasing to 20 by the end of 18 months.⁴ To develop mechanisms to handle these inquiries, he visited the journal's office regularly to study our editorial processes. He interviewed editors, talked to assistants, attended all meetings, and dug through deep filing cabinets. His effect on editors was startling. At first, most were either opposed to or profoundly skeptical about an "outsider" having total freedom to roam through the editorial department, ask questions, and read any document relevant to his investigations. Many felt that this maneuver was an exercise in "big brother" oversight that compromised their independence. Slowly, a phase of grudging acceptance was entered, and now we have begun a period marked by polite approval, if not joyous enthusiasm, at his presence. Our ombudsman seems to have shouldered his burden well; I can detect no long-lasting adverse changes to his personality despite his exposure to these difficult environmental pressures.

Appeals to our ombudsman concerned matters that went beyond the editorial department (Table 2). Although these complaints were not originally intended to be part of our ombudsman's remit, he decided that it was a matter of courtesy to offer a reply. Inferior standards were detected in the journal's decisions about overseas advertising compared with more local procedures, and a subscriber complained about the efficiency of our subscription service. Appeals against editorial decisions about publication were made, despite clear instructions ruling out these complaints, and were rejected. In one instance, the standard of our peer review process was called into question and, after further peer review, editors agreed that their earlier decision to reject a letter had been incorrect.

Povl Riis summed up the difficulties inherent in the editor-author relationship very well when he wrote the following: ". . . the editorial system is generally without appeal mechanisms. This makes justice a central ethical principle of the editorial process. Justice means ensuring fairness in evaluation [of] the manuscript."⁵

The ombudsperson offers one means of improving justice at the hands of editors. However, the published reaction to our initiative has been largely critical. George Davey Smith argued that "the real interest is in papers The Lancet rejects."⁶ The effect of studying the outcome of rejection "would be considerably greater than the flattery of authors through the correction of discourtesy. . . ." Tim Albert, a former editor of a medical magazine himself and now a trainer of editors, was irked. Why appoint "an ombudsman who spends most of his time soothing the egos of disappointed authors"?⁷ "If editors spend most of their time worrying about whether they are being fair to authors, they are not communicators; they have become bureaucrats," he concluded.

A former editor of The New England Journal of Medicine (NEJM) was even more caustic. In response to a call for the NEJM to appoint an ombudsperson, Arnold Relman pleaded, ". . . I can hope the NEJM's present editors will resist that suggestion and wait for the results of your initiative before deciding whether to open such a Pandora's box. It will be interesting to see how many complaints . . . your ombudsman will be able to satisfy—and at what cost."⁸

Despite the criticism heaped on us, our ombudsman has proven helpful. His presence has led us to devote far more attention to our editorial process than we might have done otherwise. Editors tend to be preoccupied by the content of their journals, by the new data and ideas that they are dealing with, perhaps at the expense of the seemingly more mundane parts of their editorial operation.

At The Lancet, we have started to set time limits for handling all manuscripts, introduced a fast-track publication procedure for articles and research letters, and appointed an editor with specific responsibility for editorial process. Our instructions for authors have been clarified and we have conducted our first author survey. An additional benefit is that we now have an experienced and independent clinician who rules on matters of editorial and commercial dispute. This assistance could be of decisive help in maintaining the journal's integrity and independence.

One aspect of our work has been deliberately protected from the grasp of our ombudsman—namely, decisions about publication or rejection of submitted material. We judged that this activity is the proper—and final—responsibility of the editor. An editor's job is to balance the content of a journal to create a mix that will interest the reader. Appeals are welcome but an appeals procedure outside the editor's control seems to run contrary to the role of editor. If the appeal is handled badly—delays, rudeness, and the like—then the ombudsperson has a part to play, but not otherwise.

Finally, the idea for an ombudsperson arose out of a call for an international scientific press council. Is there still a case for another body to which aggrieved authors could go? Clearly, yes. At the time of this writing (April 1998), The Lancet remains the only scientific journal to have appointed an ombudsperson. If more journals were to appoint ombudspeople, a press council might be a good place for them to share their experiences and develop guidance for editors about how to improve their journals. Indeed, it might provide a valuable means of supporting their decisions: for ombudspeople surely have rights too.