CMAJ editor resigns as board fails to guarantee editorial independence

David Spurgeon

The editorial autonomy of the CMAJ, the journal of the Canadian Medical Association (CMA),"is to an important degree illusory," says a highly critical commentary published last week. The commentary was produced by an ad hoc committee of the journal�s editorial board in response to the firing of the journal�s editor and deputy editor. Soon after the commentary was published the acting editor resigned after the association refused to accept a plan he drafted that was aimed at ensuring editorial independence.

In an early release published online on 28 February (www.cmaj.ca), the committee said that the association and its publishing company, CMA Holdings (CMAH), "must make a choice about what kind of publication it wants CMAJ to be." It said that the choice is between a publication that accepts as inviolable editors� responsible exercise of editorial independence or one that makes publicly clear that its editors� conduct must "be consonant with the political, ideological, and strategic objectives of the CMA."

The committee said, "Any attempt by the CMA to impose its influence on the editors would be catastrophic for the CMAJ�s reputation as well as damaging to the reputation of the CMA � CMAJ cannot be deemed to be a CMA newsletter, a cat�s paw that is under the editorial direction of its custodians, the CMA/CMAH � In fact, the �highest interest� of the CMA and of CMAJ can and should coincide."

John Hoey, the editor in chief of CMAJ who was dismissed with his deputy, Anne Marie Todkill, on 20 February by Graham Morris, publisher of the journal and president of CMA Media, a subsidiary of CMA Holdings (BMJ 2006;332:503), had asked the committee to review a series of events that he said had compromised the journal�s independence. These involved interference by the CMA and CMAH over a news story about the emergency contraceptive pill levonorgestrel (Plan B). The intervention resulted in the story�s suppression and the subsequent publication of a "sanitised" version.

There was also a dispute between editorial staff and the CMA over the publication of an article about Canada�s new health minister which was highly critical of him. This was later removed from the journal�s website and then subsequently replaced. The committee found that the replacement report was "more supportive and less critical of the new health minister" and seemingly "more beneficial of the CMA."

The committee noted that the CMAJ is ranked fifth in impact factor (a rating of journals� influence) among general medical journals, is the leading medical journal in Canada, and has an international standing similar to that of journals such as JAMA and the BMJ. To sustain its standing immediate corrective action is needed, the committee said. It recommended that improvements be made to the journal�s oversight committee, which it said had become "an instrument through which CMA/CMAH can complain about journal content considered politically inconvenient."

The committee expressed concern about the structure and operation of the oversight committee. For at least the first year of its existence it had no chair, and the person eventually selected to chair the committee was also the publication liaison member from the association board, "a choice that strikes the ad hoc committee as procedurally inappropriate," it said. For several months the oversight committee included the president elect of the CMA, which the committee said "represents a conflict of interest."

The review, appendices containing the suppressed news story and its replacement, a position statement on the nature of editorial independence from the International Committee of Medical Journal Editors, and an editorial governance plan for CMAJ can all be seen at www.cmaj.ca.