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Open Access means people die

Reader beware, a rant ahead.

Believe me, I waited 24 hours to calm down before writing this text. But a day passed and I’m still outraged by recent posts of Peter Murray-Rust entitled “Open Research Reports: What Jenny and I said (and why I am angry)” and “Open Access saves lives“. He made there following assertions:

  • close access publishing restricts access to information
  • no access to information means suboptimal decisions, for example in choosing medical treatment
  • therefore closed access means people die
  • which means that open access saves lives

And then he offers some anecdotal evidence supporting this claim.

I would like to offer an alternative view:

  • scientific papers sometime contain false conclusions (whether by a mistake or a fraud)
  • untrained people can use scientific papers with false conclusions as a support for wrong decisions (as many people did with Wakefield’s Lancet paper by not vaccinating their kids)
  • open access means that there will be more potentially harmful papers available to general public
  • therefore open access means people will die

You see? Both claims are based on anecdotal evidence. Both are easy to falsify if you try (and it’s not hard). But there’s more – claiming that Open Access will save lives suggests that access to literature is currently the most crucial problem, at least in medicine. But there far more important problems in health-care, many of which could be solved much faster. If you want to have an impact, please make freely available  summaries of primary literature translated into 60 most popular languages – you don’t need to make it open, free is enough. If you want to have an impact, please make physicians to adopt clinical decision support systems – there are studies showing that between 50 000 and 100 000 people die in the US from diagnostics error alone of which even 75% could be preventable and these mistakes already happen before a physician has a chance to make his suboptimal decision. While I’m not sure both solutions will have substantially more impact in the long run, both will have an impact much faster, because Open Access simply needs time.

Unscientific approach plus ideologization makes Open Access a religion. And I’m not interested in joining religious wars. I’m interested in fixing the problems with scholarly publishing, such as lack of access and outrageous costs. Dear Peter, while I admire your work on openness, by making your language “less nuanced”, as you wrote (and less thought-through as I would say), you’re making my work much more difficult.

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