The July 16, 2022 issue of the well regarded journal Lancet considers a persisting issue concerning editorial peer review. Done on a double-blinded basis as to the identity of author and reviewer, it has traditionally been undertaken without compensation. Peer review of medical journal articles is important. It is intended to provide an assessment of articles submitted for publication that is unbiased, independent, and critical in determining the acceptability and validity of submitted manuscripts. It has become an essential component of the scientific process and medical publishing. Although there has been some debate in the medical profession as to whether there is evidence to support the use of editorial peer review as a mechanism to ensure the quality of biomedical research, nonetheless, peer review has continued to be regarded as the gold standard for evaluating and selecting quality publications. Moreover, the U.S. Supreme Court in its landmark decision of Daubert v. Merrill Dow Pharmaceuticals, Inc. identified one of the factors to be used in determining the reliability and admissibility of an expert opinion as whether the subject matter had been subject to peer review and publication. The New Jersey Supreme Court has taken a similar position in the more recent decision in In re Accutane Litigation.

Reviewers serve at least two functions. First, the reviewers help editors determine whether a submitted paper is suitable for publication by providing their own expert opinion on the subject matter. The second function is the opportunity to provide the authors with constructive feedback about how to improve the manuscript to make it acceptable for publication.

Not surprisingly, undertaking peer review responsibilities is time-consuming. Notwithstanding any philanthropic urge to contribute to biomedical research, difficulties in recruiting reviewers have been frequently noted. This has been the experience even with journals that provide some prestige from the affiliation. Accordingly, the notion of paying for people to participate in the peer review process has been discussed.

Lancet’s July 16 issue presents published correspondence providing differing perspectives on the question of whether peer reviewers should be paid. These perspectives were stimulated by a letter to the journal published in April 2022 advocating for such action, at least on a trial basis. The proposition advanced was that paying for reviews could increase the potential pool of reviewers, provide motivation to review, and to do so in a timely manner.

Support for this approach was presented in two responding letters. The first correspondent noted that peer review activities were usually added to routine commitments in universities, hospitals, and other professional activities. Accordingly, the reviews were commonly done in personal downtime with occasional postponements contributing to delayed publication. Paying for peer review would permit conditions to be met before payment. Editors and publishers could insist on a tight timeline to avoid delays that make the peer review process frustrating as well as requiring greater consistency, professionalism, objectivity, and comprehensiveness of the review. The authors of the other correspondence addressed exploitation of academia to do peer review as free labor, noting: “Lines on a curriculum vitae are not remuneration.”

A contrary perspective was provided by a third correspondent, asserting that using money to lure reviewers would exacerbate inherent and structural biases in the publishing systems. In addition, paying fees would likely result in increased subscription costs. The commenter also posed the question and consequences of whether the payment would be due regardless of whether a manuscript was accepted or rejected, and also presented the prospect of “new commercial peer review agencies, cronyism, or nepotism.”

The standing and prestige of a journal depends on the validity, usefulness, and quality of the articles published. Although imperfect, the peer review process contributes to achieving that goal. Finding competent peer reviewers remains a challenge.