Where Is Bristol’s Review of Professor Crawley’s Ethics Missteps?

By David Tuller, DrPH

I have repeatedly raised concerns about Professor Esther Crawley’s habit of bypassing ethical review in her research. This issue first came to my attention in connection with a study she conducted about whether school absence could be used to identify undiagnosed cases of the illness she has generally called “chronic fatigue syndrome.” In that study, published in BMJ Open in 2011, she shattered ethical principles by interviewing more than 100 minors and their family members without the typical oversight and scrutiny mandated for research with human subjects. She managed this feat by falsely claiming this research to be “service evaluation,” as I documented at length on Virology Blog. (The original post explains the distinctions between “research,” which requires ethical review, and “service evaluation,” which does not.)

When confronted with clear evidence of the problem, BMJ Open obfuscated, dodged and dissembled in its efforts to deflect responsibility–as I documented in multiple subsequent posts. Instead of acknowledging the obvious, the journal accused me of inaccurate reporting. (I have requested an apology for this untrue allegation but have not received one.) So I brought my concerns to the attention of the UK Health Research Authority, the arm of the National Health Service that oversees the work of research ethics committees. As it turned out, Professor Crawley exempted at least 10 other studies from ethical review on the same questionable grounds. Perhaps in some of these cases it was warranted; perhaps not.

In any event, the HRA found the situation concerning enough that it requested Bristol University to conduct an investigation into the issue. The report from that investigation was supposed to be delivered to the HRA by June. Since late June, my HRA contact has predicted every few weeks that Bristol would deliver the report. As of two weeks ago, he was still waiting. He assured me that after the HRA received the report, it would be forwarded to me in short order. He hoped this would happen last week. It is now this week, and I haven’t seen the report. As of October 1st, it was more than three months overdue.

I have some concerns about this report—especially given how BMJ has whitewashed what could be argued is a case of research misconduct with its decision to correct and republish–rather than retract–Professor Crawley’s Lightning Process study. When the HRA confirmed that Bristol would be overseeing or conducting a review of the matter, I was informed that this was to be an “independent” effort. (It wasn’t clear to me exactly how it would be “independent” when Bristol was overseeing or conducting it, but still.) I since have learned that the three-person review panel included two people from Bristol unaffiliated with Professor Crawley and one person from outside with no Bristol affiliation. I have pointed out to the HRA that this does not seem to me, on the face of it, to qualify as a review that is “independent” of Bristol. The HRA has promised to elaborate on this issue when it provides me with the report itself.

I have another concern about this report: To what degree will the Bristol vice chancellor be involved in adjudicating the official response or sanctions that might be imposed on the investigators for violating core ethical principles? After all, the vice chancellor’s office has complained at least three times to Berkeley’s chancellor about what the university’s legal department referred to in a letter as my “behaviour” toward Bristol personnel. (I have not seen these letters of complaint to the Berkeley chancellor but they have been described to me in general terms.)

Since that “behaviour” consisted of making tough but fair critiques of Professor Crawley’s research and asking her at a public event why she had accused me of libel, I couldn’t see what possible complaint Bristol could reasonably make about me or my work. The fact that I maintain my position as a senior fellow in public health and journalism at the Center for Global Public Health can be taken as Berkeley’s response to this effort by Bristol to squelch my academic freedom.

In short, Bristol has proven itself to be a dishonest or at least incompetent broker in this matter. But then, so have most of the presumed gatekeepers of quality in this domain in the UK–research ethics committees, universities, journals, health agencies, publishers of systematic reviews, news organizations. As I have discovered, the British culture of deference to authority seems to play a major role in this abasement of UK science. Even knights and eminent professors can be wrong. But as with President Trump, it seems they and their high-level enablers just can’t bear to admit it.