Circumcision is a hot topic. So hot, questions about a reviewer’s potential conflict with the author of an article promoting circumcision prompted a journal editor to resign, and one academic to call another a “fanatic.”

It began in August, when Brian Morris, professor emeritus of molecular medicine at the University of Sydney, published a critique of a paper that itself had critiqued the practice of circumcision. But the sole reviewer of Morris’s article was a frequent co-author of his, Aaron Tobian of the Johns Hopkins School of Medicine. In his reference section, Morris listed five papers on which he and Tobian were co-authors.

A tipster forwarded us emails from Eduardo Garin, editor in chief of the journal, saying he had resigned from the journal after it refused to retract the paper, despite the fact that its sole reviewer was a frequent collaborator of the author. However, Garin is still listed as editor in chief on the journal’s site.

Garin confirmed to us that he resigned after the publisher refused to retract or correct the Morris article; however, Xiu-Xia Song, vice director of the editorial office at Baishideng, told us by email that Garin is still the journal’s editor.

Here are some specifics:

Morris’s paper is “Critical evaluation of unscientific arguments disparaging affirmative infant male circumcision policy” in the World Journal of Clinical Pediatrics, put out by the Baishideng Publishing Group. It critiqued “Risks, Benefits, Complications and Harms: Neglected Factors in the Current Debate on Non-Therapeutic Circumcision,” published in the Kennedy Institute of Ethics Journal by Robert Darby, an independent scholar who also wrote the anti-circumcision book “A Surgical Temptation: The Demonization of the Foreskin and the Rise of Circumcision in Britain.”

As usual, we sent emails to everyone else involved.

Morris defended Tobian’s impartiality, noting:

Tobian is an expert on the topic and would be highly unlikely to allow any past relation with me over an unrelated paper to influence his assessment of this recent manuscript. You are clutching at straws … and for what? Do you have a hidden agenda. If so think one would regard that as unethical…Did [Darby] put you up to this nonsense?…Tobian was not on the list of suggested reviewers. So now will you go away and stop bothering me? This is a non-issue. If you are looking for someone to annoy I suggest you go and harass Darby.

When we contacted Tobian, the sole reviewer, he declined to comment, saying “I am conflicted.”

Tobian is still listed as a peer reviewer at the bottom of the journal article; Song didn’t respond to questions, about the World Journal of Clinical Pediatrics’ conflict of interest policy for peer reviewers. That policy reads:

Reviewers will decline participation in the peer review process for any manuscript if a conflict of interest exists, including interests related to the manuscript’s authors, personal interests, or academic or economic interests. If a conflict of interest becomes apparent during the peer review process, the reviewer must inform the Editorial Office immediately.

There are two comments on the article, one from circumcision critic John Dalton, and the other a response from Morris. Dalton’s comment reads in part:

Morris, Krieger, Klausner and reviewer Tobian are members of an authorship cartel who seek to promote circumcision by co-authoring papers and reviewing each other’s work. They also seek to repress papers with opposing views by writing damning reviews.

Morris’s response reads, in part:

We suggest you be wary of comments posted by opponents of male circumcision. These pose a threat to good science, public health and individual well-being. The comment by Dalton provides false allegations against the authors. This appears to be a deliberate strategy undertaken in a desperate attempt to discredit high quality scientific work when no credible criticisms can be made.

Darby, the author of the paper Morris et al was criticizing, acknowledged to us that the topic of circumcision raises strong feelings:

Circumcision is in itself an intensely emotional topic because it is the focus of discourses that are themselves likely to generate intense emotions: sexuality, body image, masculinity, health, religion, science etc. Most people writing on the topic have an interest one way or another and passionate feelings may arise among people on both sides of the debate: circumcision critics through resentment at having been circumcised, for example, or supporters because they have circumcised their own boys and do not wish to believe that they have done the wrong thing. But even admitting that, it has to be said that the intensity Prof. Morris brings to the debate is in a class of its own, and I don’t think it is unreasonable to describe him as a fanatic…I don’t think Morris has any particular aversion to me – he tends to hate all circumcision critics equally, and generally responds to them with great personal venom.

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