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I only became a member of your listserve this week but am already intrigued by both the amount of activity and the discussions that take place here. I am a general internist at Ohio State University with an interest in EBM and was told about this listserve by a colleague here. He recommended it to me both because its a great discussion area for EBM but also because recently you have been discussing an issue that is very important to me -- the future of JAMA. I'd like to get my conflict of interest on the table right away -- I am also a member of the AMA Board of Trustees. If you'll allow me, I'd like to make a few comments on what has happened over the past week and give you some background. Dr. Anderson's decision to relieve Dr. Lundberg last week was not motivated by censorship or political/religious conservatism or totalitarianism (as was mentioned by one observer on the BMJ's website). It also had nothing to do with the statistical science used in the article or a dislike of the data's conclusions in and of themselves. However, the fact is that the conclusions of the article -- when published this week -- interject the Journal and, by the inference of the media, the public, and government officials, the rest of the AMA into a purely political debate which has no relevance to medical science or the practice of medicine. As you all know, the Journal and the AMA as a whole do not shy away from politically sensitive issues -- however, those issues should have some relevance to medicine or public health. For example, an article/opinion piece on HIV policy, needle exchange policy, medicare or managed care policy are political issues by their very nature -- but all of these issues are political issues that relate to medicine, medical professionals and our patients. The issue of the President's definition of sex and how it applies to his impeachment trial is NOT one of those issues. Also, many have argued that the study is important to doctors and patients in that if you treat adolescent and college age patients, you need to know what their definition of sex is in order to communicate with them. I would agree with that contention. However, I would have to ask why - if this data is so important - did it take eight years to have it submitted for publication? I would also wonder if the perceptions of college aged patients about what is and what is not sex may have changed over the last decade? I would argue with that they have (especially in the wake of HIV education in the high schools and colleges in the US). Lastly, I would hope that you could look at this issue from a managerial perspective. It was Dr. Lundberg's responsibility to guide the Journal and to ensure that its integrity and credibility were above reproach. This is not an issue of science or medicine -- this data is closer to a gallup poll than it is to true medical science. To publish it at this time (when the urgency of releasing the data for medical science purposes does not seem to be present), places the Journal in jeopardy of losing its credibility as an impartial, recorder of scientific fact as opposed to a partisan propagandist for a specific non-medical political cause. The AMA itself is an advocacy organization and does take political stances on issues related to medicine and our patients, but we do not use JAMA for those purposes. Our organization has nearly 300,000 members from both sides of the political spectrum and our scientific Journal cannot afford to be construed as simply a political mouthpiece for either political party. Editorial independence is a reality at JAMA -- Dr. Lundberg has had immense freedom to take the Journal in many new directions during his tenure. Many of you are correct in your comments crediting Dr. Lundberg for much of JAMA's success. However, he should not have put the Journal's integrity and credibility at risk by fast-tracking this article to coincide with the President's trial in the Senate when the article only concerned the definition of sex of 600 college students 8 years ago. Whatever your political beliefs, I think you can agree with me that a scientific medical journal (or even a medical society) should not take sides in the debate about the impeachment of a President for charges of perjury and obstruction of justice. That would be irresponsible. Please read the article and wrestle with the thought question of whether you think it meets the publishing priorities which you feel that a journal like JAMA should have -- especially to fast track it to publication in about six weeks. Its not a question of censorship; it's a question of management. I hope that this information helps shed some light on the facts surrounding this issue and helps you understand the background behind this decision. Please feel free to contact me if you have any questions regarding this issue. Andrew Thomas, MD Ohio State University Asst Professor, General Internal Medicine [log in to unmask]