“…Harry stared back into the face that had haunted his nightmares for three years. Whiter than a skull, with wide, livid scarlet eyes, and a nose that was as flat as a snake’s, with slits for nostrils...” (Harry Potter and the Goblet of Fire)

Brian Earp has a great publication ethics piece in the Spring 2016 HealthWatch UK Newsletter titled “The Unbearable Asymmetry of Bullshit” where he discusses a particular kind of illegitimate scientific publishing practice. Earp constructs a hypothetical perpetrator engaged in this sort of nefarious behavior, and amusingly names him Lord Voldemort. Earp is very clear to disclaim that our Dark Lord does not represent a real person:

While everything I am about to say is based on actual events, and on the real-life behavior of actual researchers, I will not be citing any specific cases (to avoid the drama). Moreover, we should be very careful not to confuse Lord Voldemort for any particular individual. He is an amalgam of researchers who do this; he is fictional.

I certainly do not intend any assertion to the contrary, but I must observe that one particular individual comes to mind who fits Earp’s description extremely well:

In this story, Lord Voldemort is a prolific proponent of a certain controversial medical procedure, call it X, which many have argued is both risky and unethical. It is unclear whether Lord Voldemort has a financial stake in X, or some other potential conflict of interest. But in any event he is free to press his own opinion. The problem is that Lord Voldemort doesn’t play fair. In fact, he is so intent on defending this hypothetical intervention that he will stop at nothing to flood the literature with arguments and data that appear to weigh decisively in its favor.

As the first step in his long-term strategy, he scans various scholarly databases. If he sees any report of an empirical study that does not put X in an unmitigatedly positive light, he dashes off a letter-to-the-editor attacking the report on whatever imaginable grounds. Sometimes he makes a fair point—after all, most studies do have limitations (see above)—but often what he raises is a quibble, couched in the language of an exposé.

These letters are not typically peer-reviewed (which is not to say that peer review is an especially effective quality control mechanism); instead, in most cases, they get a cursory once-over by an editor who is not a specialist in the area. Since journals tend to print the letters they receive unless they are clearly incoherent or in some way obviously out of line (and since Lord Voldemort has mastered the art of using ‘objective’ sounding scientific rhetoric to mask objectively weak arguments and data), they end up becoming a part of the published record with every appearance of being legitimate critiques.

The subterfuge does not end there.

The next step is for our anti-hero to write a ‘systematic review’ at the end of the year (or, really, whenever he gets around to it). In it, He Who Shall Not Be Named predictably rejects all of the studies that do not support his position as being ‘fatally flawed,’ or as having been ‘refuted by experts’—namely, by himself and his close collaborators, typically citing their own contestable critiques— while at the same time he fails to find any flaws whatsoever in studies that make his pet procedure seem on balance beneficial.

The result of this artful exercise is a heavily skewed benefit-to-risk ratio in favor of X, which can now be cited by unsuspecting third-parties. Unless you know what Lord Voldemort is up to, that is, you won’t notice that the math has been rigged.

Like Earp, I will not name the individual I’m thinking of, and I only mention this at all to show that Earp’s description may resonate with a typical(?) reader. Thanks to Earp’s brilliant codename, I can simply refer to this person as You-Know-Who, and what I am interested in considering are You-Know-Who’s motives.

Of course, J. K. Rowling’s Voldemort was just about pure evil, but is this a realistic possibility for You-Know-Who? The idea that our adversary is flush with classically antisocial traits seems especially uncharitable, though this is not to say that such individuals cannot attain professional positions of success from which they might engage in Earp’s subterfuge (I am reminded of an eye-catching book I saw on a clinical social worker’s shelf during my psychiatry rotation).

Excluding the sort of profound malice above, could You-Know-Who be motivated to dishonest conduct by some explicit personal interest, financial or otherwise? One of Earp’s conditions for You-Know-Who is that it is “unclear” whether a meaningful financial or other conflict of interest (COI) exists. Such COI’s may nonetheless exist and be inapparent, and it’s not clear to me whether we ought to expect a highly motivating COI to be easy to spot. What is clear is that it should surely be possible for some explicit interest to provide enough motivation to drive You-Know-Who to engage in behavior recognized as wrong, but seemingly justifiable by the desired ends. Some of these interests are concrete (e.g. money, publications), but others less so (e.g. fame, policy influence).

What about implicit personal interests? There are certainly psychological reasons why someone would feel compelled to fortify their position rather than admit they were wrong. Perhaps the deeper one’s hole is dug (and the higher the price of climbing out), the more driven is the digger.

Is it possible that You-Know-Who is simply misguided? Could a scientist be so certain of the accuracy (or righteousness) of their position that they blind themselves to the underhandedness of their work? Not to be one to underestimate human fallibility, I’m sure this is possible, but I don’t know how likely this explanation might be. A related explanation might be that the researcher is simply so inept that they find their efforts reasoned, restrained, and entirely above board. However, to some extent this seems almost as uncharitable as attributing their misconduct entirely to malice!

A complicating factor, which Earp describes in his hypothetical, is that You-Know-Who has more than a few collaborators! The fact that others fail to reject the underhanded tactics of our Dark Lord suggests (to me, at least) that some combination of implicit interests and incompetence must be at play. Though Rowling’s Death Eaters were evil, I see no reason that followers of You-Know-Who need share any malice held by their leader. So much of science (and its factions within) is based on trust that I am far less surprised by myopia on the part of followers than leaders.

In the case of You-Know-Who, I do not believe explanations of profound malice or stupidity are informative. I am speculating, of course, but I think this particular researcher is driven more by overconfidence and various implicit interests. Although I don’t think You-Know-Who is evil in essence, I do think that the ends pursued by this Dark Lord do constitute profound moral injury. In that sense, perhaps picturing the face of the original Lord Voldemort is fitting imagery.