Investigators, research students, authors, peer-reviewers, and journal editors must operate within an ethical framework that is transparent and has principles that are understood and accepted by all players in the biomedical research community. Publication ethics is a broad term embracing the many processes involved in the conduct of research and its publication.4 The spectrum ranges from the most serious types of research fraud to the criteria required for authorship and the failure to declare conflicts of interest in research publications. Editors in addition must be concerned with ethical issues associated with the reviewing process and the legitimacy of product advertising in their journals. For the author and editor, publication ethics can be considered under two major categories, research integrity and publication integrity.
This must be uppermost in the investigator's mind during the conception, design, and execution of a research study. It is a multistep process and ethical considerations occur throughout. At the initiation of the research process there should be a protocol that has been reviewed and approved by all
Box 18.1 Research misconduct
• Errors of judgment
• Inadequate study design
• Inappropriate statistical analysis
• Misdemeanours ("trimming and cooking")
• Data manipulation
• Data exclusion
• Suppression of inconvenient facts
• Plagiarism contributors and collaborators. Research integrity therefore covers study design, collection and collation of results, data analysis and presentation. Failure to ensure integrity in any of these components can amount to research misconduct. However, this will form a continuum ranging from errors of judgment (that is, mistakes made in good faith) to what have been regarded as minor misdemeanours, so called "trimming and cooking", through to blatant fraud, usually categorised as fabrication, falsification, and plagiarism (Box 18.1).
This begins with the writing of the paper. Common examples of failure to meet acceptable standards include inappropriate or "gift" authorship, redundant (or duplicate) publication when all or a substantial part of the work has been published previously, and plagiarism in which text is "lifted" directly from another publication. Full declaration of any conflicts of interest is vital to encourage authors to ensure balance in their discussion and conclusions, and to facilitate peer review. Conflicts include direct or indirect financial support from the study, consultancy agreement with a study sponsor, the holding of any patents relating to the study, and any other mechanisms by which financial benefit might accrue as a result of publication of the study. Authors should declare all such associations, and it is the responsibility of editors to ensure that these are clearly detailed in any publication. The tendency to attempt to identify "the minimal publishable unit" sometimes referred to as "salami-slicing" should be discouraged.
Editors have other ethical concerns particularly about the quality of peer review and conflicts of interest that might arise in the review process. It is essential that editors reinforce to peer-reviewers the need to observe the rules of confidentiality; in many respects the relationship between an editor (and the reviewer) and an author is similar to the doctor-patient relationship. Additional concerns relate to sponsored supplements to the journal and the influence that advertising by the biomedical industry and others might have on journal content.
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