Big Bloody Nose for the Canadian Medical Association

Post Reply New Topic

Daily Women's Health Policy

International News | Canadian Medical Association Fires Journal Editors; Some Say Move Tied to Report on Nonprescription Plan B Sales
[Feb 22, 2006]
The Canadian Medical Association, which owns the Canadian Medical Association Journal, on Monday fired two editors from the peer-reviewed journal -- a move some say is tied to the deletion of part of a news report released in December 2005 that questioned the way pharmacists in Canada are handling sales of Barr Laboratories' emergency contraceptive Plan B, the New York Times reports (Austen, New York Times, 2/22). Canada's national health agency, Health Canada, in April 2005 approved nonprescription sales of Plan B, which can prevent pregnancy if taken up to 72 hours after sexual intercourse. Staff at CMAJ asked women in each province and territory in the country to attempt to buy the drug and describe their experiences. Some of the women said that pharmacists requested personal information -- including their names and addresses -- and entered the information into a database, which is not standard practice for nonprescription drugs. The CMAJ report originally was to include the women's experiences -- which news report authors said constituted investigative journalism -- but the Canadian Pharmacists Association heard about the upcoming report and complained to CMA. Publisher Graham Morris told CMAJ staff to remove the women's experiences or not run the report because it could be seen as unethical research, and the staff decided to publish an abridged version of the article in the Dec. 5, 2005, issue. An editorial published online on Dec. 13, 2005, said CMA demanded the deletion (Kaiser Daily Women's Health Policy Report, 12/15/05). According to the Toronto Star, Ontario, Canada, Privacy Commissioner Ann Cavoukian as a result of the report issued guidelines prohibiting pharmacists from asking women about their sexual history, except in "rare instances" (Daly, Toronto Star, 2/22).

Reaction
Jerome Kassirer, former editor of the New England Journal of Medicine and a member of CMAJ's editorial board, said he believes the firings were made as the result of a draft report he issued on Friday regarding the Plan B article. In the report, Kassirer criticized CMA for interfering with editorial decisions, adding that the journal should not have given in to Morris' demands (New York Times, 2/22). Morris on Tuesday said the firing of CMAJ Editor John Hoey and Senior Deputy Editor Anne Marie Todkill was a "totally separate issue" (Daly, Toronto Star, 2/22). He said, "Dr. Hoey was at the journal for 10 years. I felt it was time for a fresher approach," adding that he supports the editorial independence of the journal. Philip Devereaux -- a cardiologist and researcher at McMaster University in Hamilton, Ontario, and a member of the CMAJ board -- said he felt it was not "credible" to say that "at this point in time there's a need to refresh the CMAJ." He added, "There's no question about the huge advances the journal has made under John and Anne Marie" (New York Times, 2/22). Kassirer said CMA's decision would hurt the publication "enormously" (Curry, Globe and Mail, 2/22).

Canadian Medical Association Journal fires 2 editors
Last Updated Tue, 21 Feb 2006 18:02:06 EST
CBC News
The editor-in-chief of the Canadian Medical Association Journal has been fired, along with his senior deputy editor, CBC News has learned.

Dr. John Hoey and his deputy, Anne-Marie Todkill, were pushed out over questions of editorial freedom, sources say.


Dr. John Hoey was the editor-in-chief of the Canadian Medical Association Journal. (file photo)
There are also suggestions the journal's publisher, CMA Media Inc. – a subsidiary of the Canadian Medical Association – was unhappy with Hoey's editorial stance on private health care.

The first public controversy between Hoey and the journal's owner resulted from an investigative news story on ease of access to the "morning-after" pill from pharmacists, part of which was quashed by the publisher.

Hoey responded to changes to the story by writing an editorial condemning the medical association's interference with editorial autonomy. He also struck a panel to look at the issue.

Privacy concerns raised about morning-after pill rules
Last Updated Dec 6 2005 09:10 AM CST
CBC News
A new Saskatchewan protocol for dispensing the morning-after pill that includes a question about recent sexual history is raising concerns about women's privacy.

The drug levonorgestrel, sometimes known as Plan B, is 89 per cent effective at preventing pregnancy if women take the first of two doses within 72 hours of having unprotected sex.

In April, Health Canada approved it for sale without a prescription.

Pharmacists in Saskatchewan and other provinces keep the pill behind the counter. They're required to provide counselling and ask women a series of questions, such as when the customer had her last period and when she had unprotected sex. That information, along with a woman's name, phone number and address, remains on file.

Unfortunately, this will deter some women from going in to get the pill, according to Dr. Donna Stewart, a professor of women's health at the University of Toronto.

"They're worried about confidentiality, they're worried it's going to get around town they had a scare," she said. Stewart has concerns in particular about young women in rural Saskatchewan.

"In small communities, young women are very hesitant to have these discussions with pharmacists when they often know them or they're family," she said. "Moreover, many of these pharmacists don't have a private place in which to speak with these young women and that deters young women from seeking this out."

Ray Joubert, the registrar of the Saskatchewan College of Pharmacists, the questions are necessary so the pharmacist can assess the appropriateness of therapy and help the woman make sure the medication is taken properly.

Women's groups across the country want pharmacists to stop asking question and put the drug on the shelves next to other non-prescription medication.

Private health care

Dr. Jerome Kassirer, the head of the panel, said the immediate cause of Hoey's firing may be a story published online earlier in February headlined "Two-tier Tony Clement appointed new minister of health."

FROM FEB. 9, 2001: New Health Minister dubbed 'Two-tier Tony'


The article suggested Clement, the new federal health minister, would be friendly to private health care.

"There's no question that private health care could be a boon for Canadian physicians and that the CMA probably would want to support privatization," said Kassirer, who is also a professor at Tufts University School of Medicine in Boston and a former editor of The New England Journal of Medicine.

"Any argument against that by critics is likely to be seen as counter-productive to the goals of the CMA."

The Clement story never made it into the printed journal and has since been pulled from the CMAJ website.

When Clement was Ontario's health minister in 2001, he gave a speech to the Empire Club supporting more choice in getting health care.

CMA's media publisher, Graham Morris, denies concerns over specific stories or that Hoey's approach led to the firing.

"Nothing specifically about his approach, but we feel there are some changes in emphasis that we would like to make in the journal," said Morris. "We felt this is the time to make the change."

Morris wouldn't elaborate on what changes he wants. He said he stands behind the principle of editorial independence.

I wonder what questions the pharmacists would ask if the boyfriend went in to purchase the "morning after" pill? I don't think I'd have any problem telling him/her that *I* am not pregnant and where I stick my appendages is none of there f-ing business.