Response Addressing polarisation in science Brian D Earp ABSTRACT Ploug and Holm argue that polarisation in scientific communities can generate conflicts of interest for individual researchers. Their proposed solution to this problem is that authors should self-report whether they are polarised on conflict of interest disclosure forms. I argue that this is unlikely to work. This is because any author with the self-awareness and integrity to identify herself as polarised would be unlikely to conduct polarised research to begin with. Instead, I suggest that it is the role of (associate-level) editors of journals to detect and report on polarisation. One consequence of this view is that they need to be sufficiently familiar with the field of research they are evaluating to know whether polarisation is at stake. INTRODUCTION In a recent issue of the Journal of Medical Ethics, Ploug and Holm1 point out that scientific communities can sometimes become rather polarised.i This happens when two different groups of (comparably respectable) researchers argue for more or less opposite positions on some hotbutton empirical issue or question of public policy. The examples they give are debates over the merits of breast cancer screening and the advisability of prescribing statins to people at low risk of heart disease. Other examples can be easily brought to mind.ii It is important to note, however, that—according to Ploug and Holm— i Note: This article is adapted from a blog post by the author2 originally published at the Journal of Medical Ethics blog. This post is available at the following link: http://blogs.bmj.com/medicalethics/2015/04/30/how-can-journal-editors-fightbias-in-polarized-scientific-communities/. ii For instance, there is the ‘enhancement’ debate in biomedical ethics, which pits so-called bioconservatives against so-called bioliberals (eg, ref. 3, p.12)—with each group taking roughly opposite positions on the question of using medical technologies for purposes other than treatment.4 Another example, familiar to me from my own research focus, is the debate over the health benefits versus risks of male circumcision.5–9 I will say a little more about this debate in a subsequent footnote. Correspondence to Brian D Earp, Uehiro Centre for Practical Ethics, University of Oxford, Oxford OX1 1PT, UK; brian.earp@gmail.com mere disagreement is not the same as polarisation. Instead, the latter can (only?) be said to happen when researchers POLARISATION AS A CONFLICT OF INTEREST Ploug and Holm’s suggestion is this: the polarisation of a scientific community can generate conflicts of interest for particular researchers. Specifically: [T]he threat is that a polarised group may nourish an interest in advancing the position and views of the group, and that this interest may come to be a main criterion and goal for the choice of methods, the reporting of findings and the provision of policy advice. This interest may well be based on an honest conviction that one is right and thus not be in any way morally reprehensible, but even honestly held convictions can introduce potential biases in research and reporting. ( p.356) (1) begin to self-identify as proponents of a particular position that needs to be strongly defended beyond what is supported by the data, and (2) begin to discount arguments and data that would normally be taken as important in a scientific debate. ( p. 356) But there is something peculiar about criterion number (1). On the one hand, it is framed in terms of self-identification: ‘I see myself as a proponent of a particular position that needs to be strongly defended’. That much makes sense—and there probably isn’t anything wrong with regarding oneself this way. But on the other hand, it states that this act of position-defending must go ‘beyond what is supported by the data’. The problem is: who would self-identify as someone who makes inadequately supported arguments? As it seems to me, if one realises that one’s arguments are getting too one-sided (to the point of being biased), then one would have a hard time carrying on producing them without making some suitable adjustment. At least, one would without losing a degree of academic credibility—and no small measure of self-respect. This point will become important later on. Now, we might chalk this up to ambiguous phrasing. Perhaps the authors mean that (in order for polarisation to be diagnosed) researchers have to selfidentify as ‘proponents of a particular position’, while the parts about going ‘beyond the data’ and ‘discounting’ important information are what an objective third-party would attribute to the researchers (even if it's not what they would say about themselves). It is difficult to know for sure, based upon the way the criteria are written. But whatever the case, I am going to suggest that this issue of self-identification poses a problem for Ploug and Holm’s ultimate proposal – ie, for how