Medical journal retracts article on “tribalism” after readers call it offensive

Journal of Hospital Medicine editor Samir Shah

A journal has retracted — and replaced — an article on “tribalism” in medicine and deleted a tweet about it, too, after readers complained that the language in the piece was offensive to Indigenous peoples. 

The article, which appeared in the Journal of Hospital Medicine in April, was titled “Tribalism: The Good, The Bad, and The Future.” The authors were Zahir Kanjee and Leslie Bilello, of Harvard Medical School. 

The journal used social media to promote the article — which prompted a flood of criticism about the use of the word “tribalism” and its permutations. 

On May 21, Samir Shah, the editor-in-chief of JHM, and four other editors issued a statement  apologizing for publishing the article:

Despite pre- and post-acceptance manuscript review and discussion by a diverse and thoughtful team of editors, we did not appreciate how particular language in this article would be hurtful to some communities.

The statement continues: 

From this experience, we learned that the words “tribe” and “tribalism” have no consistent meaning, are associated with negative historical and cultural assumptions, and can promote misleading stereotypes.4 The term “tribe” became popular as a colonial construct to describe forms of social organization considered ”uncivilized” or ”primitive.“5 In using the term “tribe” to describe members of medical communities, we ignored the complex and dynamic identities of Native American, African, and other Indigenous Peoples and the history of their oppression.

Shah, of Cincinnati Children’s Hospital Medical Center, and his colleagues also note that moving forward, they will try to more rigorously police the language in the articles they publish: 

This misstep underscores how, even with the best intentions and diverse teams, microaggressions can happen. We accept responsibility for this mistake, and we will continue to do the work of respecting and advocating for all members of our community. To minimize the likelihood of future errors, we are developing a systematic process to identify language within manuscripts accepted for publication that may be racist, sexist, ableist, homophobic, or otherwise harmful. As we embrace a growth mindset, we vow to remain transparent, responsive, and welcoming of feedback. We are grateful to our readers for helping us learn.

In a series of tweets explaining the move, Shah wrote:

Here’s the new version, with the altered language: “Silos” in place of “tribes.”

Although some readers praised the journal for its decision to retract and replace the article, others were more critical. As one user wrote

Shah tells Retraction Watch:

The medical community on social media has been very supportive. Also, lots of folks reaching out to offer support via email. It’s obviously a nuanced issue of using the term tribe to describe medical specialties, a nuance that has largely but not surprisingly been ignored on social media. Additionally, the authors were part of the discussion on the best approach and they were very supportive of retraction and re-publication so, contrary to the accusations of “censorship” on social media, the authors were very much part of the dialogue on decision. Negative social media attention has largely been trolls, right wing media (e.g., Quillette), and Glenn Greenwald (whatever one makes of him).

This isn’t the only recent example of journals reacting to pressures on social media. Earlier this week, JAMA announced that its long-time editor, Howard Bauchner, was stepping down in the wake of criticism over his handling of a podcast — and a related tweet — that dismissed the notion that structural racism was a problem in medicine.

Update, 1745 UTC, 6/4/21: Kanjee, the first author of the paper, tells us:

As we mentioned in author note of revised article, we didn’t realize that that was a harmful word, so the reaction did initially come as a surprise to us. Now that we know, the reaction makes sense. We are glad people let us know it was harmful and hurtful because we learned how to use better language on this topic. 

In terms of the retraction and republication, once we learned of the harm and hurt caused, we were in favor of retraction/republication as well (as the journal pointed out in a subsequent tweet). I was on that initial zoom call w the editorial leadership mentioned in the editorial to think about the right thing to do and agreed 100% with this plan of retraction and republication. Still do. 

Disclosure: Until October of 2020, Retraction Watch co-founder Ivan Oransky led the editorial team at Medscape, which publishes the JHM on behalf of the Society of Hospital Medicine. 

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17 thoughts on “Medical journal retracts article on “tribalism” after readers call it offensive”

  1. The Washington Post article about the meaning and nuances of the term tribalism, linked in the retraction, is worth reading. Not totally sure if I agree with the logic, but it’s certainly worth a more nuanced discussion than just calling Dr. Shah a craven worshiper of indigenous people.

  2. I am surprised at the statement that we will “police” language (“…of note that moving forward, they will try to more rigorously police the language in the articles they publish”). The term police implies that this bad or that we’re censoring authors. I appreciate an opportunity to clarify our intent. We’re developing a system to identify language in accepted manuscripts that may be problematic (e.g., racist, sexist, ableist, homophobic, or otherwise harmful) as I believe every journal should. When we identify such language, we’ll engage in dialogue with authors about the right path forward. Medical and scientific journals are very different than lay press or op-ed pages and how we use language is part of those differences.

    1. “I am surprised at the statement that we will “police” language (“…of note that moving forward, they will try to more rigorously police the language in the articles they publish”). The term police implies that this bad or that we’re censoring authors.”

      Yes you are.

  3. This seems like it was handled transparently and maturely. Kudos to the authors and the editorial team for being so responsive to criticism.

  4. That’s utterly hilarious, especially the earnest statements from all involved about having been newly educated on the danger of naughty words!

    I wait to see whether the agricultural lobby has anything to say on the negative portrayal of silos, which are, let’s not forget, vital to solving starvation and food insecurity around the world…

      1. So one must not only submit your paper to a journal for peer review one must now submit your paper to the twitter mob for twitter review. And if it’s found wanting for any reason up to an including the use of doubleplusungood words (tribe/tribalism instead of silos etc.) the paper must be immediately retracted, republished with acceptable terminology and the authors must prostrate themselves upon the alter of wokeness and produce an abject, groveling twitter apology in the hopes that the twitter mob will be appeased in their woke vocabulary induced outrage and allow you to continue to publish works in scientific journals.

        Yes, I’d say science and the scientific endeavor are truly dead.

        The sky is falling.

        And I’d also say that Orwell meant his novel 1984 to be a warning. Not an instruction manual. But here we are.

        That is all.

  5. We had a word that described what the authors were saying. Some people complained so we arbitarily picked another word with a different meaning to make everything clearer!

  6. Everyone on the planet practices ‘tribalism’ – not just indigenous peoples. (Well that is what I have always thought.)
    To me, it has always meant a broader extension covering a range of similar human behaviours of which racism is just one. While ‘racism’ discriminates purely on the criterion of race; tribalism can discriminate on the basis of neighbourhood, class, academic achievement, religion, customs and other beliefs, apparel/fashion, national affiliation, football team affiliation, etc. etc.
    Am I going to have to look for another word?

  7. Can’t blame them. They had to. Just ask yourself what would have happened to Zahir, Leslie, and Samir if they had acted differently. This is not about language or particular communities. It’s about their careers, future funding, grants, publications, social circles, etc.

    Everything to lose, nothing to gain. Costs nothing (very important). Easy decision. Extra points for talking about how they learned their lesson, about the ‘vigorous’ (‘robust’ would have worked equally well) debate that took place, about how their peers should do the same, and for bringing up right-wing operatives.

  8. I think it would be appropriate for the headline and the first paragraph of this post to explicitly mention that the article was immediately replaced, with updated wording, to more accurately convey the situation. The article/research wasn’t ‘cancelled’, just that the wording was slightly modified. But this is not mentioned until more than halfway through the post, which I think is misleading.

    It is important that this site consider its role in shaping the optics in science. Accuracy is more important than clicks. Please do better.

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