BMJ  2004;329 (6 November), doi:10.1136/bmj.329.7474.0-g

Editor's choice

Should journals mix medicine and politics?

Along with easy access to pornography, gambling (p 1055), and school friends who best remain forgotten, the internet has unleashed instant—and mass—complaint. This incredible people power makes publications instantly accountable. Why bother sending a written complaint or organising a paper petition when you can flood a website or an editor's inbox with cries of pain, anger, and sometimes vitriol? In addition to this welcome development bmj.com amplifies that criticism by posting electronic letters—we call them rapid responses—within 24 hours, provided they do not breach our rather laissez-faire rules of engagement (see bmj.com for rules).

We now encourage all readers to submit their letters electronically via our rapid response facility—it's easier than you might think—and select the best of these to publish in the print version of the BMJ. This week we publish a selection of responses to Derek Summerfield's personal view on the public health effects of Israel's security wall in the West Bank ( BMJ 2004;329: 924[Free Full Text], 16 Oct), a view that triggered a deluge of initial complaints and then praise as both sides of the argument mobilised their wired up supporters (p 1101). Amid the hundreds of polarised opinions are a number of strong but constructive views, particularly from people with experience of the region, suggesting that a solution through dialogue not violence is possible.

For this dialogue to be meaningful, voices from both sides need to be heard, which is why we published Summerfield's view and why this issue carries a response from a doctor critical of Summerfield's opinion (p 1110). Both are powerful pieces, argued with emotion, and our personal view section is one that caters for strong opinion. It is inevitable that in a state of conflict those views will be sometimes abrasive and unpalatable. One way that the BMJ differs from many medical journals is that it offers a diverse mixture of articles. Many sections are rigorously peer reviewed, others are more journalistic—such as our news and reviews sections. Most of our readers understand and value this dichotomy.

Most of our readers also want us to reflect the entanglement of medicine and politics, according to a survey we conducted on bmj.com in 2002 (http://bmj.com/misc/politics.shtml). And the BMJ has traditionally published on broader social and political issues that affect health care. Indeed, a logical extension of the report by the Commission on Macroeconomics and Health in 2001 is that any issue has a health angle in the same way that the Economist has shown that any issue has an economic one. The BMJ will not shy away from difficult issues that impinge on health care. More so, medical journals have a duty to highlight concerns about abuses of state power—be they by the government of the United Kingdom, United States, China, Israel, or the Palestinian Authority. Medicine cannot exist in a political void.