US medical journal editor fired in cave-in to the right

Dr. George D. Lundberg was fired January 15 as editor of the Journal of the American Medical Association (JAMA), after 17 years in the post, following the magazine's publication in its most recent issue of a survey of sexual attitudes of US college students. The brief study indicated that 59 percent of those questioned did not define oral-genital contact as "having sex." Bill Clinton advanced the same view in rejecting the accusation that he lied about the nature of his relationship with Monica Lewinsky.

In announcing the firing, E. Ratcliffe Anderson, executive vice president of the American Medical Association (AMA), declared, "Dr. Lundberg ... has threatened the historic tradition and integrity of the [journal] by inappropriately and inexcusably interjecting JAMA into a major political debate that has nothing to do with science or medicine." Anderson charged that Lundberg sped up the publication process so that the study would appear during Clinton's Senate trial. He went on to apologize to anyone who may "feel JAMA has been misused in the midst of the most important congressional debate of this century."

As Anderson's apology indicates, the firing of Lundberg was an explicit effort to appease right-wing elements. Time correspondents Harriet Barovick and Dick Thompson report that "An AMA source says panic over potential wrath from Republicans was the prime reason" for the action. The association owns the journal but is not generally involved in its day-to-day operations.

Lundberg was a well-respected editor, who had apparently done a good deal to raise JAMA's standing among medical journals. Frank Davidoff, editor of the Annals of Internal Medicine, told the Washington Post, "He was recognized as someone who had taken the journal and turned it around. He hired a spectacular group of editors with very high visibility."

The editor had aroused the ire of reactionary forces before. In 1993 he editorialized in JAMA that it would be "immoral" if Clinton's proposed healthcare plan did not include coverage of the uninsured. According to the Post, Lundberg, a physician himself, angered many in the AMA when he claimed on the CBS news program "60 Minutes" that one reason for the low autopsy rate in the US was that "some doctors, some medical staffs, are afraid to find out what happened in people who died." The AMA officialdom angered conservatives last year by supporting a healthcare proposal to make HMOs liable for malpractice.

In a statement to the press Lundberg's attorney William Walsh charged that the AMA "has inappropriately intruded into the historically inviolable ground of editorial independence in scientific journalism" and chosen to "sacrifice Dr. Lundberg's distinguished career." He indicated his client may take legal action.

Lundberg defended the publication of the survey to CNN Medical Correspondent Elizabeth Cohen. The topic of sexual attitudes is "a public health issue," he said. "Doctors have to be explicit or they would get entirely inaccurate information."

The research article published in the January 20 JAMA was based on data collected in a 1991 survey of 600 university students conducted by the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University in Bloomington, Indiana. The questions about attitudes to oral sex were part of a survey containing more than 100 items on various aspects of behavior associated with the transmission of sex-related diseases. Other studies have been published based on aspects of the findings.

June M. Reinisch, the retired director of the Kinsey Institute and the author of the JAMA article, explained that various colleagues had urged her to write a paper when the issue of defining sex came up in the Clinton-Starr controversy. She observed that if Lundberg had held up the article he would have been accused of concealing relevant data. "I'm absolutely shocked," she commented after the firing. "This may have to do with issues of academic freedom. There was nothing unusual about the paper."

The firing of Lundberg is an attack on free speech and democratic rights. It was entirely legitimate for JAMA to address an issue raised in the course of the current political crisis. It is likely that Reinisch's study is one of the few that provides a clue to prevailing attitudes toward the subject in question. What AMA officials responded to was not the article, but conclusions that the right wing would find objectionable.