THE MEDICAL PUBLISHING CRISIS CONTINUES—EVEN MEDICAL ETHICISTS HAVE A RIGHT TO BE INCORRECT!
That many—if not most—prominent medical and science journals can no longer be considered politically neutral between left and right viewpoints, is nowadays difficult to argue with and must be understood to have paralleled the journey of the medical profession in recent decades from obviously conservatism to very obviously liberalism. What we in this article, however, wish to point out is that denying this change in medical and scientific publishing, is not the right way to deal with the problem of unbalanced reporting. To the contrary, if one—as the CHR does—believes that medicine and science—in general—should be agnostic in coverage of an increasingly divisive political landscape, then ignoring facts will not resolve the problem of unbalanced reporting.
A federal prosecutor, a while ago, allegedly sent a letter to some prominent journals’ editorial offices, in which he asked for information regarding how these journals were handling misinformation and competing viewpoints that made headlines at the time and received considerable pushback from many in the medical publishing community and organized medicine. Interestingly, there was, however, basically no follow-up from either the writer of the letter, Edward E. Martin, a US attorney for the District of Columbia. As of this point, it is, indeed, still unknown which journals received such a letter (Chest was apparently confirmed, The New England Journal and JAMA were rumored to have), and apparently only US journals were included. It is also unknown whether any of the journals responded and, if so, what the answers were. Moreover, it is unclear whether the US attorney’s office is still even pursuing the matter.
It therefore was somewhat surprising to see a recent Commentary article from the CHR’s longstanding friend, Arthur L. Caplan, PhD, from the Division of Medical Ethics at NYU Grossman School of Medicine in NYC, on Medscape (he is a regular commentator on ethical issues for Medscape) on the subject, arguing that any potential federal action against medical journals was “dangerous.”¹
His article is obviously a good example that good friends can disagree. But the article, beyond that, surprised us for several reasons: First, as already noted, our perception has been that this issue had basically died on its own since nothing has happened for weeks in response to the sent letter.
Second, we were surprised by Caplan’s line of thought since he concluded that the AG’s letter was inappropriate in asking medical journals to advise how they educated the public fairly about a “broad array of viewpoints” since medical journals, in his opinion, did not serve to inform the public but the medical community. This is, of course, a difficult argument to accept because, as a leading academic ethicist, he must know that medical journals almost uniformly release their issues to public media well ahead of the formal release to their medical subscribers. And they do that for what reason? Of course, to inform the public! The irrationality of Caplan’s argument, therefore, appears obvious.
But his argumentation becomes even more surprising when he, in somewhat difficult-to-understand language (in our opinion), appears to suggest that medical journals “do not necessarily have to accept manuscripts that are oriented toward the ideology and politics of contributors.” In isolation, this sentence is, of course, correct. However, it becomes somewhat strained in trying to communicate that medical journals—when it comes to Opinion articles—still have the choice of rejecting an article if the editors feel that the opinion is driven by too much of the authors’ ideology and/or political affiliations.
Once again, we in principle agree; but Caplan, as it turns out, then moves into truly strange territory when suggesting that “every site (i.e., medical journals he looked at in preparation for his Commentary on the subject) was pretty neutral and balanced and says—here’s what we expect the opinions, comments, editorial, and articles to look like.”
We, frankly, don’t know which medical journals Caplan looked at because, as we have repeatedly noted in these page—the last time in some detail in the July-August issue of the CHRVOICE—we have never (never !!) seen balancing conservative Opinion articles to generally liberal-minded Opinion articles in The New England Journal of Medicine, JAMA (especially in more recent years), The Lancet, the BMJ, and we could go on and on. Anybody who does not see at least these medical journals as biased in their reporting, frankly, is politically biased as well!
We, therefore, can see nothing wrong in the federal government trying to make the point that if these medical journals (and their publishers, - most often medical societies) expect financial support from the federal government (as all do in a variety of ways), the federal government not only may—but must insist on equal opportunity exposure for all legitimate opinions, whether liberal, conservative, or in-between.
We can’t wait for an invited opinion article in The New England Journal of Medicine or JAMA that acknowledges what an unbelievable mistake the medical establishment’s sex-transition therapies and surgeries have been for children and young adults! And we could list several other interesting topics in these general medical journals, which—similarly—would benefit from contrarian opinions to the one-way streets we have been privy to for so many years.
And that, of course, also applies to some of the journals in the fertility field. Wouldn’t it, for example, be refreshing to hear from somebody who does not believe that every twin pregnancy represents an adverse IVF outcome and that elective single embryo transfer for almost everybody really makes sense, especially considering the rapidly declining birth rates in so many countries? Or how about a politically really incorrect paper from somebody who asks the question How come the field has been using various versions of PGT-A for over 20 years without any evidence that it improves IVF outcomes, but with considerable evidence that it, indeed, in many patients reduces the chances of a favorable cycle outcome.
Reference
Caplan AL. Medscape. August 26, 2025. https://www.medscape.com/viewarticle/fed-action-toward-medical-journals-dangerous-ethicist-says-2025a1000me6