Intended for healthcare professionals

BMJ ethics committee annual report 2010

John Coggon
Research Fellow, School of Law, University of Manchester, UK
John.Coggon@manchester.ac.uk

During 2010 the Committee met three times (19th January, 17th June, 12th October; the meeting scheduled for 6th April was cancelled). There were two new cases brought to the Committee. In addition, there were ongoing cases still open from earlier years. Furthermore, various issues of ethical importance were presented for the Committee’s consideration: members of the Committee raised a number of current ethical issues that they believed would be of interest and importance to readers of the BMJ, and discussed matters of ethical controversy relating to medical research, clinical practice, professional conduct, and publication ethics. This annual report details key themes that arose given points of discussion from across the three meetings.

Publication Ethics

Various issues arose concerning breaches of publication ethics. In some instances, it became apparent that the role of the BMJ’s ethics committee was necessarily quite limited. Amongst other things, discussions addressed the following:

Authorship Disputes

Of particular note were complaints from parties who considered they should have been listed as authors but were not. From the Committee’s perspective, these were hard to investigate, especially when some time had passed since publication, and where there were conflicting factual accounts. Any form of investigation was also hard if implicated parties did not respond to letters making inquiries. Often the best course of action available to the Committee, or journal editors, was to notify a relevant manager (eg a medical director in the department where the research in question was undertaken) of the accusation, and suggest that he/she might investigate.

Plagiarism

When considering cases of possible plagiarism, the Committee sometimes noted that it is unclear precisely where the line is drawn, for example, between duplication and plagiarism (noting that self-plagiarism is wrongful practice, just as is plagiarism of others’ work). Some assessments of plagiarism demanded expertise in the relevant speciality of the research. For example, concerning one research project that produced several papers, it was accepted that there will be natural overlap in reporting of methodology and data, and a specialist understanding is needed to judge whether the papers plagiarise each other, or present validly separate bodies of work.

Ethical Standards Expected of Authors

The Committee explored in some detail the issue of whether the ethical standards expected of doctors, and the standards of publication ethics expected in journals such as the BMJ, should apply in other, independent forms of publication. Furthermore, where an author had elsewhere breached ethical codes applicable in medical publications (eg breaching ethical and/or legal duties of confidentiality), should this debar that author from publishing in the BMJ? A wide mix of views was expressed amongst the Committee, probing issues such as: the public interest (both in a narrow sense, concerning the value-judgment of the validity of publishing some specific data/facts, and in a broader sense, concerning the public value of different forms of publishing, reflecting different methods and ethical standards); the nature of a decision to refuse to publish (is it punitive against the author, reflecting the journal’s disapprobation of his/her earlier conduct, or required to sustain the integrity of the journal?); and evidentiary issues (how can the journal/the Committee come to a sufficiently informed judgment on an alleged instance of malpractice?).

Obligations to Authors

The Committee considered a complaint concerning the opacity and potential incoherence/ethical indefensibility of the BMJ’s processes of appeal against decisions to reject papers submitted for publication. The complainant asked whether it was acceptable that authors might have no right to respond to reviewers’ comments. Furthermore, there was a complaint that it is problematic if an editor who has rejected a paper can assume responsibility for reviewing the decision to reject, with no duty to come to further reasons for not accepting the paper. Whilst authors may have felt aggrieved by journals’ procedures on these matters, there was no indication of unethical practices in appeals at the BMJ, and it was argued in the Committee that whilst a review would be conducted into the appeals process, this issue was editorial rather than ethical.

Journal Policies

The Committee was asked to offer ethical advice on issues relating to journal policy, including:

BMJ Journals’ Transparency Policy

The Committee remained informed of a review of BMJ Group policies concerning conflicts of interest and ethical issues, following an audit conducted outside of the Committee by Committee member Liz Wager. The Committee queried policy issues including the listing of funders, the sorts of articles on which competing interests statements should be needed, the utility and desirability of using anti-plagiarism software, and transparency regarding complaints/appeals following editorial decisions.

Pre-publication history

The Committee was asked for opinions on the policy of publishing pre-publication histories alongside research articles (eg decision letters, reviewers’ comments). The Committee explored concerns about the potential influence of such a policy on reviewers, and the potential effect if these documents were to be edited. It was thought that instances where any form of editing—probably in the form of redaction—would be extremely rare. The idea of publishing pre-publication history was welcomed, though continued audit was recommended to assess its effects.

Open Access Charges

The Committee considered arguments for and against asking for funding to pay for open access to research papers. There was a proposal that the BMJ should ask authors to request funding for open access from their funders, with the administrative process for this being kept separate from editorial consideration of the paper. There was agreement amongst the Committee that the two should be separate matters, and a discussion of who should be responsible for paying for open access. Considerations included whether the research itself is funded, but also the potential effects on funders (eg charities) with tightly limited resources.

Reporting ongoing Ethical Controversies

Issues discussed included: surgical treatment for body identity dysmorphia; self-harm, particularly in pursuit of some perceived gain (eg to avoid military service); a policy of asking girls under 16 whether they are pregnant, in front of their parents, prior to appendix surgery; doctors treating homosexuality as a disorder.

Committee Membership in 2010

Neena Modi (chair)
Liz Wager
Nick Pace
Fiona Godlee
Julian Sheather
Peter Lapsley
Robert Wheeler
John Coggon
Michael Millar
Jane Smith
Charles Warlow
Ainsley Newson

JC conflict of interest: none declared