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Diversity of thought is at risk in medical journals
March 06, 2024
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A couple of years ago, a new editor was appointed to one of the world’s leading medical journals, JAMA, or the Journal of the American Medical Association, and its network of associated journals.
Dr Kirsten Bibbins-Domingo set out her goals in an editorial entitled, “The Urgency of Now and the Responsibility to Do More”. She aspired to ensure that JAMA had “the highest standards of editorial integrity and quality independent of any special interests”. She warned against “Insularity and parochialism”; she said that “it is paramount that the voices in the room where decisions are made represent diversity of thought, expertise, and backgrounds”.
I wonder, though, how committed JAMA is to diversity of thought. Two articles in the March 4th issue of JAMA Internal Medicine are promoting a narrow and controversial approach to the beginning and the end of life.
The first is a savage attack on Catholic healthcare in the United States by the associate editor and the deputy editor of the journal. As an “editor’s note”, it nails its flag to the mast of reproductive rights.
“Catholic hospitals are an important source of health care in the United States for persons of all denominations. Pregnant persons [sic] may not always have a choice as to where they will deliver if their labor comes rapidly and they require emergency transport to the nearest hospital,” they write. “There must be a path to assure that pregnant persons get the care they wish regardless of what hospital they go to.”
And what might that path be? The clear implication is that Catholic hospitals should be forced to provide healthcare like abortion, sterilization, and contraception to which they have deep moral objections.
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The second is a sentimental plea to extend legal assisted suicide throughout the United States. The authors are both doctors -- the wife and daughter of a distinguished physician in the state of Washington, J. Randall Curtis, who died of amyotrophic lateral sclerosis (ALS) last year. They write: “For Randy, the only end to his extreme suffering while ALS was surely killing him was the overwhelming act of hastening his own death. In his case, he was his own most compassionate physician.”
Dr Curtis’s loved ones are eloquent in describing their sorrow at losing a man they dearly loved. But their arguments for extending Washington’s law permitting assisted suicide are tendentious -- and far from original. Yes, physicians should be compassionate. Yes, patients should have autonomy.
But that hardly exhausts the question of the “right to die”. The authors blithely say that compassionate science will protect social welfare. That is a dubious assumption. Just look on the other side of the border in British Columbia, where people are choosing to die because they cannot access palliative care or supportive social services.
Back to the editorial policy of the JAMA journals. Do these articles represent “the highest standards of editorial integrity and quality independent of any special interests”. No. I’d argue that they do represent a special interest – a campaign to deny the sanctity of all human life from conception to natural death.
In today’s America, of course, this is a contested proposition, with arguments on both sides. But when will the readers of JAMA Internal Medicine read a defence of Catholic healthcare? When will they read a heart-rending personal account by a doctor who cared for her terminally loved one until the very end?
Not very soon. Insularity and parochialism have triumphed at JAMA. It is looking more and more as though the world’s leading medical journals have been captured by the culture of death.
Many critics have accused the American medical profession of going “woke”? What do you think? Leave a comment in the box below.
Michael Cook is editor of Mercator.
Image credits: Bigstock
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Hosen Kiat commented 2024-03-29 04:07:45 +1100My response as an experienced contributor to medical journals:
Addressing Access to Healthcare:
The first publication (1) in question, an editorial by Corbie and Katz, scrutinizes Catholic healthcare in the United States and advocates for reproductive rights. While Mr. Cook characterizes it as a “savage attack,” it is essential to recognize that the intent is to address concerns regarding access to healthcare for all individuals, regardless of their religious beliefs. The publication highlights the need to ensure that pregnant individuals have access to the care they desire, even in emergency situations.
It does not seek to force Catholic hospitals to provide services that go against their moral objections but rather to explore pathways that can guarantee comprehensive care for all.
Exploring End-of-Life Choices:
The second publication (2) mentioned by Mr. Cook discusses legally assisted suicide and shares a personal account of a physician’s family member with ALS. While Mr. Cook questions the arguments put forth, it is important to acknowledge that end-of-life choices are complex and multifaceted. The paper (2) focuses on the concept of autonomy and compassion, recognizing that patients should have the right to make decisions about their own lives. It does not claim to exhaust the question of the “right to die” but rather serves as a starting point for further discussion and exploration.
Considering the Broader Context:
The critique raises concerns about the assumption that compassionate science will protect social welfare, citing challenges faced in British Columbia. While it is crucial to acknowledge the limitations and potential risks associated with certain approaches, it is equally important to examine the broader
context. Exploring different perspectives and considering the availability of palliative care and supportive social services is essential to ensuring a well-rounded discussion on end-of-life choices.
Maintaining Editorial Integrity:
Mr. Cook questions whether these articles align with JAMA’s commitment to the highest standards of editorial integrity and quality. It is important to note that medical journals have a responsibility to present a variety of perspectives, even on contentious issues. By providing a platform for diverse voices and viewpoints, journals contribute to the advancement of knowledge and facilitate informed
discussions within the medical community.
Seeking Balance and Inclusivity:
Mr. Cook concludes by suggesting that insularity and parochialism have triumphed at JAMA, insinuating a capture by the “culture of death.” However, it is important to recognize that promoting diverse perspectives does not equate to a denial of the sanctity of life. Rather, it allows for a more comprehensive understanding of complex issues and fosters a climate of inclusivity, where different viewpoints can be explored and debated.
Conclusion:
Ensuring a balanced and inclusive approach to discussing controversial topics is crucial in the medical field. JAMA and other reputable medical journals have a responsibility to provide a platform for diverse perspectives, fostering informed discussions and advancements in healthcare. By embracing compassion, choice, and diversity of thought, we can continue to learn, grow, and better
serve patients and society as a whole.
References:
1. Corbie G, Katz MH. Access to Reproductive Services and Catholic Hospitals. JAMA Intern Med.
Published online March 04, 2024. doi:10.1001/jamainternmed.2023.8430.
2. Curtis A, Hamblin A, Rosa WE. The Strength It Takes to Suffer. JAMA Intern Med. Published
online March 04, 2024. doi:10.1001/jamainternmed.2024.0106
Hosen Kiat, a consultant cardiologist, Professor of Medicine at ANU College of Health and Medicine, Australian National University, and Professor of Cardiology at the Faculty of Medicine, Health and Human Sciences, Macquarie University.
Professor Kiat has published several hundred peer-reviewed academic and research publications. In 2007, he was co-editor and co-author for a special issue of 10 papers in the MJA (Medical Journal of Australia) on the topic of Prayer as Medicine.
Conflict of Interest: none. -
mrscracker commented 2024-03-07 01:53:22 +1100“Catholic hospitals are an important source of health care in the United States for persons of all denominations. Pregnant persons [sic] may not always have a choice as to where they will deliver if their labor comes rapidly and they require emergency transport to the nearest hospital,” they write. “There must be a path to assure that pregnant persons get the care they wish regardless of what hospital they go to.”
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Unless the “pregnant person” has a desire to snuff out their child whilst in labor or be surgically sterilized postpartum, Catholic hospitals are going to give them proper labor & delivery care because that’s their mission & what they’re obliged to do. -
