In the last few weeks (although I've paid little attention to it here; stupid, lazy me), a real-life drama over the critical issue of editorial independence has been playing itself out at the Canadian Medical Association Journal.

Amir Attaran, writing on globeandmail.com, fires a broadside at the CMA board. Some excerpts:

Credibility, it is often said, takes a long time to build, and only an instant to destroy. This is unfortunate, because lately the Canadian Medical Association's attention span is measured in instants when it comes to managing its flagship publication, the Canadian Medical Association Journal (CMAJ). Its actions are an embarrassment to this country.

Two weeks ago, the CMA, acting through a holding company that publishes the journal, scandalized the medical world by sacking the CMAJ's editor and deputy editor. Their offence? To attempt to publish an investigative article demonstrating that some pharmacists, acting without medical cause, and sometimes in violation of privacy laws, inquired into women's sexual history before permitting them to buy the "morning-after" pill. The editors were sacked after the Canadian Pharmacists Association complained to the CMA that the editors' investigation caused controversy "at the expense of another health profession," and made their members appear prurient and unprofessional.

But that is hardly the trouble. What should be a minor tale of pinched pharmacists' pride has triggered a conflagration, in which smoulder the principles of editorial and academic freedom. Hardly one week after the CMA sacked the two editors, their replacements quit because the CMA would not agree to their future freedom to publish. Specifically, the CMA rejected an explicit statement that "editorial independence of the editor-in-chief [should] be absolutely protected and respected."

Thus, in deeds and, now, in words, the CMA has insisted on its authority to censor. ...

... Its actions have made Canada the object of derision in medical journals worldwide. A puppet medical journal manipulated by the CMA is something Canadians can ill afford, as our society braces for meaningful debates on private health care, better access to medicines, wait times, and so on.

If the Canadian Medical Association has reasons not to invite the departed editors back, with full independence, I'd like to hear them.

If their reasons fail to persuade, then I and many of my colleagues believe there should be a general boycott of the journal - by authors, by peer-reviewers, and by advertisers alike, none of whom ought to gift a minute of their time or a single dollar until the CMAJ's independence is restored.

It would be sad if such action were to lead to the CMAJ's demise, but it would still be preferable to accepting anything less than a fully free journal of the highest standards. Anyway, Canada's best scholars could create a new, freer, and better journal to replace the CMAJ in short order. The integrity of our country's science, medicine and conscience may depend on it.