Scientific journals and public disputes
Authors: Dorothy Nelkin
Journal: The Lancet (1998)

Dorothy Nelkin holds a University Professorship at New York University, teaching in the Department of Sociology and the School of Law. Her research, in. the area of science, biomedical technology, and society, focuses on the relationship between science and the public as expressed in public disputes, In media coverage of science, and in institutional responses to scientific information. She is a member of the National Academy of Sciences' Institute of Medicine, a fellow and former Director of the American Association for the Advancement of Science. a fellow of the Hastings Center, and was a member of the executive committee of the Ethical. Legal, and Social Implications working group of the NIH Human Genome Project. Professor Nelkin's recent books include Selling Science: How the Press Covers Science and Technology (New York: WH Freeman. revised edn 1995), Dangerous Diagnostics: The Social Power of Biological Information (with L Tancredi) (University of Chicago Press, 2nd edn 1994) and The DNA Mystique: The Gene as a Cultural Icon (WH Freeman. 1995) (with Susan Lindee).In 1988, the Journal of the American Medical Association published, an anonymous account of a mercy killing, entitled Its Over, Debbie",1A piece of my mind.in: It's over, Debbie. 2nd edn. JAMA. 259. 1988: 272Google Scholar fuelling a heated debate over the public role of medical journals. Should journals seek to stimulate public discussion of controversial ethical and political issues as George Lundberg, JAMA's editor, had intended? Or should they focus internally on maintaining existing professional standards? Are these two roles compatible? The JAMA artidle surely succeeded in stimulating debate, but it also attracted a grand-jury investigation, a subpoena of the journal's records, and a vitriolic attack from a profession uncomfortable With their journal's involvement in a heated public dispute.Many scientists and medical researchers have been wary about becoming involved in controversial public affairs. Working, in a context in which success has been measured by the judgment of peers, they have directed their publications towards professional colleagues, often treating with disdain or marginalising "visible scientists".2Goodell R The visible scientists. Litle Brown, Boston1977Google Scholar Journal editors during the 1980s generally avoided taking a position in public disputes, and some looked down on the media as "caring more about the story than the facts".3Relman A Medicine in the media: Panel Discussion.P&S. 1982; 2: 16Google Scholar But recently things have changed. Increasingly dependent on corporate support or direct congressional appropriations, many scientists believe that scholarly communication is no longer sufficient to maintain their enterprise. They regard gaining national visibility through the mass media as crucial for securing support and ensuring favourable public policies towards science and medicine.4Nelkin D Selling science: how the press covers science and technology.2nd edn. Freeman, New York1995Google ScholarProfessional journals have responded by seeking to communicate beyond their discipline. Public communication is a way to expand their readership and attract advertising revenue: Being defined as newsworthy is also a way for journals to attract key scientific papers. Thus, editors are increasingly willing to engage in public-policy disputes and to take a strong editorial position on controversial issues.Some scientific and medical journals employ their own news writers and publish special sections reporting on science news and policy affairs. But they mainly rely on the media to reach the broader public. Thus, they publish provocative editorials and articles with catchy titles intended to capture media attention. And they welcome scientific papers that deal with matters of wide media interest, such as experimental AIDS therapies, bovine spongiform encephalopathy, the latest study on diet and cancer, or the health risks from exposure to toxic substances. Scientific studies that may have a role in public controversies are especially newsworthy, and they help the journals maintain presence in the public eye.To focus the attention of reporters and give them time to assimilate and write up technical information, journals send advanced copies to newspapers and magazines and circulate press releases that call attention to the studies likely to be newsworthy. News stories are to be released only after the journal's publication date so that it is clear that the journal itself is the source of "breaking" news.Silicone breast implantShow full captionHow safe?View Large Image Figure ViewerDownload Hi-res image Download (PPT)Some journal editors have, by expressing strong editorial judgments, taken on a personal mission to influence public opinion on controversial issues. JAAU editor Lundberg had agreed to publish "It's Over Debbie", but he had deliberately avoided making editorial comments on euthanasia. By contrast, Marcia Angel& executive editor of the NEJM, has been outspoken in her support of