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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Responsibilities of the Ethics Committee?
- susanne mccabe (27 August 2004)
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Experiences of the BMJ ethics committee
- Terence W. Wiseman (27 August 2004)
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Where was the Ethics Committee when Dr Horrobin's obituary was published?
- Jay Ilangaratne (31 August 2004)
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Response from the BMJ Ethics Committee
- Liz Wager (11 October 2004)
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Re: Response from the BMJ Ethics Committee
- susanne mccabe (12 October 2004)
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Re: Response from the BMJ Ethics Committee
- Jay Ilangaratne (12 October 2004)
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Nothing from the Ethics Committee since 2006
- susanne stevens mccabe (29 May 2009)
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More info about Ethics Committee
- Elizabeth Wager (2 June 2009)
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susanne mccabe, retired cf24 3pf
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The advice given to the previous editor of the Journal of Psychiatry was that the editor of a journal is responsible for published material. Richard Smith agreed this was the case for the BMJ. Can this advice still apply and indeed is it ethical when a group of people on the Ethics Committee are jointly responsible for drawing up new guidelines? They as individuals and as a committee are obliged in any event to comply with laws and guidelines of regulatory bodies and as such need to be able to assure contributors that the material they submit will not make them liable for complaints, should these established regulations be breached. The newly set up Healthcare Commission which includes the setting up and investigation of governace, standards, compliance with rights and investigation of complaints, is headed by a Professor of Law. This is a body which cannot be sidestepped in any rejigging of guidelines I would think. Any increase in the transparency of the working of the Ethics Committee is to be welcomed - but the time for debate is not AFTER a relatively small group of people has come to a decision but DURING the process. How are members elected by the way? Competing interests: Years of work on the need for higher ethical standards in medicine |
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Terence W. Wiseman, Member, Multi-centre Research Ethics Committee. Lincolnshire
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I note from the list of members of this Committee (given at the end of the article) that: a) The Committee does not appear to include representatives from Research Ethics Committees - unless some of the members happen also to be members of a REC. This is quite ridiculous, considering that the overwhelming majority of the work of the committee concerns ethical conduct in research. An expert committee without a single expert ? b) The Committee has no lay representation. Lay members carry out an essential role in Research Ethics Committees and for this committee not to have lay representation is arrogant in the extreme. Competing interests: lately Chairman of a local Research Ethics Committee. Currently a member of a Multi-Centre Research Ethics Committee. |
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Jay Ilangaratne, Founder Medical-Journals.com
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The BMJ ethics committee identifies its remit as "help editors with difficult cases, to review policies that have ethical implications, and to expand the journal's coverage of ethics"[1]. If that is the case,one would have expected the committee to show some degree of condemnation of inaccurate and most insulting remarks that appeared in Dr Horrobin's obituary, published in the BMJ. Sadly, neither the ethics committee nor any of its members expressed any concern or condemnation in the rapid responses section. So are they really practising what they preach, or didn't they feel inclined to rock the dominant editorial apple-cart (then)led by 'dear' Dr Richard Smith? I think the new management of the BMJ publishing group should seriously consider the real need for an ethics committee. Well balanced, ethical and accountable editor,alone, would be more than enough to maintain the integrity and ethical standards of the journal.Further, the current appointment methods of members,should be wholly revamped should the BMJ management decides to maintain this committee; otherwise, it may look as if this is another example of jobs for 'the boys and girls'. I wonder whether the committee members are also compensated for their loss of private practice when dealing with BMJ matters. References [1]Elizabeth Wager. Experiences of the BMJ ethics committee BMJ 2004; 329: 510-512 Competing interests: None declared |
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Liz Wager, Member of BMJ Ethics Committee c/o BMJ
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The three previous responders make some assertions and raise some questions about the BMJ’s Ethics Committee which we will try to answer. First, we can reassure readers that the Editor remains responsible for what appears in the BMJ. The Ethics Committee is purely advisory, and the Editor is free to ignore our advice. In fact, our discussions only occasionally focus on whether an item should be published, and are much more often about how the journal should respond to ethical questions arising independently of the decision to publish. We developed the guidelines on when it might be acceptable to publish material without obtaining patient consent at the request of the BMJ editors and in close consultation with them. The editors were concerned that, since they had no guidelines, they might not be following a consistent policy and also that the journal did potential authors a disservice by not making its policy explicit. The editors who handle the ‘Filler’ sections (where these issues most often arise) have told us that they find the guidelines helpful and the Committee has not subsequently been involved in decisions about acceptance of such items or whether consent is required. Susanne McCabe asks how the Committee was elected. The answer is that we were selected, initially, by Richard Smith from nearly 150 people who responded to an announcement in the journal in 2000. We also have a representative from the BMA’s medical ethics department. Since the initial group was established, we have appointed some additional members who bring particular skills or experience to the group. The position of Chairperson (which became vacant when Professor McCall Smith stepped down) was advertised in the journal. Candidates (both existing members and external) had to submit applications and were selected on the