It is most unfortunate that Kelmenson and Wilets' vitriolic response to my piece on the so-called Neubauer Twins Study not only goes in so many directions that it would require another very long paper (if not an entire volume!) to address the issues raised, but contains a truly astounding number of blatant errors and misrepresentations. As the purpose of my paper was to put truth in high relief, I will focus here on rectifying their many mistakes and inaccuracies.
To begin, I am faulted for defending Neubauer while failing to answer the (as if there were but one) “legitimate ethical question…” As I make clear from the start, my objective was neither to voice an opinion on any of the highly complex ethical matters nor to correct what they term “errors of judgment and conscience.” Rather, my objective was simply to set straight the facts. I am faulted for my critique of “Wardle's artistic license.” There is a world of difference between “artistic license” and misrepresentation of facts. A documentary is meant to provide an accurate record of what took place. Three Identical Strangers does not. The separation of the twins, whatever one's judgment of it, was neither a practice instituted by Neubauer nor initiated for the purpose of the study. To say otherwise is grossly inaccurate and constitutes an inaccuracy extending well beyond any notion of “artistic license.” Crediting Natasha Josephowitz as Peter Neubauer's “research assistant” despite her having said she knew nothing of the study and learned about it only by “hearsay” [see reference in my paper] is, of course, far less significant. Nonetheless, it too is a misrepresentation that can hardly be considered “artistic license” in a documentary film. The identification of Samuel Abrams as “professor of Psychology at Yale”—as it appeared in the version of Kelmenson and Wilets' commentary to which I was invited to respond and which was later, unbeknownst to me, corrected—is also, in a word, simply wrong. As they appear to have realized late in the game, Abrams was Clinical
Professor of Psychiatry at NYU-Langone School of Medicine. Though he held several other positions as well, he was never affiliated with Yale. The unpublished manuscript to which I refer is cited by Kelmenson and Wilets as “Abrams, ‘Disposition and the Environment,’” which makes no sense whatsoever. That paper by Abrams was published and was cited by me as one among several places where information on the study was presented in print or as a lecture. Even more astonishing is the claim that my “opinions of the study are similarly shaped by the manuscript's contents, though, it is unclear if [I have] reviewed it.” How can one be unclear as to whether I have “reviewed” the unpublished study given that I not only discuss its contents, but quote from it, indeed rather extensively at the end, and even go so far as to say from the start “I had access” to it? How remarkable that my access to this unpublished manuscript is questioned because, as Kelmenson and Wilets write, “the participants themselves have tried unsuccessfully to review study materials.” How remarkable that my access to this unpublished draft is questioned because its name “is not listed on the Columbia University or Yale University finding aids related to the concealed documents from the study.” It really is not rocket science! How could it not occur to Kelmenson and Wilets that the unpublished manuscript might have been produced after the materials in question were deposited in those locations?
Also thrown into question is the “identification of Balzert as an expert on Neubauer's Study.” Balzert was a member of the three-person study team at the time the manuscript was written, a team that consisted precisely of Neubauer, Abrams, and Balzert, a team that met weekly to produce the 183-page unpublished manuscript. “Balzert further states,” claim Kelmenson and Wilets with a nod to a paper by Perlman, “that she neither conducted any of the home visits nor met any of the subjects.” How much more wrong could this be? While she did work initially more on data analysis, she most certainly also made home visits. Indeed, Christa Balzert was Project Director of the study. As for what I termed my “exclusive interview” with her, this is refuted by the responders to my paper on the basis of a telephone conversation between Balzert and Perlman. Recently asked if she had ever been interviewed by him, Balzert replied, “Perlman called me once and wanted to interview me, as two filmmakers had already wanted and I had refused. With Perlman, I had a chat about our respective times at CDC and the twin study” (personal
communication). More to the point, however, is that my referring to the interview as “exclusive” was simply a means of saying that Balzert had made very clear to me that she would grant one interview, the interview I have now published in this journal, and not give any interviews to anyone going forward.
