EDITORS of medical journals should agree to expose dubious or unethical research submitted to them for publication, according to a proposed code of conduct. Editors signing up to the code would be obliged to blow the whistle on all types of bad practice and misconduct that in the past might simply have led to papers being rejected.
Published by the Committee on Publication Ethics (COPE), which represents 178 mainly British medical journals, the code goes further than any other in obliging editors to blow the whistle. For instance, they would have to inform institutions where offending research was carried out, or funding bodies. 鈥淭here鈥檚 nothing quite equivalent to my knowledge,鈥� says Michael Callaham of the University of California at San Francisco, who chairs the ethics committee of the World Association of Medical Editors (WAME).
Publication of the code comes a week after The Lancet alleged that Andrew Wakefield, the main author of a report in 1998 linking autism to the MMR triple vaccine for measles, mumps and rubella, had failed to declare to it a possible conflict of interest prior to publication of his report. The new code would oblige editors to press authors hard to declare conflicts of interest.
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鈥淭he problem is not having conflicts of interest: it鈥檚 not declaring them,鈥� says Richard Smith, deputy director of COPE and editor of the British Medical Journal. He admits that editors can鈥檛 force authors to own up to competing interests, such as funding from companies. But the code would give editors stronger grounds to demand honesty, and would give them a shield to help rebuff pressure from advertisers or sponsors of research.
In its 2003 annual report, published last week, COPE catalogues cases of misconduct brought to its attention. The list includes instances of attempted bribery of editors and 鈥渁rm twisting鈥�; fabrication of evidence; plagiarism; and unethical research projects. In one study, babies were subjected to a painful procedure purely for research. In another, a patient with a life-threatening but easily treatable disease was offered complementary therapy, a 鈥済rave issue鈥� according to COPE.
It鈥檚 time for editors to stand up and be counted, Smith says. 鈥淒octors have been professionally accountable for years to bodies like the General Medical Council. Now the time has come to introduce accountability for medical editors.鈥�
Editors signing up to the code would agree to try to identify and expose any unethical research trials, and vet papers more closely to spot conflicts of interest. Failure to observe the code could see editors forced to run corrections, or even expelled from COPE.
Callaham says WAME is updating its own code of ethics for editors around the world, and may issue a joint statement with COPE.