Crisis at the Croatian Medical Journal: Considering a Proposal for Its Destruction

Abstract

Founded on September 23, 1669 by Emperor and King Leopold 1, the Academy of Zagreb enjoyed a long, rich, intellectually productive and indeed enviable tradition of scholarly research and advanced education. Transformed into the University of Zagreb by a charter from Emperor Franz Joseph, in 1869, the University of Zagreb is now “a central source of spiritual, intellectual, and scientific strength of the Croatian people” (1). The mission of the University is based on “scientific and artistic research.” It is to be the “central and leading institution” for the Republic of Croatia, and “all university activities shall aim at the full development of human personality and promotion of human rights and fundamental freedoms” (1). It is impossible for those of us working in medical schools in North America to meaningfully absorb the depth of this cultural, intellectual, and scientific history. It is almost as impossible for us to understand the apparent violations of the Statute by the Dean of its medical school (2): except that we’ve seen it before; scientific misconduct covered up or not acted upon, attempts to stifle scientific and intellectual independence and freedoms, and even retaliation against and censorship of those seeking to correct the wrongs and maintain the standards of excellence. I will not review here the increasingly sordid mess that the Zagreb Medical School and, by association the University of Zagreb, has created and now finds itself in (3), other than comment that it seems to be getting worse. The most recent contribution is Dean Nada Cikes’ proposed castration of the editorial independence of the Croatian Medical Journal (CMJ) by altering its founding Agreement on Governance (2). Editorial independence of a scientific or any academic journal means that (4): “...editors-in chief should have full authority over the editorial content of their journal. Journal owners should not interfere in the evaluation; selection or editing of individual articles either directly or by creating an environment that strongly influences decisions. Editors should base decisions on the validity of the work and its importance to the journal’s readers not on the commercial success of the journal. Editors should be free to express critical but responsible views about all aspects of medicine without fear of retribution, even if these views might conflict with the commercial goals of the publisher.” In her proposed revisions to the Agreement on Governance of the CMJ, Dean Nada Cikes violates almost every aspect of this internationally recognized and respected definition and set of defining principles that have been adopted by almost all legitimate scientific and medical journals, worldwide. Dean Cikes’ revisions (I gave up counting at 50 revisions, most of them major alterations) would render the CMJ, not the bold experiment in internationalism and exacting ethical standards that it developed though the hard work and diligence of its editors and the scholars, Croatian and international, that populate its Editorial and Advisory Boards, but an inward-looking house organ of the Croatian medical schools, led by the School of Medicine of the University of Zagreb. The devastation of the founding charter is most telling with the first alteration – deletion indicated in bold and strikethrough (2): “The Agreement should support and stabilize the excellence and achievements of the CMJ and allow maintenance and growth of the system and environment, which will make the CMJ a stable, lasting and independent institution.” If Dean Nada Cikes’ changes are accepted by her colleagues at the other 3 medical schools in Croatia, the Journal may be stable and lasting, but it will no longer be the CMJ and will no longer meet internationally accepted standards for independence in research and publication. Croatians will have to judge if the changes proposed by Croatia’s lead medical school violate Emperor Franz Joseph’s lofty 1869 challenge (1) that the University of Zagreb be “a central source of spiritual, intellectual and scientific strength of the Croatian People.” I have no right or basis on which to pass judgment on the University of Zagreb, and its esteemed faculty and students. Nor any desire. My only wish is that the CMJ’s independence be preserved, and with it the independence of the editors, the members of its editorial and advisory boards, its support staff, and of the countless contributors and peer reviewers that depend on and value its scientific and cultural independence. It would be a labor worthy of medieval scholars to assemble the many changes to the Agreement on Governance being proposed by Dean Cikes. Here are but two of the most outrageous emasculations of scientific independence (Dean Cikes’ proposals paraphrased in italics) (2): 1.The Advisory Board Members will be chosen by representatives of the Deans of the Medical Schools. At the CMJ, the Advisory Board members are important peer reviewers. Under the revisions, the journal’s peer reviewers would no longer be independent. One would hope and expect that both international and Croatian scientists and academics would refuse membership on a future Advisory Board and would not participate in peer review for the CMJ. 2.The Deans of the medical schools appoint members of the CMJ Editorial Board and can dismiss them. The Editorial Board meets during the preparation of every issue of the CMJ and participates in the approval of the issue content. These proposed changes transmogrify the Editorial Board into a Deans’ mouthpiece. There is an additional, rather bizarre, section of the proposed changes to the Agreement that includes a non-inclusive list of criminal acts that would preclude appointment of an editor-in-chief; and a similar list for an editor, with a record of “breaching ethical principles or disciplinary work obligations.” Both requirements, I expect, violate the United Nations statement on human rights and freedoms, and may well violate Croatian law. The current agreement on governance of the CMJ provides a mechanism for the owners of the Journal – the four Schools of Medicine – to propose dismissal of an editor. Under the current agreement, the Editorial Board can dismiss the Editor in Chief. This decision has to be confirmed by the Joint Management Board, whose members are chosen by the medical schools. Further, the Joint Management Board can propose to the Editorial Board that an editor be dismissed. This arrangement for dismissal of an editor or for non-renewal of his or her contract is purposely indirect. It requires that 2 of the Journal’s governing structures come to agreement, thus serving to impede arbitrary, personal, or overly hasty intrusion of the owners of the journal into the intellectual and scientific life and integrity of the Journal. If Dean Cikes wishes to sack current editors she should use the extant Agreement on Governance and request that her appointed Management Board consider her request and rationale and act accordingly.