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Rapid Responses: Rapid Responses published:
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The decision will hurt CMAJ reputation
- Dinesh K Sharma (3 March 2006)
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Way to Survive as an Employee-Editor
- Jay Ilangaratne (3 March 2006)
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Speaking Truth to Power
- Nicholas J G Pimlott (3 March 2006)
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Response of CMA members
- Jo Hauser (5 March 2006)
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Medical Journalism took a huge hit...
- Mohammad A Qayyum, Ayaz Ahmad (7 March 2006)
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A Big Mistake
- SamI Sussman (7 March 2006)
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Send not for whom the bell tolls
- Michael Goodyear (8 March 2006)
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What should we learn
- Anil Kumar, Punam Sinha (9 March 2006)
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Reinstate Sacked Editors of CAMJ
- Ajai R Singh (9 March 2006)
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Editorial Independence and Unraveling the Public Good
- Mark H Wilson (10 March 2006)
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Dinesh K Sharma, Editor, TB News from India Amritsar-India (143001)
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It is a sad for medical journalism. I have been reading CMJ on my PDA, provided free by Highwire Press. CMJ had recently began bold new initiatives to improve the the quality of its contents. It is sad that publishers have chosen to remove the Editor mid way in the process. The Canadian health system is facing a number of problems. One of these is lack of medical doctors to meet the routine health care needs of its population. With almost a third of its population without access to family physicians, Canada needs to act fast. The conflicts with in the system are preventing the entry of hundereds of international medical graduates (IMG) already in Canada in to Canadian health care system. The efforts of former health minister Dosanjh resulted in Ontario working towards accomodating these IMGs. But other states in Canada have lagged behind. The new health minister would have to follow up on steps taken by earlier administration, other wise Canadian people would continue to suffer. The removal of Editor of CMAJ is an unwanted step. By gagging an independent discussion on woes of health system in Canada, CMAJ risks hurting its own reputation Competing interests: I am Editor of e-newsletter 'TB News from India' |
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Jay Ilangaratne, Founder medical-journals.com
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Simply because there is a "public statement supporting editorial independence (as the BMA has)"[1] it is foolhardy to believe or suggest that it guarantees editorial independence. Like most things, surely, editorial independece must have some limitations,thus it would be wrong to pretend that 100% independence exists.Nor would it be realistic for employee-editors to expect such absolute freedoms in a world full of conflicting interests.One way of avoiding the fate that CMJA editor suffered is by not criticising the journal's ownner; simple as that. However, it is unlikely to be an issue for the BMJ editor at least, as hardly anything is published in the BMJ nowadays that suggests criticism of its owner,BMA. Sometimes, sacking an editor is not necessarily a bad thing. References [1]Fiona Godlee. A big mistake BMJ 2006; 332: 0-f. Competing interests: None declared |
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Nicholas J G Pimlott, Assistant Professor Department of Family and Community Medicine, Women's College Campus, 60 Grosvenor Street, Toronto, O
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The recent firing of Dr. John Hoey and Ann Marie Todkill as editors of the Canadian Medical Association Journal, followed rapidly by the departure of Senior Editor Dr. Stephen Choi and Editorial Fellow, Dr. Sally Murray, earlier this week is a disturbing and shameful chapter in the history of the journal. As Fiona Godlee has pointed out, under the leadership of Dr. Hoey and Ms. Todkill the CMAJ has substantially improved its impact factor and become one of the leading general circulation medical journals in the world. In my opinion it has also neatly balanced the publication of high quality research, clinically relevant articles for the practising physician, news, and thoughts and reflections on the art of medicine itself. A petition has been circulated electronically, protesting against these firings and I would encourage all physicians who care about the integrity of the CMAJ and its editorial independence to sign it. The petition can be found at http://www.chaps.ucalgary.ca/cmaj.htm. Dr. Hoey and the other members of the editorial team should be strongly supported in their courageous attempt to speak truth to power. Competing interests: None declared |
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Jo Hauser, Physician, CMA member K1S 4Z9
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In your editorial you implied that the CMA members supported the fireing of the CMAJ editor because "there is no sign of a concerted outcry from...its members." This is not true. I am a CMA member and I have signed a petition requesting the editor be reinstated. If the opportunity to support sanctions against CMA management arises I will be among the first in line. I did not know that the 'final straw' that led to fireing was the publication of a an article critical of the new health minister. I assume this is correct because it appeared in the BMJ. As our new health minister bumbled through his tenure as Ontario's health minister and I assume will continue to make dumb decisions, we should be critical of him. On the other hand, I would have hoped that the editor also approved articles that support privatization in health care. If an editor is to be impartial he or she must support the publication of all points of view. Jo Hauser Competing interests: None declared |
