Editorial Freedom and Integrity - AMA Manual of Style

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Editorial Freedom and Integrity 

Ethical and Legal Considerations

Annette Flanagin

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PRINTED FROM AMA MANUAL OF STYLE ONLINE (www.amamanualofstyle.com). © American Medical Association, 2009. All Rights Reserved. Under the terms of the license agreement, an individual user may print out a PDF of a single chapter of a title in AMA Manual of Style Online for personal use (for details see Privacy Policy).  Subscriber: null; date: 25 November 2015

Editorial Freedom and Integrity

  • The freedom of the press is one of the greatest
  • bulwarks of liberty.
  •     George Mason1

Editorial freedom implies a range of independence, from complete absence of external restraint and coercion to merely a sense of not being unduly hampered or frustrated.2 Integrity is the state of honesty, credibility, incorruptibility, and accountability.2 A biomedical journal has editorial integrity if it adheres to these values, but different journals have different levels of editorial freedom. The First Amendment of the US Constitution affirms several freedoms, including the freedom of the press.3 Thus, communication through the US press or other media is a right that should not be interfered with by the government, other institutions, or individuals.4 Many countries guarantee similar freedoms of the press.5 Freedom of the press is a foundation for editorial independence, “which is the distinct right of the editor to publish any material that passes defined criteria for quality and that fits within the mission of the publication, without suffering undue interference from others.”6

A journal’s editorial independence must be balanced against the need for appropriate authority, responsibility, and accountability as well as trust between the editor and the journal’s many stakeholders: readers, authors, reviewers, publishers, owners, subscribers, advertisers, and others6 (see also 5.11, Editorial Responsibilities, Roles, Procedures, and Policies). The level of editorial freedom differs among different biomedical journals, from maximum independence for those peer-reviewed journals in which the editor has complete authority and responsibility for the journal, its content (including all editorial and advertising content), reuse of its content, and use of the journal name/logo, to no independence for those journals that are not peer reviewed and in which all authority and responsibility rests completely with others (eg, publishers or owners). Journals that are published primarily to serve business, political, or other concerns of their owners are known as “house organs.”2 For some biomedical journals and editors, the level of editorial freedom may be best described as somewhere between complete editorial independence and no independence. Furthermore, editorial freedom may be assumed to exist by an editor, and the journal’s readers, until and unless a major conflict occurs. A 1999 survey of the editors of 33 peer-reviewed medical journals owned by professional societies (10 journals represented in the International Committee of Medical Journal Editors and a random sample of 23 specialty journals with high impact factors) found that 23 (70%) of the 33 editors reported that they had complete editorial freedom, and the remainder reported that they had a high level of freedom.7 However, many of these editors reported having received at least some pressure in recent years over editorial content from the professional society’s leadership (42%), senior staff (30%), or rank-and-file members (39%).7

There are numerous examples of editors and journals battling incursions from interpersonal, social, political, and economic forces. Editors have been dismissed from their posts and journals have ceased publication after a mere “stroke of the editorial pen.”8 In one case, the Irish Medical Journal was voted out of existence in 1987 after the editor published an editorial against physician strikes that angered some influential members of the Irish Medical Organisation.8,9

During the last 10 years, editors of several leading general medical journals have been unwillingly removed from their positions after publishing articles that were considered inappropriate by various external forces (eg, owners, publishers) and for having disagreements with owners or publishers about the editor’s level of autonomy and authority over the journal’s content and the journal’s name and brand (eg, logo).10-26 In each of these cases, long-term struggles between the editors and the owners of the journals resulted in loss of trust between the parties, and because of a lack of effective protective oversight and governance and apparent lack of an effective system for conflict resolution, precipitate decisions to remove the editors resulted in widespread criticism of the owners and threats to the integrity and continued existence of the journals. (See 5.10.1, Maintaining Editorial Freedom: Cases of Editorial Interference and the Rationale for Mission, Trust, and Effective Oversight and Governance.)

