The future

The recent Banerjee case at the GMC illustrates a number of important deficiencies in the way in which we handle possible cases of research misconduct in the UK. Firstly, it is evident that it is relatively simple to fabricate data and get it published in a reputable medical journal. In the majority of cases it will be virtually impossible for reviewers and editors to identify fraudulent material. Detection in this case, and in many others, will almost always depend on the willingness of a vigilant whistleblower to speak out. As stated previously, there is little in it for the whistleblower, particularly when their comments fall on "deaf ears" or they are threatened with professional extinction. Secondly, the case demonstrates the potential weakness of the internal enquiry. Although it is unclear as to the location of the final resting place of the King's Banerjee Report, it is alleged that its findings were not in Banerjee's favour.10 It then took almost a decade and the persistent efforts of an external whistleblower who had no conflicting interests to bring the case to the GMC. This cannot be regarded as a satisfactory state of affairs and will do nothing to reassure the public that the medical profession is still fit to self-regulate. The case also shows the importance of the role of the research supervisor as a custodian of research quality.When it was clear in 1991 that Banerjee's work was suspect, did he not withdraw his support and insist on an external review by the GMC?

This case, and indeed many others considered by COPE and probably others still in the GMC pipeline, convinces me that the procedures currently in place in the UK are inadequate to deal with many of the possible instances of research misconduct. COPE has campaigned for more than three years for an independent body to consider such cases.20 Although many universities and medical schools have written guidance as to how to pursue an internal review, I have concerns that a lack of independence may not be facilitatory for an otherwise reluctant whistleblower and provide appropriate protection when required. In October 1999 a consensus conference was held at the Royal College of Physicians in Edinburgh on Misconduct in Biomedical Research. The consensus panel recommended that a National Panel should be established that would develop and promote models of good practice for local implementation, provide assistance with the investigation of alleged research misconduct, and collect, collate, and publish information on the incidence of research misconduct. Although discussions have taken place and a report is said to be in preparation, no clear action has as yet become apparent to those of us on the outside.21 Even if such an advisory panel is established, will it really have the teeth to ensure that we do not have a rerun of the Banerjee case? I have my doubts. What COPE is proposing is not new. The USA, Nordic countries, and others have had external agencies in place to deal with alleged cases of research misconduct for almost 10 years;22 why is the UK lagging behind? One is reminded of the fact that it took 20 years longer to establish Research Ethics Committees in Britain than it did in the USA!

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