The following post is not a Trip Database post, I have been asked to host it by Tom Jefferson, a colleague/friend who I have a huge amount of respect for….

The Crucifixion of Brother Peter

By Tom Jefferson

I write from Edinburgh, at the 25th Cochrane Colloquium where events are still unfolding.
Given the visibility that the story of the drumming out of Peter Gøtzche from the Cochrane Management Board and the lack of a single source on the story, I shall give a brief account of it and then suggest a way for Cochrane to get out of the pickle. If it pulls together. I have also selected a few sources where readers can go and check up on some of the details. When reading this summary, you must remember that I am a co-worker and friend of Brother Peter and am also one of the two Cochranites who nominated him for election, so my views are probably not impartial.

Peter is Peter. His apparently brash style hides the reality to most of who do not know him well. It also hides his notable accomplishments such as a realistic reassessment of the benefits of mammography and the opening up of the European Medicines Agency regulatory submissions. This last enables independents to incorporate regulatory data in our reviews (https://ebm.bmj.com/content/23/2/46).

At some stage in the past Peter developed a personality clash with Cochrane’ CEO Mark Wilson. Whatever its merits, the clash has been allowed to degenerate into an open confrontation against a background of growing discontent in the organisation about changes: the dropping of the suffix “Collaboration” and the introduction of market terms such as ”brand” are just two examples.

Peter was elected to the Cochrane Management Board over a year ago and probably the confrontations got more frequent and involved other members of the Board.

Peter may not have fallen into line with whatever he was asked to do and this led to an administrative procedure to expel him from the organisation and the Board. In June the Board commissioned a legal review of what evidence there was. This is still confidential. The charge of bringing the organisation into disrepute is vague but we are told that no more information has been released (for the moment) for legal reasons. At the end of July Lars Jørgensen, Peter and I published an analysis of the Cochrane review on HPV vaccines, a delicate topic according to some. Our analysis did not go down well with Cochrane editors and although the Board denies it, our public criticism of the review appeared to be the straw that broke the camel’s back.
Everything came to a head on the 13th of September during a 5-hour hearing at which Brother Peter was given a few minutes to plead his case before being asked to wait in a separate room for the verdict. This was communicated later by email from the co-Chairs of the Board. Next day 4 Board members announced their resignation. Peter’s case was discussed in a heavily stage managed AGM on 17th where a nervous discussion took place. This should be soon available on video. The rump Board made it clear that it felt empowered to oversee elections to fill the vacancies and bring the Board to full strength.
Peter now has until midnight on the 19th to appeal, which he is doing. Both sides feel aggrieved and anyone present at the AGM could witness the emotions in play.

While all this was playing out, a media circus was gathering speed in the background, with delegates being bombarded by scores of emails and tweets by people wanting to know what was going on.
The dispute seems to be assuming large proportions, despite the Board’s efforts to limit available information. The damage to the credibility and unity of Cochrane, however is probably done.

So where to now?

In all the cut and thrust of the dispute those involved may have lost sight of the fact that the only winners in the confrontation are likely to be lawyers, the media and extremists peddling plot theories. There are other casualties, no less regrettable to old timers, such as friendships and relationships. However, resources which should be devoted to producing or updating Cochrane reviews are being used to fuel a war which threatens to split or debase Cochrane. Those that think that the issue may be over, do not take into consideration the strength of feeling between the parts and the personalities involved.
Amongst most of the people I spoke to the feeling is that the rump Board does not have the moral authority to run an election of make decisions on anyone’s behalf. Brother Peter also.

Here is what I would do with a magic wand:

1. Get everyone to step down and step away from the Board, Brother Peter included.
2. Suspend all legal and disciplinary actions currently underway.
3. Nominate a caretaker 3-month Board made up of people who were not in the fight and have not taken sides, including those who spoke at the AGM.
4. Hold elections for a brand new Board with members of the current dispute asked not to run for office.
5. Hold the elections under the auspices of a neutral body such as the Election Commission.
6. Start afresh from a webinar-based extraordinary meeting, if necessary over two days, giving any member the chance to input into policy making. Because of Charity Commission rules, this cannot take place instead of an AGM.

I hereby solemnly declare my undertaking not to run for any position in Cochrane for the next 50 years, only for the one I currently hold: author. So help me God.

Here are a few resources to give some back ground and try and understand what is going on (although they are probably not the full picture)

A statement from the rump Governing Board released before the Annual General Meeting:
https://www.cochrane.org/news/message-governing-board

It is not very informative, possibly for legal reasons.

Peter Gøtzsche’s statement: “I regret to inform you that I have been expelled from membership in the Cochrane Collaboration by the favourable vote of 6 of the 13 members of the Governing Board”. Four other members of the Board have resigned.
https://nordic.cochrane.org/sites/nordic.cochrane.org/files/public/uploads/moral_crisis_in_cochrane.pdf

The 4 Board members who have resigned: Gerald Gartlehner, David Hammerstein, Joerg Meerpohl, Nancy Santesso explain their motives in a statement.
https://austria.cochrane.org/news/why-we-resigned

Two other members of the Governing Board (Rae Lamb and Catherine Marshall) resigned because of governance issues. https://www.cochrane.org/news/message-governing-board

Cochrane – A sinking ship? By Maryanne Demasi.
https://blogs.bmj.com/bmjebmspotlight/2018/09/16/cochrane-a-sinking-ship/

This dispute has been going on for some time but the trigger may have been our critique of the Cochrane review of HPV vaccines (not of the vaccines, but of the methods used): https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012

And here is the Cochrane Editor in Chief’s response to our critique:
https://www.cochrane.org/news/cochranes-editor-chief-responds-bmj-ebm-article-criticizing-hpv-review

Our response to this is in BMJ-EBM.
https://ebm.bmj.com/content/early/2018/07/27/bmjebm-2018-111012.responses#the-cochrane-hpv-vaccine-review-was-incomplete-and-ignored-important-evidence-of-bias-response-to-the-cochrane-editors

Cochrane HPV vaccine review: BMJ journal defends “inconvenient criticisms”
https://www.bmj.com/content/362/bmj.k3927.full

There is coverage in BMJ, Science, The Lancet and other main stream journals.

Part of what Martin Burton said at the Cochrane AGM
https://www.cochrane.org/news/statement-cochranes-governing-board
There is a lot more but these are all the public facts, up to now.

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