The peer-review process within academia, science and medicine can work well so long as it is not unduly influenced and manipulated by political and business interests. Unfortunately, this pure form of peer-review is increasingly rare. Sometimes the influence and manipulation are subtle and gentle, and sometimes they are overt, awfully blatant. The problem is often greater within hierarchical institutions, where speaking out and rocking the boat too much is not viewed as a good thing, and so the truth is often ignored or clumsily covered up. Witness the WHO or the CDC or FDA. Institutions are primarily focused on self-preservation, and their hierarchies are there to ensure that.
Peer-review within medicine is particularly flawed, as is noted by Marcia Angell, MD, former Editor-in-Chief of The New England Journal of Medicine.. “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” But this should come as no big surprise, given how much chronically sicker just about everyone seems to be getting these days.