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Rapid Responses: Rapid Responses published:
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The body bags have been filling with children.
- Charles Pragnell (25 October 2003)
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Freedom of Information Act 2002
- Mark S. MacGregor (26 October 2003)
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Lock's polemic: a missed opportunity
- james n hardy (30 October 2003)
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Britain is ahead of the rest of the world
- Hervé Maisonneuve, Alain Bérard, Dominique Bertrand (31 October 2003)
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Update on Britain Prefers Talk to Action
- Gordon DO Lowe, Gordon D. Murray and Niall D. Finlayson (5 November 2003)
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Charles Pragnell, Expert Defence Witness - Child Protection and Child/Family Advocate Victoria 3931
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Stephen Lock has rightly and astutely brought attention to a very serious issue which bedevils the professions in the U.K. But it is not only research misconduct which requires urgent investigation but medical research which lacks scientific integrity and is often no more than fanciful speculation. This has been notable where medical theories have been applied in the field of child protection. Lock suggests we need “dramatic deaths” to bring about change but the body bags have been filling for over 25 years of children whose parents have been falsely accused of child abuse based on unproven and scientifically-lacking theories and such theories have been unquestioningly accepted by the more gullible or over-enthusiastic workers in the child abuse industry. It is incredible that such theories are never subjected to any form of independent verification or validation by a national professional body before being introduced into general practice. Such theories as the Anal Dilatation Test, Munchausen Syndrome By Proxy, Repressed Memory Syndrome, Fabricated or Induced Illness in Children (uncritically endorsed by the Royal College of Paediatrics and Child Health and the DoH Social Services Inspectorate), Dissociative Disorder, Somatic Disorder etc have variously led to a `Stolen Generation’ of children being snatched from parents, often within moments of birth, and have been rushed through an adoption process with unseemly haste in order to meet and maintain key performance targets set by government. Even in those instances where children and their families have been subjected only to child protection investigations (about 160,000 children per year in England) but no further proceedings are pursued as there is no substantive evidence to support the accusations, scientifically-based research has shown that unnecessary and unwarranted child protection investigations are not a benign or neutral experience for children, but that they suffer severe and long-lasting emotional harm and their families are devastated and often destroyed, by the investigatory processes. But the proponents of these tactics tritely take the position, “Who cares if nine innocents suffer, as long as we get the guilty one!”. One might say a very highly principled basis for a medico-legal process.! False accusations of child abuse for mistaken, mischievous, malicious, or monetary reasons have reached scandalous proportions in the U.K. involving many thousands of children and their families every year and unproven, scientifically deficient medical theories contribute to a considerable proportion of such false accusations. I would suggest there is an urgent need for an independent national body to carry out a verification and validation process into medical research with child protection implications and for a similar disciplinary body which would have public confidence in its integrity, efficiency, and independence from professional influence. Competing interests: None declared |
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Mark S. MacGregor, Specialist Registrar Glasgow Royal Infirmary, G4 0SF, Scotland
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Lock is too pessimistic about the creation of a national body to tackle research misconduct. He states that "we are a long way...from any Freedom of Information Act." The Freedom of Information Act(1) was passed in 2002 by the Scottish Parliament, just three years after it was (re)created. This was achieved without any major scandal or dramatic deaths, and certainly without any charismatic leader. All it took was the will of the people. If the medical community can find the will, the scandal which would be required to attract the general population's attention to research misconduct might be avoided. 1. Freedom of Information (Scotland) Act 2002. London:TSO Ltd 2003. Competing interests: None declared |
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james n hardy, GP principal Bethnal Green Health Centre, 60 Florida Street, London E2 6LL
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Editor, Lock's editorial on Britain's failure to tackle research misconduct made interesting reading, but he didn't make enough noise about the real issue (1). Quite rightly he draws our attention to the smugness and duplicity in many areas of British life, but then fails to mention the perverse structure that underpins this. Britain is still a feudal society hand in glove with a monarchy whose rot is enclosed by a government and civil service that draws its succour from the self-serving privileged classes. I don't especially wish to bang the republican drum, but I think William S Burroughs was right when he said that nothing would change in Britain until there are 10000 people outside Buckingham Palace shouting, "fuck the Queen". Jim Hardy (1) Lock S. Britain prefers talk to action. BMJ 2003;327:940-1 Competing interests: None declared |
