|
|
| |||||||||||||||||||||||
A quick look at other journals shows why it is so easy to become confused about the first question. Consider, for example, the five largest general medical journals: the New England Journal of Medicine, the Lancet, JAMA, BMJ, and Annals of Internal Medicine. The single-page lead editorials in the Lancet are signed with the name of the journal, clearly indicating that they represent a consensus of the editors. Although the other four journals publish only editorials signed by individuals, each editorial in JAMA is accompanied by the explanation, "Editorials represent the opinions of the authors and The Journal and not those of the American Medical Association," implying that the journal as a whole somehow endorses the content.
In the New England Journal of Medicine editorials are always signed by individual authors, and they represent the opinions of the authors alone, not those of the Journal itself (assuming journals can have opinions). Nor do they represent the official view of the Journal' s owner, the Massachusetts Medical Society. When the editor-in-chief wrote an editorial in favor of making marijuana available to relieve symptoms in terminally ill patients,1 he was presenting his own analysis and opinion; when the executive editor argued for physician-assisted suicide in certain circumstances,2 she spoke for herself; when one of our deputy editors urged restrictions on the use of appetite-suppressant drugs,3 he spoke for himself, as did another deputy editor who concluded that there has been enough research on electromagnetic fields4 and still another editor who suggested nationwide reporting of human immunodeficiency virus infections.5 Only when editors write about editorial policies do they speak for the Journal itself. Thus, editorials about such matters as the Ingelfinger Rule,6 authors' financial conflicts of interest,7 or criteria for authorship8 are not merely the opinions of the authors but explanations of policies that govern the Journal' s practices. The distinction between editorials about general issues and those that announce or clarify editorial policies (as this one does) is readily apparent.
Most of our editorials fall into neither category. Instead, they are solicited expert commentaries on Original Articles or Special Articles appearing in the same issue of the Journal. Their purpose is to put into perspective for our readers research findings that are particularly important, unexpected, or difficult to understand. Although these editorials often include the authors' personal judgments about the subject, they are meant primarily to interpret, explain, and advise. Sounding Board articles, in contrast, are opinion pieces not tied to another article in the Journal, and almost all are unsolicited. They often deal with health policy, economics, law, or ethics.
Editorials written by the editors and Sounding Board articles sometimes take strong positions on controversial issues. What is our responsibility to seek an objective or balanced viewpoint in these articles? We believe we have no such responsibility. In the editing process we do not ask that opinion pieces hew to a middle-of-the-road view. Even if it were possible to define such a thing, a journal filled with conventional wisdom would not be useful to our readers, let alone stimulating. No one is particularly interested in reading that everything is just as they thought it was yesterday. Furthermore, a view that seems eccentric or even outrageous today may become commonplace tomorrow. When we select opinion pieces for publication, therefore, we consider the importance of the topic, the novelty of the argument, and the logic and persuasiveness with which the argument is made, but we do not ask whether it conforms to today's dominant view, nor do we necessarily agree with it. (Indeed, the requirement of freshness militates against publication of the currently dominant viewpoint.) An editor may choose to write an accompanying editorial when the subject is particularly interesting and the editor believes he or she can make a substantial contribution. Editorials, like Sounding Board articles, should offer fresh insights and be well reasoned, but all the editors need not agree with them.
Since we do not try to achieve balance in opinion pieces, what about doing so by publishing opposing points of view in the same issue of the Journal? In fact, sometimes we do solicit a piece on the other side to accompany an especially contentious paper and publish the two together as Sounding Board articles. And our new series, Clinical Debate, from time to time presents opposing perspectives about diagnostic or treatment choices. But we believe that publishing opposing articles on every controversial issue discussed in the pages of the Journal would not only be unwise but also tedious. First, it would suggest that all issues have two, equally persuasive sides. Although the popular media, with their adversarial style and emphasis on combat, may promote that idea, we believe it is simplistic. Sometimes there are not two but many points of view, and sometimes there is only one credible one (there is, for example, no need to waste paper on those who do not accept the microbial theory of disease). Furthermore, the debate format tends to drive out considerations of the subtleties of an argument in favor of its most extreme or provocative elements, which are usually well known.
We also believe that trying to balance one point of view with its opposite each time we feature a controversial subject would be insulting to our readers. It would imply that they cannot evaluate an argument on its own merits or retain and modify it in the light of later arguments. Ideas, even unpopular ones, do not need antidotes. Instead, we try over time to present as many well-reasoned perspectives as possible on important controversial issues. We also try to keep our correspondence section interesting and critical. This section is the best place to air disagreements about published articles. Thus, although we do not seek balance in any given issue of the Journal, we often achieve it in the long run, because it serves our readers. That is not so different from what good newspapers and periodicals do. We see these policies as a way to maintain a lively and varied marketplace of ideas from which readers can choose, and we intend to continue this practice. We cannot afford to be too concerned about whether some people or groups will be offended. As Benjamin Franklin said, "If all Printers were determin'd not to print anything till they were sure it would offend nobody, there would be very little printed."9
Jerome P. Kassirer, M.D.
Marcia Angell, M.D.
References
| |||||||||||||||||||||||
This article has been cited by other articles:
HOME | SUBSCRIBE | SEARCH | CURRENT ISSUE | PAST ISSUES | COLLECTIONS | PRIVACY | TERMS OF USE | HELP | beta.nejm.org Comments and questions? Please contact us. The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved. |
Previous
