Water used to be free. More than two-thirds of the planet is covered
with water. Yet, American consumers (particularly) pay more for a bottle
of water than they do for a soda, a bottle of juice, or even a beer (and
yet all of these products are 90 % or more water in the first place). Cars
cost more nowadays than a house did on twenty years ago. I remember going
to see Star Wars (1977) for only about $...
Water used to be free. More than two-thirds of the planet is covered
with water. Yet, American consumers (particularly) pay more for a bottle
of water than they do for a soda, a bottle of juice, or even a beer (and
yet all of these products are 90 % or more water in the first place). Cars
cost more nowadays than a house did on twenty years ago. I remember going
to see Star Wars (1977) for only about $2.50. Now it costs three hundred
percent more for the same seating space in the same, old theatre to see
the most recent installation of Star Wars. Turn of century homes in
Brooklyn, dilapidated and leaking, with old pipes, lead paint, improper
wiring, and wood rot, are selling for half a million dollars!
In America, it seems, everything is has its price and that price
increases annually. While unethical from a Judeo-Christian point of view
where we should help the less fortunate, the selling of organs for major
profit is well within the realm of expectations for a nation too bent on
money, wealth, and insta-win lotteries.
Professor Williamson makes a valid point about the term "research fraud" and I agree that the term covers a number of different categories of unethical behaviour. I also pointed out that "Research fraud can take many forms" in the discussion section of my paper. For the purposes of my article I stated that consultants who had answered "Yes" to questions 1,2 or 3 of table 1 had reported "observed misconduct" and...
Professor Williamson makes a valid point about the term "research fraud" and I agree that the term covers a number of different categories of unethical behaviour. I also pointed out that "Research fraud can take many forms" in the discussion section of my paper. For the purposes of my article I stated that consultants who had answered "Yes" to questions 1,2 or 3 of table 1 had reported "observed misconduct" and I stand by this conclusion. The dictionary on my bookshelf (Concise Oxford Dictionary (6th Ed.)) defines "misconduct" as "improper conduct, esp. adultery; bad management" and I think that what the consultants were reporting in the questionnaire fits this definition. The same dictionary includes in its definition of "fraud" the phrases " use of false representations to gain unjust advantage" and "person or thing not fulfilling expectation or description". The behaviour described in questions 1,2 and 3 (i.e. inappropriate authorship, omission of names of contributors who made a substantial contribution, and the intentional alteration of data for publication) fits this definition. In the article I tried to use the term "fraud" as a more general term than "misconduct" and I apologise if this caused confusion. However, I think that the majority of readers (and certainly the majority of my colleagues) would have had something approaching the above definitions in mind when they read the article (although several colleagues have told me to get a more up to date dictionary!). Whilst I acknowledge that Prof. Williamson makes a valid point, I do think there is a danger of any rational discussion becoming bogged down in semantics and I think that it is clear from my article what the initial data was and how I have derived my variables.
Prof. Williamson dismisses the medical consultants (not cleaners!) who answered yes to questions 1 and 2 as having "more often delusions of grandeur" on their part. That is a point of view - but I suspect the majority of respondents to my questionnaire do not share it. Indeed I think his attitude risks sweeping a very real problem under the carpet and, whilst I am aware of attempts to standardise authorship, I think this is a problem which requires further investigation.
I find the overall tone of this letter and phrases such as "into fairyland" and "give me a break" inflammatory and this, unfortunately, distracts from some valid points.
The main criticism of Prof. Williamson appears to be that he has learnt nothing new from my paper. The original idea for this study came after a lively discussion in a bar about the prevalence of research fraud (a subject of which I knew very little). After this discussion I did a literature search and could find only a few references to research fraud and misconduct. I decided to perform the study in an attempt to answer the questions I had. I wish that Prof. Williamson had been present at the original discussion - he could have saved me a lot of trouble! On a more serious note, I am sure that the Professor is aware that in the "hierarchy of evidence" questionnaire surveys rank higher than anecdotal evidence and personal experience (although only just!). The value of my article is that it adds evidence to a subject in which there is a marked paucity of hard facts.
I am sorry that Prof. Williamson was unimpressed with my paper. Unfortunately, the very nature of the subject of research fraud/misconduct mitigates against good quality research. I am sure that readers would welcome any double-blinded RCTs on the subject and, if the Professor wishes to carry out some research in this area I am sure that the scientific community would welcome it.
