Global cost of silencing science BMJ ...

Editorials

Global cost of silencing science

BMJ 2025; 390 doi: https://doi.org/10.1136/bmj.r1370 (Published 10 July 2025)Cite this as: BMJ 2025;390:r1370

'Public trust in scientific integrity is eroded by the politicisation of institutions under Donald Trump’s US presidency. The implications extend far beyond American borders, striking at the core of how scientific knowledge is produced, disseminated, and trusted worldwide.

Recent directives seek to eliminate diversity, equity, and inclusion (DEI) initiatives, cut federal funding to critical health research agencies, and restrict references to gender, race, and climate science in official documentation. Scientific staff at federal agencies face mounting pressure to comply with politically motivated communication policies. Such institutional interference not only distorts scientific findings—it undermines the principles of transparency and editorial independence outlined in the International Committee of Medical Journal Editors (ICMJE) recommendations.1 As members of ICMJE we feel compelled to speak out.

The ICMJE underscores that “editors should preserve the integrity of the scientific record by critically evaluating manuscripts free from undue influence and without compromising scholarly values.”1 Yet, under the current administration, several US federal science agencies require pre-approval for external publications—a direct contravention of these editorial standards.2 This climate of control stifles open inquiry and discourages evidence based discourse, particularly when scientific conclusions diverge from political narratives.'
...

'Independent scientific communication is equally under threat. Increasing pressure on government researchers to avoid controversial topics or reframe findings to suit political narratives creates an institutional chilling effect. Self-censorship born of fear may be more damaging than overt censorship. Researchers, particularly early career scientists and those from under-represented backgrounds, may choose to abandon public communication or controversial areas of inquiry altogether. This trend further narrows the scope of scientific innovation, limits the range of perspectives reflected in research agendas, and ultimately harms health.'
...

'This is a call for science grounded in ethical principles and dedicated to the service of humanity. Scientific research, especially in medicine and public health, is inherently intertwined with social justice. Silencing DEI initiatives, censoring climate science, and delegitimising minority researchers is not neutrality—it is complicity in perpetuating harm.'
...

Footnotes

This article is being jointly published by The BMJ, Deutsches Ärtzeblatt, Journal of Korean Medical Science, Lancet, La Tunisie Médicale, Medwave, and New Zealand Medical Journal.

References

1. ↵
   International Committee of Medical Journal Editors. Recommendations. 2025. https://www.icmje.org/recommendations/
2. ↵
   Bush V. Science—the Endless Frontier. 75th anniversary edition. National Science Foundation, 1980. https://nsf-gov-resources.nsf.gov/2023-04/EndlessFrontier75th_w.pdf

https://doi.org/10.1136/bmj.r1370

My source: https://x.com/bmj_latest/status/1944478436489134350

See, hear, feel... Drama still has a role to play

Mr Bates vs The Post Office

4 Episodes

The first part of a four-part drama.

Mysterious financial losses lead the

Post Office to sack and prosecute village

sub-postmasters who have no way

 to prove their innocence.


INDIVIDUAL
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     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

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GROUP

personal ethics? listen - listening Well, this hasn't happened to anyone else! Losing control of one's horizons ...	socio-technical methods software testing verification - validation life-cycle management data/information standards human-factors - (need a chance to breathe?) ... !?
	politics law justice Establishment Institutions Public services group think lack of whistleblowers?

Sometimes* political and legal action -::- needs a social nudge.

*All the time?

My sources:
Quality press and BBC Radio 4 The Great Post Office Trial

'Safe space' - which one?

 Individual
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     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

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GROUP

psychological safety

physical safety

social safety

"NHS staff will be able to speak out about mistakes without fear of reprisal for the first time, thanks to a new investigation unit with "safe space" powers. The Health Services Safety Investigations Body (HSSIB), which was launched last week, has been granted a remit that in effect means any testimony or evidence given to it by doctors, nurses and other staff medical staff will not be handed over to another agency - such as the police, a coroner or the General Medical Council - unless the High Court rules that it must."

Lintern, S. 'Safe space' unit to protect NHS staff reporting medical errors, The Sunday Times, 22nd October 2023, p.11.

NHS management accountability

INDIVIDUAL

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     INTERPERSONAL    :     SCIENCES               

HUMANISTIC --------------------------------------  MECHANISTIC      

SOCIOLOGY  :   POLITICAL 

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GROUP

NURSING ACCOUNTABILITY	NURSING ACCOUNTABILITY
NURSING ACCOUNTABILITY^	Managers accountable? It's about time!* Nurses have been here for a long time. You're still not listening though ...

