As is clear by now, each country reacted in its own particular way (echoing Tolstoy's opening phrase in Anna Karenina: "Each unhappy family is unhappy after its own fashion"). Once galvanised, the USA, where Congress became heavily involved with John Dingell as an incisive and aggressive chairman, set up a body for looking into accusations of fraud in research sponsored by the National Institutes of Health. It soon altered the direction of this when the founding organisation, the Office of Scientific Integrity (based on dialogue among peers), was shown to have failed, particularly by its denial of fairness ("due process") to the accused and whistleblower. Since its creation in June 1992, its successor, the Office of Research Integrity, is generally acknowledged to have worked well. It has published regular reports and has set up task forces to look into individual problems, including the definition of misconduct and problems encountered by whistleblowers. To be sure, it has had problems, and in two major instances those implicated were eventually exonerated, but most people agree that this merely reflects problems inherent in any legal process and is no reason for abandoning the policing of a probably small but important element in scientific deviance - certainly major cases continue to be reported from major centres with all the familiar features.
Other countries where the problem seems to have been addressed head-on are the Nordic bloc, where each nation has established a central committee working in a slightly different way. All these responses are detailed in the individual chapters in this book. Conversely, the anciens regimes - Britain, France, and Germany - have been much slower to tackle the problem. One common theme behind this seemed to be a feeling by the grandees that science does not wash its dirty linen in public: that such matters are best ignored or discussed privately and any conclusions brushed under the carpet. Thus in the first edition of this book (1993), two French commentators wrote: "As identification of fraud is not organised in France, and known cases remain confidential, no mechanism for dealing with it exists ... Mechanisms for dealing with fraud at the publication stage do not exist. Papers disclosing misconduct on fraud such as those published by French or American journals, seem unlikely to be published in France in the next decade."22 In the second edition (1996) Stegemann-Boehl commented: "Before the introduction of specific misconduct provisions can be discussed in Germany, it must be generally accepted that misconduct in science is more than a sign of decadence in the New World, and that the prevailing strategy of muddling through must give way also in Germany to a discussion of the problem within the scientific community as well as by the public ... Very likely, the prestige of science will suffer more as a result of accidentally discovered scandals than as a result of a discussion which makes it clear that the problem has been recognised."23
An exception to the behaviour of the anciens regimes might seem to have been Britain, where, spurred by two of the editors of this book (Stephen Lock and Frank Wells), the Royal College of Physicians set up a committee in 1990, producing a report in the following year.24 This leant heavily on earlier documents, in particular that produced by Harvard Medical School (substantive and later document),25 reproducing both its guidelines and the statement on authorship by the International Committee of Medical Journal Editors as appendices, and recommending that all authorities should adopt a twofold approach: promoting high standards of research and developing a mechanism for the management of complaints of research fraud - publicising the name of the screener and setting up the threefold process of receipt, inquiry, and investigation.
There, however, matters stopped. The committee's suggestion that a central organisation, such as one of the Nordic central bodies or the US Office of Scientific Integrity, should be set up was dropped. Unusually the Royal College held no press conference to launch the report, as it does for virtually all of its reports. A few years later, when I asked the registrar to question the postgraduate deans about their experiences of implementing the report, virtually none of them knew that the report had charged them with this responsibility, and very few had even heard of the report. The whole situation was indeed very similar to an earlier episode where the British Establishment had shortchanged society by failing to admit that there had been lax standards in the ethics of some medical research procedures. Only the persistence of an outsider, Maurice Pappworth (who documented some egregiously unethical research), had resulted in belated action being taken to recommend the establishment of research ethics committees (and even today these are still not a statutory requirement).26 Nevertheless, as this new edition also shows, belatedly the anciens régimes have begun to take some action, even if this has still only been halfhearted and mostly talk. In each instance, action has arisen from a pivotal case, and here I will stray past my self-imposed limits to describe the case that at least led to the first conference on the subject in Britain, at Edinburgh in 1999 (well after two meetings had been held in Warsaw and one in Beijing, let alone many other nations).
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