An earlier example of a medical editor credited for his struggles to maintain editorial freedom is Hugh Clegg, editor of the BMJ from 1944 to 1965. In 1956, Clegg wrote an unsigned editorial entitled “The Gold-headed Cane,” in which he castigated the president of the Royal College of Physicians for taking office for the seventh successive year. He also admonished the college for its failure to recognize the modern welfare state and its lack of attention to postgraduate medical education.4,27 With much difficulty, Clegg kept his editorial position and freedom and purposely published a reply from the president that rebutted all of Clegg’s criticisms. Clegg believed that medical editors are the protectors of the conscience of the profession, and he is well known for his assertion that editors who maintain this ideal will often find themselves in trouble. This trouble may come in the form of incursions into editorial freedom, which editors must be able to defend.

Editors of biomedical journals that have editorial freedom must have complete authority for determining all editorial content of their publications.6,28-33 (Note: Unless otherwise dictated by a journal’s specific mission, this may not be the case for journals that are house organs or that have minimal editorial freedom.) While many stakeholders may offer useful input and advice, editorial decisions must be free from restraint or interference from the publication’s owner, publisher, advertisers, sponsors, subscribers, authors, editorial board or publication committee members, reviewers, and readers. Owners, publishers, boards, and publication committees may have the right to select, hire, evaluate, and dismiss the editor, but they should not interfere with day-to-day editorial decisions and policies.6,15,29,30,33

Without a clear delineation of editorial freedom and the authority to maintain it, an editor might not be able to ensure the integrity of the publication. Thus, owners, publishers, and editors must have a clear and mutually understood definition of the editor’s level of editorial freedom, authority, responsibility, and accountability.6,30 Editors of journals with complete editorial freedom should not comply with external pressure from any party—including owners, publishers, advertisers, sponsors, authors, reviewers, and readers—that may compromise their autonomy or their journal’s integrity.29,30 Examples of such inappropriate pressures include, but are not limited to, the following:

  • Pressure from an owner or a politically powerful or motivated individual or group on the editor to avoid publishing certain types of articles or to publish a specific article

  • Pressure or requirement of an editor by a publisher or owner to modify or suppress specific content before publication

  • Demand from an owner or publisher to censor or remove published content deemed controversial or contrary to the owner’s position or that of an another organization or entity allied with owner

  • Demand from an owner or publisher or external person or organization to have access to confidential editorial or peer review records (see also 5.7.1, Confidentiality, Confidentiality During Editorial Evaluation and Peer Review and After Publication)

  • Demand from an author or group of authors to bypass the journal’s standard editorial and peer review processes and publish their manuscript without review or revision (eg, a society demanding acceptance and publication without review or revision of its meeting abstracts, proceedings, or papers)

  • Attempt by an author or peer reviewer to have an editorial decision reversed by threatening the journal’s editor or owner

  • The use or repurposing of the journal’s content or name by the publisher without the editor’s consent or in a manner that could harm the journal’s integrity

  • Request by an advertiser to insert an advertisement next to an article about or related to the advertised product or a threat to withdraw advertising support because of publication of a specific article (see also 5.12, Advertisements, Advertorials, and Sponsored Supplements)

  • An advertiser or publisher’s attempt to publish an advertisement or sponsored content disguised as editorial content (advertorial) (see also 5.12, Advertisements, Advertorials, Sponsorship, Supplements, Reprints, and E-prints)

  • A publisher demanding information about accepted or pending editorial content in advance of publication to sell that information to advertisers/sponsors or for other commercial purposes

  • A sponsor attempting to exert influence over editorial decisions or selecting specific content for publication (eg, sponsored supplements) (see also 5.12, Advertisements, Advertorials, Sponsorship, Supplements, Reprints, and E-prints)

  • A publisher demanding publication of an advertisement that the editor deems inappropriate (see 5.12, Advertisements, Advertorials, Sponsorship, Supplements, Reprints, and E-prints)

  • Request from a company to an editor to purchase reprints of an article under consideration but not yet accepted for publication

  • Demands by a commercial entity or governmental agency to publish or censor specific content

  • Compliance with governmental or other external policy to not consider manuscripts from authors based on their nationality, ethnicity, race, political beliefs, or religion (see 5.11, Editorial Responsibilities, Roles, Procedures, and Policies)

  • Pressure from a news organization or journalist to publish information about a journal article before the news embargo is lifted (see also 5.13.3, Release of Information to the Public and Journal/Author Relations With the News Media, Embargo)

Editors may need to educate and remind the journal’s various stakeholders about the fundamentals of editorial freedom and its direct relation to the publication’s integrity.

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