1. Mason, Diana J. PhD, RN,FAAN, AJN Editor-in-Chief

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On February 20, John Hoey, editor-in-chief of the Canadian Medical Association Journal (CMAJ), and his senior deputy editor, Anne Marie Todkill, were fired by the publisher, Graham Morris. Morris has asserted that the firings were simply the result of a desire to take the journal in a different direction, but an article in the March 20, 2006, issue of the New England Journal of Medicine (NEJM) by Shuchman and Redelmeier suggests that disagreements between the CMAJ and the Canadian Medical Association (CMA) over what the journal published led to the terminations. According to the article, one of the disagreements between the CMAJ editors and the CMA was over "an unflattering profile of Canada's new minister of health, Tony Clement." Acting editor-in-chief Stephen Choi subsequently requested that the CMA agree to a written document on editorial independence for the journal, but it refused and he resigned. The World Association of Medical Editors is understandably concerned that these actions represent an assault on editorial independence, the hallmark of credible biomedical publishing (see


There are several reasons nurses should care about the firing of a medical journal editor.


First, what happens in medical journalism can happen in nursing journalism. Editorial independence is not discussed in schools of nursing, at nursing conferences (except for those of the International Academy of Nursing Editors, or INANE), or in most nursing journals, including those owned by societies and nursing organizations. But if the editor of a leading medical journal can be fired for publishing something his association doesn't like, the editor of a nursing journal is also at risk.


Editorial independence is essential to the integrity and quality of a journal.

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Second, nurses rely upon the objectivity of journal editors when seeking scientific information and critical analyses. But nursing and medical journal editors, including me, are constantly subjected to attempts by others to control the content of their publications. I receive manuscripts from nurses who've put their names on papers written by people hired by the manufacturers of products they want to promote. Even though turning away such articles means we won't reap revenue from the sale of article reprints to the product's manufacturer, such biased manuscripts don't pass scrutiny by AJN 's peer reviewers or our editorial staff.


Third, professional organizations have an obligation to serve their members. One way, of course, would be to give them the best in clinical information and news; another would be to control their journals' content, especially when it conflicts with their official positions. But the latter practice leads to bad science, bad practice, and bad decisions about important issues.


Editorial independence is essential to the integrity and quality of a journal. At almost every annual meeting of INANE that I have attended, discussions have arisen on the conflicts faced by editors of journals affiliated with professional organizations. As Catherine DeAngelis, editor-in-chief of the Journal of the American Medical Association (JAMA), wrote to me, "An association must decide if the publication would be a peer-reviewed, scientific journal or a house organ. By definition, no single publication can serve both purposes."


There is a perception that journals are profitable ventures for professional organizations and societies. While JAMA and NEJM are profitable, both journals have full separation between advertising and editorial content. And even though nursing journals don't attract the kind of pharmaceutical advertising that leading medical journals do, their editors are under pressure to publish content that will attract advertising, particularly if the journal relies solely on advertising dollars for its financial viability.


This is an age of marketing hype and ideology that trumps science. The editors of scientific journals must make it their priority to deliver the most accurate information they can on the topics they deem important. Anything short of that is a disservice to readers-and the patients who may fall victim to biased and inaccurate information. It's time for nurses to call for integrity in nursing and medical publishing.