Ethics in Publishing: Where does Ophthalmology Times stand?

February 15, 2005

The television newsmagazine "60 Minutes" airs an investigative report about President Bush's service in the National Guard 2 weeks prior to the election. Fraudulent documents, an alleged cover-up, and an internal investigation lead to the dismissal of four CBS employees. Shortly thereafter, the Bush administration is reported to have paid a radio and newspaper pundit $240,000 to advocate on behalf of the government's "No Child Left Behind" initiative.

The television newsmagazine "60 Minutes" airs an investigative report about President Bush's service in the National Guard 2 weeks prior to the election. Fraudulent documents, an alleged cover-up, and an internal investigation lead to the dismissal of four CBS employees. Shortly thereafter, the Bush administration is reported to have paid a radio and newspaper pundit $240,000 to advocate on behalf of the government's "No Child Left Behind" initiative. The presidential campaign of Howard Dean hires two Internet political "bloggers" as consultants so that they would say positive things about the former governor's campaign in their online journals (The Wall Street Journal, Friday, Jan. 14, 2005).

This leads to a sorry state of affairs, we are told, and we are allegedly witnessing a decline in journalistic ethics. Television, radio, print media, and even the internet are contaminated by some with hidden agendas-a desire to be first out with a headline, a political leaning, or a "consultancy" with big dollars involved. By contrast, it seems that in our parents' day, the news media enjoyed a remarkable perception of credibility and reliability among the American public. Every word out of the mouth of Walter Cronkite could be immediately accepted as the unvarnished and unbiased truth.

Have things really changed? Are those in the media less ethical today than a generation ago? Or, are people pretty much the same today as always, but the few bad apples easily are spotted today by a less-trusting audience?

The editorial code is detailed and proscribes editors from investing in companies they cover, from accepting payments for speeches for companies or associations they cover, and from allowing advertisers to select topics, determine editorial decisions, or review articles prior to publication.

Clearly, advertising revenue allows for the distribution of this publication without charge to physicians. However, we do not accept "targeted advertising," which means publishing a certain article from Dr. Jones, a consultant for company X, in return for a big advertising purchase in that issue by the company whose product is coincidentally lauded in Dr. Jones' article.

Editorial board review The articles that appear in Ophthalmology Times are reviewed by our editorial board, with the goal of permitting only thoughtful analysis and opinion based upon carefully generated data from laboratory studies, clinical trials, or clinical experience. All physician authors and sources are asked to disclose, in writing, any potential conflicts with any manufacturers whose products are the subjects of their articles.

If we allow grossly biased articles, or "junk" into OT, we'll offend you, you'll stop reading, and OT will cease to exist. The commitment by this publication's staff to acting in accordance with the highest ethical standards of this industry is something that meant a lot to me when considering whether to assume the role of Chief Medical Editor.

For me personally, any interaction with a company or publication has to be reviewed by my university's Conflict of Interest Committee. While I have certainly become aware over the years of new drugs and devices that looked like winners, I have never purchased shares of any pharmaceutical or medical device manufacturers, but may own some "indirectly" today via mutual funds.

In my role as department chairman lies my greatest potential for an appearance of conflict. Industry support for research and education (resident and continuing medical education) in my department is considerable. As it does for the AAO's annual meeting and educational foundation, industry also generously supports the AUPO (Association of University Professors of Ophthalmology), which is the society of department chairs and residency program directors.

While these are valid educational and research endeavors, in my opinion, the sums involved are sometimes considerable. Support for a department's research and resident education may seem different from personal compensation paid to a department chairperson, but the reality is that a chairperson's sense of well-being is often intertwined with that of his/her department.