doctor-assisted suicide.8Angell M The supreme court and physician-assisted suicide—the ultimate right.N Engl J Med. 1997; 336: 50-54Crossref PubMed Scopus (69) Google ScholarAngel1 actively took part in public disputes over the safety of silicone breast implants when this issue was being considered by the courts.9Dreyfuss RC Galileos tribute: using medical evidence in court.Michigan Law Rev. 1997; 95: 2055-2076Crossref Google Scholar In editorials, a popular book, and appearances on television and radio talk shows, she attacked the media, the courts, and the US Food and Drug Administration for the way they politicised the issue of health risks.10Angell M Science on trial. Norton, New York1996Google Scholar Lawyers, she said, are simply greedy and courts inappropriate in their evaluation of evidence. The media are biased against science, and journalists are duped into believing claims that are not scientifically validated. She criticised anti-science groups for harassing and discrediting science, the FDA for precipitously pulling breast implants off the market, and women for irrationally amplifying problems that were "mainly in their minds".11Leonard Lopate Show, National Public Radio. June 26, 1996Google ScholarDaniel Koshland, former editor of Science, was also out-spoken on widely debated issues—for example, on the social role of genetic information and on the importance of biological predisposition in determining behaviours such as criminal violence. Science had been the first major scientific journal to accept an article from the controversial Minnesota studies of identical twins that purported to show the genetic basis of behavioural conditions and personality traits.12Bouchard TJ Sources of human psychological differences: the Minnesota studies of twins reared apart.Science. 1990; 250: 223Crossref PubMed Scopus (905) Google Scholar This provocative 1990 paper attracted the anticipated media attention. In his editorials, Koshland contributed to the public visibility of studies in behavioural psychology by arguing that research on the genetic basis of behaviour is a useful way to solve social problems such as crime.13Koshland D Elephants, monstrosities, and the law.Science. 1992; 255: 777Crossref PubMed Scopus (9) Google Scholar He, like Angel& used his editorial position to project personal opinions and to define social and political problems in scientific terms.In 1997, the NEJM took a strong editorial position on the ethics of clinical trials of AIDS therapies involving 12 000 HIV-infected pregnant women in developing countries. An editorial compared the use of placebos in the clinical trials of zidovudine to the infamous Tuskegee experiments in which poor black men with syphilis were left untreated.14Angell M The ethics of clinical research in the Third World.N Engl J Med. 1997; 337: 847-849Crossref PubMed Scopus (568) Google Scholar In a telling comment explaining the NEYM editorial to the New York Times, Jerome Kassirer, the journal's chief editor, said that if you try to present all sides of an issue, "you could end up with a kid of Talmudic discussion in which readers would end up having no particular view … and it would be rather boring".15Altman L AIDS experts leave journal after studies are criticized.New York Times. Oct 15, 1997; : A10PubMed Google ScholarAs scientific and medical journals seek media attention to reach a broader public audience, what messages do the media actually convey? And are these messages conveyed as the journals and their editors had intended? What, in fact, reaches the public domain? Let me address these questions through a brief review of media reports about three- newsworthy scientific articles that appeared in prominent journals and attracted wide public attention— first, the publication in Science of an article on sex differences in mathematical ability; second, the publication in JAMA of an epidemiological study on the health effects of silicone breast implants; and third, the publication in Nature about the cloning of Dolly from the cell line of an adult sheep.Battle of the sexesView Large Image Copyright © 1998 Robert Harding Picture LibraryIn 1996, JAMA published a paper by Charles Hennekens and colleagues, which reported on an epidemiological study evaluating the association of breast implants with connective-tissue diseases.20Hennekens CH Lee IM Cook NR Self-reported breast implants and connective-tissue diseases in female health professionals.in: A retrospective cohort study. JAMA. 275. 