Talking SMACK

In recent days, a study has surfaced on the practice of maternal kissing of minor injuries of childhood (boo-boos), by the Study of Maternal and Child Kissing (SMACK) Working Group:

Maternal kisses are not effective in alleviating minor childhood injuries (boo‐boos): a randomized, controlled and blinded study

The practice of maternal kissing of minor injuries of childhood (boo-boos), though widely endorsed and practised, has never been demonstrated to be of benefit to children. To determine the efficacy, if any, of maternal kissing of boo-boos in toddlers. Randomized, controlled and double-blinded study of children with experimentally induced minor injuries.

The study, clearly a parody, is a solid take on everything wrong with scientific publishing. Predictably, the handwringing has begun and everyone is pointing their fingers in the wrong direction. Jack Marshall, who writes at Ethics Alarms, has sent out the most awful of them, calling the publication unethical. Let’s be clear about this at the onset: Marshall claims to be an ethicist, but he clearly does not understand ethics.

One of two things happened here. In the first possibility, the Journal of Evaluation in Clinical Practice was in on the joke. If that’s the case, the parody publication is a playful send up of study-after-study that attempt to show effects where we know, a priori, there are none. From electromagnetic hypersensitivity to psychokinesis to telepathy, PubMed is full of obviously fraudulent studies. And someone paid for these studies, which is worse than we can say about the SMACK Study. Harmless fun is not unethical, especially when it brings to light flaws in the broken system.

The second possibility is that the Journal was not in on the joke. In this case, the SMACK authors slipped this past the editorial board, the reviewers, secondary editorial review, and made it to publication. If so, praise be unto them for even getting a response. More importantly, if this study did expose review and editorial weaknesses at JECP, then that’s a critical problem that should be highlighted, because the rest of the JECP articles should be reconsidered in that light.

In either case, the study says that kissing small injuries will not lead to pain reduction. If anyone took this seriously and applied this, there is no downside risk. Let’s repeat that: There is no downside risk to following the advice this paper implies. That’s a lot better than articles from, say, The Lancet. And this is before we get to the real end of the joke. The SMACK authors claim to work for a bandage manufacturer.

According to The Federalist, it seems the Journal was in on the joke. It really doesn’t matter what happened here. Neither the SMACK authors nor the editors have done anything unethical. Publishing this article was just the opposite of unethical. It was the right thing to do.