Should medical journals carry drug advertising? Yes

doi:10.1136/bmj.39259.472998.AD

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Richard Smith, executive director

UnitedHealth Europe, London SW1P 1SB

richardswsmith{at}yahoo.co.uk

No one can fail to notice the adverts in medical journals but are they really necessary? Richard Smith maintains they are essential to editorial independence, whereas Gareth Williams argues that they undermine a journal's integrity

The central argument for carrying advertising in medical journals is independence. Ironically, the main argument against may also be independence, but you can place greater trust in a journal that carries advertising than one that does not.

Price of independence

Independence is a journal's most precious asset, and independence means financial independence. “He who pays the piper calls the tune.” So to be able to play multiple tunes a journal needs multiple sources of income—and drug advertising is one of the most important and profitable. The beauty of drug advertising is that there are many companies who want to advertise in a journal that has a wide circulation. This means that none of them alone has the power to influence the journal.

Advertisers may huff and puff in response to articles that upset them, and they may for a while take away their advertising. But the journal doesn't depend on any one advertiser—and so can ignore the protests. Furthermore, the multiple advertisers keep a close eye on each other. If an advertiser breaks any of …