An ethics committee for the BMJBMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7263.720 (Published 23 September 2000) Cite this as: BMJ 2000;321:720
It helps us to think harder and do better
- Alexander McCall Smith, professor of medical law,
- Alison Tonks, assistant editor,
- Richard Smith, editor
Readers wondering why the BMJ or any other medical journal needs an ethics committee should read the latest annual report of the United Kingdom's Committee on Publication Ethics.1 It describes cases that until 1997—when the committee was set up—editors had to tackle alone: authors who cannot agree on their respective contributions to a piece of research, allegations of fraud (against editors as well as researchers), victimisation of whistleblowers, investigators who slice their work up in to “least publishable units” and submit to several different journals simultaneously, and research papers that come without ethics committee approval “because there isn't one in our hospital in [unnamed country].” Less dramatic issues come up every day: reviewers who write that they have shares in the drug company that sponsored a trial but don't think it's affected their judgment; or editors who share manuscripts with another journal's editors without thinking to tell the author first. Editors, just like doctors, live in a morally complex world where ethical judgments are needed constantly.
The Committee on Publication Ethics is a useful sounding board for editors needing general advice about specific anonymised cases of potential misconduct, but the BMJ needs more. It needs an ethics committee to examine critically all editorial practices, including policies on patient confidentiality and consent, declaration of competing interests, open peer review, disclosure of research results to trial participants, and relationships with the media and the developing world.
The frequency and complexity of ethical issues means that editors need help, which is why we are creating an ethics committee. An independent committee will help us with difficult cases and review our policies—clarifying those that are imprecise, telling us where we need new ones (on whistleblowing, for example) and adding legitimacy to those that are right already. A committee may not be good at painting pictures or writing sonnets, but it should make for better ethical decisions, not least because it will include experts, BMJ readers, and patients' representatives.
The committee will also help us to expand our existing coverage of ethics, identifying new issues and their broader implications. These issues are likely to include both the immediate ethical dilemmas of medical practice and wider policy issues, such as the ethical questions posed by advances in genetics. Our surveys of readers show consistently that you want more on ethics.
The committee has an independent chairperson, and, although its membership will include editors, the committee will be expected to give impartial advice. If the editors choose not to follow this advice, they will have to explain their reasons in the journal, maintaining the BMJ's tradition of open discussion. We already have a chairperson, recruited by open advertisement. An advertisement for further members appears in this week's classified supplement. Members will be expected to attend quarterly meetings and contribute to email discussions between meetings. We are not necessarily looking for experts in ethics; we are looking for people who can bring to the committee a real understanding of how medicine's moral maps may be drawn in the ward, the general practitioner's surgery, the accident and emergency department, and in the conduct and publication of research. We also need lay members. Since ethical issues are not constrained by national boundaries, so international applications are welcome. The committee intends to play a full part in the broader international debate on medical ethics and the ethics of research and publication. For further details contact Alison Tonks at. The deadline for applications is Friday 6 October.