How far a style manual or style guide is an authority
A style manual provides shared decisions and guidance for a particular publishing or writing context. Its usefulness depends on its scope, the conventions adopted for the document and the judgement needed to apply its advice. Familiarity or reputation does not remove disagreement about individual rules.
Scope and shared decisions
The AMA Manual of Style primarily establishes standards for AMA journals, which helps explain its differences from other manuals. A 2009 editorial account described its wider influence as suggesting, by example, that standardisation is desirable and practical in medical writing.
In a 2021 address, the chair of the AMA manual committee recommended a shared stylebook to make decisions more efficient and consistent than repeatedly asking colleagues, who may give different answers about the same detail. It is a reference tool for consultation, like a dictionary, rather than necessarily a book to read from beginning to end. Chapters explaining the history of particular policies can supply context worth reading in full.
The guidance can extend beyond punctuation and spelling to data display, inclusive language, identifiable patient images, authorship, conflicts of interest and retractions. Manuals also guide information organisation, helping readers locate what they expect and skim for a basic understanding of a study. A manual can provide authoritative wording to cite when explaining an editorial policy, while the practical recommendation is to have an appropriate resource available rather than necessarily use the AMA manual.
Judgement in applying guidance
A manual can be useful as a common reference even to an editor who disagrees with parts of its style. One experienced editor's approach rejects slavish adherence, accepts AMA style where it seems correct and appropriate, and prioritises sensible consistency within a piece of work. Journal editors may change wording in any case, so good judgement remains necessary.
The governing manual can affect what is classified as an editing error. In a study reported in 2012, many capitalisation errors in medical editing tests concerned AMA conventions for organisms and pathogens, viruses, tests, sociocultural designations and common words derived from proper nouns, such as parkinsonism. The findings emphasise the importance of knowing the stylistic standards and practices governing the discipline.
Disagreement and suitability for the document
Advice that suits creative writing may not suit scientific, technical or medical writing. Medical-writing resource recommendations published in 2014 criticised The Elements of Style for poor advice, grammatical errors and guidance more appropriate to creative writing.
Even a guide devoted to scientific writing can contain positions that other editors reject. In a 2014 review of Mastering Scientific and Medical Writing, the author’s claim that mixed British and American English is invariably tiresome and annoying was rejected by the reviewer, who did not find the mixture annoying. The reviewer also disagreed with some hyphen and en-dash advice and noted that the book's position on introducing abbreviations did not fully agree with an earlier discussion in the same medical-writing journal.
The same review questioned the claim that poor spelling undermines the science's credibility, while agreeing that careless writing can justifiably affect judgement of the writer. These differences illustrate a lack of consensus in discussion of writing and language. The guide's recurring advice is to follow house style, remain consistent and choose meaning over rules; the review's wider caution is that almost every writing rule has people who hold a contrary view.