At the risk of being booted off a list I find very informative, I would like to
add perspective of someone outside of medical publishing circles. Having just
come from a long stint in Washington, there are a couple questions that I have not
seen addressed here.
I think everyone would agree that Congress has really put their necks on the line
to get this impeachment trial to where it is today. They are currently being
portrayed somewhat as juvenile in the media (which seems to forget it is also
responsible!), highly partisan, and are rightly concerned about their reputation.
I would not underestimate the animosity Congress may have towards those who show
their issues to be trivial AT THIS MOMENT IN TIME. For those who are not
American, the heart of one of the Articles of Impeachment IS perjury, including
Clinton’s denial that he had “sexual relations” with you-know-who based on his
interpretation of the term: oral sex is not “sex”ual relations. As the JAMA study
demonstrates, many Americans share this interpretation.
When it comes to editorial freedom/censorship, I have a couple questions. Isn’t
the issue in this instance more of timing, rather than actual publication of the
study? (If I understand correctly, wasn’t its review/publication accelerated?)
Secondly, I will pose this question to list participants, since I am not aware of
the relationships here. Doesn’t JAMA represent the “AMA”, or is it an
independent publication? If the former, does getting involved in such politics
reflect the sense of AMA members? (I’m sorry, but I don’t see the public health
urgency of a study on attitudes of Mid-Western college students toward oral sex.
I DO see a political value though.) From a Washingtonian’s perspective,
ACCELATING publication of this particular study AT THIS TIME would have set off
alarm bells, and might be considered akin to "murdering ones boss." Publication
of the study in itself would not. One chooses their battles with Congress.
Right or wrong, Anderson’s press release reads a lot like damage control. Was the
AMA faced with two equally bad choices? OR was AMA aware, and are now serving one
head on the sacraficial platter?
"When I asked him what he might have done differently, Anderson said that
"Perhaps I could have earlier on conveyed to Dr Lundberg the seriousness
of my expectations and the potential results of his actions"."
Personally, I had to hoot when I heard of the study. I find it a timely dose of
reality into the maelstrom whirling inside the Beltway. But I don’t know that I
would have expected it out of the AMA.
I recently had the pleasure of hearing Dr. Lundberg speak at a conference in Asia
(on the ethics of publishing, in fact.) He is a charismatic man, and a very
commanding speaker. I’m certain JAMA will suffer his loss.
IF I have not worn out my welcome by now, I would like to pose one to those who
are editors about ethical responsibilities of publishers. It is a question that I
drafted for Dr. Lundberg/JAMA (but never sent) regarding a study they recently
published.
Dave Sackett wrote:
> 1. the executive veep of the AMA who fired george lundberg answered your
> question for you, henry, in an interview with richard horton, editor of
> the lancet:
>
> "When I asked him what he might have done differently, Anderson said that
> "Perhaps I could have earlier on conveyed to Dr Lundberg the seriousness
> of my expectations and the potential results of his actions"."
>
> 2. the BMJ's site on this affair is full of interesting statements and
> views (lots of them inappropriately ad hominem in my view), and the
> parallels drawn by our colleagues in former eastern europe are chilling.
>
> http://www.bmj.com/cgi/content/full/318/7177/DC1
>
> cheers
> dls
> ............................................................................
> Prof David L. Sackett
> Director, NHS R&D Centre for Evidence-Based Medicine
> Consultant in Medicine Editor, Evidence-Based Medicine
> Nuffield Department of Medicine, University of Oxford
> Level 5, John Radcliffe Hospital, Oxford OX3 9DU, England
> Phone: +44-(0)1865-221320 Fax: +44-(0)1865 222901
> Email: [log in to unmask] WWW: http://cebm.jr2.ox.ac.uk
> ............................................................................
>
> On Wed, 20 Jan 1999, Henry Barry wrote:
>
> If an employee makes a
> > mistake, preemptive termination is usually reserved for the most egregious
> > of errors (murdering ones boss, betrayal of patient confidentiality,
> > falsification of medical records, etc). All other errors usually warrant
> > other action: collecting information about the nature of the error,
> > informing the employee of the error, identification of circumstances that
> > may have precipitated it, and developing a plan of action. In some cases a
> > plan of monitoring, warnings, and other disciplinary/remediation action are
> > considered. If serious enough, then repeated mistakes of a similar nature
> > may warrant progressive disciplinary action up to and including termination.
> >
> >
> > My point is that for less serious errors there is usually some due process.
> > If this was the culmination of a series of appropriately taken, private
> > disciplinary actions, then maybe the AMA acted appropriately. If not, then
> > they certainly, among other things are guilty of poor labor management and
> > ought to be taken to task for it.
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