Letters in Defence of Sir Richard Doll

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No scientists are immune from accusations that they are too close to industry these days, not even recently-deceased ACSH Advisor Sir Richard Doll, despite his pioneering work demonstrating the terrible cancer toll of cigarettes. Luckily, other eminent scientists sprang to his defense in letters to the London Times printed December 9, 2006:

From Professor Colin Blakemore et al

Sir, Richard Doll was one of the world's greatest cancer researchers. To this day and in the years to come, many tens of millions of people, in the developing as well as the developed world, will owe their lives and health to his studies. Sir Richard died last year at the age of 92. It is with dismay that we now hear allegations against him that he cannot rebut for himself.

We feel it is our duty to defend Sir Richard's reputation and to recognise his extraordinary contribution to global health, which began in 1950 with his first paper demonstrating a link between smoking and lung cancer. He played a key role in the development of randomised controlled clinical trials -- now the standard method by which new treatments are evaluated. He also helped identify several occupational hazards most notably asbestos and assess reliably the dangers of radiation.

Sir Richard willingly made his expert advice available to industry and to government. The personal papers that he generously donated to the Wellcome Library included correspondence with commercial and other organisations. On the basis of those papers, it has recently been suggested that Sir Richard's advice to industry somehow compromised his own publications. We know of no evidence to support this allegation. Sir Richard was open about these consultancies and felt it appropriate that companies should seek expert advice on the safety of their products.

It was in the character of this remarkable man that he donated private income to charities and to Green College in Oxford, which he helped to found in 1979 to enhance academic research in the medical sciences.

Sir Richard changed the way scientists think about the causes of disease and the methods they use to investigate these. He identified some of the major threats to human health and, in doing so, saved countless lives. He should be remembered with fondness, respect and gratitude.

PROFESSOR COLIN BLAKEMORE
Chief Executive, Medical Research Council

DR MARK WALPORT
Director, Wellcome Trust

LORD MARTIN REES
President, Royal Society

PROFESSOR JOHN BELL
President, Academy of Medical Science

PROFESSOR ALEX MARKHAM
Chief Executive, Cancer Research UK

From Sir Richard Peto

I agree with the modern requirement that potentially relevant funding sources be disclosed, but I do not agree with the recent attack on the integrity of Richard Doll, or of his work, for non-disclosure in previous decades.

Sir Richard Doll was the world's greatest cancer epidemiologist. In the 1950s he and others showed that smoking was "a cause, and an important cause, of lung cancer" and that smoking caused many other diseases as well. He also helped to identify several occupational hazards, most notably asbestos, and to assess reliably the hazards of radiation. Worldwide, his work has probably prevented millions of deaths already, and it may well prevent tens of millions more.

After retiring in 1979 from his Oxford professorship he continued to work on major and minor causes of cancer for another 25 years, sometimes in a purely academic role and sometimes as a paid industrial consultant. This was widely known (and accepted), as he saw no reason to make a secret of it, but he generally donated any fees or honoraria to charitable causes to help avoid any unjustified accusations of bias. The correspondence about these honoraria was, therefore, openly among the papers that he deposited in the Wellcome Library (for public availability) before he died last year. In the 1980s there was no formal requirement of disclosure and his publications from that period do not necessarily include such information. That does not mean that they were biased; indeed, he was extraordinarily dispassionate and accurate in his assessment and description of epidemiological evidence.

Nowadays medical publications do have to include disclosure statements about sources of funding. This requirement is appropriate, and Richard himself approved wholeheartedly of its introduction, as do I. It will help avoid unjustified accusations of bias like those recently made posthumously against him. Richard Doll changed the way people think about the causes of cancer and the methods used to investigate these causes. He identified major threats to human health, and in doing so has already saved many lives. He should be remembered with fondness, respect and gratitude.

SIR RICHARD PETO,
Co-Director, MRC Clinical Trial Service Unit & Epidemiological Studies Unit