May 30, 2024

Interview: Julian Savulescu, editor of JME

The editor of the Journal of Medical Ethics discusses the fraught job of editing a leading journal.

Julian Savulescu / photo copyright John Robertson 

Julian Savulescu is the editor of the Journal of Medical Ethics, one of the world’s leading platforms for academic debate in bioethics. Australian-born, he is Uehiro Professor of Practical Ethics at the University of Oxford. Xavier Symons, deputy editor of BioEdge, asked him about the nuts and bolts of editing.

Xavier Symons: How did you get involved in the Journal of Medical Ethics? Editing a monthly journal must take a huge amount of time!

Julian Savulescu: I first edited the Journal of Medical Ethics in 2001. It was a fantastic career opportunity for me at that time. I began a second editorship in 2011. This time my motivation was not career — I had more than enough to do. Rather it was because of dissatisfaction and frustration with publishing in the field of medical ethics. I also had a group of very talented young medical ethicists who were keen to work together on the project. We wanted to make a difference. We wanted to improve the philosophical quality of work in medical ethics.

XS: How do you measure the journal’s success? By the h5 index? By the impact factor? By subscriptions?

My main measure of success is that when I pick up an issue, I find the articles stimulating, original and philosophically rigorous. We introduced the Feature Article section to attract more substantial philosophical contributions. Over the last four years those feature articles have included a number of high quality, rigorous and novel contributions to debate by philosophers and ethicists.

Another important marker of success is the quality and quantity of submissions you are receiving. Again, I think we are getting some very good submissions. When we took over, the acceptance rate was about 50%. We now accept only about one-quarter of the papers that are submitted, allowing us to apply a much higher standard for publication. It is also important to reach a wider public and press coverage is a marker of that.

Markers of impact are important, like Google Scholar H-index, ISI Impact Factor and Altmetrics. We have been extremely encouraged to note that the JME has been cited by Google Scholar as the top journal in bioethics for 2015. While all of these indices have shortcomings, they are important to communicate to people some objective markers of publication impact, so we use them.

XS: Back in 2012, a JME article on “after-birth abortion” created global media storm. Did that come as a surprise to you? What lessons have you taken away from the incident? Do you welcome media coverage any more?

Yes, I was surprised by the extent of the coverage — it was a new phenomenon. The article did not introduce any radically new ideas. The arguments made had been discussed in philosophy and medical ethics by a number of different philosophers over more than 30 years. What was different was the audience.

A month before, a very good article by Frank Miller and Walter Sinnott-Armstrong, both leaders in the field, created a similar, but smaller, sentinel controversy in the US. The paper was about what makes killing wrong and challenging the dead donor rule. Again, this was not radically new but it was sufficient to get into the mainstream media with demands for sacking of at least one of the academics concerned. Blogs and social media connected these articles with Christian-right groups that then moved them around the internet.

What I have learnt is that it is not Big Brother who is watching, but everyone. In the current era, everything that is published can be instantly accessed by nearly everyone. Ethicists have to be prepared for titles and one-liners to be pumped around the internet. You have to be prepared to defend what you have written or published against the harshest criticism.

Do I welcome media coverage? I used to and it was part of my previous job to engage with the media. These days, I think it can sometimes do more harm than good. It is mostly the people who violently disagree who get involved, not those who agree or even who are open to an engaged debate. The terms of internet discourse are not pleasant — there are few rules that people abide by and it tends to be nasty and brutish — but not necessarily short.

XS: How should journal editors and academics “manage” the media? It must be hard to navigate between being too “boring” and being too “controversial”.

You can’t manage the media. It is hard to perfectly predict what will be picked up and how. But on any potentially provocative piece, you need to make sure that you can defend it, that the title is not going to be offensive or damagingly inflammatory, and that lines can’t easily be pulled to misrepresent what the argument actually is.

My previous boss said to me about the media — it doesn’t matter so much what you say as what people hear. I think the goal should be to get people to hear the argument in its entirety without being sidestepped into a knee jerk response without engaging in it. They might well still disagree but then it is a debate, not a meaningless controversy for a few days.

XS: Editing a journal impartially can’t be easy. What do you think it means to be “balanced”? And how do you go about achieving balance in what you publish?

On provocative pieces, we try to run commentaries that give the opposing side now. We give priority to pieces that present a different perspective than those that we have previously published on a topic. Editing a journal is a job — you have a duty to the readers, as well as to authors.

XS: Blind peer review is one way to achieve objectivity, but it has been attacked in recent years. Are you happy with it?

Peer review is less than perfect. Blind peer review is an attempt to reduce the subjectivity but you can still send the same article to two experts in the field and receive completely divergent views. We are moving towards a system of “triple blinding” — blinding not just to reviewers, but also to editors as to who the contributor is.

In our case the handling editor has the information but the editorial committee discussions take place blinded as to who the contributor and the reviewers are in final discussions about the piece.

I have encouraged associate editors to benchmark papers against other work we have published and rejected and all papers are discussed at weekly editorial meetings prior to rejection or acceptance. To be honest, I think it is a big issue.

XS: What is the JME’s unique slant on bioethics? Utilitarian? Transhumanist? Is there any significance in the fact that your journal is about “medical ethics” rather than “bioethics”?

The JME is a journal of the Institute of Medical Ethics and the British Medical Journal. Its focus is on medical ethics, not bioethics more broadly. Its audience includes health professionals. It does not have a philosophical slant. The Associate Editors have a range of philosophical perspectives, including virtue ethicists, practising Catholics and a theologian. Our unique slant is that we seek to make progress on philosophical medical ethics.

XS: A number of JME articles deal with futuristic technologies like human enhancement. Why is this important for you? Isn’t it a bit outside the scope of standard bioethical discourse?

Medical ethics is not just about reacting to questions or issues that people are currently facing. It is critical to also anticipate future problems. That allows careful and considered analysis of the ethical issues before clinicians, politicians and the wider public are having to make decisions about them. For example, some of the discussion in medical ethics about gene therapy in the 1980s and 1990s is only now being applied as gene therapies are reaching the clinic.

One of the areas where medicine is changing is its use for enhancement purposes. And the most promising near-term bioenhancements will arise from medical research. For example, memory enhancers are most likely to come on the back of drugs developed to treat Alzheimer’s Disease. Enhancement is a “sexy” topic and partly our publication in these areas reflects what people are working and submitting on. But we also make a conscious effort to cover traditional topics in medical ethics. For example, we have just produced a special issue on euthanasia.
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