JAMA: Editor Fired For Timing Of Sex Study
The American Medical Association Friday fired the editor of its prestigious journal for publishing a study in which a majority of college students echoed President Clinton's contention that oral sex does not constitute "sexual relations." The firing of the Journal of the American Medical Association's editor of 17 years, Dr. George Lundberg, "embroils the Chicago-based physicians' organization in yet another controversy," the Chicago Tribune reports. Speaking at a news conference Friday, AMA Executive Vice President E. Ratcliffe Anderson said, "Dr. Lundberg, through his recent actions, has threatened the historic tradition and integrity of [JAMA] by inappropriately and inexcusably interjecting JAMA into a major political debate that has nothing to do with science or medicine. This is unacceptable" (Japsen, Chicago Tribune, 1/16). He said the science of the study was not at issue, only the timing of its publication, which conspicuously coincides with the president's trial before the Senate. The president said during grand jury testimony that oral sex was not included in his definition of "sexual relations" (Hellmich, USA Today, 1/18). Anderson added, "On behalf of the AMA, we apologize to JAMA's readers, its contributors, and to any others who feel that JAMA has been misused in the midst of this most important congressional debate of the century" (Price, Washington Times, 1/16).
Semantics
The New York Times reports that the "paper that proved to be Dr. Lundberg's downfall was by Dr. June Machover Reinisch, the former director of the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University." In the study, Reinisch reported that a 1991 survey of 599 undergraduates at an unnamed midwestern university found that 59% said oral sex did not equate to "having sex" (Kolata, New York Times, 1/16). Referring to the "[r]ecent public discourse" on the definition of sex, and saying the results have "implications for both clinical and research purposes," Reinisch and colleague Stephanie Sanders indicated that 37.7% of women and 43.9% of men said "oral contact with [their] genitals" would constitute sex. They wrote that the "virtually universal endorsement of penile-vaginal intercourse as having 'had sex' in contrast with the diverse opinions for other behaviors highlights the primacy of penile-vaginal intercourse in American definitions of having 'had sex,'" and suggest that parts of the current impeachment controversy may stem from a longstanding "lack of consensus" over what sex is. Of further note is that the authors collected and published as part of the study the party affiliations of the respondents, reporting that 78.5% classified themselves as "moderate to conservative," and Republicans in the sample outnumbered Democrats (Sanders/Reinisch, JAMA, 1/20 issue).
Who's Got An Agenda?
Reinisch said her data had been presented to "at least three scientific meetings since 1994 but never published." When the presidential scandal broke, colleagues urged her to publish her findings. She said, "I wish it had been in publication before this whole thing ... started, and it could have been referred to all along. If someone is to blame for the timing, it's the authors, because we should have done it earlier, but we just couldn't believe it would be such a major issue" (USA Today, 1/18). "I'm absolutely shocked," she said of the firing. "This may have to do with issues of academic freedom. There was nothing unusual about this paper," she added (Coleman, AP, 1/15). Anderson noted, however, that there was "some acceleration" of the normal review process for works to be published (Tye, Boston Globe, 1/16). But he added that he "would never fire someone for one mistake," saying that a series of events "caused me to lose confidence in Dr. Lundberg" (Peck, Reuters Health, 1/18). Dr. Tom Delbanco of Harvard Medical School said, "I read it simply as the AMA wanting the Republicans to do better than the Democrats" (Globe, 1/16). Lundberg's attorney, William Walsh, said that the AMA's "virtually unprecedented action ... intruded into the historically inviolable ground of editorial independence in scientific journalism" (Monmaney, Los Angeles Times, 1/16). But others said the meaning of the article's timing was unmistakable. "This has all the earmarks of the Iraqi bombings in terms of timing," said Robert Knight, director of cultural studies for the Family Research Council (Geller, New York Post, 1/16).
More Bad Timing?
The Tribune reports that the flap comes at an inconvenient time for the AMA, which "is losing members and is recovering from a loss of credibility over an ill-fated product endorsement deal with Sunbeam Corp.." Now the AMA must deal with questions over its political neutrality. The organization has long contributed financially almost twice as much to Republicans as it has to Democrats (Tribune, 1/16). But its "No. 1 lobbying priority in Congress is legislation aimed at regulating the managed care industry that is being championed principally by the Democratic Party." One source said the AMA did not want to be perceived as being any more friendly to the Democrats with publication of the article. Princeton health care economist Uwe Reinhardt said, "The management of the AMA obviously feels that they are getting too close to politics. The Republicans are kind of ticked at them" (Winslow, Wall Street Journal, 1/18). Boston University science journalism professor Ellen Ruppel Shell said, "[I]t appears that Dr. Lundberg's interest in setting news and policy agendas may have exceeded his concern for publishing only the highest level of scholarship" (McCullough, Philadelphia Inquirer, 1/16).
'AMA Identity Crisis'
The Chicago Tribune weighed in today, asking, "Is it a professional society or a trade union? A sponsor of dispassionate research or a self-interested political lobby?" The editorial charges that the AMA "cannot have it both ways. It cannot be the jealous guardian of a nation's health and of its own members' finances." Calling Anderson's explanations "hollow," the Tribune asserts that "good editors, even of scientific journals, always strive for relevancy. When the country must decide whether to inoculate school children against hepatitis B, say, or provide sterile needles to HIV-vulnerable junkies, that is exactly when publications like JAMA should weigh in with the best available data ... no matter how it cuts politically." The paper concludes, "it is no coincidence ... that the offending article undermines Republican claims that Clinton perjured himself by using a very narrow definition of what constitutes sex. If you're an AMA gamesman, undermining the majority party is a bad idea when you're also asking the GOP to crack down on HMOs and protect doctors' fees under Medicare" (1/19).