to combat polarisation. To see why this is the case, I shall have to say a little bit more about what they see as being the matter with polarisation in the first place. Earp BD. J Med Ethics Month 2015 Vol 0 No 0 That would be a serious problem.iii As Ploug and Holm explain, it could ‘threaten the objectivity of science, and may in turn bias public debate and political decisionmaking’ ( p.356). Indeed, in many areas of biomedicine (as well as in other scientific fields), one often gets the feeling that a particular group of researchers—whether they are direct collaborators or not—is ultimately more interested in scoring points for their ‘side’ than in getting to the bottom of a genuine dispute. One situation in which this can occur is when there is a contentious moral or political question hanging in the balance (although perhaps at some remove), such that individual studies start to look like so many chess pieces in an extra-scientific debate (see generally, eg, refs. 10 and 11).iv iii As David Trafimow ( personal correspondence, 4 May 2015) has pointed out, however, ‘Few researchers are completely objective [and] the history of science is full of examples where researchers with considerable—even extreme— biases made important contributions. [So,] although [ polarisation] has the potential to cause harm, it also can confer benefits. [For example,] researchers with a strong bias may gain extra motivation to support their point of view or disconfirm an opposing one, [and] this [may in turn] lead to more creative ideas and new insights. Furthermore…polarised researchers may [ultimately turn out to] be right. [But] even when they are wrong, polarised researchers can greatly aid the progress of science by proposing conundrums for the other side to attempt to solve’. iv This sort of phenomenon can be seen in the debate over male circumcision (if I may pursue the example from footnote number ii). Since circumcision is a religious ritual for some groups—and one that is at least prima facie harmful12–14—it might be seen as important (for some researchers) to show that ‘health benefits’ can be ascribed to it, since these could be used to mount a ‘secular’ defense of the practice.15–18 On the other hand, there are moral and even human rights objections to 1 Response Simple career interests can play a role here too. For example, there may be a perceived need to save face by defending one’s own prior work, or that of one’s friends or ideological allies. There are many other factors as well. And these can apply to any contested topic in science or medicine. So polarisation may very well contribute to bias in research. How do Ploug and Holm propose to address it? A SIMPLE SOLUTION? Their basic suggestion is that researchers should self-report polarisation as a ‘conflict of interest’ on the standard forms they fill out when submitting their papers. After reflecting on a few diagnostic questions, that is, they might end up writing something like this (from p.357): (1) This article reports research in a polarised field. (2) The research group I/we belong to generally believe that the intervention we have researched should/should not be introduced in healthcare. Is this a promising solution to the problem of polarisation? SOME DOUBTS I argue that it is not. Imagine that you are a researcher with enough self-awareness and personal integrity to identify yourself as ‘polarised’ on a conflict of interest disclosure form (if in fact that is what you are). How likely is it, in this scenario, that you are also the sort of person who would conduct polarised research—and write up polarised articles—to begin with? I do not think it could be very likely. As I suggested earlier, once one realises that one is getting dogmatic about pressing a particular viewpoint (so: failing to engage seriously with the best arguments from the other side, discounting important information, and so on), one cannot go on submitting the same sorts of papers, as though this realisation has had no force. At least, one cannot if one has even a modicum of academic integrity— which is precisely what (self ) disclosure of potential conflicts of interest requires. circumcision,19–24 which are quite a bit easier ‘sell’ if one can demonstrate harm.25–27 This ends up resulting in a strange—and contentious —cocktail of religion, science and ethics in the circumcision literature,9 28 29 with extremely polarised camps making largely incompatible empirical claims and related policy suggestions.30 31 2 A ROLE FOR EDITORS? So what about shifting the onus to editors? Ploug and Holm touch on this issue themselves when they write ‘Journal editors have important roles to play here’ (p.357). Specifically, ‘[i]f editors are aware that a field is polarised’, they should factor this into their editorial process regarding, for example, ‘choosing referees or when scrutinising the quality of the science or the policy recommendations’ (ibid.). But what if an editor is not aware that a specific field is polarised, in the sense defined by Ploug and Holm? As Ploug and Holm point out, there are ‘many cases where [ journal editors] are not themselves able to identify polarisation because they are in a similar position to the average user of scientific evidence’ (p.357). This is where they suggest that author self-reporting could be a helpful (if admittedly partial) solution. If I am right, however, and this is not likely to be a feasible strategy, then what alternative is there for these problematic cases? I would like to make the following suggestion. Any associate-level (handling) editor who is charged with making a publication recommendation about a particular manuscript, should know at least enough about the field in question to judge whether it is polarised (in the Ploug and Holm sense) and—if it is—on which side of the fence the manuscript falls. They do not need to be experts in every field. But if they do not know enough about the relevant subject matter to assess if something as ‘big picture’ as polarisation is an issue, then I do not see how they could be qualified to make the other sorts of important editorial decisions that are involved in, say, selecting appropriate peer reviewers for the manuscript, or making an informed recommendation about whether to publish the paper on the basis of the peer reviews. Here is what this means in practical terms. If a journal editor is not sure about whether a given field (or manuscript) show signs of being polarised, then she should probably take the time to do some background reading in the relevant area of research. If she cannot, however—or if she doesn’t have the time, etc—then she should consider recusing herself from the review process (for that paper) and sending it to a different editor who knows more about the field. Of course, it would be important to make sure that this alternative editor was not herself a polarized participant in the same scientific debate. On the other hand, if the original editor can assess polarisation—and sees that the manuscript sits at one extreme pole—then she can choose from among the following options: A. encourage the author(s) to resubmit the manuscript in a less polarised form (ie, by taking more seriously the best arguments and data from the other side and responding to them in a charitable fashion), B. invite a commentary or response paper ( prior to publication) from a respectable researcher on the ‘other side’, C. publish the paper as it is, but with an editorial statement alerting the reader to the polarised nature of the research and/or its author(s) (perhaps with a list of references to credible opposing arguments) or D. some combination of the above. These kinds of measures, in my view, would have a decent chance of mitigating some of the bias that may come with polarisation, without relying on individual researchers to self-characterise as making polarised arguments. CONCLUSION In conclusion, it should not be the responsibility of authors to ‘out’ themselves (on a conflict of interest disclosure form) as being polarised: ie, as making inadequately supported arguments. After all, anyone with the integrity to do this would not be making such arguments in the first place! Instead, journal editors who are directly handling manuscripts (ie, at the associate level) should make sure that they know at least enough about the relevant field of research to judge whether it is polarised— and then take steps (along the lines I have suggested) to mitigate any associated biases or conflicts of interest. Acknowledgements Thanks are due to Julian Savulescu and David Trafimow for feedback on an earlier draft of this commentary. Competing interests None declared. Provenance and peer review Not commissioned; internally peer reviewed. To cite Earp BD. J Med Ethics Published Online First: [ please include Day Month Year] doi:10.1136/ medethics-2015-102891 Received 7 May 2015 Accepted 25 May 2015 J Med Ethics 2015;0:1–3. doi:10.1136/medethics-2015-102891 Earp BD. J Med Ethics Month 2015 Vol 0 No 0 Response REFERENCES 1 2 3 4 5 6 7 8 9 10 Ploug T, Holm S. Conflict of interest disclosure and the polarisation of scientific communities. J Med Ethics 2015;41:356–8. Earp BD. How can journal editors fight bias in polarized scientific communities? J Med Ethics Blog 2015a. Earp BD, Wudarczyk OA, Sandberg A, et al. If I could just stop loving you: anti-love biotechnology and the ethics of a chemical breakup. Am J Bioeth 2013;13 (11):3–17. Earp BD, Sandberg A, Kahane G, et al. When is diminishment a form of enhancement? Rethinking the enhancement debate in biomedical ethics. Front Syst Neurosci 2014;8(12):1–8. Earp BD. The ethics of infant male circumcision. J Med Ethics 2013;39(7):418–20. Earp BD. Sex and circumcision. Am J Bioeth 2015;15 (2):43–5. Earp BD. Do the benefits of male circumcision outweigh the risks? A critique of the proposed CDC guidelines. Front Pediatr 2015;3(18):1–6. Earp BD, Darby R. Tradition vs. individual rights: the current debate on circumcision. The Conversation 2 November 2012. https://theconversation.com/tradition-vsindividual-rights-the-current-debate-on-circumcision10199 Earp BD, Darby R. Does science support infant circumcision? The Skeptic 2015;25:23–30. Betz G. In defence of the value free ideal. Eur J Philos Sci 2013;3(2):207–20. Earp BD. J Med Ethics Month 2015 Vol 0 No 0 11 12 13 14 15 16 17 18 19 20 21 Longino H. Beyond “bad science”: skeptical reflections on the value-freedom of scientific inquiry. Sci Technol Hum Values 1983;8(1):7–17. Dworkin G. Cutting edge bioethics. 