1996: 616-621Google Scholar In light of the continuing medical, legal, and regulatory controversy, the paper was of considerable media interest. The study had found a small degree of risk, but offered "reassuring evidence against a large hazard of breast implants on connective tissue disease". The JAMA paper differentiated its findings about risk: for some diseases there was a "small but statistically significant risk", for others the risk was of borderline statistical significance, and for still others there was no significant risk. Its conclusion, by excluding large risks, ran counter to the claims of thousands of women who had filed lawsuits against Dow Chemical, one of the manufacturers of the implants. Because of the anticipated media interest, the American Medical Association, Brigham and Women's Hospital (where the study was done), and several implant manufacturers sent out press releases describing the study. It was, as expected, very widely reported on television and in the press. Although the JAMA article was about the association between implants and disease, the media reported it as a study of cause and effect. And, playing on the article's qualifications, different reporters used the study to support very different conclusions. Some emphasised the finding that there was some increased risk, however small. Others stressed the failure to find significant risk. The range of messages conveyed in headlines was remarkable: "Higher risk of arthritis", "Small risk if any", "Implants do not pose significant risk", "Data reveal new woes", "Fresh fuel for debate", "Bogus claims", "Medical spin".21Swazey S The media and science: communicating research, risk and controversy.in: Acadia Institute Report to Dow Chemical. Acadia Institute, Bar Harbour, MaineJanuary 1997Google ScholarIn February, 1997, Nature published the report of the cloning experiment at the Roslin Institute, Edinburgh, UK.22Wilmut I Schnieke AF McWhir J Kind AJ Campbell KH Viable offspring derived from fetal and adult mammallan cells.Nature. 1997; 385: 810-812Crossref PubMed Scopus (4010) Google Scholar After 276 attempts, scientists had cloned Dolly from the genetic material of a 6–year-old sheep. In their scientific paper, Wilmut and his colleagues fussed over the problem of whether "a differentiated adult nucleus can be fully reprogrammed". They called the lamb in question 6LL3 rather than Dolly, and made it clear, in diagrams and illustrations of gels, that there is some question about the precise genetic relationship between Dolly and the "donor". Somatic DNA, which was the source of Dolly's genes, is constantly mutating. Dolly, in fact, may not be genetically identical in every way to her "mother".For the media, however, such technical details were less important than the symbolic images evoked by a cloning experiment. The experiment was set in a context of futuristic fantasies and Frankenstein fears about science and its applications. One journalist compared cloning to weapons development. Another worried that the shortage of organs for transplantation would be resolved by cloning anen-cephalic babies specifically to harvest their organs. Reflecting widely held and simplistic assumptions of genetic essentialism-that human beings in all their complexity are simply readouts of a molecular text23Nelkin D Lindee S The DNA mystique: the gene as a culturalicon. Freeman, New York1995Google Scholar— reporters anticipated a market in the cloning of human beings. Why not clone sports heroes, media stars, or children with desired characteristics? Above all, the media and also the US National Bioethics Advisory Commission called for regulation24National Biotheics Advisory Commission Cloning human beings: report and reccomendations NBAC.Rockland, MD. June, 1997; Google Scholar-hardly the response desired by scientists, who defended the importance of the work for medical progress, pharmaceutical developments, and agricultural productivity. But media coverage continued to reflect mistrust of science and a fear that the outrageous possibilities suggested by a cloned sheep would inevitably be realised. News headlines implied that science cannot be controlled: "Science fiction has become a social reality", "Whatever's Next?". And, of course, "Pandora's Box,"25Nelkin D Lindee S Cloning in the popular imagination.Camb Q Healthcare Ethics. 1998; 7: 145-249Crossref PubMed Scopus (15) Google ScholarFrankenstein's monsterShow full captionSome people's idea of the future of scienceView Large Image Copyright © 1998 Moviestore collectionsProfessional journals try to manage the messages conveyed to the public, but they cannot control the media's interpretations, especially when an issue is newsworthy and has already had wide public exposure. Public responses may follow less from technical details than from pre-existing knowledge, social biases, and prevailing myths or fears. Thus, the considerable effort to communicate the findings of epidemiological studies about the risks of silicone breast implants failed to convince the jury in a major case against Dow Chemical.26Meier B Dow chemica deceived women, breast implant jury decides.New York Times. August 19, 1997; Google Scholar The belief that the company had deceived women overwhelmed the science-based arguments. Similarly, myths about cloning, assumptions about genetic essentialism, and mistrust of science shaped the public response to the cloning of Dolly, and sex biases coloured the coverage of the Science article on differences in mathematical reasoning.The cases also suggest that scientific journals can have an important influence on public affairs. Articles that are published under the imprimateur of reputable journals-and then promoted through the press-may affect the framing of social policies, the