Ethics in medical sciences research may not always translate into ethical publications. Ethical violations in conducting medical research always promote unethical scientific publications. Published research influences other researchers and establishes credibility for individual or journal.

2. IMPORTANCE OF ETHICS
“The collection of fundamental values, attitudes, and norms considered by most of
the population as essential for personal life, life with one another, and life in
relation to a society’s institutions.”
Ethical transgressions can be considered to be misconduct.

3. WHAT IS PUBLICATION?
It is the dissemination of your findings to the scientific community.
Scientific publications are subject to peer review.

4. SCIENTIFIC PUBLICATION IS A TEAM EFFORT
Publication
Journal
ReviewerAuthor

5. Ethics in medical sciences research may not always translate into ethical publications.
Ethical violations in conducting medical research always promote unethical scientific
publications.
The research misconduct that promotes unethical publication impacts badly on other
researchers who follow the steps shown in unethical scientific publications and resulting wrong
practices or applications on patients.
Scientific and research misconduct is defined—‘as any behavior by a researcher, whether
intentional or not, that fails to scrupulously respect high scientific and ethical standards’.

6. TYPES OF RESEARCH MISCONDUCT
Fabrication or falsification of data.
Plagiarism.
Problematic data presentation or analysis.
Failure to obtain ethical approval by the Research Ethics Committee or to obtain the
subject’s informed consent.
Inappropriate claims of authorship.
Duplicate publication.
Undisclosed conflict of interest (COI).

7. In the era of ‘publish or perish’ medical fraternity should not focus only on his/her career advancement
but also consider the professional ethics including research and publication ethics seriously.
E.g. Hwang’s revolutionary work on stem cells published in Science (2004 and 2005) and later found
that both the papers are fakes.
According to Fanelli,
Research misconduct should be redefined as ‘any omission or misrepresentation of the
information necessary and sufficient to evaluate the validity and significance of research, at
the level appropriate to the context in which the research is communicated’.

8. CONSEQUENCE OF RESEARCH MISCONDUCT
1. Society and humanity: Wrong procedures, false and fabricated data bring out products, which may be
considered unsafe for humanity.
2. Fellow researchers: Published data and knowledge derived from research misconduct in medical
sciences will mislead fellow medical researchers and that will lead to huge loss of money, funds, times
and reputations.
3. Medical practitioners and students: Medical practitioner also suffers a lot due to unethical research
publications as many wrong diagnostic and therapeutic published guidelines lead to professional
disaster for them.
4. Public trust and Government policies: It may destroy public trust on science. Such false information
and data may misguide government and lead to implement some erroneous health policies and laws.

9. WHY WE SHOULD BE CONCERNED
Influences research and clinical practice.
Patients put at risk by flawed research.
Retracted work goes on being cited.
Waste of resources, human and financial.
Damages public trust in research/science.

10. REASONS FOR MORE MISCONDUCT
AND UNETHICAL BEHAVIOUR?
Lack of knowledge about research and publication ethics.
Larger, multi-disciplinary and more global collaborations.
Increasing pressure on researchers to publish.
Financial inducements compromising integrity.

11. HOW COMMON IS MISCONDUCT ?
 Systematic Review and meta-analysis on fabrication and falsification of results (Fanelli 2009)
2% admitted to fabrication, falsification or manipulation of results – 14% reported witnessing this
behavior in a colleague.
67.4% of retractions due to misconduct (Fang et al. 2012)
Fraud 43.3%, duplicate publication 14.2%, plagiarism 9.8%.
Estimates on prevalence of plagiarism in submitted manuscripts vary
One Chinese journal found ‘unreasonable degrees of copying’ in 22.8% of submitted
manuscripts(Zhang2010).
Fanelli D. PLoS ONE. 2009 4(5):e5738 Fang F, Steen R, Casadevall A. PNAS. 2012 109:42 Zhang H. Learned Publishing. 2010 23:9-14

12. AIM
To discuss how medical publications might have abused various ethical norms not only while
conducting research but also during the publication process and possible preventive measures
against unethical practices of research and publications.

