Although the formation of the Danish committee was done in the anticipation of some future instance, most countries have examined the problem in response to a particularly egregious case. In Britain, as I have stated, the feeling among the medical Prominenten was that research fraud was a squalid affair confined to poorly qualified and practising general practitioners, and hence could be dealt with through the disciplinary machinery of the General Medical Council. Thus, even though an early case in Britain did concern a consultant, any suggestion that this showed that fraud existed in hospital or academic practice could still be dismissed because the malefactor was an overseas-qualified psychiatrist whose motivation had been greed (see Chapter 5 for a discussion of Dr Siddiqui). It took another, and more high profile case before it became obvious that in Britain, just as elsewhere, fraud also affected research in hospitals and laboratories.
In 1995 Malcolm Pearce, a British gynaecologist, was removed from the Medical Register for fraud: he had published two papers in the British Journal of Obstetrics and Gynaecology describing work that had never taken place. In the first paper Pearce claimed that he had successfully relocated a 5-week-old ectopic embryo via the cervix; he had two co-authors, including the editor of the journal, who was also the then president of the Royal College of Obstetricians and Gynaecologists and Pearce's boss at St George's Hospital Medical School in London. The second fraudulent claim was of a complex trial in 191 women with the rare syndrome of polycystic ovary disease and recurrent abortion. After a meticulous inquiry, conducted by a knowledgeable and determined dean of the medical school on the lines recommended in the Royal College of Physicians report, Pearce was dismissed from his post and reported to the GMC, while both articles were retracted, as were subsequently several others at the request of the special investigative committee.
By now, even if some of the features of the Pearce case were new to those in Britain, regrettably it illustrated yet again some of the lessons learnt elsewhere. As well as the demonstration that academics could commit research fraud, there was also the question of gift authorship in both papers - and, again, a personal tragedy, this time for an eminent and much-liked jovial professor of obstetrics. From the journalological aspect, the editorial processes at the journal were slapdash. The case report had not been peer reviewed by an external assessor, whilst in the second paper the credulity of the referee and of the editors in accepting Pearce's claims in a condition of such rarity (which he repeated when they checked with him) was extraordinary.
Subsequently two further cases of consultants from teaching hospitals, who were also struck off the Medical Register by the GMC, confirmed that Pearce's story was by no means unique: John Anderton, an Edinburgh physician and some time registrar of the Royal College of Physicians of Edinburgh, had faked some results in a drug trial (see Chapter 5),27 as had Robert Davies, professor of respiratory medicine at St Bartholomew's Hospital, London.28 All this led to three editors voicing their concerns (for example, an editorial in the Lancet29) and the formation of COPE, discussed by my fellow-editor, Michael Farthing, later in this book. Yet another committee was set up at the time of the Edinburgh conference, and at the time of writing it still has to report. (Ironically, also, as I was completing this chapter, the BMJ and the Lancet had a further editorial from these editors, commenting yet again on the failure of the British medical Establishment to do anything in the 13 months that had elapsed since the Edinburgh meeting).30 However, to anybody aware of how the Establishment fails to do what it doesn't want to - seen also, for instance, with the failure of the GMC to protect the public by efficient self-regulation of professional standards - the omens for a really worthwhile outcome (an efficient system, with teeth) are not, I think, very positive. I have instanced the way in which this country failed to ensure that proper ethical standards were applied in research involving patients and volunteers. Indeed, for any ancien régime (including France and Germany, where I suspect that the future is also going to be dolce far niente) confronted with a paradigm shift, the response is to smile gently and go on in the smug old ways. Not for nothing was it a physician, Wilfred Trotter, who stated that: "The most powerful antigen known to man is a new idea."
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