Furor erupts at medical journal

By HELEN BRANSWELL

Tuesday, December 13, 2005 Page A12

Canadian Press

TORONTO -- The Canadian Medical Association Journal said yesterday that
its owner, the Canadian Medical Association, transgressed the journal's
editorial independence by demanding changes to a news report
questioning the way pharmacists were handling sales of Plan B, the
morning-after birth-control pill.

In an editorial slated for the Jan. 3 issue but released on-line
yesterday, journal editor John Hoey announced he had struck a
blue-ribbon panel to draw a clear line for the CMA on the issue of
editorial autonomy.

"That interface between us, the journal, and the owners needs to be
fortified and strengthened and understood, I think, by the CMA," Dr.
Hoey said in an interview.

The editorial revealed that its publisher had given the journal an
ultimatum about an article suggesting women's privacy rights were being
violated during Plan B sales. The ultimatum: Remove a portion of the
piece, or the entire item would be killed.

The directive came after the Canadian Pharmacists Association
complained to the medical association about the item, the editorial
stated.

The journal chose to run an abridged version of the article in the Dec.
6 issue, said Dr. Hoey, who noted that when he acquiesced he warned the
publisher he would write about the conflict at his earliest
opportunity.

Dr. Hoey said that during his decade-long tenure, the journal has
experienced sporadic conflicts with the Canadian Medical Association's
board, which is elected from medical professionals across the country.
But those set-tos have always been about items that had already been
published, he said.

"It's the first time they've actually censored something," he said of
this case.

"We're trying to be a reputable journal. They clearly went over the
line."

Publisher Graham Morris said he was simply holding the journal's news
staff to the standards required of the researchers whose work the
journal publishes.

"My job is to protect the integrity of my organization," Mr. Morris
said.

The conflict stems from a piece of investigative reporting on the
information pharmacists around the country were demanding of women
seeking to buy levonorgestrel, sold under the brand name Plan B.

Since earlier this year, the drug, once available through prescription
only, has been sold on a behind-the-counter basis, meaning women can
get it from a pharmacist without a prescription. The goal was to
improve access to the drug, which must be taken within 72 hours of
intercourse to prevent pregnancy.

The journal asked a woman in each province and territory to try to buy
the drug. Some reported that pharmacists demanded and entered into a
computer database personal information, including the woman's name and
address.

That's not common practice for sale of other behind-the-counter drugs,
such as sinus medications containing codeine.

Pharmacists in Ontario were asked to stop collecting the data, after
the province's privacy commissioner complained.

Dr. Hoey said the Canadian Pharmacists Association learned of the
article before it went to press. The association complained to the CMA,
which in turn told the journal it could not publish the material
gathered by the women who attempted to purchase the drug.

Where the journal characterized the women's efforts as investigative
journalism, Mr. Morris argued the work could be construed as research
-- and research on shaky ethical ground.

"We always hold ourselves up to a higher standard when we . . . publish
research done by others," he said. "And if this could be interpreted to
be research, we should hold ourselves up to the highest standards as
well."

Dr. Hoey said in an effort to prevent future interference, he has asked
a panel of "heavyweights" to delineate the lines of editorial
independence for the CMA. High-profile participants were chosen to
ensure the association would have difficulty ignoring their advice.

The panel will be chaired by Jerome Kassirer, former editor-in-chief of
the New England Journal of Medicine. Other members are Donald
Redelmeier, a medical professor at the University of Toronto; and Frank
Davidoff, editor emeritus of the Annals of Internal Medicine.

http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20051213/HJOURNAL
12/TPHealth/