Commentary on the Code of Medical Ethics and Deontology

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Chapter X: Professional publications

A chapter of the Code regulating the ethics of medical publications is required today for a number of reasons. Firstly, and in contrast to what happened in the past, because it is nowadays very easy for physicians to publish on aspects of the science of medicine or the practice of their profession. Scientific journals and journals of information and professional opinion are now very numerous. And they publish a wide variety of different types of writings: works of research, reviews, editorial or opinion articles, letters to director, interviews or simple news items.

Secondly, because a physician's publications play a decisive role in his or her degree program: they are one of the essential elements by which personal merit is measured with a view to promotion on the academic or professional ladder. The conduct of a member who bases his or her prestige on fraudulent or plagiaristic publications is unethical and should be punished. By asserting his or her false merits, he or she may cause serious and unfair prejudice to other honest colleagues who do not resort to such mischief to enrich their curriculum vitae staff.

Thirdly, because professional publications play a decisive role in the doctor's permanent Education and contribute to creating what could be called the "public opinion" of medicine at any given time. They therefore influence what doctors think about scientific subject , about health policy or about how the profession should be practised. Since there is a real risk that falsified scientific articles or libellous opinion pieces may be published that could mislead the good faith of readers or taint the scientific or professional environment, the WTO is obliged to set standards in this area and to discipline the authors of fraudulent or offensive publications.

article 38.1. It is the duty of physicians to communicate as a matter of priority to the professional press the discoveries they have made or the conclusions derived from their scientific work programs of study . Before disclosing them to the non-medical public, he/she must submit them to the judgement of his/her peers, following the appropriate channels.

The text of this article is an almost verbatim transcription of article 31 of the Principles of European Medical Ethics. The obligation to inform colleagues before the public is easy to understand. Medical developments, especially those involving new treatments, could cause a disproportionate echo among patients and their families if what is only a modest or not yet consolidated result were presented to the public as a sensational breakthrough. Many people, anxiously waiting for a remedy to be found for the diseases they or their relatives suffer from, would then go to their doctor and ask him or her to apply the new treatment. If the doctor lacks the necessary scientific information, because the professional press has not yet published either the original article or a critical assessment of its merits, he is in a hurry status to admit his ignorance of the topic and will have to refrain from giving advice on the subject.

The appropriate channels, as referred to in article, can be considered to be those that allow for sufficient peer review assessment . Firstly, publication in a journal that requires, prior to acceptance for publication, peer review of the manuscript by competent colleagues. And secondly, the same critical assessment after publication, either in writing (letters to publisher, of review articles) or through open discussions in scientific associations.

article 38.2. When publishing a work of research clinical , authors shall state that their protocol has been supervised and C by an ethics committee .

It is not possible to design one hundred percent safe rules that, while respecting the freedom of researcher, prevent different modes of unethical conduct in the conduct and publication of scientific work. Only the honesty of the authors can achieve this. This article establishes a measure that can eliminate certain ethical and scientific risks of what is published. agreement In the budget that the author has acted in accordance with the Declaration of Helsinki of the World Medical association (i.e. that no biomedical research should be undertaken without the authorisation and supervision of an ethics committee ), the article imposes the obligation that this must be stated in the published article .

This measure, which has been included in the requirements for accepting articles for publication by the committee International Association of Biomedical Journal Editors, can have a very favourable effect on the development ethics of biomedical research and, more specifically, on the ethics of Institutional Ethics Committees in hospitals.

article 38.3. In subject of scientific publications, the following misconduct constitutes deontological misconduct: 1. prematurely or sensationally publicising or exaggerating procedures whose effectiveness has not yet been determined; 2. giving opinions on matters in which one is not competent; 3. falsifying or inventing data; 4. plagiarising what has been published by other authors; 5. including as an author someone who has not substantially contributed to design and carrying out the work, and repeatedly publishing the same findings.

This article sets out a list of infringements at subject of academic publication. Some may seem excusable, but they must always be judged severely. Science is constructed as an honest effort to discern truth. Among the cultivators of science there is a confident attitude, whereby all are accorded a credit of truthfulness. Error is admitted as inevitable, and no one judges another pejoratively for being unintentionally mistaken. But academic community abhors dishonesty: manipulating data, exaggerating certain results and maliciously concealing others, falsifying or fabricating evidence, are scientific crimes and those who commit them are shunned as those who have betrayed science.

1. It applies here what has already been pointed out when commenting on article 38.1 a purpose on the priority of publication in the professional press: that it is unethical to present to the public, and even less so in a sensationalist manner, new procedures whose efficacy has not yet been demonstrated or confirmed, as this may raise expectations of cure or relief among many patients. It is not easy to make them believe that their good faith has been deceived and that they have been the victims of presumption or of some colleagues' light-heartedness, if not of their clumsy desire for profit. This results in a loss of credibility for the medical profession.

2. The validation of data and medical practices takes place through the joint action of two streams: factual information and its assessment, its scientific discussion. The latter is not only done by the authors of the article of research, but also by other competent members of the academic community, using new research to confirm or refute such data and interpretations, or by criticisms appearing in letters to publisher or in editorial articles. It is obvious that only a true expert on topic can participate with moral authority in such a assessment. Commenting on matters in which one is not competent can cause serious damage, or give an unjustified credit , to the reputation of other colleagues.

3. This article also warns against certain errors and temptations into which doctors who publish may fall. One is that of inventing results or distorting data, or fabricating entire articles, in order to give plausibility to a hypothesis staff, to lend elegance to its demonstration, or to inflate the list of publications. This is a serious offence, as the author contaminates scientific information with more or less disguised falsehoods, misleads researchers in good faith, and sets a trap for the judges of merit competitions.

4. The same temptation of false prestige leads some, eager to add to the list of their publications, to plagiarise more or less extensive parts of articles published by others, or even to copy and publish, with slight modifications, entire articles already published by others. They assume that, since many articles are hardly read by anyone and given the gigantic issue of articles published in an unmanageable issue of scientific journals, it is highly unlikely that anyone will notice their crime, so their behaviour will most likely go unpunished. They do not realise that, sooner or later, the forgery will be discovered and their credit staff will be irreparably damaged. Plagiarism is, in addition to a deontological infringement, a crime against intellectual property, in accordance with the provisions of Organic Law 6/1987, which introduced new articles 534 bis, a), b) and c) and 534 ter into the Criminal Code.

5. Lastly, it is considered deontological misconduct to include as an author anyone who has not substantially contributed to the design and implementation of the work and the repeated publication of the same findings. No one is entitled to be listed as co-author of a work if they have not participated in the design of the article, or in the realisation and essay of any of its parts, so that, without their contribution, the article could not have been published in its current form. Author slots may not be given away to pay for other services or to reward the group ruler. Nor can alliances be formed between authors to offer each other co-authorship of the papers they prepare: they all sign articles written by any member of group, thus ensuring that each author's publication list grows in proportion to the productivity of the whole. The internship of repeated publication or self-plagiarism is committed by the author who, without indicating it specifically, republishes previously published articles, disguising them under different titles and after introducing minor cosmetic changes to the text, figures or the bibliography cited, to give the impression that they are new works.