Published 24 February 2009, doi:10.1136/bmj.b500
Cite this as: BMJ 2009;338:b500

Editorials

What to do about orchestrated email campaigns

Authors, editors, publishers, advertisers, and shareholders should ignore them

Karl Sabbagh’s article in our Analysis section (doi:10.1136/bmj.a2066) examines emails sent to the BMJ’s acting editor, Kamran Abbasi,¹ in response to a BMJ article criticising Israel.² In the article published in 2004, Derek Summerfield asked whether the death of an Arab weighed the same as that of a US or Israeli citizen. Behind this question was his claim that the Israeli army had killed more unarmed Palestinian civilians since September 2000 than the number of people who died on 11 September 2001. In addition, he alleged that the pattern of injuries suggested that Israeli soldiers had been routinely authorised to shoot Palestinian children in situations of minimal or no threat—a charge that was later corroborated by Israeli soldiers.³

Based on his analysis of emails, Sabbagh concludes that the BMJ was the target of an orchestrated campaign to silence criticism of Israel. And that is certainly how it felt. As well as almost 1000 emails to the editor, the BMJ’s website received hundreds of electronic responses to the article itself as well as feedback generally critical of the journal’s decision to publish it. The feedback messages began in earnest three days after publication and then streamed in, almost in alphabetical order of the senders’ names. Their wording was uncannily similar, with some authors seemingly ignorant of the article they were criticising—well described features of orchestrated campaigns.^{4 5} Some took us to task for covering the difficulties faced by diabetic Palestinians in Gaza; this issue had been raised not by the BMJ but by Diabetes Voice, which has no connection to the BMJ.⁶ We had been used to unfamiliar voices from unfamiliar places crowding in to debates on the Middle East before, but never on this scale.

Does any of this matter? Isn’t it just evidence that pressure groups have embraced electronic media as enthusiastically as everybody else? Shouldn’t we expect to receive thousands of critical emails where once we received dozens of critical letters—and not be swayed by the numbers? In his commentary, Jonathan Freedland recommends that we grow a thicker skin. In today’s wired world, wading into any controversial topic triggers a deluge of emails: "These days it simply comes with the territory."⁷

And yet orchestrated campaigns can succeed in closing down debate. The International Diabetes Foundation apologised for the article on Gaza, and the editor of Diabetes Voice (the foundation’s quarterly publication) resigned.⁸ Sabbagh sees a similarity between the campaign he describes and the one contributing to the demise of World Medicine. Michael O’Donnell, World Medicine’s editor at the time, describes in his commentary how that campaign "was directed not just at author, editor, and publisher but at World Medicine’s advertisers . . . and one of our major shareholders."⁹ Success of a campaign doesn’t require that a publication closes down or that an editor resigns or is sacked; it’s enough for the publication to succumb to the temptation "quietly to avoid the topic in future."¹

And it’s not only the small fry who are cowed. John Kampfner, chief executive of Index of Censorship, detected signs of caution in the BBC’s recent coverage of the Gaza conflict following earlier criticisms of pro-Palestinian bias¹⁰ (and this before the corporation refused to broadcast the Disasters Emergency Committee’s fundraising appeal for Gaza¹¹).

Avoiding topics where medicine and politics collide is not an option for the BMJ. It’s not possible to remove medicine from politics or politics from medicine.¹² Nor is this what our readers want. In an online poll on bmj.com less than a quarter of respondents wanted less space devoted to political issues in the BMJ.¹³

Oxfam was describing conditions in Gaza as a "humanitarian crisis" a year ago.¹⁴ Since then Israel’s invasion of the Gaza strip has left 1300 Palestinians dead, 5500 injured, and much of Gaza in ruins. The journal cannot avert its gaze from the health and human rights consequences of this catastrophe, no matter how "political" the issue.

By the same token, the journal cannot ignore the effects on Israelis’ health of the indiscriminate rocket attacks fired against them, the proximate cause of the Israeli invasion of Gaza. But drawing attention to these health consequences can provoke responses as fierce as those to Summerfield’s original article—as our blogger, Mark Clarfield, has found.¹⁵ Similarly, both supporters and opponents of a boycott of Israeli academic institutions have found themselves vilified for their stance.^{16 17} On the vexed issue of Israel v Palestine, orchestrated campaigns can emerge from both extremes of the political spectrum.

