Ethical questions about peer review.

SIR Your editorial in the March 1992 issue (1), is in my opinion something of a landmark and a positive, favourable one in the history of scholarly communication. In effect, you are urging the medical research community to take seriously a paper that leading peer review authorities rejected (for one reason or another) for publication. The peer review authority rejection might be characterised as having been made on a wholesale basis, and you yourselves were recently part of this rejection effort. At the same time, I feel that a very serious ethical question regarding peer review and scholarly communication remains unanswered. Therefore, I respectfully request the editors of the Journal ofMedical Ethics to include, as an extension of or part ofthis letter to the editor, the 'open letter' ofJanuary 31, 1992 regarding JME editorial policy in relation to the rejection of articles that will result in the saving of millions of lives.