In her lead article, Marcia Angell expresses concern about the state of American medicine. Angell, former editor-in-chief of the New England Journal of Medicine, thinks that drug research and medical training are being overwhelmed by financial support from pharmaceutical companies. That support comes at a cost: a loss of professional independence for doctors and clinical researchers. And the cost of dependence is unacceptable because the missions of doctors and drug companies are fundamentally different: as different as fostering human health and maximizing shareholder value.
Some of Angell’s respondents share her concerns and extend them to other areas of medical practice—including nursing and the identification of novel diseases. But not everyone agrees. Emma D’Arcy thinks that patients, newly empowered by modern information and communications technology, can make sensible judgments about treatments and drugs. And Thomas Stossel, writing separately, rejects the entire framework of analysis. For Stossel, results (what he calls “value”) are the only significant measure in assessing the nexus of academia and industry. The results that matter are longer lives of higher quality with less pain. And measured by these standards, the nexus looks pretty good.
Putting aside medicine, when it comes to journalism, we have laid our bet on independence. We think that independent magazines provide information and analysis that play an essential role in a thriving democracy. And we are pleased to have some support for that view from the American Society of Magazine Editors (ASME), which nominated Boston Review this year for an award recognizing magazine journalism that illuminates issues of public importance. And, of course, the Utne Reader is as devoted as we are to the continuing success of independent publications. We are proud to have won their 2010 Indepdendent Press Award for Best Writing.
The ASME singled out for special attention Tom Barry’s remarkable November/December article, A Death in Texas. Independent magazines depend for their success on the dedicated efforts of people like Tom. We are grateful to him for his work and writing. And we wish to acknowledge everyone else—staff and writers—who labor hard for little extrinsic reward to make this magazine work. They share an aspiration to illuminate issues of public importance, and they appreciate the necessity of editorial independence in achieving it.