One year ago, as conflict raged in the Middle East, Manduca and colleagues (24 individuals) published the Open Letter for the People in Gaza, accompanied by an unusual invitation and petition on the Lancet Website to “support the letter”. The letter was widely perceived to be unbalanced, filled with factual errors, unsubstantiated accusations, and libelous assertions. Despite vigorous objections contesting the accuracy of the content of the Manduca letter, not to mention the undisclosed allegiances and activities of many of the signatories, the Lancet and Elsevier, the publisher, cited “editorial independence’ and declined to take meaningful corrective action. We are aware of numerous subsequent submissions from esteemed scholars, rejected for publication by the Lancet, that contained factual material which directly contradicted the assertions made in the Open Letter. Dr. Horton penned an Editorial accompanying the Manduca letter emphasizing the perilous plight of the civilian population in Gaza, and justifying the publication of the Manduca letter. After his first visit to Israel some time later, Dr. Horton penned another Editorial, expressing regret that a schism had developed in the medical community due to the Manduca letter, but providing no apology for publication of a one-sided, politically motivated, highly biased and inaccurate narrative. Elsevier repeatedly made a spokesperson Tom Reller, Vice President, Global Corporate Relations, available for chats with concerned individuals, but declined to take meaningful corrective action despite clear evidence that the Lancet Editorial policies had been contravened. This issue, notably the multiple factual errors and assertions in the Open Letter, accompanied by defamatory accusations that “Israeli academics are complicit in the massacre and destruction of Gaza” should not be such a difficult matter for the publisher to acknowledge and correct. Reed Elsevier Editorial Policy (http://www.relx.com/corporateresponsibility/Documents/policies/reed-elsevier-editorial-policy.pdf) states that “We have a responsibility to all stakeholders, including our authors, customers, and employees, to produce information of the highest quality, which is accurate, comprehensible, and timely; which avoids bias, defamation, conflict of interest or plagiarism; which makes a clear distinction between fact and opinion”. It is one thing to publish a code of conduct, and quite another to willfully decline to take corrective action and ignore its contents. Furthermore, Lancet and Elsevier do not seem to care that in deflecting criticism and appropriate correction of the Manduca letter, it contravened its own Ombudsman guidelines: “Our ombudsman’s remit will not extend to areas normally covered in our correspondence columns—namely, issues of editorial content and editorial policy” ((http://www.thelancet.com/ombudsman), ) While it is commendable that Dr. Horton has visited Israel and is developing a series of related articles, some have questioned the timing and asked why it took so long for the Lancet to engage a country with formidable sustained scientific and medical research productivity. Furthermore, engaging some Israeli scientists and physicians is in no way a substitute for the appropriate exercise of Editorial responsibility. When a published communication (Manduca et al) is found to be intentionally one sided, filled with errors and unsubstantiated assertions, the appropriate corrective action is very clear, it must be retracted. Regrettably, the Lancet and Elsevier have allowed their publishing platform to promote hatred, polarization and division of medical communities, sewing further mistrust and suspicion. One year later, the Manduca letter continues to glorify the Editorial pages of the Lancet, while some of its signatories have further revealed their transparent agenda and propagate David Duke-inspired materials. All of us make mistakes, and we learn, as children, that we should apologize, and take the appropriate corrective action to undo the consequences of our errors. In medical publishing, we have a very clear process for dealing with published material that is incorrect, and the Lancet and Elsevier have declined to follow their own published process. So one year later, while we all regularly fill out forms disclosing our conflicts, and as authors, we constantly affirm that what we publish is accurate and correct, Lancet and Elsevier willfully ignore their own ethical publishing and Ombudsman guidelines, and it is business as usual in Amsterdam and London. It seems that those who make the rules feel no obligation to actually abide by them. Medical scientists and clinicians trust their journals (and publishers) to be honest arbiters of truth, enabling science to be published that is factually correct and thereby contributes to improving the health and lives of millions of patients worldwide. Violation of this trust, and failure to take constructive remedies when appropriate, has consequences. Just ask the tens of thousands of children who were not vaccinated and subsequently suffered as a result of the failure of the Lancet to responsibly act in a timely manner to retract and correct the damaging Andrew Wakefield vaccination/autism publication. There are many outstanding individuals who work for Lancet Journals and Elsevier and their dedication, accomplishments and achievements are substantial. Regrettably, to date, Elsevier has remained silent, declined to take meaningful corrective action, and turned its back on concerned members of the medical and scientific community. We have waited a year for the Lancet and Elsevier to act responsibly and we are still waiting; please note that many of us are very, very patient and deeply committed to honesty and ethics in scientific and medical publishing. For the welfare of our medical community and the patients we serve, we hope all of our Publishers, including Elsevier, rededicate themselves to the Hippocratic oath, still recited annually by thousands of medical school graduates, “primum non nocere”, Above all, do no harm. Daniel Drucker Senior Scientist, Lunenfeld-Tanenbaum Research Institute, Mt. Sinai Hospital Professor of Medicine, University of Toronto