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Monday, July 21, 2003



The Canadian equivalent of the AMA (American Medical Assocation) is called the Canadian Medical Association. It has a well-known journal, the Canadian Medical Association Journal or CMAJ.

As my regular readers know, since I have blogged about it incessantly, the CMAJ published an article in May which indicated that women who obtained abortions had considerably higher rates of psychiatric hospitalizations than women in unexpected pregnancies who did not abort. At that time, they also published a response from Brenda Major, a psychology professor at the University of California-Santa Barbara.

Many e-letters to the CMAJ were published about both May articles. Those e-letters can be found here and here.

The new July 22 dead-paper CMAJ is just out, and it devotes its lead editorial, Unwanted Results: the ethics of controversial research, to this controversy.

It also publishes ten letters-to-the-editor about the original article, which are linked to here. I particularly recommend that you read David Reardon's letter.

The lead editorial comes down right where it should and in a surprisingly forthright manner. It says:

"Hence, perhaps the thing that is most offensive to some of our correspondents is the apparent co-opting of the medical view by persons they believe to be unqualified — or disqualified. The attack in our letters column is largely an ad hominem objection to the authors' ideological biases and credentials.

There are two questions here: first, does ideological bias necessarily taint research? Second, are those who publish research responsible for its ultimate uses? The answer to the first must be that opinion can of course cloud analysis. In light of the passion surrounding the subject of abortion we subjected this paper to especially cautious review and revision. We also recognized that research in this field is difficult to execute. Randomized trials are out of the question, and so one must rely on observational data, with all the difficulties of controlling for confounding variables. But the hypothesis that abortion (or childbirth) might have a psychological impact is not unreasonable, and to desist from posing a question because one may obtain an unwanted answer is hardly scientific. If we disqualified these researchers from presenting their data, we could never hear from authors with pro-choice views, either."

and:

"Should we deny the publication of a study because it might be applied by one or the other side of a factionalized debate? It strikes us that the results of the study by Reardon and colleagues are neutral: they could be "used" to further the argument that abortion is undesirable; or to support arguments for better post-abortion counselling and support. We cannot second-guess such interpretations without unfairly imposing our own values on the research we choose to publish."

This editorial is a welcome development.

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