In this journal's recent symposium on disability Prof. John Harris
vigorously defended his general view on "disability" and "harm" before a
range of critics, including me. This letter is not offered as a rejoinder
to his argument but instead presents a brief clarification of a point he
obviously misinterpreted.
A part of my argument for the protection of persons of difference -
especially tho...
In this journal's recent symposium on disability Prof. John Harris
vigorously defended his general view on "disability" and "harm" before a
range of critics, including me. This letter is not offered as a rejoinder
to his argument but instead presents a brief clarification of a point he
obviously misinterpreted.
A part of my argument for the protection of persons of difference -
especially those who might be aborted because of genetic distinctions -
was that to eliminate a person who might develop a limitation later in
life (Motor Neuron disease, Huntington, etc.) "would be to deprive society
at large of people such as physicist Steven Hawking . . .." That is,
that elimination of a future person of difference on the basis of that
difference's presumed "harm" would be to deprive us all of important
members of society.
Professor Harris dismissed this as the "'aborting Beethoven' fallacy."
Choosing to terminate the birth of a fetus with inherited syphilis, he
argues, "is not to decide that the world would be better off without
Beethoven." While I am unconvinced that the "aborting Beethoven" argument
is a fallacy, that argument is tangential to the one I attempted to make
in my paper.
The point I sought to argue centered on the degree to which physical
or cognitive distinctions may contribute to the life quality and
achievements of individuals who are from birth or later become physically
distinguished. That is: physically distinguished conditions may be the
impetus to a rich life whose extraordinary and unique development results
in consequent achievements. "Harm" is balanced, and in some cases
outweighed, by resulting "benefit."
Stephen Hawking, for example, has written about the manner in which
his adaptation to Motor Neuron disease-a physically limiting condition-
focused his work and in many ways enriched his life. In a real way, his
life's work was enabled by his condition. As a US journalist with Motor
Neuron disease has said, a physically restricting condition may result in
a way of being whose physically enforced tempo requires a detailed and
focused perspective that is itself extraordinarily rich and rewarding.
For this reason a Canadian jurist with this disease called it a "life
enhancing condition," albeit one not freely chosen. A plethora of
examples detailing the manner in which differences resulting in
limitations acted as a catalyst for positive change, and often socially
important work, can be marshaled.
Some would argue that the emotional and financial cost of care to the
family members of persons who are or will be physically or cognitively
distinguished results in a secondary "harm." Opposed to this posture is a
literature on and by parents of children of difference. A parallel
literature reflects the view of caring adults maintaining adult relatives
who are physically or cognitively distinguished. In these cases the
experience is formative and in some cases positively
transforming.
This is a vastly different perspective, I believe, from the one
dismissed by Prof. Harris as a clear fallacy. It insists that assumptions
of "harm" resulting from "difference" must acknowledge the potential
benefits (to the individuals involved, their families, and society)
resulting from difference.
The issue of how we are to perceive those among us who are physically
or cognitively different is a hoary problem given new urgency by advances
in genetics and genetic engineering. Because the issues of difference are
important not only to those effected but to society-at-large, I offer this
correction to assure that my limits as a writer do not effect the greater
debate in which Professor Harris, others, and myself, are currently
engaged.
Tom Koch, Ph.D.
Simon Fraser University
Vancouver, BC.
Canada
References
(1) Equality and disability symposium, Journal of Medical Ethics
2001; 27:6.
(2) Harris, J. Equality and disability symposium: One principle and
three fallacies of disability studies, Journal of Medical Ethics 2001;
27:5, 383-387.
(3) Koch, T. Equality and disability symposium: Disability and difference:
balancing social and physical constructions, Journal of Medical Ethics
2001; 27:5, 370-76.
(4) Harris, Op. Cit Note 2, 385.
(5) Hawking, S. Black Holes and baby universes. NY: Bantum, 1993: 14;22-3;167.
(6) Graves FG. Writing for his life. American Journalism Review. March
1997, 25-31.
(7) Goldblatt D. A life-enhancing condition: The Honorable Mr. Justice
Sam N. Filer. Seminars in Neurology. 1993;13, 375-379.
(8) Koch, T. Life quality vs. the 'quality of life':" Assumptions
underlying prospective quality of life instruments in health care planning.