13. Graf et al said that academic publishing depends mainly on ‘trust’.
‘Scientists are generally perceived as well‐intentioned seekers of truth; universities, as cathedrals of
learning and as producers of knowledge vital to the health and welfare of society’.
World Association of Medical Editors (WAME), International Committee of Medical Journal Editors
(ICMJE) and Committee on Publication Ethics (COPE) are the guiding force to interpret ethical
publication appropriately.
Graf C, Wager E, Bowman A, Fiack S, Scott‐Lichter D, Robinson A. Best practice guidelines on publication ethics: a publisher’s perspective. Int J Clin Pract. 2007;61(Suppl. 152):1–26.
La Follette, MC. The evolution of the “Scientific Misconduct” issue: an historical overview. Proc Soc Exp Biol Med. 2000;224:211–215.

14. WHY DO PUBLICATION ETHICS
MATTER?
Published research influences other researchers and establishes credibility for individual or
journal.
Honest scientific reports build trust among peers and within scientific community.

15. Sr.
No.
sin Examples Punishments
1. Carelessness Citation bias, understatement, negligence Request for correction, letter to editor.
2. Redundant publication Same tables or literature review reported without
noting prior source
Rejection of manuscript. Copyright infringement
3. Unfair authorship Failure to include eligible authors, Honorary authors Angry colleagues, complaints to editor or employer
4. Undeclared Conflict of
Interest
Failure to cite funding source Notification in the journal, possibly retraction of the
article, mistrust among colleagues
5. Human/animal subjects
violations
No approval from Review Board or Ethics
Committee
Ethical review a necessary requirement for all
scientific research
6. Plagiarism Reproducing others’ work or ideas without as one’s
own
Retraction of manuscript & notification of employer
7. Other Fraud Fabrication of falsification of data, Misappropriation
of others ideas or plans given in confidence
Retraction of manuscript, notification of employer
& publication ban

16. NEGLIGENT CARELESSNESS AND
CITATION BIAS
A failure to adequately review the literature on a topic.
Lack of candor or completeness in describing one's research methods.
Presentation of data that are based on faulty statistical analyses.
Citation of articles without having read the primary sources.
Selective citation of only those articles that support a particular point of view .
Selective citation to enhance one's reputation, epitomized by self-citation.

17. PREVENTING CARELESSNESS
AND CITATION BIAS
Read what you cite.
Cite critically.
Minimize self-citation.
Avoid other selection biases (e.g., language or cultural preferences).

18. PLAGIARISM
Plagiarism is defined as ‘to copy ideas and passages of text from someone else's work and use them as
if they were one's own’.
The word plagiarism may further extended to unreferenced use of the ideas of others submitted as a
‘new’ paper by a different author!
The most vulnerable part for plagiarism in any research publication is ‘methods’.
Another form of plagiarism is self‐plagiarism where author copy and paste from his/her previous
publications including results, tables and figures without providing copyright clearance certificate from
publishers.

20. TYPES OF PLAGIARISM SOURCES NOT CITED
"The Photocopy":
The writer copies significant portions of text straight from a single source, without alteration.
"The Potluck Paper":
The writer tries to disguise plagiarism by copying from several different sources, tweaking the sentences to
make them fit together while retaining most of the original phrasing. Also known as "patch writing."
"The Poor Disguise":
Although the writer has retained the essential content of the source, he or she has altered the paper’s
appearance slightly by changing key words and phrases.

21. "The Labor of Laziness":
The writer takes the time to paraphrase most of the paper from other sources and make it all fit together,
instead of spending the same effort on original work.
"The Self-Stealer":
The writer "borrows" generously or "recycles" from his or her previous work, violating policies concerning the
expectation of originality adopted by most academic institutions.
"The Forgotten Footnote":
The writer mentions an author’s name for a source, but neglects to include specific information on the location
of the material referenced. This often masks other forms of plagiarism by obscuring source locations.