An insightful meeting without the insight of the largest safety critical profession seems more of an echo chamber
Assume #nursing not required to deliver the winter plan. https://t.co/8fHSACVLtf

— Prof Alison Leary 💙#ProtectNurse (@alisonleary1) September 13, 2023

*Assuming NHS managers become subject to regulation and can also be held to account.

^Yes, spiritual too.

Many nurses may not want to acknowledge or contemplate the 'politics' of health. They respond quickly: It is not why they came into the profession. But, in practice and theory you / we cannot avoid it. In nurse-patient encounters, it is ever-present; it is the other / shadow encounter.

"Models, Theories and Concepts" c/o Smith (1994). Plus ça change ...

"Whilst the impracticality of unified approaches has been noted for some time (McFarlane, 1976), it is still considered that many theories, in their efforts to explain everything, succeed only in explaining nothing (Draper, 1990). Therefore, as Kenny (1992) points out, the use of theories and models in nursing has resulted in sweeping generalizations which 'are not always personally, culturally or contextually appropriate'.

In overcoming this difficulty many authors advocate that theories of lesser scope and abstraction are considered (McFarlane, 1976; Clarke, 1986; Draper, 1990; Moore, 1990; Ingram, 1991; Reid & Bond, 1991). Such theories have been termed 'mid-range' and address a more limited number of variables in particular situations (scope), whilst being empirically grounded and focusing on practical problems (abstraction) (Rogers & Shoemaker, 1971; Walker & Avant, 1983; Fawcett, 1984; Lowenberg, 1984). According to Clarke (1986), mid-range theories should appeal to practitioners as being more directly accessible conceptually and linguistically. Reed & Robinson (1991) contend that, given the diversity of nursing practice, the search for grand theory is inappropriate and nursing would be better served by developing mid-range theories that are 'more precisely stated, more easily treated and produce more specific indications for practice'." pp. 59-60.

Smith, J.P. (1994) Advanced Nursing Series - Models, Theories and Concepts. Oxford: Blackwell Scientific Publications.

While the structure of Hodges' model is global - 'grand' in scope, the model, as a template is blank and open to whatever conceptual content follows in the practice situation, or context. 'Precision' can be assured using Hodges' model as it can facilitate person-centred care, integrated care, reflection, critical thinking and conceptual development. 

Delivery of high-quality health care is not a given. 

Safe, effective and equitable care is variously dependent upon staffing, the skills and attitudes of individual nurses, staff numbers, skill-mix, team effectiveness and resource allocation. Hodges' model can also assist users to recognise and call-out unmet needs, deficits in the quality of care, and risks to the safety of patients, the public, staff and the profession.

At risk of sounding grand if not grandiose ...

Change will and must follow - in respect of models and theories, not just of and for nursing but health and care at scale.

Pioneering safe staffing whistleblower nurse dies aged 91: c/o RCNi

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

Graham Pink at his home in Manchester in January 2008 Picture: Neil O'Connor courage : compassion : values : commitment : leadership

"A nurse who was among the first in the UK to blow the whistle on safe staffing issues has died aged 91. Graham Pink first raised concerns about poor staffing and the dangers to patients when he worked at Stepping Hill Hospital in Greater Manchester in 1990. His four-year campaign to highlight inadequate staffing levels made a lasting impression on the nursing profession. Mr Pink died on 6 March in Barnsley, South Yorkshire. Nurses caring for him remembered his safe staffing campaign Speaking to Nursing Standard about his final months, his niece and carer Sarah Pink said: ‘Barnsley Hospital gave him a lot of care and attention and treated him with a huge amount of respect. There were nurses caring for him who said they knew him from what he did and how he stood up for the NHS back then. One sister said it was an honour to meet him and take care of him.’"

