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    One thing that jumped out at me in the responses to these questions is that Dr Pesce was actually one of the peer reviewers of the article. Surely that constitutes a conflict of interest. For starters he is the President of the AMA and the AMA owns and publishes the Medical Journal of Australia. The AMA, with Dr Pesce as its key advocate, is knee-deep in a political campaign against homebirth. So in order to avoid any perception of bias the Journal should be going to a different expert to review this article (given that according to their website they have a panel of 3000 experts to review articles and Dr Pesce cannot be the only one who specialises in obstetrics). I am not saying that Dr Pesce is biased but an appearance of bias is as good as the real thing and generally to be avoided at all costs.

    The Journal’s website links to the World Association of Medical Editors Position Statement on “Conflict of Interest in Peer-Reviewed Medical Journals”:
    http://www.wame. org/conflict- of-interest- in-peer-reviewed -medical- journals

    Here are some sections of it I found pertinent:

    “However, it constitutes a problem when competing interests could unduly influence (or be reasonably seen to do so) one’s responsibilities in the publication process. If [conflict of interest] COI is not managed effectively, it can cause authors, reviewers, and editors to make decisions that, consciously or unconsciously, tend to serve their competing interests at the expense of their responsibilities in the publication process, thereby distorting the scientific enterprise. This consequence of COI is especially dangerous when it is not immediately apparent to others. In addition, the appearance of COI, even where none actually exists, can also erode trust in a journal by damaging its reputation and credibility. ”

    “A COI exists when a participant in the publication process is directly affiliated with an institution that on the face of it may have a position or an interest in a publication. …Professional or civic organizations may also have competing interests because of their special interests or advocacy positions.”

    “Reviewers should be asked if they have a COI with the content or authors of a manuscript. If they do, they should be removed from the review process. “


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