What is the Norwegian Medical Association’s opinion?

Erlend Hem About the author
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The Norwegian Medical Association owns this journal. But the content does not reflect the views of the association.

Photo: Einar Nilsen

In March 2013, Member of the Storting Jan-Henrik Fredriksen (Progress Party) submitted a written question to the Minister of Health and Care Services (1). As grounds for his question, he referred to a recent scientific article in the Journal of the Norwegian Medical Association (2). Mr. Fredriksen wrote that «(…) the medical association recommends the use of functional MRI and CT» (1). I was nonplussed. Had the Norwegian Medical Association really recommended specific medical imaging in an article about atlantoaxial rotatory fixation? No, of course not. But this politician is probably not the only one to think so.

As its name indicates, The Journal of the Norwegian Medical Association is the journal of the Norwegian Medical Association. The association owns the publication, all members of the association receive it as part of their membership, and those of us who work as editorial staff are employed in the association’s secretariat. But what is the relationship between the Norwegian Medical Association and the journal? In every single issue, the same message appears on the same page: «The Journal of the Norwegian Medical Association is edited according to the declaration of Rights and Duties of the Editor, and all content represents the author’s views. These will not necessarily accord with those of the editors or the official views of the Norwegian Medical Association, unless this is explicitly stated.»

The declaration of Rights and Duties of the Editor, which is used by Norwegian media, was signed 60 years ago. Its purpose is to ensure editorial independence of media owners (3). In 1996, the Norwegian Medical Association decided to include a provision in its by-laws stating that its journal should be edited according to this declaration: «The editor exercises his authority and responsibility in accordance with the Rights and Duties of the Editor» (4). Since 2009, the principles in the Rights and Duties of the Editor have been given statutory status through the Freedom of the Media Act, but the act states explicitly that it does not apply to media «(…) that are mainly directed at members or employees of specific organisations, associations or enterprises» (5). In other words, it is not self-evident that this journal should be edited according to the Rights and Duties of the Editor. This has been described in this column previously, but there may be reason to call attention to this fact (6).

A number of other medical journals are also owned by medical associations. This applies to some of the most prominent ones, such as JAMA, owned by the American Medical Association and The New England Journal of Medicine, owned by Massachusetts Medical Society. Some journals (e.g. JAMA) state explicitly on the same page as the editorials that these represent the opinions of the author and not those of the owner, i.e. the medical association in question. Other journals, such as The New England Journal of Medicine print similar information on the colophon page, and so does the Journal of the Norwegian Medical Association. We have chosen to include this text with the general information about the journal to emphasise that the statement applies to all types of articles where opinions and viewpoints are voiced. Most articles have a subjective content – not only the editorials. As the editor of the Annals of Internal Medicine has stated: «Research is not truth, but narratives» (7). In other words: Medicine is debate (8). It would be inappropriate to provide every single article in this journal with a note saying that it represents the viewpoints of the authors.

Let me illustrate my point by using a parallel from the dailies: For example, when the anti-islamist Peder Jensen («Fjordman») has an op-ed published in the daily Aftenposten, nobody in their right mind would say that «the Schibsted media group is of the opinion that…». The situation is the same for the Journal of the Norwegian Medical Association. The content of the articles is the authors’ responsibility.

Today, it is quite self-evident that the owner of a media enterprise cannot instruct or overrule the editor in matters of editorial content (3). The Norwegian Medical Association is a professional owner of its journal, and never during my more than 12 years as editor has the association attempted to modify the content in any way. There is only one place in the journal where the association’s viewpoints are voiced, namely in the section called News from the Norwegian Medical Association, which is found on the final pages of every issue. Here you can find an editorial by the association’s president, who voices the official viewpoints of the association. Here – and only here – you can read the opinions of the Norwegian Medical Association in the journal’s pages.

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