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Ethics at the BMJ

BMJ 2007; 334 doi: (Published 22 February 2007) Cite this as: BMJ 2007;334:0
  1. Fiona Godlee, editor
  1. fgodlee{at}

    One of the BMJ's assets is its ethics committee. The committee meets every three months to provide the editor with broad ethical guidance and consider ethical dilemmas arising from articles submitted to and commissioned by the journal. Chaired by Iona Heath (a GP, ethicist, and BMJ columnist (BMJ 2007;334:341 doi: 10.1136/bmj.39125.448287.59)), its members are appointed after open application and competitive interview. Rather than publishing the minutes of the meeting, which presented problems of confidentiality, we now publish an annual report (

    In the report for 2005 (2006 is coming shortly), Liz Wager describes the issues raised by the year's 11 new cases. Several cases raised the perennial question of what constitutes research rather than innovative practice or audit. Should the use of unlicensed treatments require prior approval from a research ethics committee or institutional review board? The ethics committee judged that it should. These cases also raised concerns about whether patients had given fully informed consent, and led to a discussion about whether verbal consent can ever be adequate—the committee concluded that it could, provided there was adequate documentation and a witness. The committee also helped resolve two cases in which submissions underwent significant and troubling changes in authorship in the course of publication.

    In almost all cases considered by the committee the editorial decision has already been made and the committee is being asked for advice on how to handle residual ethical concerns, usually about articles we have decided to reject. This is in keeping with the BMJ's commitment not simply to reject a paper if there are ethical concerns but to pursue the matter as far as possible with the authors and if necessary their institutions. We ask the authors for their explanation of events and let them know that we have referred the case to the ethics committee to see whether any further action is needed. Our aim is to support and educate authors rather than condemn them, since in many cases the ethical problems seem to have arisen out of ignorance or honest error.

    Where a serious reprimand or retraction of a published paper is needed, the ethics committee's expert support in reaching this decision is a huge comfort. The editors of the two journals embroiled in the disputed trials of mannitol in head injury, described in this week's BMJ (doi: 10.1136/bmj.39129.611516.80, doi: 10.1136/bmj.39118.480023.BE) might well wish they had such a body to confide in. Perhaps they may turn for advice to the Committee of Publication Ethics, which holds its annual seminar in London on 16 March (contact cope{at}

    Almost all the BMJ's ethics committee cases relate to research papers, which gives me the opportunity to emphasise the importance of research to the BMJ. Some readers have commented on the apparent downplaying of research in the new print journal. This is quite the opposite of what we are doing. Original research remains at the core of this academic journal. In her recent editorial, Trish Groves outlined the sorts of research we are keen to publish and the reasons why authors should submit their best clinical research to us (BMJ 2007;334:4, doi: 10.1136/bmj.39057.516250.80). Not least among these is the fact that the BMJ is that rare beast among the major international medical journals—an open access journal that lets authors and readers share research for free. That's another asset we definitely don't want to hide.

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