“TO be an editor is to live dangerously”, wrote Dr Martin Van Der Weyden, former editor of the MJA after completing his tenure at the journal in 2011.
In an article setting out some of the attempts by interested parties to influence content in the journal on his watch (covering everything from medical euthanasia to timing of vertebroplasty), Dr Van Der Weyden mounted a passionate defence of editorial independence, describing it as “crucial for the viability of a journal”.
“At the outset, editors understand that they will be subjected to a myriad of pressures, including those from the journal’s owners, whether these be commercial publishers or professional organisations”, he wrote.
A good editor, he concluded, must have many enemies.
The history of medical publishing is littered with editors who, unlike Dr Van Der Weyden, did not survive, instead seeing their tenures summarily ended after coming into conflict with the proprietors of their journals.
In 1999, Dr George Lundberg was sacked as editor of the Journal of the American Medical Association after he published a report concluding US college students did not consider oral sex to be “having sex”.
His decision to fast track publication so that the report’s appearance coincided with the impeachment of President Bill Clinton over the Monica Lewinsky affair outraged the journal’s proprietor, the American Medical Association.
An association spokesman said Dr Lundberg had “threatened the historical tradition and integrity of JAMA by inappropriately and inexcusably interjecting [it] into a major political debate that has nothing to do with science or medicine”.
Less sensationally perhaps, that same year, Dr Jerome Kassirer’s contract as editor of the New England Journal of Medicine was not renewed after he disputed plans by his journal’s owner, the Massachussetts Medical Society, to use the journal’s brand to promote other commercial ventures.
Commenting on Dr Kassirer’s forced retirement, Dr John Hoey, then editor of the Canadian Medical Association Journal, wrote: “It is easy for marketing and its sometime accomplice, greed, to slip under an editor’s door”.
While acknowledging medical journals needed to be profitable, or at least break even, if they were to survive, Dr Hoey argued a commitment to quality and independence was central to achieving this.
“… any honest intellectual enterprise must proceed on the optimistic and disinterested premise that excellence is not only its own reward but is also the best guarantor of healthy circulation figures”, he wrote.
Those lofty ideals did not work out so well for Dr Hoey himself, who was dismissed in 2006 amid allegations his journal’s owner, the Canadian Medical Association, had repeatedly sought to influence editorial content.
A lot has changed in the publishing world since 2006 — and even more so since 1999 — though summary dismissals of medical journal editors are still with us, as anyone who has not had their head in the sand these last few weeks will know.
Tensions between editorial staff and proprietors are only likely to increase as publications of all kinds face unprecedented financial pressures in our age of digital disruption.
The economic models that have long supported scholarly and general publishing — principally advertising and subscriptions — are broken.
And, in a world where content is increasingly expected to be free, we have yet to find new financial models to replace them.
The potential disappearance of platforms to publish high-quality, independent research — and high-quality, independent journalism, for that matter — poses an incalculable threat to the maintenance of a healthy, just and equitable human society.
Publishing companies undoubtedly need to find new and creative solutions if they are to survive but, if they walk away from longstanding commitments to quality and independence, they risk ending up with something that was not worth the effort of saving.
Jane McCredie is a Sydney-based science and medicine writer.
Declaration: Jane McCredie has in the past worked as a consultant to Elsevier on its digital platforms and for Reed Elsevier as a journalist on Australian Doctor.