22. "The Misinformer":
The writer provides inaccurate information regarding the sources, making it impossible to find them.
"The Too-Perfect Paraphrase":
The writer properly cites a source, but neglects to put in quotation marks text that has been copied word-for-
word, or close to it. Although attributing the basic ideas to the source, the writer is falsely claiming original
presentation and interpretation of the information.

23. "The Perfect Crime":
Well, we all know the perfect crime doesn’t exist. In this case, the writer properly quotes and cites sources in
some places, but goes on to paraphrase other arguments from those sources without citation. This way, the
writer tries to pass off the paraphrased material as his or her own analysis of the cited material.
"The Resourceful Citer":
The writer properly cites all sources, paraphrasing and using quotations appropriately. The catch? The paper
contains almost no original work! It is sometimes difficult to spot this form of plagiarism because it looks like
any other well-researched document.

24. HOW TO AVOID PLAGIARISM
The best way to avoid plagiarism is to cite other's work always in the research
articles, put the cited words in quotation marks
Seek permission from appropriate authorities for references to cite tables, figures,
etc.
Methods and literature reviews should be paraphrased.
Griffin GC. Don Don’t - 15-t plagiarize even yourself. Post Graduate Medicine 1991: 89:15 16

25. REDUNDANT PUBLICATIONS
Redundant or duplicate publication is another serious issue pertaining to ethical publications.
Many times, it happens without the knowledge of co‐authors or the group of researchers who
published it in previous journal.
More damaging of all kind of misconducts
It is called “wasteful publication”.
It is damaging because of its economic implications for publishers, readers, libraries, and indexes.
It can also affect the results of meta-analyses.

26. `
Major redundancy is always considered with evidence of deliberate duplication such as
changes of title and data sheet with identical findings.
Minor redundancy is something ‘salami publication’ types with looks of extended follow‐up of
previously published article.
It may be, editor must contact corresponding author and ask explanation, if satisfied, do not
take any action.

27. AUTHORSHIP DISPUTES AND ETHICAL
MISCONDUCTS
International Committee of Medical Journal Editors (ICMJE) guidelines states authors
Anyone who has made a substantial contribution to the conception
Design or acquisition of data or analysis and interpretation of data
Drafting or revising the article for intellectual contents
Participated in the final approval of the version to be published
Disputes: ‘Question of interpretation’ like whether
Contribution’ by the authors was substantial?
Whether authorship criteria were discussed when research was planned ?
It was decided before submission of manuscript?

28. ICMJE EXCLUDE FROM AUTHORSHIP
Someone who just:
Is the departmental/Institutional chair.
Acquired funding.
Provided general supervision.
Collected data.
Provided purely technical support.
Provided writing assistance.
-Acknowledgement

29. Misconduct: Authorship is unethical like ‘gift’ or ‘ghost’ authorship.
Gift authorship: When research or administrative hierarchy comes in to the picture or because of a
colleague with whom we have a personal relationship like son/daughter or husband/wife/relatives.
Senior researchers or administrative boss who have substantial contribution on the subject at
 Any point like writing manuscript.
Editing manuscript.
Reviewing manuscript.
Providing additional knowledge with high intellectual input on writing science are not considered as ‘gifted’.

30. Ghost authors are the researchers who writes the research article without acknowledgement.
This is very common for many cases where researcher drafts an article at the behest of
pharmaceutical company.
The real author's name never comes in domain of publication.
Problem of the ghost author is that whatever they write may not always be correct
interpretation and may be biased; hence, it badly affects the researcher community.

31. To tackle this publication misconduct COPE, ICMJE given certain guidelines:
Journals must have clear authorship criteria.
Authors should disclose all contributors, regardless of author status and their specific individual contributions
and affiliations.
Authors must sign about their contributions details.
Authors should disclose any of his/her conflict of interest and a statement whether they have received any
support from medical writers.