HRH The Duke of Edinburgh RIP

https://www.rcn.org.uk/employment-and-pay/safe-staffing

My source: RCNi via twitter: 

https://twitter.com/rogerkline/status/1380398894740348929?s=20

The meaning of "Care Package"

individual

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INTERPERSONAL : SCIENCES

humanistic ----------------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group - population

"I return to my hotel room in central Wuhan to find a package from the local government waiting for me. They have sent foreign journalists two large bottles of hand sanitiser, 20 masks and a 55-page comic book dedicated to sanitation. In one cartoon, a grinning bottle of ethyl alcohol reminds readers to wipe down their phones up to four times a day. But the main item in the care package is a hastily bound white booklet with a cover that reads simply: The Chinese Way. ... But the omissions in the document are often more telling than the official timeline itself. The Chinese Way makes no mention of Dr Li Wenliang, the national hero of the epidemic. On December 30, Li raised an early alarm when his hospital in Wuhan began seeing patients with a Sars-like strain of pneumonia."

Art in Wuhan depicting Dr Li Wenliang, who raised an early alarm about the coronavirus outbreak and later died of the disease © Don Weinland

Don Weinland (2020) Inside Wuhan: China’s struggle to control the virus — and the narrative, FT Weekend - Magazine, 25-26 April, pp.12-19.

https://www.ft.com/content/61ec68d8-8432-11ea-b872-8db45d5f6714

Image source: ft.com

Courage: One of the 6Cs - for Individual & Governments? [i]

individual

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INTERPERSONAL : SCIENCES

humanistic --------------------------------------- mechanistic

SOCIOLOGY : POLITICAL

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group

Courage is perhaps one of the more challenging of the 6Cs for learners to grasp and even for experienced staff  to exercise. As a concept a definition is easy to find. Courage is often associated with whistleblowing. Over the decades whistleblowing has proved critical and vexed to both an individual's career and organizations.  Hodges' model encourages us to expand on this ...

The courage of seeking data, information, knowledge, diagnosis and prognosis Address: assumptions : misinformation : disinformation ["Dr Google", fake news, drugs online..?] Disclosure or withholding information ||||||||||||||| LONG GRASS |||||||||||||||

Husbands, wives, partners, sons and daughters with many friends find courage every moment of everyday (and many nights) when caring for someone living with dementia and other chronic illnesses. Practitioners may need courage to challenge promises made by family members that - "A nursing home? Never!" But, is the patient still at the centre of concern in these cases? Care at home at any cost? This can be the 'record' that matters to families.

Governments of all hues and globally are vested with courage, but how they exercise this quality depends vitally on governance. This is same reason, constraint that operates on the individual. "Do I? Don't I?" becomes "Do we? Don't we?" But then that individual practitioner is (must be) supported (governed) by supervision and the deliberations of the multidisciplinary team. What is the governments' record? Do governments have the courage to address the problems sustainable health and social care presents? Or, do they just kick the  problem...

Courage [ii]: One of the 6Cs - for Individual & Governments?

Evidence and the increasing effect of parallax

INTERPERSONAL : SCIENCES

SOCIOLOGY : POLITICAL

individual

from here ...	EVIDENCE
from here...	and here

group - population

Additional link: parallax

Extrasolar planets, x-phi and The Francis report

I'm sure there is a planet out there - extrasolar - with the physical make-up such that be it an incredible water fall, tidal surge, or rolling polished mega-rocks - the noise, could we hear it, would do far more than make your ears bleed.

Today, here in England there is a legal, health and political media event of very serious import. The ruckus in health and political circles might also make for more than bleeding noses and definitely thousands of continuing broken hearts.

The Francis report will be published today. Further insights and findings will be revealed c/o the Public Inquiry with recommendations on the Mid Staffordshire NHS Foundation Trust health care debacle.

In Philosophy Now Jan/Feb 2013 Tibor Fischer's editorial mentions the need for marketing within philosophy and literature, with the suggestion of placing x-phi on a T-shirt.

'X-phi' of course reads as experimental philosophy.

In health care, nursing and social care evidence counts for everything (and for h2cm too). Evidence based practice that is founded upon research is essential. Experiments are needed that can be reproduced, extended, validated. ...

Today is a profoundly sad day for everyone in the NHS, as many commentators have already predicted. The future constantly beckons, but today reflect we must that in the clamour for evidence based care, does this mean we must don T-shirts?:

x-care

Have we forgotten the principles of what it is to care: compassion - our duty of care?

No, but amid the cacophony of technology, technical care, the targets, statistics, budget cuts, the challenges to morale and nursing's values we need to be ever more vigilant.

We must learn how to x-listen and x-shout in the 21st century health care environment(s).

But experiments in how to listen, how to blow a whistle? Surely not.

Well yes: as clearly here basic care systems did not work they failed terribly: individually, organisationally and across the FIVE care domains of h2cm.