I would suggest that this issue may be a bit more complicated than we first
thought, based on my reading of the article: (Sanders SA, Reinisch JM. Would
you say you 'had sex' if...? JAMA 1999; 281: 275-277)
In the introduction to the article (and repeated in the abstract) is the
statement "recent public discourse regarding whether oral-genital contact
constitutes having 'had sex' highlights the importance of explicit criteria..."
The introduction then goes on to refer to "social and legal definitions of
'sex'..." but not specifically to public health or clinical definitions. The
introduction then repeats the reference to "current public debate" citing both
the Starr report and a news article about President Clinton from the Washington
Post. The introduction does not make any mention of public health or clinical
issues whatsover.
The comment section does make a brief reference to the relevance of the
results to sexual history taking and prevention education, but reiterates the
issue of "current public discourse," and oddly emphasizes the political party
affiliations of the study subjects.
Although it is not obvious to me that publication of this article per se is a
reason to fire an editor, I do not recall ever seeing an article which made so
much of current political (but not health policy) controversies and made so
little of the public health or clinical implications of its findings. This
is particularly surprising because the results reported do have both
clinical and public health implications. Why the authors did not emphasize
these implications (and why the editors did not push them into doing so) is
a complete mystery to me, unless, again, the purpose of the article was to
influence political proceedings that had nothing to do with clinical care or
health policy. Therefore, IMHO, the article reads like an attempt to influence
the political (but not the health policy or clinical care) process and so
seems completely out of place in a scholarly medical journal. Therefore, I am
very surprised that the Editor and Editorial Board allowed it to be published
in this form.
Whether the sacking of Dr. Lundberg was a justified response to his editorial
decision in this case, or was wildly disproportionate is open to question. I
would hesitate, however, to accuse the AMA leadership of censorship. If what
they did is censorship, then I could also say the last time JAMA rejected one
of my papers because of the "publication priorities" of the journal it also was
guilty of censorship. Journal editors make decisions about publishing
individual papers based on their content all the time. This is not censorship.
It is judgment about publishing priorities. Editors of journals owned by
non-profit organizations must be responsible to the boards of these
organizations. So the decisions they make to hire or fire Editors based on
their decisions about publication priorities also do not amount to censorship.
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