Scientific misconduct and unethical practices in anaesthesiology: Stumbling blocks to quality research and publications

The celebrations heralding modern anaesthesia were clouded in controversy when a serious legal fight broke out among Sir WTG Morton, Crawford Long and Horace Wells, each claiming credit for the invention of ether. Credit was ultimately bestowed on Morton, even though he died in financial penury. He would have bowed his head in shame, with the modern anaesthesia research and publications being beset with allegations of scientific misconduct and unethical practices. The growth of the speciality has been based on innovations and sound scientific evidences but is increasingly marred by allegations of falsification, fabrication, plagiarism, and ‘fraud’. It is high time that this issue is tackled in a stern and swift manner lest it is too late, and the quality of patient care is impinged upon.

The word ‘ethics’ is derived from the Greek word ‘ethikos’ meaning a system of right conduct and the word ‘plagiarism’, from ‘plagiare’ meaning ‘to kidnap’ in Latin.[1] Plagiarism has been the bane of publications for long and needless to say, it creates doubts on the authenticity of the research itself. Sub-average knowledge of the research methodology and publication guidelines have contributed to some extent, but deliberate misconduct is frequent; motives related to career enhancement and pecuniary gains form a sizable proportion. The Medical Council of India has made publications mandatory for promotions of teaching faculty, and this has created a ‘Publish or Perish’ situation for some of them.

Copying of text from someone else's work and claiming it to be one's own, copying ideas and concepts without citing the reference of original authors and similar other acts of academic dishonesty constitutes plagiarism. Plagiarised content may be checked using software available to editors and reviewers, but they are not completely fool proof and fail to pick up some of the plagiarised content. The most authentic and efficient plagiarism checking tools are beyond the financial capacity of many journals and is a constraint for reviewers and editors.[2,3]

To claim oneself to be an author, as per the criteria fixed by the International Committee of Medical Journal Editors, there must be substantial contribution towards conception or design of the work, or the acquisition, interpretation of the data, etc.[4] On numerous occasions, names are entered by virtue of being seniors, by request, by pressure/coercion or simply because of friendship. The chief responsibility for such misconduct lies with the principal author.

In this issue of IJA, authors have tried to convey the various forms of scientific misconducts, authorship criteria, and conflicts prevalent in medical field through a special article. They have also suggested some concrete measures to curb these menaces by formulating appropriate policies.[5] In an upcoming publication in this journal, authors, in a survey, evaluate the various forms of challenges faced by the current generation of authors and faculty members while writing for anaesthesiology journals in India. They have suggested more stress to be laid on evidence-based formulation of journal policies so as to minimise professional misconducts, plagiarism, and conflicts.

The editorial board also faces bitter challenges from authors requesting special and rapid attention. Continuously pressurising the editor by any means of communication, conveying inappropriate remarks on rejection of the article, not adhering strictly to the revision comments sent by the editor, exerting external pressures on editor from influential persons and criticising the functioning of the journal without a deep understanding also constitutes gross misconduct on the part of the authors.

Submission of same manuscript simultaneously to multiple journals despite clear instructions and despite author self-declaration is attempted by some authors to enhance chances of acceptance or chances of early acceptance; this also amounts to misconduct.[6,7] The reviewers and the editorial group are subjected to additional workload and that too for substandard submissions. Redundant publication that is a reproduction of a part or whole of the previously published manuscript or reproduction of same data in more than one manuscript (‘salami slicing’) also amounts to a serious professional misconduct. This constitutes a violation of copyright law and such publications make the findings of the meta-analysis inappropriate and are detrimental to the scientific dignity and reputation of the journal.[6,7] The withdrawal of unpublished manuscript or retraction of the published article may provide some comfort for the respective editors, but repeated activities by other authors may create distrust among authors, editors and the reviewer.

The limited access to full-text PubMed indexed articles in resource challenged nations like India is one of the major reasons that such manuscripts go undetected under the scrutinising eyes of the reviewers and editors during the review stage. However, misconduct is not just prevalent in the developing nations but is equally prevalent throughout the globe.[8] Unfortunately, the evidences and results of such publications may actually find acceptance in guidelines and practice with potential for harm to patients.[9]

The Committee on Publication Ethics (COPE) has laid down a code of conduct for scientific research and publication ethics for authors, reviewers, editors, editorial board members, administrators, and members of the scientific committees.[10] The reviewers and editors have great responsibility to ensure that injustice is not done to the authors who submit their genuine work with years of hard work with high expectations.[9]

Statistical analysis is one of the common areas where maximum errors are committed and fabricated results are presented. Lack of awareness and knowledge can lead to the application of inappropriate techniques and tests and sometimes done deliberately so as to enhance the significance of their study. Such falsified data are difficult to detect even during the peer review stage as most of the reviewers and editors are not well versed in the science of biostatistics. Responsibility also lies with teaching faculty to impart scientific knowledge to the post-graduates during their training. Unfortunately, many lack this knowledge themselves.

It is imperative on the part of the editorial board to deal with various types of violations of COPE guidelines.[10] Not doing so can amount to professional misconduct by the board. Rejecting the manuscript, censuring the author, informing the misconduct to institutional authorities, and retracting the article if already published are some of the countermeasures to be adopted by the journal. Details of the violations should also be conveyed to other journals of similar interest and speciality.

The biggest drawback in the scientific world is that, for an identical offence, the disciplinary action is not uniform among different journals/countries.[3] It is high time that journals in India take proactive measures and follow the lead established by some of the popular journals such as ‘Anesthesia and analgesia’. Issues related to plagiarism have made headlines in Indian newspapers but without any exemplary action or punishment from the journals. In current circumstances, it behoves us in the editorial board of IJA to strive hard to make its scientific content free of any plagiarised and redundant text with suitable education and guidance to authors, not just punishment. The endeavour is to facilitate quality research and publications in anaesthesiology and improve the journal's global ranking.