Journal of the New Zealand Medical Association, 10-March-2006, Vol 119 No 1230
The importance (and cost) of editorial independence
Dr John Hoey, editor of the Canadian Medical Association Journal (CMAJ), and his deputy, Anne Marie Todkill, were abruptly fired on Monday 20 February 2006 by Graham Morris, president of CMA Media (the holding company that publishes the journal—which in turn is owned by the Canadian Medical Association [CMA]). The firing was the culmination of a conflict over editorial autonomy at the journal and follows a recent public disagreement between Hoey and the CMA over editorial interference—not the first such conflict between the editor and the journal owners.
Two weeks later, Dr Stephen Choi, the acting editor of the embattled Canadian Medical Association Journal, quit after the owners of the publication, the CMA, refused to accept a plan he drafted aimed at ensuring editorial independence. Another editor, Sally Murray, also tendered her resignation.
The International Committee of Medical Journal Editors (ICMJE), of which the editor of the CMAJ and the NZMJ are members, has a robust policy on the importance of editorial independence.
The ICMEJ website (http://www.icmje.org/) states under the heading “Editorship”:
The role of the editor
The editor of a journal is the person responsible for its entire content. Owners and editors of medical journals have a common endeavour—the publication of a reliable and readable journal, produced with due respect for the stated aims of the journal and for costs. The functions of owners and editors, however, are different. Owners have the right to appoint and dismiss editors and to make important business decisions in which editors should be involved to the fullest extent possible. Editors must have full authority for determining the editorial content of the journal. This concept of editorial freedom should be resolutely defended by editors even to the extent of their placing their positions at stake. To secure this freedom in practice, the editor should have direct access to the highest level of ownership, not only to a delegated manager.
Editors of medical journals should have a contract that clearly states the editor’s rights and duties in addition to the general terms of the appointment and that defines mechanisms for resolving conflict.
An independent editorial advisory board may be useful in helping the editor establish and maintain editorial policy.
The ICMJE adopts the World Association of Medical Editors’ definition of editorial freedom (http://www.wame.org/wamestmt.htm). This definition states that editorial freedom or independence is the concept that editors-in chief should have full authority over the editorial content of their journal. Journal owners should not interfere in the evaluation; selection or editing of individual articles either directly or by creating an environment that strongly influences decisions. Editors should base decisions on the validity of the work and its importance to the journal’s readers not on the commercial success of the journal. Editors should be free to express critical but responsible views about all aspects of medicine without fear of retribution, even if these views might conflict with the commercial goals of the publisher. Editors and editors’ organisations have the obligation to support the concept of editorial freedom and to draw major transgressions of such freedom to the attention of the international medical, academic, and lay communities.
In response to the firings, the ICMJE posted this on their website:
The ICMJE have serious concern at the Canadian Medical Association (CMA) recent dismissal of the Canadian Medical Association Journal (CMAJ) editor and senior deputy editor, John Hoey and Anne Marie Todkill. The CMA gave no specific reasons for this action. The ICMJE believes this action took place in the context of the CMA interfering with the journal editorial function. If a journal is to serve as an independent scientific voice, the editor must be free to publish anything that addresses contemporary problems in medicine.
Removing editors for unclear reasons provides ipse facto evidence of publisher interference. Members of the ICMJE protest this action and believe that it violates the principles of editorial independence expressed in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals. By taking this action, the CMA has damaged its most priceless asset, the reputation of its world-renowned journal, and diminished itself in the eyes of the world. To safeguard the journal reputation as an independent scientific voice, the ICMJE urges the CMA to assert the journal freedom to express an independent opinion and to put in place systems to protect the journal against interference.
Fiona Godlee, editor of the British Medical Journal (BMJ), said in their editorial published last week:1
Tensions are bound to exist be journal editors and owners. I could argue that unless these exist the editor is not doing her job. But editors must be accountable and accept that there are limits to their freedom: a series of poor decisions or unethical behaviour would be reasons for removing an editor. Neither of these charges is laid at John Hoey's door. He is widely credited with taking the journal to new heights, with gains in its impact factor, readership, and international profile. However, a journal's credibility cannot survive interference from its owner.
During the previous 7 years, 3 of the 10 editors of the ICMJE group have been fired over similar issues. In 1999, George Lundberg, editor of the Journal of the American Medical Association (JAMA), and Jermone Kassirer, editor of the New England Journal of Medicine (NEJM), were both fired.
Writing in an editorial at the time, Richard Smith, former editor of the BMJ,2 said:
...The Massachusetts Medical Society and the American Medical Association are looking for new editors for their prestigious journals, and both need to build systems of governance that encourage trust. If they don’t, they’ll never find good editors—and their journals will fade.
However the predictors of doom have been incorrect as both the JAMA and the NEJM have continued to go from strength to strength. Indeed, editors like all employees are only missed for the length of time it takes for someone to move into their office, whatever the circumstance of their leaving. None of us are indispensable. To do a good job, editors must be willing to lose their job and not expect the readers to care too much.
Perhaps AJ Liebling (1904–1963) was correct when he said, “Freedom of the press is limited to those who own one.”
However, readers who chose not to care should consider Ralph Waldo Emerson’s (1803–1882) comment, “Democracy becomes a government of bullies tempered by editors.”
For the record, the New Zealand Medical Association (NZMA) and the present editor of the New Zealand Medical Journal (NZMJ) have not had any major conflicts in regard to editorial freedom—as the NZMA have always been supportive of the need for editorial freedom, even when the views expressed in the NZMJ differ from those of the NZMA.
Author information: Frank A Frizelle, Editor, New Zealand Medical Journal, Christchurch
Correspondence: Professor Frank A Frizelle, Editor, New Zealand Medical Journal, Christchurch School of Medicine, PO Box 4345, Christchurch. Fax: (03) 364 1683; email: email@example.com
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