Open

The value is not in content. We like to think that what we create and what we write is what is important, but it's not. For hundreds of years, copyright law protected content, and only now are we beginning to see that influence is what's important. It's the perception, the reception, the reading of, digesting of, and interpretation of the content which is important.

What I mean is this. Social media - Facebook, Twitter, Google+ - has created the phenomenon of "reposting" content. It used to occur in the form of chain e-mails - back in the AOL days, you'd see a joke you thought funny and forward it to your friends. A decade later, we started talking about "viral" videos, videos that picked up momentum in a seemingly unreal fashion. Now, when we find things we like, we repost it, retweet it, plus it. And this, it seems, is the goal of a lot of content out there. Authors want their work to be rebroadcasted; they want the audience, the influence, the interpretation of their content.

As with most things, scientists are slow adopters. We still protect our content with lock, key, and lawsuit. We have to pay to get access to certain journals, and the fees aren't cheap; downloading an article may cost as much as a fancy dinner. As residents, our institutions provide us access to major journals, and for private practice physicians, medical groups (like the American Medical Association or American Society of Anesthesiologists) grant access to their particular publications. But why do we do this?

The content does not need protection; the content needs distribution. If a breakthrough in science occurs, you want more people to read it, not fewer. Spreading information speeds innovation, progress, experimentation. It helps patient care, levels the playing field of academic, private, and rural medicine, and provides ongoing learning. It makes no sense to me that journals are not open-access. Cloistering information is a thing of the past. Imagine if medical studies spread wildfire like cat pictures on the Internet. Each morning, over coffee, you read the articles your colleagues identify as most important; you "like" some of them, and pretty soon, the most relevant research is the most read. Currently, the process moves like molasses; an article's "relevance" is measured by how often it's cited, a process that manifests over decades. When I rifle through junk mail and find a journal, I don't know which articles matter or which my peers are most excited about.

This post was indeed spurred by the death of Aaron Swartz, a prodigious programmer and Internet activist. He was arrested for downloading academic journals from JSTOR; although charges from JSTOR were dropped, the government continued to pursue the lawsuit. He committed suicide recently, a big loss of the innovator who coauthored RSS 1.0, campaigned for a free and open Internet, and founded multiple companies. He was charged with downloading academic journals with the intent of distributing them. This may be a crime, but was it morally reprehensible? What value do academic journals have but to be read, and understood, and built upon? Research is not funded by the $40 I pay for that one article I really want. But research is inspired by and dependent upon those giants that come before us, whose shoulders we crouch upon today.