The going gets really good, however, when the authors discuss my claim that my piece was rejected by other journals “because various editors disagreed with Balzert's viewpoint that the research was ethical in nature.” “It is not inconceivable,” they write, “that legitimate academic forums rejected the work on the basis of its concealed sources, both the manuscript and the exclusive interview with Balzert.” This is careless in the extreme: How is the exclusive interview with Balzert “concealed”? It appears right there, in the article itself; indeed, it constitutes the article almost in its entirety! As for the study remaining concealed, that hardly kept JAMA (the Journal of the American Medical Association) from publishing in 2019 a piece I co-authored with Leon Hoffman, M.D. in which reference is made to the then anonymous as well as concealed study. Moreover, the rejections to which I refer came only from editors whose personal exchanges with me offered very precisely (and respectfully) their reasons, which were just as I stated them.
“The reader will notice that Balzert herself never speaks to the concealment of study data or manuscripts as a means to secure subject privacy.” Did Kelmenson and Wilets actually read the article they are critiquing? Christa Balzert was very clearly quoted as saying: “We intended to publish our findings all along, but felt constrained by clinical considerations and reasons of confidentiality.” Similarly, they say, “Balzert fails to acknowledge the researchers' ethical obligation to provide ancillary care for harms discovered during, or caused by, the study.” Once again, I must ask: Did Kelmenson and Wilets actually read the article they are critiquing? Balzert explicitly says in the interview: “During our home visits we looked for signs of potential pathology and discussed this during our regular team meetings. It was understood that the parents would be notified should there ever be reason for concern and intervention.”
Kelmenson and Wilets argue that my work “is lacking in its review of ethical sources and ethical analysis of Neubauer's work.” Had the purpose of my paper been to discuss the ethics of the study, how right they
would be. I am an academic, a scholar who takes very seriously the review of sources and the scope of my areas of expertise as well. Ethics is not one of these areas. I would not engage in an ethical analysis of this kind without the appropriate qualifications to do so. I did not aim in this paper to discuss from a personal perspective any of the ethical issues related to the study. Once again, that was made clear from the outset. Thus to argue that my noting, for instance, that “Adopting parents signed consent forms which explicitly acknowledged and agreed that they would not be told the facts of the birth family” rendered “counterintuitive” my noting that informed consent, such as it exists today, was not endemic to scientific research before the 1972 implementation of the Belmont Report is nonsensical. Both are true, despite their claim that I made a significant error in my statement about the consent forms. But to state that I made much of the “alleged informed consent in the adoption process as a defense of the study's actions” is to misunderstand and misrepresent my intentions. For, once again, my purpose was not to defend either the study or the researchers on any sort of ethical basis, but rather to expose falsifications.
I wish now to address the two most stunning articulations of Kelmenson and Wilets' response to my paper, the “Louise Wise Services Adoption Committee Meeting Minutes” containing notes by Gertrude Sandgrund and the 1965 letter to Viola Bernard from Florence G. Brown that refers to sample size of a study. With regard to the first, the JCCA, the organization referred to in the Sandgrund notes, is not to be confused with any other organization. It is an establishment separate from any other mentioned in my paper and had then, and continues to have today, its own programs. There is no evidence whatsoever in what is quoted in the critique that any dealings they may have had with the Louise Wise Services were in any way related to Peter Neubauer and the Twins Study. Concerning the second, there too there is no evidence that the study in question is the Twins Study. Sample size may well refer to any study either undertaken or merely proposed for funding. Supposition is not fact.
Space prevents me from extending this corrective further. But I cannot close without making two additional points. The first concerns Kelmenson and Wilets' complete failure to recognize that this study, as clearly articulated by Balzert, involved no form of experimentation. It was purely observational. I wish to reiterate that here as vociferously
as I can and add to it that the implication that the study was in any way like the Nazi or Tuskegee experiments is as outrageous as it is false. Moreover, the comparison in Three Identical Strangers of Neubauer to Nazi experimenters is not only defamatory but potentially libelous. My saying so in no way constitutes an approval or disapproval of the study or of his work. The second point concerns my dismay at the carelessness with which the authors reviewed my paper. I looked forward to an engaging “controversial discussion.” Instead, I met with an ensemble of contentious and egregious errors. I hope nothing more than to have set the record straight.