Do you remember the days when medical publications focused almost exclusively on medicine? They seem to have gone with the wind, and I am not sure why.
Medical journals have an important role in the dissemination of knowledge and the promotion of new ideas. At their best, they are an important building block in the construction of a solid base for the practice of medicine.
Of course, it is entirely appropriate for medical journals, particularly ones that belong to national medical societies, to include articles that concern broader issues that influence health, such as environmental factors and social determinants of disease. And it is acceptable for such articles to discuss matters that may not yet be supported by solid scientific data; indeed, at their best, they may point out possibilities that have not been explored yet and encourage their investigation.
Medical newspapers and magazines, such as Interventional News, usually include commentaries on the significance of scientific advances by the authors of scientific articles, and by other experts in the field. They combine such articles with reports of political and institutional issues relevant to medicine.
The editors of medical publications have to tread carefully. Medical politics are relevant and interesting to many readers. But there are significant challenges related to issues that are only tenuously related to medicine. Handling them appropriately requires objective, unbiased reporting and editing, as well as avoiding being obsessed with these issues and highlighting them repeatedly. Editors can have passionate views about certain subjects, but they must set them aside when they are preparing the next issue of their journal.
Let’s take the example of climate change: depending on your views, this is an acute emergency that necessitates immediate action or a natural cyclical event that should be mitigated, as it always has been. Judging whether an article on this topical subject in a medical publication is a sensible analysis of legitimate concerns, or a venting of one’s frustrations, depends on the balance between true medical issues and matters that are outside the expertise of most doctors. If most of the text focuses on subjects such as the impact of climate on medication supply chains, or on temperature fluctuations affecting the demand for treatment related to climate-induced illnesses like heatstroke and respiratory issues, it is likely to be a sensible analysis of genuine climate-related problems. But an article that briefly mentions such matters and then discusses at great length how governments should change their energy policies to achieve net zero, and lectures readers on the obligation of citizens to protest the mining of fossil fuels, does not belong in a medical publication.
I am not suggesting that physicians are not entitled to hold strong opinions about controversies related to gender, race, politics, wars, or climate change. But if they want to express their views in public they should do so in the mainstream media. Using medical publications to try to influence their colleagues about issues on which they have no special expertise is an abuse of their position. It is regrettable that several previously respectable medical journals have allowed themselves to be used in this way, week in and week out, and even worse that some editors are playing this game and demeaning themselves and their publications.
My next editorial will analyse in detail how Greenland could annex the USA.
Andy Adam is emeritus professor of interventional radiology at King’s College London, UK and joint editor-in-chief of Interventional News.