3 Quarks Daily 23 September 2013. http://www.3quarksdaily.com/ 3quarksdaily/2013/09/cutting-edge-bioethics.html Merkel R, Putzke H. After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault? J Med Ethics 2013;39(7):444–9. Sarajlic E. Can culture justify infant circumcision? Res Publica 2014;20(4):327–43. Goldman R. Circumcision policy: a psychosocial perspective. Pediatr Child Health 2004;9(9):630–3. Darby R. The riddle of the sands: circumcision, history, and myth. N Z Med J 2005;118(1218):U1564. Darby R, Svoboda JS. A rose by any other name? Rethinking the similarities and differences between male and female genital cutting. Med Anthropol Q 2007;21(3):301–23. Fox M, Thomson M. A covenant with the status quo? Male circumcision and the new BMA guidance to doctors. J Med Ethics 2005;31(8):463–9. DeLaet DL. Framing male circumcision as a human rights issue? Contributions to the debate over the universality of human rights. J Hum Rights 2009;8 (4):405–26. Svoboda JS. Circumcision of male infants as a human rights violation. J Med Ethics 2013;39(7):469–74. Ungar-Sargon E. On the impermissibility of infant male circumcision: a response to Mazor (2013). J Med Ethics 2015;41(2):186–90. 22 23 24 25 26 27 28 29 30 31 Darby R. The child’s right to an open future: is the principle applicable to non-therapeutic circumcision? J Med Ethics 2013;39(7):463–8. Darby R. Risks, benefits, complications and harms: neglected factors in the current debate on nontherapeutic circumcision. Kennedy Inst Ethics J 2015;25(1):1–34. Royal Dutch Medical Association. Non-therapeutic circumcision of male minors. Amsterdam: KNMG, 2010. Hammond T. A preliminary poll of men circumcised in infancy or childhood. BJU Int 1999;83(Suppl 1):85–92. Boyle GJ, Goldman R, Svoboda JS, et al. Male circumcision: pain, trauma and psychosexual sequelae. J Health Psychol 2002;7(3):329–43. Sorrells ML, Snyder JL, Reiss MD, et al. Fine-touch pressure thresholds in the adult penis. BJU Int 2007;99(4):864–9. Bell K. Genital cutting and Western discourses on sexuality. Med Anthropol Q 2005;19(2):125–48. Carpenter LM. On remedicalisation: male circumcision in the United States and Great Britain. Sociol Health Illn 2010;32(4):613–30. Bell K. HIV prevention: Making male circumcision the ‘right’ tool for the job. Glob Public Health 2015;10 (5–6):552–72. Collier R. Ugly, messy and nasty debate surrounds circumcision. CMAJ 2012;184(1):E25–6. 3 

Response Addressing polarisation in science Brian D Earp ABSTRACT Ploug and Holm argue that polarisation in scientific communities can generate conflicts of interest for individual researchers. Their proposed solution to this problem is that authors should self-report whether they are polarised on conflict of interest disclosure forms. I argue that this is unlikely to work. This is because any author with the self-awareness and integrity to identify herself as polarised would be unlikely to conduct polarised research to begin with. Instead, I suggest that it is the role of (associate-level) editors of journals to detect and report on polarisation. One consequence of this view is that they need to be sufficiently familiar with the field of research they are evaluating to know whether polarisation is at stake. INTRODUCTION In a recent issue of the Journal of Medical Ethics, Ploug and Holm1 point out that scientific communities can sometimes become rather polarised.i This happens when two different groups of (comparably respectable) researchers argue for more or less opposite positions on some hotbutton empirical issue or question of public policy. The examples they give are debates over the merits of breast cancer screening and the advisability of prescribing statins to people at low risk of heart disease. Other examples can be easily brought to mind.ii It is important to note, however, that—according to Ploug and Holm— i Note: This article is adapted from a blog post by the author2 originally published at the Journal of Medical Ethics blog. This post is available at the following link: http://blogs.bmj.com/medicalethics/2015/04/30/how-can-journal-editors-fightbias-in-polarized-scientific-communities/. ii For instance, there is the ‘enhancement’ debate in biomedical ethics, which pits so-called bioconservatives