Retraction of XPCC Study by Prominent Medical Journal Shows Editors Need to Get Serious About Research Ethics Red Flags


October 11, 2023

A UHRP Insights column by Henryk Szadziewski, PhD, Director of Research, and Louisa Greve, Director of Global Advocacy, Uyghur Human Rights Project 

On August 25, 2023, the academic journal BMC Public Health announced the decision to retract an article titled “Health-related quality of life among ethnic minority residents in remote Western China: a cross-sectional study.” The editor’s retraction note states that “the authors had not obtained appropriate ethical approval before the recruitment of participants for this study began.” 

While this retraction may seem modest, it marks a step towards highlighting unethical research practices involving Uyghur subjects, in light of ongoing crimes against humanity. 

It also reveals continuing blind spots that journal editors and publishers must address. A mandate for editors to check submissions against a research ethics “atrocity red flags” would be a bare minimum to prevent the worst cases, when international journals stumble into complicity in whitewashing criminal behavior in atrocity zones. 

We filed an ethics complaint regarding the April 2023 “quality of life” in Western China article based on internal evidence from the study and its methodology section. We detailed the features of the field environment demonstrating that the subjects lacked the autonomy to provide informed consent and respond freely to research inquiries.

The study in question, conducted by Jiaxin Dong, Xiaoju Li, Rong Fan, and Jielin Yang, involved interviews with 1,019 Uyghurs between July and August 2021. In the “Methods” section, the authors state that the field study took place in “Tumushuk, Xinjiang Production and Construction Corps, China.” Tumushuk is a quasi Chinese pinyin spelling of “Tumshuk” and is part of the 53rd Regiment of the XPCC. According to the authors’ Ethics Declaration, the study received approval from the Ethics Committee of the 1st Affiliated Hospital of Shihezi University School of Medicine. It is relevant to note that Shihezi University operates under the administration of the XPCC.

The XPCC is a paramilitary government entity known for its role in land expropriation and its deployment by the highest levels of the party-state to suppress Uyghur dissent. It is under targeted human-rights sanctions, by the United States, Canada, the United Kingdom, and the European Union, for its grave and systematic human rights violations. Since 2020, three XPCC officials have been subject to U.S. human-rights sanctions due to their involvement in these abuses. Notably, the 53rd Regiment has been implicated in “surplus labor transfers” that routinely entail the forced relocation of Uyghur residents under conditions tantamount to forced labor.

In August 2022, the UN High Commissioner for Human Rights released a 46-page report detailing evidence that “[s]erious human rights violations have been committed in Xinjiang,” citing policies relating to religious identity, expression, privacy, and movement that constitute “interlocking patterns of severe and undue restrictions” and “far-reaching, arbitrary and discriminatory restrictions on human rights and fundamental freedoms.” 

The study by Dong et al. relies on face-to-face questionnaire interviews with Uyghur respondents. The authors’ Ethics Declaration maintains that “All of the participants provided their written informed consent prior to the start of the study.” However, government policies outlined in the UN report provide compelling evidence that Uyghurs did not possess the freedom to make an unconstrained decision to participate in such a study in 2021. 

We pointed out to the journal editor that a questionnaire-based research methodology cannot yield legitimate findings in a climate of pervasive surveillance, gross restrictions on freedom of speech and movement, and mass arbitrary detentions targeting members of the respondents’ ethnicity.

Furthermore, one of the study’s conclusions, that Uyghurs experienced “fewer issues with depression and anxiety” compared to a study conducted in Shaanxi, also raises concerns about the study’s validity. This finding alone should have been a red flag, as implausible and incongruent with well-documented, ongoing government policies of targeted ethno-religious repression. 

The authors’ speculate that the finding “might be explained by the Uyghur population’s positive attitude toward life, a strong sense of self-sufficiency, and the simple cultural concept of ‘cheerfulness and contentment’.” Even if the expert reviewers somehow didn’t know about the mass round-ups and torture victimizing millions of Uyghurs since 2017, why did none of them raise a concern about blatant stereotyping and a patronizing colonialist attitude toward the so-called “minorities” being studied?

We addressed our research ethics complaint to BMC Public Health and received a prompt acknowledgement from the Research Integrity unit of the publisher, Springer Nature. Four months later, we were heartened to see the editor’s retraction.

This is not the first time that Springer Nature has conducted a serious review of ethical issues arising from research on Uyghur subjects only after they were raised by outside researchers. In 2021, two other journals published by Springer Nature, the International Journal of Legal Medicine and Human Genetics, withdrew research papers that relied on DNA samples collected from Uyghurs. The ethics red flags were detailed in 2019 by Sui-lee Wee and Paul Mozur in The New York Times, in an intensively researched article. Shockingly, both DNA studies credited a high-level member of China’s police force as an author: Li Caixia, the chief forensic scientist at the Ministry of Public Security. We note that the retracted 2019 research, like the 2021 research we flagged to the editor of BMC Public Health, took place in the XPCC-administered city of Tumshuk.

It’s progress of a sort that the retraction of the BMC Public Health XPCC study took only four months instead of two years. 

But Springer Nature and other publishers need to do better. It’s hard to believe editors would publish human-subject and medical-sample research conducted under the auspices of a Syrian institution run by Bashar al-Assad’s military forces. Why are Chinese institutions under multiple Magnitsky human rights sanctions given a pass? 

An atrocity red flags checklist

Publishers of peer-reviewed journals need to require that editors know the “red flags” regarding atrocity environments that trigger a deeper review. It can’t be enough to rely on outside reviewers who may or may not consider whether the authors “Ethics Declarations” stand up to scrutiny. Here are four simple questions to start with:

  • Are the authors or their institutions under human rights or war crimes sanctions by the UN or entities such as the EU or U.S.?
  • Is current UN reporting consistent with authors’ ethics declarations regarding informed consent of human subjects, and their ability to freely respond to survey questions?
  • Are research institutions involved in the study located in a country that consistently upholds Article 15.3 of the International Covenant on Economic, Social and Cultural Rights (ICESCR), which commits states to protect the “freedom indispensable for scientific research”?   
  • In the case of China, what safeguards were in place to indicate that the study is unaffected by the well-documented internal and extraterritorial state-imposed censorship and intimidation directed at disfavored scientific research? 

When safeguards fail, retraction is the right thing to do. To make it clearer when journals have done the right thing, “date of retraction” needs to be part of the formal record of the publishing history, beyond the current standard in many journals, which only record “date of submission” and “date of publication” but do not include “date of retraction.”   

Follow the authors at @henrykszad and @LouisaCGreve