course of litigation, and the funding of research. They help to set the agenda of public discourse and affect the priorities guiding personal choices and institutional behaviour. The articles they publish may legitimate or call into question public policies. And some studies on the risks and benefits of certain products have influenced stock-market prices and product sales.When journals move beyond the cloistered domain of scientific publishing to expand their public role, they certainly become more newsworthy and less boring. But they also assume some risks. The JAMA experience a decade ago is still telling. A journal's own constituency may not be supportive, for many scientists remain ambivalent about involvement in public affairs. When the NEJM published its inflammatory editorial criticising the AIDS experiments in developing countries, two prominent AIDS researchers on the journal's editorial board resigned. Harold Varmus, director of the National Institutes of Health accused the journal of "trying to attract attention by making political, ethical, philosophical, and economic statements".27Altman L Aids experts leave journal after studies are criticized.New York Times. Oct 15, 1997; (Quoted in): A10PubMed Google Scholar And other scientists worried about jeopardising future AIDS research and believed the editors had misused the journal's power.Involvement in public disputes may also subject journals to pressure from the many interests concerned about public policies or consumer practices. Their files and records, including peer-review material and primary data, may be subpoena'd by the courts. Yet, as the cases described above suggest, the messages communicated by journal articles and editorials may be received and interpreted by the public in unintended ways.Finally, greater public visibility may undermine the credibility of professional journals. The authority of scientists and their journals has been based on their: distance from controversy and their image as disinterested, unbiased sources of information. The peer-review system has long served as a buffer against accusations of bias. But the conflicts of interest within science-the financial interests of researchers and the interests of their corporate sources of support-are reducing trust in this system.28Krimsky S Rothernburg Ls Stott P Kyle G Financial interests of authors in scientific journals.Science Engineering Ethics. 1996; 2: 395Crossref PubMed Scopus (64) Google Scholar Ironically, at a time when the editors of professional journals are seeking greater involvement in public affairs, their engagement in public disputes may compromise the very image of neutrality that has supported the public credibility of scientific journals and sustained their policy influence. Dorothy Nelkin holds a University Professorship at New York University, teaching in the Department of Sociology and the School of Law. Her research, in. the area of science, biomedical technology, and society, focuses on the relationship between science and the public as expressed in public disputes, In media coverage of science, and in institutional responses to scientific information. She is a member of the National Academy of Sciences' Institute of Medicine, a fellow and former Director of the American Association for the Advancement of Science. a fellow of the Hastings Center, and was a member of the executive committee of the Ethical. Legal, and Social Implications working group of the NIH Human Genome Project. Professor Nelkin's recent books include Selling Science: How the Press Covers Science and Technology (New York: WH Freeman. revised edn 1995), Dangerous Diagnostics: The Social Power of Biological Information (with L Tancredi) (University of Chicago Press, 2nd edn 1994) and The DNA Mystique: The Gene as a Cultural Icon (WH Freeman. 1995) (with Susan Lindee). In 1988, the Journal of the American Medical Association published, an anonymous account of a mercy killing, entitled Its Over, Debbie",1A piece of my mind.in: It's over, Debbie. 2nd edn. JAMA. 259. 1988: 272Google Scholar fuelling a heated debate over the public role of medical journals. Should journals seek to stimulate public discussion of controversial ethical and political issues as George Lundberg, JAMA's editor, had intended? Or should they focus internally on maintaining existing professional standards? Are these two roles compatible? The JAMA artidle surely succeeded in stimulating debate, but it also attracted a grand-jury investigation, a subpoena of the journal's records, and a vitriolic attack from a profession uncomfortable With their journal's involvement in a heated public dispute. Many scientists and medical researchers have been wary about becoming involved in controversial public affairs. Working, in a context in which success has been measured by the judgment of peers, they have directed their publications towards professional colleagues, often treating with disdain or marginalising "visible scientists".2Goodell R The visible scientists. Litle Brown, Boston1977Google Scholar Journal editors during the 1980s generally avoided taking a position in public