32. Various studies in this regard showed the nature and execution of such unethical practices among
medical professional.
Works of Dhingra and Mishra revealed that majority of respondent on questionnaires confirm
publication misconduct especially authorship disputes among Indian biomedical researchers.
Study of Das et al. they have found that around 81.4% respondents from medical faculty members
confessed authorship disputes in any form among themselves.
About 81.4% of medical and 29.26% of pharmacy faculty members also mentioned in questionnaires
that senior research colleagues interfered while writing manuscript to include their names in the
drafted manuscripts.

33. CONFLICT OF INTEREST
May be financial or others like personal interest like employment interest, promotion or career
advancement interest, patents, personal believes, grant providing, relationship, academic competition
or intellectual passion.
It has been reported in a study on five leading medical journals like Annals of Internal Medicine, BMJ,
Lancet, JAMA, New England Journal of Medicine that only 52 of total 3642 articles disclosed their
potential COI, that is only 1.4% of total.
A study conducted by Das et al. on awareness of COI among medical scientists/researchers from India
showed that only 12% authors understand COI issues correctly and 19 % of medical authors just heard
about it.

34. Each author should declare to the editor any interests that could constitute a real, potential or
apparent conflict of interest with respect to his/her involvement in the publication, between
1. Commercial entities and the participant personally.
2. Commercial entities and the administrative unit with which the participant has an
employment relationship.
Sources of funding for the study, review, or other item should be declared in the final
publication.

35. FABRICATION AND FALSIFICATION OF DATA
Fabrication means cooking up data or results (fictitious by nature) as per the hypothesis of research and publishes
it in a journal whereas falsification is simply manipulating data or result.
Fabrication also covers selective reporting authors just report a small number of significant values of the study but
hide large number of insignificant observations.
A meta‐analysis by Fanelli reported that around 2% of studied medical scientists confessed that they had
fabricated or falsified research data.
Dr. Vijay Soman of Yale University was found an offender on publication ethics because of fabrication and
falsification of data from his colleague.
Malcolm Pearce who was an Assistant Editor of British Journal of Obstetrics and Gynaecology was found to be a
publication ethics defaulter.

36. BEST PRACTICES
One of the most important things to promote ethical publication is to encourage research integrity
among medical researchers.
COPE advocated for a research integrity officer in each of the research institution to monitor and guide
various issues pertaining to research ethics including publication ethics.
Research Institutionsbear the primary responsibility for promoting a culture of good scientific conduct
among researchers and students and for the prevention, investigation and punishment of scientific
misconduct in their midst.

37. PUBLISHERS, EDITORS AND PEER REVIEWERS
Editors ensures that reviewer is adequately qualified and can keep confidentiality and also protects the
whistle blower in case of reports on publication misconduct.
Journal editors must provide a link to WAME or COPE or ICMJE for authors, readers or reviewers to get
first‐hand information on ethics in publication.
Ethical publication also includes timely peer reviewing and publication of the manuscript which is the
responsibility of editor and publisher.
Editors is to remain cultural and gender sensitive on any article.

38. PREVENTION
Institution must have clear and transparent functioning on not only ethical research policy but also on
ethical publications.
A Strong peer‐reviewing system.
Uses of latest technological support.
Strong publication ethics policies.
Active monitoring, protection of whistle blowers.
Cooperation between journals and research institutions or universities possibly prevent publication
misconduct effectively.

39. IN A SUMMARY
Better education on publication guidelines and ethics.
Introduction of registers for planned and ongoing clinical trials.
Change criteria from quantity to quality when papers are used for assessment of posts or grants.
Punish the culprits but be careful that innocent is not victimized.

40. GENERAL ETHICAL PRINCIPLES
Respect /Autonomy for persons Individuals should be treated as autonomous agents
Persons with diminished autonomy are entitled to
protection (Vulnerable population)
Meaningful informed and voluntary consent.
Beneficence Maximizing benefits by promoting the well-being of
subjects and society.
Justice Persons bearing burden of research should receive
appropriate benefits: subjects should not be placed
at risk merely because of convenient access, their
compromised position, or ability to be manipulated.
Non-maleficence Minimizing harm / No harm to the participant.

41. HAPPY TEACHERS DAY