Auckland University is defending a history professor's "academic freedom" to express her views despite scientific evidence showing her central conclusion is wrong. The university says errors in Linda Bryder's A History of the 'Unfortunate Experiment' at National Women's Hospital are "matters of interpretation" and won't be corrected.
The book, published by Auckland University Press last year, already has an errata slip and other errors have been corrected in the British edition. Professor Bryder, who received a $345,000 Marsden Fund grant for her research, created a storm of controversy with her revisionist version of the "unfortunate experiment" conducted by Dr Herbert Green on National Women's patients from 1965-1974.
Bryder said there was no experiment and Judge (now Dame) Silvia Cartwright, who presided over an inquiry in 1987 into whether women were mistreated, got it wrong.
Respected academics at both Auckland and Otago Universities have been scathing about the standard of the research.
Sir David Skegg, vice-chancellor of Otago University, said the book was "replete with factual errors and selective quotations" and "not a worthy contribution to the debate about Green's study".
The latest to join the chorus of concern is associate professor Linda Hancock of Deakin University, Australia. "It's a very biased reading of history. She misrepresents the weight of evidence and privileges Green's voice," says Deakin, a former Victoria law reform commissioner.
In June, a report in the Australian and New Zealand Journal of Obstetrics and Gynaecology confirmed the scientific evidence presented to the Cartwright Inquiry. It conclusively showed that during the "clinical study", 127 women at the hospital "underwent numerous interventions" that aimed to observe, rather than treat a potentially pre-cancerous condition.
The group denied proper treatment for "cervical carcinoma in situ" (now CIN3) had a 10 times greater risk of invasive cancer, and many had to undergo radical surgery. Eight of them died compared to one in the conventionally treated group.
The Herald asked how the scientific evidence, which shows there was an experiment, women were harmed and Judge Cartwright's judgment was correct, reconciled with Bryder's conclusion. The professor, Auckland University Press and the book's British publisher, Palgrave Macmillan, declined to respond.
In the wake of the journal report, the Auckland Women's Health Council has called for Bryder to apologise to the women and their families who were part of Dr Green's study. In 1992 the dean of the School of Medicine at Auckland University, apologised to the victims of the National Women's experiments.
In May, Bryder, with the endorsement of Auckland University Press, apologised to retired professor Richard Seddon and Otago University for a mistake in the book. But when Clare Matheson, one of the women mistreated by Green, also asked for errors about her to be corrected, she was refused.
"None of these matters can reasonably be considered avoidable errors of fact warranting an apology," said University registrar Tim Greville in an email to Matheson. The errors relate to the number of children Matheson had and when she had them, what her job was, where she had treatment, and the description of her medical condition.
Bryder claims she is the subject of "a smear campaign" - the title of a seminar she gave at Oxford Brookes University in April and is giving at the Skeptics Conference in Auckland in August. She says our Education Act enshrines "academic freedom to put forward new ideas and state controversial or unpopular opinions", but does not provide "protection from ad hominem, scurrilous and unwarranted attacks on one's integrity and professionalism, as I have recently discovered".
Her book has been shortlisted for this year's Australian Historical Association Ernest Scott Prize.
Gaps in the system
Bryder's book highlights a chain of failures in New Zealand's system for ensuring academic accuracy and accountability. In September last year Auckland University history professors Raewyn Dalziel and Malcolm Campbell wrote to Clare Matheson: "We recognise the obligation on us as members of the University to uphold the freedom of academic staff under the Education Act 1989 to 'put forward new ideas and to state controversial or unpopular opinions'. We also accept that under the Act this must be done with the 'highest of ethical standards and the need to permit public scrutiny.' Professor Bryder's research methodology went through the rigorous scrutiny of the Marsden Fund, the University of Auckland Human Participant Ethics Committee and her manuscript went through the peer review processes of the Auckland University Press."
The professors could have also added the review process of Palgrave Macmillan. Healthy scepticism and public accountability were also casualties of decisions by the New Zealand Press Council and the Office of the Ombudsmen. The Press Council turned down a complaint against the Listener about whether its coverage of Bryder's book was factually accurate, fair and balanced. The council said: "It was reasonable to report the conclusions of a credentialled historian at face value."
The Ombudsman turned down a request by the Herald for access to AUP reviewer reports on the grounds it would prejudice "AUP's ability to publish academic works in the future".
INACCURACIES IN LINDA BRYDER'S BOOK
Errors of fact or interpretation?
"Obstetricians Bruce Faris and Richard Seddon ... were found guilty of conduct unbecoming a medical practitioner and fined in July, 1995, 20 years after the event ... Seddon was forced by the University of Otago to leave his post as professor of obstetrics and gynaecology."
In May, following legal action, Professor Bryder acknowledged the statement was incorrect and that Professor Seddon had retired of his own volition. Auckland University paid legal costs and an errata slip is now in unsold copies of the book. The last sentence of the above quote has been removed from the British edition.
"[Journalist Jan] Corbett pointed out that if she [Clare Matheson] had been given a hysterectomy when she first had a suspicious smear in 1964, aged 27, she would not have had the child she bore the following year (Matheson went on to have four children)."
Matheson had two children and a late miscarriage prior to her treatment at National Women's. Her third child was born in 1966. When the Herald pointed out the error in August last year, Bryder said: "I apologise to Clare Matheson and Jan Corbett for the insertion in parenthesis about four children which was my error." The error has been corrected in the British edition, but not in the New Zealand book. Matheson had a hysterectomy in 1985, when she was diagnosed with invasive cancer - a situation that would likely have been avoided had her carcinoma in situ been removed, as it should have been, when it was found to be present on five occasions in 1965, 1970, 1971, 1976 and 1977.
"The 'low social status' did not apply to the patient who helped spark the inquiry, Clare Matheson. Her husband was a civil servant and she herself was a secondary school teacher and deputy school principal. It is also the case that some of the patients included in the CIS [carcinoma in situ] statistics were private patients at the hospital, or patients who moved between the two sectors, as Matheson did."
Matheson did not become a deputy school principal until 1985. She became a secondary school teacher in 1976. The error is partially corrected in the Palgrave Macmillan edition, but not in the New Zealand book. All Matheson's care was at the public hospital - the only time she saw a private specialist was in 1985.
"[Professor Per] Kolstad had used the phrase 'terrifying mismanagement', in relation to Clare Matheson's treatment, but admitted to [Green's lawyer David] Collins that he had not seen her complete file, and had not realised that she had five Grade 1 (negative) smears and one equivocal report of probably carcinoma in situ in the four years preceding her discharge from National Women's in 1979."
Matheson did have negative smears, but she also had more accurate histology (tissue sample) reports. The last one referred to here was not equivocal (ambiguous), but unequivocal, reading: "fragments of carcinoma devoid of underlying stroma". As Kolstad told Collins under cross-examination, if there was any doubt, it was only between CIS and invasive cancer. It was not possible to tell because there was no underlying tissue (stroma). Kolstad also said he had read Matheson's complete file and stood by his claim.
In a letter to the Medical Superintendent at National Women's in 1985, Dr Graeme Overton described Matheson's medical history: "She had cervical biopsy in 1965 showing carcinoma in situ, selective biopsies in 1970 showing carcinoma in situ with microinvasion, cone biopsy in 1971 showing carcinoma in situ, wedge biopsy in 1971 showing carcinoma in situ, ring biopsy in 1976 showing carcinoma in situ with incomplete excision and D & C dilatation of cervix and further biopsy in 1977 showing carcinoma in situ" She was discharged in 1979 with carcinoma present. Neither Auckland University Press nor Palgrave Macmillan have corrected this error.