disputes, and some looked down on the media as "caring more about the story than the facts".3Relman A Medicine in the media: Panel Discussion.P&S. 1982; 2: 16Google Scholar But recently things have changed. Increasingly dependent on corporate support or direct congressional appropriations, many scientists believe that scholarly communication is no longer sufficient to maintain their enterprise. They regard gaining national visibility through the mass media as crucial for securing support and ensuring favourable public policies towards science and medicine.4Nelkin D Selling science: how the press covers science and technology.2nd edn. Freeman, New York1995Google Scholar Professional journals have responded by seeking to communicate beyond their discipline. Public communication is a way to expand their readership and attract advertising revenue: Being defined as newsworthy is also a way for journals to attract key scientific papers. Thus, editors are increasingly willing to engage in public-policy disputes and to take a strong editorial position on controversial issues. Some scientific and medical journals employ their own news writers and publish special sections reporting on science news and policy affairs. But they mainly rely on the media to reach the broader public. Thus, they publish provocative editorials and articles with catchy titles intended to capture media attention. And they welcome scientific papers that deal with matters of wide media interest, such as experimental AIDS therapies, bovine spongiform encephalopathy, the latest study on diet and cancer, or the health risks from exposure to toxic substances. Scientific studies that may have a role in public controversies are especially newsworthy, and they help the journals maintain presence in the public eye. To focus the attention of reporters and give them time to assimilate and write up technical information, journals send advanced copies to newspapers and magazines and circulate press releases that call attention to the studies likely to be newsworthy. News stories are to be released only after the journal's publication date so that it is clear that the journal itself is the source of "breaking" news. Some journal editors have, by expressing strong editorial judgments, taken on a personal mission to influence public opinion on controversial issues. JAAU editor Lundberg had agreed to publish "It's Over Debbie", but he had deliberately avoided making editorial comments on euthanasia. By contrast, Marcia Angel& executive editor of the NEJM, has been outspoken in her support of doctor-assisted suicide.8Angell M The supreme court and physician-assisted suicide—the ultimate right.N Engl J Med. 1997; 336: 50-54Crossref PubMed Scopus (69) Google Scholar Angel1 actively took part in public disputes over the safety of silicone breast implants when this issue was being considered by the courts.9Dreyfuss RC Galileos tribute: using medical evidence in court.Michigan Law Rev. 1997; 95: 2055-2076Crossref Google Scholar In editorials, a popular book, and appearances on television and radio talk shows, she attacked the media, the courts, and the US Food and Drug Administration for the way they politicised the issue of health risks.10Angell M Science on trial. Norton, New York1996Google Scholar Lawyers, she said, are simply greedy and courts inappropriate in their evaluation of evidence. The media are biased against science, and journalists are duped into believing claims that are not scientifically validated. She criticised anti-science groups for harassing and discrediting science, the FDA for precipitously pulling breast implants off the market, and women for irrationally amplifying problems that were "mainly in their minds".11Leonard Lopate Show, National Public Radio. June 26, 1996Google Scholar Daniel Koshland, former editor of Science, was also out-spoken on widely debated issues—for example, on the social role of genetic information and on the importance of biological predisposition in determining behaviours such as criminal violence. Science had been the first major scientific journal to accept an article from the controversial Minnesota studies of identical twins that purported to show the genetic basis of behavioural conditions and personality traits.12Bouchard TJ Sources of human psychological differences: the Minnesota studies of twins reared apart.Science. 1990; 250: 223Crossref PubMed Scopus (905) Google Scholar This provocative 1990 paper attracted the anticipated media attention. In his editorials, Koshland contributed to the public visibility of studies in behavioural psychology by arguing that research on the genetic basis of behaviour is a useful way to solve social problems such as crime.13Koshland D Elephants, monstrosities, and the law.Science. 