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Mohammad A Qayyum, Medical Student (Final Year) Punjab Medical College, Faisalabad, Pakistan. 55000, Ayaz Ahmad
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The recent dismissal of Mr. John Hoey as the editor of CMAJ has sent shock waves through the medical communtiy. Not only does it stain the fabric of independant medical journalism but its after effects will definitely be more drastic. Such an event will certainly tarnish the CMAJ's credentials. A journal read with great interest in our part of the World. It is unfortuante also in the sense that whosoever fills Mr. Hoey's position will always be looked be upon as a puppet of the CMA regardless of his/her own ideas. An editor who would be willing to flex the concept of independant journalism. The very idea of dismissal of the editor over independance is a source of great concern. If however one has to look at it from the other side that independace and freedom should be within limitations. In that case, the presence of a powerful impartial third party is essential. For this to succeed, I believe certain guidelines or legislations must be passed which ensure that once the the editor crosses the line a third impartial party can react to the situation accordingly. More so, it is not the dismissal of the editor but the way the editor was sacked a disgrace to Medical journalism. In my opinion, the formation of independant commissions seems to be the only solution which may result in an equillibrium state. Competing interests: None declared |
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SamI Sussman, North American Editor Mentalities Physicians Canada, N6G4M4
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With reference to the brouhaha at the Canadian Medical Association Journal there is nothing I can add to this, in a word, tragedy. Canada has approximately 60,000 physicians for a population of over 30,000,000. A first world first class ratio. Bravo Canada. However many individuals do not have access to Family Physicians. This by and large is a result of poor distribution. It is not too difficult to find a Family Physician in Toronto or Vancouver but difficult to find one in Moose Factory and in the Canadian Artic and in remote areas. International Medical Graduates are not alone in prefering large metropolitan centres. Once they qualify for full licensure they are off to the big cities. Mais c'est la vie!! Canada is a first class country with a first class medical system and new medical schools with fine faculty are being established from Ontario to British Columbia. We will have an ample supply of physicians in a decade or less. The medical system in Canada does need some fine tuning though, very much like the CMAJ. We shall overcome all hurdles! Regards,
Competing interests: None declared |
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Michael Goodyear, Assistant Professor Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada B3H2Y9
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The sources of conflict are usually embedded in patterns of interactions, not isolated instances. Therefore it is probably unproductive, particularly since we are not in possession of all of the facts, to debate the merits of various issues that could have led up to the dismissal of John Hoey, and subsequently loss of three other members of the editorial staff of the Canadian Medical Association Journal (CMAJ). Nor is it germane to debate whether Hoey was a saint, a liberal or a voice of the disadvantaged. Editors must necessarily take positions, and there will always be those who will be disaffected. What is not for debate is the tragic loss of a large part of the editorial staff of a major medical journal and member of the International Committee of Medical Journal Editors (ICMJE). Nor can we ignore the defensive chill that this action is likely to cast over other editorial staff. As Fiona Godlee points out, some conflict is normative, necessary and creative. Recognising this, the CMAJ had put in place an ad-hoc committee of the editorial board (1) to investigate instances of possible infringements of editorial autonomy, in addition to the Journal Oversight Committee. Thus mechanisms were present for providing advice to all parties and avoiding this sort of wasteful action. At a time when scientific integrity is once more of major public concern, we should be supporting editors who have carried the burdens of re-establishing scientific norms. This is no time for weakening their position. If there are lessons to be learnt from this, it is that overarching organisations such as ICMJE and the World Association of Medical Editors (WAME) need to develop and maintain explicit policies on editorial responsibilities and their relationship with publishers, and uphold their members, while all journals need permanent ethics committees for investigating and resolving differences between parties. Silence is not an option, or history will repeat itself, and the status quo is simply not acceptable. Only an independent inquiry into the events at the CMAJ can restore public confidence in the CMAJ and scientific journals in general which have seen a distressing pattern of loss of respected editors. 1. Kassirer J, Davidoff F, O’Hara K, Redelmeier DA. Editorial autonomy of CMAJ. http://www.cmaj.ca/cgi/rapidpdf/cmaj.060290v1 Competing interests: None declared |
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Anil Kumar, SpR- Care of Elderly and General Medicine Manor Hospital,Walsall., Punam Sinha
