Genetics and DNA under discussion
This paper critically analyzes and reviews the article by Khoury M. J. (1996), “From genes to public health”, published in the American Journal of Public Health, in an attempt to analyze how such discoveries as DNA may help link genetic technology to public health practice. It should be noted that Khoury provides a rather insightful views that relate to genetics-related clinical drug trials where consent is first sought from subjects to take part in the main clinical drug trial. If participants agree, they are subsequently asked to consent to the additional genetic aspect of the trial. In addition, subjects are informed that the sponsoring pharmaceutical company has sole property rights over the sample and the research results. The article examines the social and ethical implications of the development of genetic technology in clinical trials and focuses on the issue of consent to these trials and the problems and contradictions surrounding this process.
Data on the peer-review process were obtained by Khoury (1996) from two mail surveys. One survey of a group of respondents that consisted mostly of physicians, but also some statisticians, asked those individuals to describe the last article that they had been able to publish only after a substantive revision had been made. The respondents in this population reported that they had encountered: pressure to conform to the subjective preference of a reviewer (76%); false criticisms (73%–and of these 8% reported making erroneous changes in order to comply with the demands of a reviewer); inferior expertise of the reviewer (67%); concentration on trivia by the reviewer (60%); treatment as an inferior (43%); and careless reading by the reviewer (40%).
Without a doubt, evaluators inject their own particular biases into what is published. Consequently, the literature is biased, of course, both in terms of what gets in and what is blocked out. According to Khoury (1996) data, 77% of the physicians in his survey had published an article in one journal that had previously been rejected by another. Although it may seem, therefore, that the biases ultimately even out across the various journals, this does not exonerate the system. Because the number of possibilities for error in evaluation within even a single submission are great, a frequent evaluator is very likely to make at least one mistake over the course of a year–or over the course of a career. The question is not whether isolated errors are made by individuals in implementing a system, but whether the system itself is flawed by consistently permitting related errors on related topics, or refusing to correct identifiable mistakes.
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