By Steven Lubet
Steven Lubet is the Williams Memorial Professor at Northwestern University Pritzker School of Law, where he specializes in professional responsibility and ethics.
Let’s assume that everyone on the PACE team, and all of their colleagues in the biopsychosocial school, always acted in complete good faith. Let’s agree that they all want nothing more than to help ME/CFS survivors, and they sincerely believe that CBT and GET are safe and effective treatments. Let’s grant the claim that they are committed to following where science leads, and they have no desire to cling to preconceived notions. Let’s allow that the methodological problems in the PACE trial were committed in error and were not intended to skew the results.
Let’s accept all of that because (1) it allows us to focus on the important task of encouraging valid research, without the distraction of personalities; (2) the PACE trial and others like it will still fall of their own weight; and (3) it is easier and more persuasive to make the case based on facts and numbers, rather than by challenging the motives of the PACE investigators.
But even taking the highest possible road, there is an uncomfortable question that must be asked: Why won’t any of the PACE brigade disown, or at least try to moderate, the outbursts of Prof. Michael Sharpe?
It is understandable that Sharpe is unhappy about the discrediting of the PACE trial. He has devoted much of his professional life to the CBT/GET theory, and it must be frustrating and painful to see it so broadly rejected by patients and scientists. His reaction, however, has been anything but graceful. He repeatedly lashes out at those who disagree with him, often leveling intemperate charges. This cannot be unknown to the other PACE investigators.
In the promotion of last year’s “Special Ethics Seminar” at St Cross College, for example, Sharpe assailed what he called “co-ordinated pressure group action against science” and claimed that critics of the PACE trial threatened “the future of science” itself. And that was just the posted abstract. There is no telling what accusations Sharpe leveled behind closed doors, because the seminar itself was not open to the public. Nobody at St Cross College responded to my emails seeking further information, which looks like another instance of Sharpe’s colleagues covering for him. If Sharpe’s lecture was reasonable and responsible, why keep it a secret?
Then there was Sharpe’s response to David Tuller’s crowd funding efforts, which he called a “conflict of interest.” That is a serious accusation to make against Tuller, who is an academic journalist, and it was completely unfounded. There is no principle of scholarly or professional ethics that precludes someone from raising money to pursue an investigative project. As a legal ethicist, I can say that with certainty. Having presented a “Special Ethics Seminar,” Sharpe should have known that as well. If not, someone at St Cross College (or any of his co-investigators on PACE and other studies) surely could have explained it to him. But again, there is only silence from Sharpe’s colleagues.
Finally, we come to the parliamentary debate on ME/CFS held recently in the United Kingdom. It was organized by MP Carol Monaghan of Glasgow, who has been an outspoken PACE critic. As Monaghan explained during her opening speech, Sharpe had written to her in advance of the debate, accusing her of “conduct unbecoming a member of parliament.” This accusation was apparently an extreme breach of protocol that caused gasps among the other MPs, and calls for Sharpe to apologize. (The U.K. is evidently more decorous, and more protective of legislators, than is the U.S.)
Far from apologizing, Sharpe doubled down. He tweeted that his comment to Monaghan had been “about misrepresenting science in parliament,” as though that somehow made it alright to denigrate Monaghan’s conduct. Of course, that was not the first time Sharpe claimed that he personally speaks for “science,” and that everyone else is guilty of misrepresentation when they disagree with him. It is hard to tell whether he is channeling Louis XIV (“La science, c’est moi”) or Donald Trump (“I alone can study it”).
Fortunately, other MPs at the debate were well familiar with the problems in the PACE trial, which they referred to as “discredited,” “nonsense,” and “seriously flawed.” Many of them called for the abandonment of CBT and especially GET as standard treatments in the U.K. This, together with the calls for his apology, prompted a tweeted outburst from Sharpe, in which he complained about “defamation under parliamentary priviledge (sic).”
I watched the entire debate and there was nothing said that was remotely defamatory. It seems that Sharpe cannot tell the difference between disagreement and defamation, which is not a good look for a scientist. It should not require parliamentary privilege to criticize a clinical trial without having to fear a lawsuit. (Parliamentary privilege makes otherwise defamatory statements non-actionable.)
But Sharpe was not done yet. He followed up with another complaint about “the use of parliamentary priviledge (sic) to knowingly make libellous comments about a large group of researchers knowing that they can’t respond (U.K. spelling original).” Now he seemed to have taken it upon himself to speak for the entire PACE team, or perhaps for all researchers in the biopsychosocial school. So let me repeat: it is not libelous to criticize a clinical study. Quite the contrary, the scientific method itself depends on such critical evaluation, even if it is uncomfortable or embarrassing to some researchers. Hurling accusations like this – along with delivering secret lectures — simply suggests that Sharpe cannot reply persuasively on the merits.
Which brings us back to my original question. Given that Sharpe claims to speak for “a large group of researchers,” why haven’t the others disassociated themselves from his intemperate tweets?