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Dear Editor, I read your article which was published on the 4th March with interest. •I am sorry and shocked, as any one else would be, to learn that the editor of such a high esteem has been sacked. These things happen all the time in institutions where there is ‘Employer and Employee ’relationship. The perspective of one’s view changes on which side of the table he or she is sitting. In this case we do not know exactly what was brewing under the bonnet i.e. more than what has been mentioned in the journals. But what really matters is the way in which this mission has been accomplished. •Things across the Atlantic can happen anywhere and we are not immune from it. It is a warning to the editorial board that besides employer and employee there is another important factor, which is the ‘clients’. My criticism about BMJ is that some times I wonder how articles of substandard quality getting their way into the hard copies. I also wonder how sometimes articles of no relevance to the medical fraternity (referring to an article on the Historical aspect of Incest published about 2 months ago) can escape the eyes of editors and find a place in BMJ. Continuing on the same topic if you look at the cover picture of this week’s journal one feels uncomfortable to see a female being assisted for delivery which is quite obscene especially if young children are running around in the family (funnily enough they the inquisitive bunch!!!). I suddenly realised why my little daughter has got interest in scanning the pages of BMJ when intended reader postpones till a convenient time. •We should try our best to keep BMJ as one of the esteemed medical journals and save it from being labeled as a Page 3 Newspaper. Competing interests: None declared |
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Ajai R Singh, Editor, Mens Sana Monographs Aditi Hospital, Mulund, Mumbai, India 400080
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It is heartening to note that BMJ, Lancet, ICMJE and WAME President have all categorically condemned the sacking of the editors of CAMJ. I think that is a sizeable effort in the right direction. However, one point need be noted. None of them has asked for the sacked editors to be reinstated. None. I would like to be corrected on this, if possible. I find that disconcerting. Does it mean they have accepted the sacking, and are only voicing their opinion on principle? I hope it is not only that. Ideals and principles are not a substitute for action. In fact they should be a spur for greater effort. Moral indignation does not necessarily translate into moral courage, or concerted action. This is the time for concerted action that springs from moral indignation. We must ask for reinstatement of the sacked editors, as well as those who resigned later. Nothing less than that. Please note that the sacking of earlier editors at JAMA and NEJM met with the usual noises and it all subsided. But sometime, at least sometime, let us gird our loins and prepare for a showdown. Else editors will shout and rant, and employers will win. And editorial freedom will be voiced but not defended. The only way highhandedness of employers can be handled is by peaceful noncooperation. This means we follow the five point agenda outlined below: 1. The entire editorial board of CMAJ must resign;
Once one editor of integrity is reinstated. Only once. No employer, or association president, or commercial interest, will ever dare touch, or manipulate, legitimate editorial freedom. Every time we only make noises and accept, every time editors will be upturned when they become inconvenient. And nothing substantial will change, except for the filling up of journal and discussion pages with high-sounding principles. That is the challenge, my friends. Competing interests: None declared |
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Mark H Wilson, Director of Medical Ethics Health Research Associates, Ottawa, Canada
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The CMAs dismissal of its top two CMAJ editors has not only been a blow to editorial independence but also to the public good. As noted, tensions between owners of a medical journal and editors are to be expected and can be creative. (1) This can also be applied to the CMA membership which is diverse. It does not hold homogenous views on a range of health issues. Nor does the Canadian public which the CMA has a mandate to serve. Tensions between views on important issues can spark fruitful discussion and debate in an open public academic forum such as the CMAJ which is also a venue for public policy formulation and reflection. Against a backdrop of professional and public diversity, it is essential that editorial independence be maintained through good governance practices in order to promote open discussion and debate that serves the public interest. A panel has been struck by the CMA that is charged to design a new governance structure for the CMAJ and it is to be chaired by a retired Chief Justice of the Canadian Supreme Court. (2) Prima facie this should be welcomed especially in light of three CMAJ editors having now resigned over concerns about editorial independence and its possible future politicization.(3) But it remains to be seen what the terms and limits of this panel will be and whether it will address the reasons why the editors were fired. This is an issue that seeks resolve and has been heightened by a groundswell of support from within the medical community to re- instate the fired editors. The CMA needs to find the courage to address the issue why the editors were fired in a publicly open and transparent forum in order to serve its membership responsibly and to prevent its role as a steward of the public good from further unraveling. 1. Fiona Godlee. A big mistake BMJ 2006; 332 2. http://www.cmaj.ca/cgi/rapidpdf/cmaj.060294v2 3 Doug Payne. Editorial Revolt Continues at the CMAJ, The Scientist, March 9, 2006. http://proxy.bib.uottawa.ca:2755/news/display/23220/ Competing interests: None declared |
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