against so-called bioliberals (eg, ref. 3, p.12)—with each group taking roughly opposite positions on the question of using medical technologies for purposes other than treatment.4 Another example, familiar to me from my own research focus, is the debate over the health benefits versus risks of male circumcision.5–9 I will say a little more about this debate in a subsequent footnote. Correspondence to Brian D Earp, Uehiro Centre for Practical Ethics, University of Oxford, Oxford OX1 1PT, UK; brian.earp@gmail.com mere disagreement is not the same as polarisation. Instead, the latter can (only?) be said to happen when researchers POLARISATION AS A CONFLICT OF INTEREST Ploug and Holm’s suggestion is this: the polarisation of a scientific community can generate conflicts of interest for particular researchers. Specifically: [T]he threat is that a polarised group may nourish an interest in advancing the position and views of the group, and that this interest may come to be a main criterion and goal for the choice of methods, the reporting of findings and the provision of policy advice. This interest may well be based on an honest conviction that one is right and thus not be in any way morally reprehensible, but even honestly held convictions can introduce potential biases in research and reporting. ( p.356) (1) begin to self-identify as proponents of a particular position that needs to be strongly defended beyond what is supported by the data, and (2) begin to discount arguments and data that would normally be taken as important in a scientific debate. ( p. 356) But there is something peculiar about criterion number (1). On the one hand, it is framed in terms of self-identification: ‘I see myself as a proponent of a particular position that needs to be strongly defended’. That much makes sense—and there probably isn’t anything wrong with regarding oneself this way. But on the other hand, it states that this act of position-defending must go ‘beyond what is supported by the data’. The problem is: who would self-identify as someone who makes inadequately supported arguments? As it seems to me, if one realises that one’s arguments are getting too one-sided (to the point of being biased), then one would have a hard time carrying on producing them without making some suitable adjustment. At least, one would without losing a degree of academic credibility—and no small measure of self-respect. This point will become important later on. Now, we might chalk this up to ambiguous phrasing. Perhaps the authors mean that (in order for polarisation to be diagnosed) researchers have to selfidentify as ‘proponents of a particular position’, while the parts about going ‘beyond the data’ and ‘discounting’ important information are what an objective third-party would attribute to the researchers (even if it's not what they would say about themselves). It is difficult to know for sure, based upon the way the criteria are written. But whatever the case, I am going to suggest that this issue of self-identification poses a problem for Ploug and Holm’s ultimate proposal – ie, for how to combat polarisation. To see why this is the case, I shall have to say a little bit more about what they see as being the matter with polarisation in the first place. Earp BD. J Med Ethics Month 2015 Vol 0 No 0 Note: this is a corrected proof. For the published version, please see J Med Ethics 2015;41:782-784 doi:10.1136/medethics-2015-102891, available at http://jme.bmj.com/content/41/9/782 That would be a serious problem.iii As Ploug and Holm explain, it could ‘threaten the objectivity of science, and may in turn bias public debate and political decisionmaking’ ( p.356). Indeed, in many areas of biomedicine (as well as in other scientific fields), one often gets the feeling that a particular group of researchers—whether they are direct collaborators or not—is ultimately more interested in scoring points for their ‘side’ than in getting to the bottom of a genuine dispute. One situation in which this can occur is when there is a contentious moral or political question hanging in the balance (although perhaps at some remove), such that individual studies start to look like so many chess pieces in an extra-scientific debate (see generally, eg, refs. 10 and 11).iv iii As David Trafimow ( personal correspondence, 4 May 2015) has pointed out, however, ‘Few researchers are completely objective [and] the history of science is full of examples where researchers with considerable—even extreme— biases made important contributions. [So,] although [ polarisation] has the potential to cause harm, it also can confer benefits. [For example,] researchers with a strong bias may gain extra motivation to support their point of view or disconfirm an opposing one, [and] this [may in turn] lead to more creative ideas and new insights. Furthermore…polarised researchers may [ultimately turn out to] be right. [But] even when