Crisis at the CMAJ

Issue: BCMJ, Vol. 48, No. 3, April 2006, page(s) 109 Editorials
Alan Brookstone, MD

There is a very public debate taking place in the media at present relating to the editorial autonomy of the Canadian Medical Association Journal. At issue is the recent firing of the Journal’s editor in chief, Dr John Hoey, and senior deputy editor, Anne Marie Todkill, on 20 February. Acting editor, Dr Stephen Choi, resigned from the CMAJ after 1 week in that position following the CMA’s refusal to accept a 10-point governance plan that he had devised. Since the CMAJ is a highly respected scientific publication, I am not used to reading about its internal operations in the Globe and Mail; however, on 2 March, I was able to find a number of comments from readers on issues relating to the autonomy of the publication and the manner in which the owners of the CMAJ (CMA Holdings [CMAH]) have dealt with the editorial staff.

The CMAJ has published a number of editorials beginning 24 February addressing this crisis (visit The first is an editorial by the acting editor and editorial staff at the CMAJ entitled, “A catalyst for change” protesting the firing of Dr Hoey and Ms Todkill. This was followed on 28 February by “Editorial governance plan for the CMAJ,” by the chair of the Journal oversight committee, Dr Lawrence Erlick, and the chair of the board of directors of the CMA, Louise Cloutier, including a mission statement by the CMA’s Board of Directors to uphold the ideals of the medical profession and a commitment to the editorial independence of the CMAJ. The same day, another editorial was published entitled, “Editorial autonomy of the CMAJ” by an ad hoc committee that was asked by Dr Hoey (prior to his dismissal) to review a series of events that he felt had compromised the editorial independence of the CMAJ. This ad hoc committee was led by Dr Jerome Kassirer, a former editor of the New England Journal of Medicine.

The report is a scathing criticism of the manner in which the owners of the CMAJ dealt with the editorial team at the Journal but also points a finger at the willingness of the editorial team to buckle to pressure from the CMA by modifying a report slated for publication in the Journal.

Unfortunately, a power struggle has become the catalyst that has brought the reputation of a world-class publication into question, and despite attempts to revitalize the Journal, at this time, the future is uncertain. A report today in the Globe and Mail states that former editor in chief, Dr Bruce Squires, has been asked to return to the Journal on an interim basis; however, he is currently only considering this request as his own health is in question.

The principles of editorial independence of scientific publications like the CMAJ are at stake here. In an ideal situation, editorial leaders would be selected based on their skills, ethics, and reputation. Once installed, they would be given the leeway to do the job for which they have been chosen.

There is a natural tension that exists between the organization owning a publication and the editorial rights and freedoms of those selected to lead it. If an editorial board is not guaranteed autonomy, who takes on the role of being the conscience in situations that might be controversial? This is not simply a right, it is a necessity. How often has an issue been raised or an article published that is felt by many to be blatantly untrue, only to be proven correct with time?

I am certain we have not yet heard the end of this debate. I, for one, will be watching the ensuing discussions, debates, and editorials with great interest. I hope that common sense will prevail and that through a transparent and responsive journal oversight committee and a steadfast commitment to editorial independence, the reputation of the CMAJ will be salvaged. In my mind, the great issue in this debate is the question of trust. Editors make choices every day based on ethics, principles, and a stringent process of review that has evolved over time. Once installed, they must be entrusted to do what is needed in an environment that protects the autonomy of the publication and the rights and freedoms of expression.