Editorial independence is built on trust and communication.

In January of that year George D Lundberg, Editor of the Journal of the American Medical Association [JAMA], was sacked by the American Medical Association (Anderson 1999). Some five months later, Jerome P Kassirer, Editor of the New England Journal of Medicine, left the Journal when his contract with the Massachusetts Medical Society, the journal’s owners, was not renewed (Smith 1999). At the centre of both these dismissals were conflicting perceptions of journal objectives, values, accountability and editorial independence.