Dr Thomas-
Serendipity strikes<g>-I also have a trip tomorrow (packing now). Let's
continue with my response to this message after Friday.
Steve Rinsler
In <[log in to unmask]>, on 01/24/99
at 08:44 PM, Andrew Thomas <[log in to unmask]> said:
>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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[log in to unmask]
Stephen S Rinsler, MD
Chester, NJ 07930
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