Tuesday, March 07, 2006

Circling the wagons at the CMA

The Canadian Medical Association (CMA) has been rocked back by the public and professional reaction to recent events at its Canadian Medical Association Journal (see our earlier stories here and here) and there has been considerable circling of wagons in the last day or so.

For one thing, the CMA has drafted a retired Supreme Court judge, the Right Honourable Antonio Lamer, to chair the magazine's oversight committee and "study the relationship between CMAJ and the CMA, and develop principles to govern that relationship".

In the statement released Tuesday, Dr. Ruth Collins-Nakai, the President of the CMA also announced that Dr. Noni MacDonald, a professor of pediatrics at Dalhousie University and a member of the oversight committee, has been appointed acting editor of CMAJ. Clearly her other responsibilities require some backup. Dr. Bruce Squires, a former editor of the CMAJ from 1987 to 1996, has been named Editor Emeritus to assist Dr. MacDonald. Dr. Squires is also the former Vice-President of the World Association of Medical Editors.

In a radio interview on CBC's As It Happens on Tuesday evening, Dr. Collins-Nakai heaped praise on the new acting editor and went out of her way to say the board had full confidence in the President of CMA Media Inc., Graham Morris. But beyond saying that the public was "only hearing one side of the story", she refused to discuss any details concerning the firing of the editor and the departure of the person tagged to be his replacement.

Morris was quoted in the New York Times attributing the firing to his need to take the journal in a new direction. Now, the CMA seems keen to spin the whole affair as an issue of governance and oversight. No comments are coming from anywhere, however, about the issue of the "privatization" of the CMAJ by the CMA, which immediately preceeded the crisis.

Even the gravitas provided by an overworked former Supreme Court judge (who is still working on a judicial inquiry in Newfoundland that is months overdue) may not be enough oil to pour on these troubled waters.

It seems likely, however, that the CMA will now use Mr. Justice Lamer as an excuse to say nothing until he reports back (it is said, by the end of June). Meanwhile, doubtless, severance negotiations are going on between the CMA and Dr. Hoey, the former editor. And Dr. MacDonald has an issue to get out.

Meanwhile, a few days ago (March 3) the prestigious British medical journal The Lancet posited another possible reason for Dr. Hoey's dismissal (assuming the Mr. Morris's "need for a change" argument is not accepted at face value): it says the firings may have been the result of a series of articles, online and in print on health politics, articles that were particularly critical of the new federal Conservative health minister Tony Clement. Read an account of this in The Toronto Star, including the suggestion that a critical passage in an article was changed to its antithesis.

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