they are wrong, polarised researchers can greatly aid the progress of science by proposing conundrums for the other side to attempt to solve’. iv This sort of phenomenon can be seen in the debate over male circumcision (if I may pursue the example from footnote number ii). Since circumcision is a religious ritual for some groups—and one that is at least prima facie harmful12–14—it might be seen as important (for some researchers) to show that ‘health benefits’ can be ascribed to it, since these could be used to mount a ‘secular’ defense of the practice.15–18 On the other hand, there are moral and even human rights objections to 1 Response Simple career interests can play a role here too. For example, there may be a perceived need to save face by defending one’s own prior work, or that of one’s friends or ideological allies. There are many other factors as well. And these can apply to any contested topic in science or medicine. So polarisation may very well contribute to bias in research. How do Ploug and Holm propose to address it? A SIMPLE SOLUTION? Their basic suggestion is that researchers should self-report polarisation as a ‘conflict of interest’ on the standard forms they fill out when submitting their papers. After reflecting on a few diagnostic questions, that is, they might end up writing something like this (from p.357): (1) This article reports research in a polarised field. (2) The research group I/we belong to generally believe that the intervention we have researched should/should not be introduced in healthcare. Is this a promising solution to the problem of polarisation? SOME DOUBTS I argue that it is not. Imagine that you are a researcher with enough self-awareness and personal integrity to identify yourself as ‘polarised’ on a conflict of interest disclosure form (if in fact that is what you are). How likely is it, in this scenario, that you are also the sort of person who would conduct polarised research—and write up polarised articles—to begin with? I do not think it could be very likely. As I suggested earlier, once one realises that one is getting dogmatic about pressing a particular viewpoint (so: failing to engage seriously with the best arguments from the other side, discounting important information, and so on), one cannot go on submitting the same sorts of papers, as though this realisation has had no force. At least, one cannot if one has even a modicum of academic integrity— which is precisely what (self ) disclosure of potential conflicts of interest requires. circumcision,19–24 which are quite a bit easier ‘sell’ if one can demonstrate harm.25–27 This ends up resulting in a strange—and contentious —cocktail of religion, science and ethics in the circumcision literature,9 28 29 with extremely polarised camps making largely incompatible empirical claims and related policy suggestions.30 31 2 A ROLE FOR EDITORS? So what about shifting the onus to editors? Ploug and Holm touch on this issue themselves when they write ‘Journal editors have important roles to play here’ (p.357). Specifically, ‘[i]f editors are aware that a field is polarised’, they should factor this into their editorial process regarding, for example, ‘choosing referees or when scrutinising the quality of the science or the policy recommendations’ (ibid.). But what if an editor is not aware that a specific field is polarised, in the sense defined by Ploug and Holm? As Ploug and Holm point out, there are ‘many cases where [ journal editors] are not themselves able to identify polarisation because they are in a similar position to the average user of scientific evidence’ (p.357). This is where they suggest that author self-reporting could be a helpful (if admittedly partial) solution. If I am right, however, and this is not likely to be a feasible strategy, then what alternative is there for these problematic cases? I would like to make the following suggestion. Any associate-level (handling) editor who is charged with making a publication recommendation about a particular manuscript, should know at least enough about the field in question to judge whether it is polarised (in the Ploug and Holm sense) and—if it is—on which side of the fence the manuscript falls. They do not need to be experts in every field. But if they do not know enough about the relevant subject matter to assess if something as ‘big picture’ as polarisation is an issue, then I do not see how they could be qualified to make the other sorts of important editorial decisions that are involved in, say, selecting appropriate peer reviewers for the manuscript, or making an informed recommendation about whether to publish the paper on the basis of the peer reviews. Here is what this means in practical terms. If a journal editor is not sure about whether a given field (or manuscript) show signs of being polarised, then she should probably take the time to do some background reading in the relevant area of