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Hervé Maisonneuve, Associate Professsor Public Health department, Lariboisière Fernand Widal hospital, 200 rue Fg St Denis, 75010 Paris, Alain Bérard, Dominique Bertrand
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Stephen Lock warns the medical community about its lack of action in handling research misconduct (1). We agree with him but we disagree with his statement that Britain is behind the rest of the world. We think that Britain is in fact ahead of most countries and that Lock should be proud of the achievements of the Anglo-Saxon countries compared to the rest of the world. His remarks should be modified in view of the poor situation of many countries: fewer than 10, most of them small countries, have a national body with the mission of investigating misconduct and fraud in science, and few countries have open discussions under the umbrella of professional organisations such as COPE. Eastern and Southern Europe, Latin America and Asia have no mechanisms for handling fraud properly. If 23 years have not been sufficient for Britain to move on, does it mean that countries such as France will have to wait until 2020 or 2050 before the situation can be improved? In the USA, after a series of high- profile cases exposed fabrications of data in the late 1970s and early 1980s, the Health Research Institution Act of 1985 required institutions to establish procedures for addressing scientific misconduct (2). Even if the USA apparently leads the war against misconduct, the situation there is still far from satisfactory. Establishing standards, recommendations and processes for investigating research misconduct takes time, as so many interests are challenged. Professional organisations must be well organized and governments must support the commitment to setting up a system. Lock says two features are needed before progress can be made: a scandal and a charismatic leader. But must we wait to see a major scandal in the public domain in most countries? Maybe that’s life: errors and scandals are the best way to make progress. But will a scandal be sufficient in countries where misconduct is discussed and handled behind closed doors? We agree that charismatic opinion leaders are needed, but one per country is not enough. We hope, however, that charismatic leaders will be able to save us from new scandals. References 1 Lock S. Britain prefers talk to action. Which is why it has failed to tackle research misconduct. BMJ 2003;327:940-1. 2 Mello MM, Brennan TA. Due process in investigation of research misconduct. N Engl J Med 2003;349:1280-6. Competing interests: None declared |
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Gordon DO Lowe, Assessor, Royal College of Physicians of Edinburgh and Professor of Vascular Medicine Royal College of Physicians of Edinburgh, 9 Queen Street, Edinburgh EH2 1JQ, Gordon D. Murray and Niall D. Finlayson
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Sir, We sympathise with the frustration expressed by Stephen Lock(1) in the delay in establishing a UK panel for the prevention and management of biomedical research misconduct. Following this College’s Consensus Conference Statement(2) we worked with sister Colleges to develop a blueprint for such a panel(3), the subsequent development of which was charged by the UK Colleges and other relevant bodies to the Academy of Medical Sciences. This item has been monitored closely by our Audit and Research Committee and we share Lock’s disappointment that the Academy of Medical Sciences has not made more progress. Following discussion at the meeting of the Committee on Publication Ethics (COPE) on 24 October 2003 where Lock spoke, it was proposed that the Colleges should work with the General Medical Council, Universities UK, NHS Research & Development and the Academy of Medical Sciences to progress the panel. The Federation of Royal Colleges of Physicians of the UK has since confirmed its support for the joint working group. This College continues to promote its misconduct statement and remains fully committed to working actively with all other bodies to establish the UK Panel. Yours sincerely Gordon DO Lowe, Assessor, Royal College of Physicians of Edinburgh and Professor of Vascular Medicine, University of Glasgow Gordon D Murray, Member of Consensus Panel on Misconduct in Biomedical Research(2) and Professor of Medical Statistics, University of Edinburgh Niall D Finlayson OBE, President, Royal College of Physicians of Edinburgh References: 1. Lock S, Britain Prefers Talk to Action. BMJ 2003;327:940-941 2. Consensus Statement on Misconduct in Biomedical Research, Royal College of Physicians of Edinburgh, October 1999 http://www.rcpe.ac.uk/esd/consensus/misconduct_99.html 3. Stonier P, Lowe GDO, McInnes G et al, A National Panel for Research Integrity: A Proposed Blueprint for the Prevention and Investigation of Misconduct in Biomedical Research. Proc R. Coll Physicians Edinb 2001; 31: 253-255 http://www.rcpe.ac.uk/publications/articles/vol31_no3/S_National_Panel.pdf Competing interests: None declared |
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