Intended for healthcare professionals

Editor's Choice

A big mistake

BMJ 2006; 332 doi: (Published 02 March 2006) Cite this as: BMJ 2006;332:0-f
  1. Fiona Godlee, editor (fgodlee{at}

    The world of medical journals was shaken last week by the sacking of another high profile editor. John Hoey, editor of the CMAJ, was summarily dismissed in the final act of a long running dispute with the journal's owner, the Canadian Medical Association (CMA), about interference in editorial decisions. I say “another editor” because it seems no time at all since the former editors of the New England Journal of Medicine and JAMA were sacked (BMJ 1999;319: 272). Amidst the ensuing outcry about infringements of editorial freedom, some hard and important lessons were learnt but not, we now know, by the CMA.

    What happened has emerged only gradually over the past week because those directly involved are banned from speaking publicly. The story and reactions to it are described in this week's news (p 503). In brief, the CMA objected to articles published in the journal that were critical of constituencies the CMA supports. The final straw was the publication of a news item carrying critical comments about the appointment of Canada's new health minister, Tony Clement, who supports private provision within the public sector, as does the CMA. The BMJ picked up the story (BMJ 2006;332: 384), but the original news item has been pulled from the CMAJ website and has not yet appeared in print.

    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. As Hoey wrote in a brave editorial exposing the CMA's transgressions (CMAJ 2006;174: 9), “Readers expect CMAJ editors to select content without interference, and authors expect their work to be judged without regard to the interests of any third party.”

    A report on editorial autonomy commissioned by Hoey at the end of last year will come too late to prevent serious damage to the journal's reputation. It will say that the CMA must commit to establishing proper mechanisms to protect the journal from political or commercial interference and must make a public statement supporting editorial independence (as the BMA has). Unless and until the CMA takes at least these steps, there is a consensus among the editors and academics I have spoken to that no one worth their salt would or should countenance taking Hoey's place.

    This is a sorry tale that shows how little the CMA (its officers and—since there is no sign of a concerted outcry from them—its members) understands what it means to be the custodian of an international academic medical journal. It's a sad irony that, in protecting its interests so officiously, the CMA has seriously damaged one of its most important assets.