Wednesday, March 25, 2009

Is this anyway for a medical journal to behave?

Reprinted in part from the The Chronicle of Higher Education:

'JAMA' Orders Whistle-Blowers to Blow Their Whistles in Private

The longstanding ethical principle of medical students and physicians — “First do no harm” — appears to be taking on a new meaning at one of the world’s top medical journals.

The Journal of the American Medical Association, in an editorial published on Friday, has warned that anyone raising a conflict-of-interest complaint about one of its authors should do so in private to the editors, without telling any outsiders.

JAMA’s warning stems from a case involving Jonathan Leo, an associate professor of neuroanatomy at Lincoln Memorial University, in Tennessee, who found problems in a study published in JAMA by a University of Iowa psychiatry professor, Robert G. Robinson, about the use of antidepressants in stroke patients. Dr. Robinson, according to Mr. Leo, also didn’t disclose a financial relationship with the maker of the drug involved in the study.

Mr. Leo reported his concerns to JAMA in October. Finally, this month, he publicly revealed his complaint in a letter published in the BMJ (formerly known as the British Medical Journal). One week later, JAMA published a correction and a letter from Dr. Robinson conceding he had in fact been paid by the drug company and had failed to report that.

In its editorial, JAMA affirmed the need to guard against conflicts of interest. Yet JAMA said that, in the future, anyone suspecting a conflict involving one of its authors should tell JAMA and “should not reveal this information to third parties or the media while the investigation is under way.” JAMA said it could be trusted to handle the matter fairly.

“A rush to judgment may spark heat and controversy,” it said, “but rarely sheds light or advances medical discourse.”

JAMA editors denied suggestions by Mr. Leo and his university dean that the journal had threatened to damage the reputation of the university over Mr. Leo’s decision to publicly reveal his allegation against Dr. Robinson. JAMA did not say, however, what it would do if a whistle-blower behaved similarly in the future, in violation of JAMAs new policy. JAMA also did not say how long whistle-blowers should expect the journal to take to look into their complaints.

Full article plus comments can be found here.

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