1992; 255: 777Crossref PubMed Scopus (9) Google Scholar He, like Angel& used his editorial position to project personal opinions and to define social and political problems in scientific terms. In 1997, the NEJM took a strong editorial position on the ethics of clinical trials of AIDS therapies involving 12 000 HIV-infected pregnant women in developing countries. An editorial compared the use of placebos in the clinical trials of zidovudine to the infamous Tuskegee experiments in which poor black men with syphilis were left untreated.14Angell M The ethics of clinical research in the Third World.N Engl J Med. 1997; 337: 847-849Crossref PubMed Scopus (568) Google Scholar In a telling comment explaining the NEYM editorial to the New York Times, Jerome Kassirer, the journal's chief editor, said that if you try to present all sides of an issue, "you could end up with a kid of Talmudic discussion in which readers would end up having no particular view … and it would be rather boring".15Altman L AIDS experts leave journal after studies are criticized.New York Times. Oct 15, 1997; : A10PubMed Google Scholar As scientific and medical journals seek media attention to reach a broader public audience, what messages do the media actually convey? And are these messages conveyed as the journals and their editors had intended? What, in fact, reaches the public domain? Let me address these questions through a brief review of media reports about three- newsworthy scientific articles that appeared in prominent journals and attracted wide public attention— first, the publication in Science of an article on sex differences in mathematical ability; second, the publication in JAMA of an epidemiological study on the health effects of silicone breast implants; and third, the publication in Nature about the cloning of Dolly from the cell line of an adult sheep. In 1996, JAMA published a paper by Charles Hennekens and colleagues, which reported on an epidemiological study evaluating the association of breast implants with connective-tissue diseases.20Hennekens CH Lee IM Cook NR Self-reported breast implants and connective-tissue diseases in female health professionals.in: A retrospective cohort study. JAMA. 275. 1996: 616-621Google Scholar In light of the continuing medical, legal, and regulatory controversy, the paper was of considerable media interest. The study had found a small degree of risk, but offered "reassuring evidence against a large hazard of breast implants on connective tissue disease". The JAMA paper differentiated its findings about risk: for some diseases there was a "small but statistically significant risk", for others the risk was of borderline statistical significance, and for still others there was no significant risk. Its conclusion, by excluding large risks, ran counter to the claims of thousands of women who had filed lawsuits against Dow Chemical, one of the manufacturers of the implants. Because of the anticipated media interest, the American Medical Association, Brigham and Women's Hospital (where the study was done), and several implant manufacturers sent out press releases describing the study. It was, as expected, very widely reported on television and in the press. Although the JAMA article was about the association between implants and disease, the media reported it as a study of cause and effect. And, playing on the article's qualifications, different reporters used the study to support very different conclusions. Some emphasised the finding that there was some increased risk, however small. Others stressed the failure to find significant risk. The range of messages conveyed in headlines was remarkable: "Higher risk of arthritis", "Small risk if any", "Implants do not pose significant risk", "Data reveal new woes", "Fresh fuel for debate", "Bogus claims", "Medical spin".21Swazey S The media and science: communicating research, risk and controversy.in: Acadia Institute Report to Dow Chemical. Acadia Institute, Bar Harbour, MaineJanuary 1997Google Scholar In February, 1997, Nature published the report of the cloning experiment at the Roslin Institute, Edinburgh, UK.22Wilmut I Schnieke AF McWhir J Kind AJ Campbell KH Viable offspring derived from fetal and adult mammallan cells.Nature. 1997; 385: 810-812Crossref PubMed Scopus (4010) Google Scholar After 276 attempts, scientists had cloned Dolly from the genetic material of a 6–year-old sheep. In their scientific paper, Wilmut and his colleagues fussed over the problem of whether "a differentiated adult nucleus can be fully reprogrammed". They called the lamb in question 6LL3 rather than Dolly, and made it clear, in diagrams and illustrations of gels, that there is some question about the precise genetic relationship between Dolly and the "donor". Somatic DNA, which was the source of Dolly's genes, is constantly mutating. Dolly, in fact, may not be genetically identical in every way to her "mother". For the media, however, such technical details were less important than the symbolic images evoked by a cloning experiment. The experiment was set in a context of futuristic fantasies and Frankenstein fears about science and its applications. One journalist compared cloning to weapons development. Another worried that the shortage of organs for transplantation would be resolved by cloning anen-cephalic babies specifically to harvest their organs. Reflecting widely held and simplistic assumptions of genetic essentialism-that human beings in all their complexity are simply