Editor's Choice

My last choice

BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7460.0-g (Published 29 July 2004) Cite this as: BMJ 2004;329:0-g
  1. Richard Smith (rsmith{at}bmj.com), editor

    Do you need approval from an ethics committee to ring up chief executives of hospitals and ask them questions? As a journalist, a member of parliament, or a confidence trickster you wouldn't, but if you are a researcher who has drawn up a protocol you might. Ethics committees, which were devised to protect vulnerable patients from some abuse, have forgotten why they were created and have begun to equate chief executives with the unconscious or the mentally incompetent. They have, in other words, spun out of control.

    No fewer than five sets of researchers describe a series of Kafkaesque experiences with ethics committees that have made research difficult or impossible (p 277, p 280, p 282, p 286, and p 288), and an editorial analyses other barriers to research (p 241). We commissioned only the editorial; the other pieces arrived spontaneously, reflecting frustration, anger, and even despair among researchers. There must, of course, be a balance between the needs of research and the interests of patients—but, as healthcare workers lack evidence for much of what they do, research is important. It is unlikely to be in the public interest to make it more difficult to do research.

    And that is almost it. I have 280 words before I get off the BMJ stage. I end my time as editor on 30 July, and I go not alone but with Sir Anthony Grabham, the chairman of the BMJ Publishing Group's board and the holder of a great restoration comedy name. I've been around for only a quarter of a century, whereas Tony has done 50 years with the BMA, moving smoothly from young firebrand through steady hand at the tiller to elder statesman. He became chairman of the council of the BMA at a time when membership threatened to fall below 50% and the finances were distinctly shaky. He turned things round, and profits of the BMJ Publishing Group have also grown since he became chairman of the board. We, the staff, are grateful to him for his stewardship.

    Editors of the BMJ are, my predecessor insisted, alternating fools and bastards. He was clear that he was a bastard rather than a fool and that his predecessor was a fool. That makes me a fool, and I accept the judgment without a murmur. But I hope that I've been a jolly fool. Even more ambitiously, I would aspire to be like the fool in King Lear.

    It is time now for me to climb into the picture of all the past editors of the BMJ that hangs outside our office. They are mostly glum looking with lots of facial hair. I will look down from my space on my ex-colleagues for a few years before somebody takes down the picture, puts it on eBay, fails to get a buyer, and then throws it out. I find the thought of oblivion deeply comforting, but even more comforting is the thought of my successors doing wonderful things. And I know they will.


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