Dr. Rinsler,
A reply to your questions as best I can (they are denoted below by the *****):
1) I don't really want to get into the facts of the impeachment case . . but,
from my understanding, the perjury question revolves not around what exactly
Pres Clinton believed to be sex (as in the question laid before the students
in this survey) but around a definition of "sexual relations" that was set in
front of him by the federal judge in the Paula Jones case. (That point is so
far outside the bounds of my expertise -- I hesitate to even make that
comment.)
2) I think the multitude of reasons why a scientific medical journal should
not comment on a purely political and legal impeachment trial should be
self-evident. Do you expect JAMA to endorse specific non-medicine/health
pieces of legislation or specific political candidates in its pages?? Is that
the role of a medical journal??
3) There is a mission statement for JAMA. It is available on the AMA website
(www.ama-assn.org) in the JAMA area. I should have probably used the words
"publishing objectives" as opposed to "publishing priorities" in my previous
emails to be consistent. It reads as follows . . .
The mission of the Journal of the American Medical
Association is: "To
promote the science and art of medicine and the betterment
of the public
health." In addition, JAMA follows a series of key and
critical objectives,
which are outlined below in an excerpt from an editorial by
Editor George
D. Lundberg, MD (JAMA. 1993; 270:1248-1249).
JAMA has functioned under a set of goals and objectives that
were originally
approved in 1982 and updated in 1987. Using an iterative,
modified Delphi
process, the in-house editorial staff and editorial board
revised these
objectives (in 1993), and they were approved by the AMA's
Board of
Trustees in April 1993. The current objectives are as
follows:
Key Objective
To promote the science and art of medicine and the
betterment of the public
health.
Critical Objectives
1.To publish original, important, well-documented,
peer-reviewed
clinical and laboratory articles on a diverse range of
medical topics.
2.To provide physicians with continuing education in
basic and clinical
science to support informed clinical decisions.
3.To enable physicians to remain informed in multiple
areas of medicine,
including developments in fields other than their own.
4.To improve public health internationally by elevating
the quality of
medical care, disease prevention, and research provided
by an
informed readership.
5.To foster responsible and balanced debate on
controversial issues
that affect medicine and health care.
6.To forecast important issues and trends in medicine and
health care.
7.To inform readers about nonclinical aspects of medicine
and public
health, including the political, philosophic, ethical,
legal, environmental,
economic, historical, and cultural.
8.To recognize that, in addition to these specific
objectives, THE
JOURNAL has a social responsibility to improve the
total human
condition and to promote the integrity of science.
9.To report American Medical Association policy, as
appropriate,
while maintaining editorial independence, objectivity,
and
responsibility.
10.To achieve the highest level of ethical medical
journalism and to
produce a publication that is timely, credible, and
enjoyable to read.
4) The AMA has often used Letters to the Editor (not Editorials as you stated
in your question) to express it's views in JAMA. Unfortunately, no one
outside of JAMA staff became aware of the article's existence or its topic
until the week before it was to be released -- at that time, the issue was
already in print and no contemporaneous response would even have been
possible.
Given that I have an exam tomorrow and will be on the road from Tues-Fri this
week. I may not be able to keep up on this listserve as much as I have over
the last few days. I will do my best to continue answering your questions.
Sincerely,
Andrew Thomas
[log in to unmask] wrote:
> In <[log in to unmask]>, on 01/24/99
> at 12:57 PM, Andrew Thomas <[log in to unmask]> said:
>
> >Only because I was asked by some individuals to continue this thread on
> >the listserve do I respond to the larger group. . .
>
> >---------------------------------------
> >In response to Dr. Sackett,
>
> [SNIP]
> >In response to Dr. Rinsler,
>
> [my {Rinsler} responses to your comments interpolated preceded by *****]
> Thomas says-
> >First, do you really consider the notions of 600 college students
> >collected eight years ago about what is or is not sex relevant to the
> >Presidential trial?? I do not. The Senate is judging perjury in front
>
> ***Rinsler:
> The impeachment "trial" is a political process by everyone's admission and
> the question of "perjury" takes into account the "knowingness" of the
> speaker. If it is believeable that the President reasonably might not have
> considered the acts in question as sexual activity, that is relevant to
> the trial. It is also of interest (I would think) to anyone trying to
> communicate clearly with folks involving themselves in such activities for
> medical/public health reasons.
>
> >of a grand jury and obstruction of justice -- not how congruent the
> >President's opinion is with a group of twenty-year olds. (BTW, I
> >graduated from college in 1991!!) If the article (as another contributor
> >to this listeserve has pointed out) didn't continually refer to the
> >present situation or current environment in Washington or the political
> >affilitation of the survey respondents, it might not have appeared so
> >blatantly a comment on the impeachment trial.
>
> ***Rinsler -why was it viewed as inappropriate to comment on this
> impeachment trial; this is a journal published in the USA and public
> health activities will (potentially) be impacted by the activities and
> outcomes of the trial.
>
> >Second, is it JAMA's role to publish that type of data in relation to
> >this trial? I would say no -- that is not within JAMA's publishing
> >priorities.
>
> ***Rinsler. I am unclear what you mean by "publishing priorities"? Is this
> anything like a credo (NY Times "All the news that is fit to print") or
> mission statement. Please explain. If possible could you STATE these
> priorities?
>
> >I think the data is more of a suped-up Gallop poll as
> >opposed to a medically significant study. I think it leads to the
> >implication that the Journal (or the wider AMA) supports one side or the
> >other in this debate -- and by Dr. Anderson' s action -- also leads to an
> >implication that the rest of the AMA feels the other way. . . .that is
> >the key to this whole issue --
> >neither the Journal nor the AMA should be taking a position on this
> >debate -- it is not ours or the medical profession's fight to fight with
> >our publications or organizations and we all should have stayed out of
> >it. Each individual can act on their own in whatever way they'd like --
> >but a medical publication or organization should not get officially
> >involved. However, when Dr. Lundberg entered the fray with the Journal,
> >Dr. Anderson was compelled to act and say that is not how the Journal is
> >meant to be used. The "acting irresponsibly" was simply a very bad
> >management decision in a very significant situation. This leads us to
> >what becomes a significant disagreement between the Journal's
> >owner/publisher and its editor about the Journal's priorities.
>
> ***Rinsler. If the publication's board of directors felt that the article
> is a poor one, then isn't an editorial an appropriate response for a
> journal. Lundberg's firing is inexplicable to most of us on rational
> grounds because there has not been a public clear discussion of the bad
> editorial work. This is a Star chamber (no pun intended really<g>)
> activity.
>
> >We may simply have to agree to disagree on what is or is not responsible
> >in this situation.
>
> >I hope that this is helpful in further explaining my position. Thank you
> >for your input.
>
> ***Rinsler: You are welcome. I hope to hear further about this.
>
> >Andy Thomas
>
> >[log in to unmask] wrote:
> [SNIP]
>
> --
> -----------------------------------------------------------
> [log in to unmask]
> Stephen S Rinsler, MD
> Chester, NJ 07930
> -----------------------------------------------------------
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