readouts of a molecular text23Nelkin D Lindee S The DNA mystique: the gene as a culturalicon. Freeman, New York1995Google Scholar— reporters anticipated a market in the cloning of human beings. Why not clone sports heroes, media stars, or children with desired characteristics? Above all, the media and also the US National Bioethics Advisory Commission called for regulation24National Biotheics Advisory Commission Cloning human beings: report and reccomendations NBAC.Rockland, MD. June, 1997; Google Scholar-hardly the response desired by scientists, who defended the importance of the work for medical progress, pharmaceutical developments, and agricultural productivity. But media coverage continued to reflect mistrust of science and a fear that the outrageous possibilities suggested by a cloned sheep would inevitably be realised. News headlines implied that science cannot be controlled: "Science fiction has become a social reality", "Whatever's Next?". And, of course, "Pandora's Box,"25Nelkin D Lindee S Cloning in the popular imagination.Camb Q Healthcare Ethics. 1998; 7: 145-249Crossref PubMed Scopus (15) Google Scholar Professional journals try to manage the messages conveyed to the public, but they cannot control the media's interpretations, especially when an issue is newsworthy and has already had wide public exposure. Public responses may follow less from technical details than from pre-existing knowledge, social biases, and prevailing myths or fears. Thus, the considerable effort to communicate the findings of epidemiological studies about the risks of silicone breast implants failed to convince the jury in a major case against Dow Chemical.26Meier B Dow chemica deceived women, breast implant jury decides.New York Times. August 19, 1997; Google Scholar The belief that the company had deceived women overwhelmed the science-based arguments. Similarly, myths about cloning, assumptions about genetic essentialism, and mistrust of science shaped the public response to the cloning of Dolly, and sex biases coloured the coverage of the Science article on differences in mathematical reasoning. The cases also suggest that scientific journals can have an important influence on public affairs. Articles that are published under the imprimateur of reputable journals-and then promoted through the press-may affect the framing of social policies, the course of litigation, and the funding of research. They help to set the agenda of public discourse and affect the priorities guiding personal choices and institutional behaviour. The articles they publish may legitimate or call into question public policies. And some studies on the risks and benefits of certain products have influenced stock-market prices and product sales. When journals move beyond the cloistered domain of scientific publishing to expand their public role, they certainly become more newsworthy and less boring. But they also assume some risks. The JAMA experience a decade ago is still telling. A journal's own constituency may not be supportive, for many scientists remain ambivalent about involvement in public affairs. When the NEJM published its inflammatory editorial criticising the AIDS experiments in developing countries, two prominent AIDS researchers on the journal's editorial board resigned. Harold Varmus, director of the National Institutes of Health accused the journal of "trying to attract attention by making political, ethical, philosophical, and economic statements".27Altman L Aids experts leave journal after studies are criticized.New York Times. Oct 15, 1997; (Quoted in): A10PubMed Google Scholar And other scientists worried about jeopardising future AIDS research and believed the editors had misused the journal's power. Involvement in public disputes may also subject journals to pressure from the many interests concerned about public policies or consumer practices. Their files and records, including peer-review material and primary data, may be subpoena'd by the courts. Yet, as the cases described above suggest, the messages communicated by journal articles and editorials may be received and interpreted by the public in unintended ways. Finally, greater public visibility may undermine the credibility of professional journals. The authority of scientists and their journals has been based on their: distance from controversy and their image as disinterested, unbiased sources of information. The peer-review system has long served as a buffer against accusations of bias. But the conflicts of interest within science-the financial interests of researchers and the interests of their corporate sources of support-are reducing trust in this system.28Krimsky S Rothernburg Ls Stott P Kyle G Financial interests of authors in scientific journals.Science Engineering Ethics. 1996; 2: 395Crossref PubMed Scopus (64) Google Scholar Ironically, at a time when the editors of professional journals are seeking greater involvement in public affairs, their engagement in public disputes may compromise the very image of neutrality that has supported the public credibility of scientific journals and sustained their policy influence.