Let me extend my doctor / JAMA example. Do I think that there might be circumstances in which a doctor found in his clinical practice that some treatment invariably worked, but held back from prescribing it because JAMA did not approve?
Absolutely yes such circumstances could exist. Maybe the doctor, for example, is president of JAMA, and is convinced that great benefit comes from JAMA being respected, and the treatment is for a minor condition, and the patient is a news reporter trying to undermine JAMA......
The point of this post is that I think that Epicurean philosophy cannot as a general abstraction lay down blanket rules about specific actions for all people at all times and all places. It is clear in the philosophy that sometimes we chose pain, sometimes we consider what appears to be good to be bad when we add up all the consequences.
The first and major contribution of Epicurean philosophy is that while it can give you suggestions in how to proceed in your decisionmaking, ultimately the points that are certain is that when you add up your consequences, DON"T think that you are going to be rewarded or punished after death, and DON'T think that you need to worry about appeasing or being punished by supernatural forces in this life, and DO realize that in the end there's only one thing given to you by Nature for you to take and analyze and then make your decisions based on. That one thing is the faculty of pleasure and pain, which applies to everything you experience, and it's up to you to analyze *all* the consequences of your actions and make your decisions accordingly.
There's of course a lot more, but the basic view of the universe informs how *you* will evaluate pleasure and pain, and getting that basic view of the universe right is essential.