basis of this, plus an interview carried out by the Editor plus two Committee members (who were not themselves candidates). The Committee has recently agreed terms of office, so the original members will gradually be replaced by new ones. Vacancies will be advertised as they arise. Terence Wiseman notes that the Committee does not include representatives from Research Ethics Committees and suggests that we, therefore, lack expertise. As to our expertise, our members include the Directors of a Bioethics Centre, a Clinical Fellow in Medical Ethics, the former Advisor in Bioethics to the Wellcome Trust, and the BMA’s Head of Ethics. Until Professor McCall Smith stepped down, we also counted a Professor of Law among our numbers. We consider our role to be quite distinct from that of Research Ethics Committees, since we are concerned with the ethics of medical publishing rather than those of medical research per se. We do not review clinical research protocols, however we have given advice about the BMJ’s own research projects involving readers and reviewers. As we are not a Research Ethics Committee, we do not feel that we need to be constituted in the same way, although we agree with Mr Wiseman that patient representation is important. However, we feel that this role is far better served by the BMJ’s Patient Advisory Group, which has a broader remit than the Ethics Committee. We are discussing the possibility of cross-representation with members of the Patient Advisory Group. Jay Ilangaratne asks why Committee members did not comment on the Horrobin obituary. This was, in fact, discussed extensively at our meeting on 7th October 2003, and our views are available in the minutes. Committee members can claim expenses to cover the cost of travel and for providing locum cover for a clinical session (if applicable). They are not compensated for the loss of any other income. We thank the responders for their interest in the Ethics Committee and remind them that they can follow our deliberations from the minutes which are posted on BMJ.com. Competing interests: I am responding on behalf of the BMJ Ethics Committee |
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susanne mccabe, retired cf24 3pf
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Thank you to the BMA Ethics Cttee for taking the trouble to respond with helpful information as to how decisions were made, who made them and where the BMJ Ethics Cttee minutes may be accessed. Could you include a reminder when meetings have been held so that people may respond in a timely manner? I would just remind readers though, that obligations relating to publishing are still covered by GMC Guidelines; Human Rights Laws; DoH Guidelines and Data Protection and other Laws.Individual contributors and groups who may not have needed to gain Research Ethics Approval need to bear this in mind, as the authors suggest. The Ethics Committee might have included members of these organisations in their considerationss as well as lay members with experience of the issues. It seems that the advice given by Briget Diamond, Barrister,that published material is the responsibility of the Editor, still stands so it would also seem important that the Editor has an obligation to read issues of the Journal before it goes out. One question remains unanswered ie especially as Editors are keen to increase qualitative material, contributions from members of the public, people relating their own experience but crucially which will also include that of others, friends, relatives, from people not covered by professional guidelines:- How is the question of Confidentiality/Privacy/Rights to Consent going to be handled? There is nothing formal in the guidelines suggested by the Ethics Committee. The committee says it has in factlittle time to devote to Ethical issues.So although the increase in publication of the authentic voice of all sections of the community is entirely for the good,the publication of such material is increasing without having put guidelines in place first. A response from the Committee would be welcome and appreciated. As is the recognition that others with different perspectives have an important contribution to make in developing guidelines. Competing interests: a concern with medical ethics |
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Jay Ilangaratne, Founder Medical-Journals.com
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I would like to thank Elizabeth Wager for providing a summary response to the comments made by others. I hope other authors of original articles would follow Wager's example by providing a concluding response to various comments, perhaps two to three weeks after publication of the original piece.That would be a good opportunity clarify any points raised,correct errors, and clear any doubts in relation to the original piece.Should the BMJ make it mandatory that all authors of original articles provide a response to comments of readers,following a specified period after publiction,then a more a focussed debate on the original subject matter is likely to continue. As to my original comment about Horrobin obituary, whilst noting what Wager says, it remains a fact that the Ethics Committe did not express its views or concerns in the rapid response columns at the time. Though I have now traced the minutes of the meeting that Wager cites[1], I believe that it would have been much better if at least some part of the those minutes were, perhaps juxtaposed with the many rapid responses to Dr Horrobin's obituary, rather than allowing it to rest in an obscure corner of the BMJ website. Finally,I found the following statement in the published minutes somewhat interesting: **AS felt that there was a duty of care to the readership to get the facts right in an obituary but that there was no duty of care to the family.** The view that "there is no duty of care to the family" of Dr Horrobin is highly challengeable, both on moral and legal grounds. Perhaps, others may care to comment. References [1] Case 03/005 BMJ’s referral to the PCC over an obituary http://bmj.bmjjournals.com/cgi/content/full/322/7297/1263/DC1/9 (accessed 12 October 2004) Competing interests: Have commented on this subject matter earlier |
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susanne stevens mccabe, retired cf5 6su
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No news seems to be published from the Ethics Committee. Has the policy changed? Competing interests: None declared |
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Elizabeth Wager, Ethics Committee Member Sideview, Princes Risborough, HP27 9DE
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You can find more recent information about the Ethics Committee at http://resources.bmj.com/bmj/about-bmj/advisory-panels/ethics-committee/bmj-ethics-committee-annual-meeting-report-2006 Competing interests: Member of BMJ Ethics Committee |
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