research. If she cannot, however—or if she doesn’t have the time, etc—then she should consider recusing herself from the review process (for that paper) and sending it to a different editor who knows more about the field. Of course, it would be important to make sure that this alternative editor was not herself a polarized participant in the same scientific debate. On the other hand, if the original editor can assess polarisation—and sees that the manuscript sits at one extreme pole—then she can choose from among the following options: A. encourage the author(s) to resubmit the manuscript in a less polarised form (ie, by taking more seriously the best arguments and data from the other side and responding to them in a charitable fashion), B. invite a commentary or response paper ( prior to publication) from a respectable researcher on the ‘other side’, C. publish the paper as it is, but with an editorial statement alerting the reader to the polarised nature of the research and/or its author(s) (perhaps with a list of references to credible opposing arguments) or D. some combination of the above. These kinds of measures, in my view, would have a decent chance of mitigating some of the bias that may come with polarisation, without relying on individual researchers to self-characterise as making polarised arguments. CONCLUSION In conclusion, it should not be the responsibility of authors to ‘out’ themselves (on a conflict of interest disclosure form) as being polarised: ie, as making inadequately supported arguments. After all, anyone with the integrity to do this would not be making such arguments in the first place! Instead, journal editors who are directly handling manuscripts (ie, at the associate level) should make sure that they know at least enough about the relevant field of research to judge whether it is polarised— and then take steps (along the lines I have suggested) to mitigate any associated biases or conflicts of interest. Acknowledgements Thanks are due to Julian Savulescu and David Trafimow for feedback on an earlier draft of this commentary. Competing interests None declared. Provenance and peer review Not commissioned; internally peer reviewed. To cite Earp BD. J Med Ethics Published Online First: [ please include Day Month Year] doi:10.1136/ medethics-2015-102891 Received 7 May 2015 Accepted 25 May 2015 J Med Ethics 2015;0:1–3. doi:10.1136/medethics-2015-102891 Earp BD. J Med Ethics Month 2015 Vol 0 No 0 Response REFERENCES 1 2 3 4 5 6 7 8 9 10 Ploug T, Holm S. Conflict of interest disclosure and the polarisation of scientific communities. J Med Ethics 2015;41:356–8. Earp BD. How can journal editors fight bias in polarized scientific communities? J Med Ethics Blog 2015a. Earp BD, Wudarczyk OA, Sandberg A, et al. If I could just stop loving you: anti-love biotechnology and the ethics of a chemical breakup. Am J Bioeth 2013;13 (11):3–17. Earp BD, Sandberg A, Kahane G, et al. When is diminishment a form of enhancement? Rethinking the enhancement debate in biomedical ethics. Front Syst Neurosci 2014;8(12):1–8. Earp BD. The ethics of infant male circumcision. J Med Ethics 2013;39(7):418–20. Earp BD. Sex and circumcision. Am J Bioeth 2015;15 (2):43–5. Earp BD. Do the benefits of male circumcision outweigh the risks? A critique of the proposed CDC guidelines. Front Pediatr 2015;3(18):1–6. Earp BD, Darby R. Tradition vs. individual rights: the current debate on circumcision. The Conversation 2 November 2012. https://theconversation.com/tradition-vsindividual-rights-the-current-debate-on-circumcision10199 Earp BD, Darby R. Does science support infant circumcision? The Skeptic 2015;25:23–30. Betz G. In defence of the value free ideal. Eur J Philos Sci 2013;3(2):207–20. Earp BD. J Med Ethics Month 2015 Vol 0 No 0 11 12 13 14 15 16 17 18 19 20 21 Longino H. Beyond “bad science”: skeptical reflections on the value-freedom of scientific inquiry. Sci Technol Hum Values 1983;8(1):7–17. Dworkin G. Cutting edge bioethics. 3 Quarks Daily 23 September 2013. http://www.3quarksdaily.com/ 3quarksdaily/2013/09/cutting-edge-bioethics.html Merkel R, Putzke H. After Cologne: male circumcision and the law. Parental right, religious liberty or criminal assault? J Med Ethics 2013;39(7):444–9. Sarajlic E. Can culture justify infant circumcision? Res Publica 2014;20(4):327–43. Goldman R. Circumcision policy: a psychosocial perspective. Pediatr Child Health 2004;9(9):630–3. Darby R. The riddle of the sands: circumcision, history, and myth. N Z Med J 2005;118(1218):U1564. Darby R, Svoboda JS. A rose by any other name? Rethinking the similarities and differences between male and female genital cutting. Med Anthropol Q 2007;21(3):301–23. Fox M, Thomson M. A covenant with the status quo? Male circumcision and the new BMA guidance to doctors. J Med Ethics 2005;31(8):463–9. DeLaet DL. Framing male circumcision as a human rights issue? 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