The campaign that Sabbagh analyses was mostly over by the end of 2004—so why are we publishing his article four years later, especially as the world’s relationship with Israel has become more fraught? It’s partly because it took Sabbagh time to get hold of the responses and to analyse them, and it’s partly because we’ve devoted so much attention to the article given its "sensitive" nature. Compared with our usual articles, we sought more reviewers’ (and lawyers’) opinions and attempted to commission a wider than usual range of commentaries. We failed, however, to get one from the Board of Deputies of British Jews. The board shared its response to our invitation with the Committee on Publication Ethics, so that the committee could express its views about the article ahead of publication. The committee’s view was "that in this particular case the BMJ has offered you the choice to accompany the article with a comment, which we would say constitutes good editorial practice when dealing with controversial issues."

Michael O’Donnell reminds us that at the time Summerfield’s article was published, "the real world offered a host of sensitive issues: the invasion of Iraq, Guantanamo Bay, allegations of British involvement in CIA "rendition" and torture, to name but three."⁹ Yet medical journals have freely discussed these issues. "In the slightly unreal world of publishing," says O’Donnell, "the sensitivity of editorial decisions about the Israeli-Palestinian conflict is created by the orchestrated response—partly rational but, as Sabbagh shows, often malicious and personal—that writers, editors, and publishers fear they will provoke."

The best way to blunt the effectiveness of this type of bullying, counsels O’Donnell, is to expose it to public scrutiny. We have taken his advice and will try to follow Freedland’s too—to grow a thicker skin. We’ll give future orchestrated email campaigns as much credence as film producer Sam Goldwyn gave verbal contracts. He famously dismissed these as "not worth the paper they’re written on."

Cite this as: BMJ 2009;338:b500

¹ BMJ, London WC1H 9JR

---

Competing interests: None declared.

References

1. Sabbagh K. Perils of criticising Israel. BMJ 2009;338:a2066[Free Full Text]
2. Summerfield D. Palestine: the assault on health and other war crimes. BMJ 2004;329:924.[Free Full Text]
3. Urquhart C. Israeli soldiers tell of indiscriminate killings by army and a culture of impunity. Guardian 2005 Sep 6:13. www.guardian.co.uk/international/story/0,,1563255,00.html.
4. Editors. The Israel lobby [letter]. London Rev Books 2006;28 www.lrb.co.uk/v28/n08/letters.html.
5. Porter H. The enemies of free speech are everywhere. Observer 2006 Oct 15.
6. Tsapogas T. Poverty, stress and unmet needs: life with diabetes in the Gaza Strip. Diabetes Voice 2004;49(2):12-5.
7. Freedland J. Toughen up. BMJ 2009;338:b524.[Free Full Text]
8. Lèfebvre P, Silink M, Home P. Editor’s note—an apology. Diabetes Voice 2004;49(3):17.
9. O’Donnell M. Standing up for free speech BMJ 2009;338:a2094.[Free Full Text]
10. Kampfner J. Take care over caution. Guardian 2009 Jan 12
11. Thompson M. BBC and the Gaza appeal. www.bbc.co.uk/blogs/theeditors/2009/01/bbc_and_the_gaza_appeal.html.
12. Delamothe T. How political should a general medical journal be? BMJ 2002;325:1431-2.[Free Full Text]
13. BMJ. How political should a general medical journal be? [poll] www.bmj.com/polls/politics.dtl.
14. Oxfam. The Gaza strip: a humanitarian implosion. www.oxfam.org.uk/resources/policy/conflict_disasters/gaza_implosion.html.
15. Clarfield M. My surprise at fallout over dispatches from Israel. BMJ 2009;338:b722.[Free Full Text]
16. Hickey T. Should we consider a boycott of Israeli academic institutions? Yes. BMJ 2007;335:124.[Free Full Text]
17. Baum M. Should we consider a boycott of Israeli academic institutions? No. BMJ 2007;335:125.[Free Full Text]

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