Social Science & Medicine 2000 (May); 51:3; 419-428.
(9) Nussbaum, M. Disabled Lives: Who Cares? New York Review of Books,
11 January 2001. Accessed online 14 Jan. 2001 http:// www.cybereditions.com/a1daily/
.
(10) Koch, T. A Place in Time: Care givers for their elderly. NY: Praeger
Books, 1993. Also see, Koch, T. Watersheds: Stories of crisis and renewal
in our everyday lives. Toronto: Key Porter Books, 1994, 1-12.
I was not impressed by Dr Geggie’s article offering a survey of the attitudes of newly appointed consultants towards research fraud (J. Med. Ethics 2001; 27:344-346). Indeed, by mixing up categories of misconduct from what is at most “bad behaviour” to the very serious, he is not entirely beyond reproach himself. I remind readers that Dr Geggie suggested that 55.7% of the respondents had observed (from the tit...
I was not impressed by Dr Geggie’s article offering a survey of the attitudes of newly appointed consultants towards research fraud (J. Med. Ethics 2001; 27:344-346). Indeed, by mixing up categories of misconduct from what is at most “bad behaviour” to the very serious, he is not entirely beyond reproach himself. I remind readers that Dr Geggie suggested that 55.7% of the respondents had observed (from the title) “research fraud”.
If the term “research fraud” is to have any meaning, it must be
reserved for conduct that consciously and deliberately attempts to impose
a fraud on others. The U.S. National Academy of Sciences report “On
Being a Scientist: Responsible Conduct in Research” distinguishes clearly
between “misallocation of credit, honest errors and errors caused through
negligence” and “deception, making up data or results, changing or
misreporting data or results, and plagiarism”. The former are “ethical
transgressions … that generally remain internal to the scientific
community .. dealt with locally through peer review, administrative
action and the system of appointments and evaluations”. The latter
“strike at the heart of the values on which science is based”. The White
House’s Office of Science and Technology Policy reached similar
conclusions, restricting research misconduct to “fabrication,
falsification and plagarism”. I agree with these assessments.
In Dr Geggie’s paper, deception would include deliberate falsification of
data (category 3 of Dr Geggie’s table 1), cheating (4A) and deliberately
plagiarising without attribution (4D). We then move into fairyland,
because Dr Geggie next asks “have you ever been an author on a paper for
which any of the authors have not made a sufficient contribution to
warrant credit for the work” or “has your name ever been omitted from a
paper for which you had made a substantial contribution”, and, surprise,
surprise, over half answered yes. These are examples of, at worst,
ethical transgressions (but more often examples of delusions of grandeur
on the part of the offended) but are not research fraud.
Those of us who run large research groups know from experience that
authorship of any paper poses problems. I have never met anyone, from
the cleaner to the director, who undervalued his/her own contribution to
the work! The issue arises with such consistency that many labs
(including my own) have long documents on how to resolve the problem of
who goes on, and who stays off, the authors’ list. But research
fraud? Give me a break!
Of those who responded, approximately 10% had personal knowledge of
research fraud, and 5% at most (it is not possible to tell if there is
overlap between those answering different questions) admitted to acts
that could be regarded as research fraud. This corresponds to my own
experience. I have spent more than 40 years in human molecular genetics,
a very competitive field, of which 25 years has been spent running very
large groups. I know the work of over 1000 scientists well. I have
personal knowledge of one case of serious research fraud and perhaps
three or four cases where the reporting of data was so careless as to
verge on misconduct (though without intent to commit fraud). I also know
of one case of plagiarism. To blur the boundaries between “research
fraud”, “research misconduct”, “possible future misconduct”, and
complaining about not getting your name on a paper does no one any good,
and certainly does not help any rational discussion about research ethics.
Further research is needed into the effects of alcohol and drugs, and in particular opiates on suppressing morality. Alcohol is often involved in emotionally charged acts of violence where as opiates in calculated, 'callous' acts of violence. Therefore, substance misuse or susceptibility to dependency are factors that need specific attention when assessing the risk for unethical behaviour.
Could I make a request of the newly installed editor, whose first
editorial is titled 'Future directions of the journal'? A direction I
would not wish to see is towards more and more abbreviations. They serve
little purpose other than to save printer's ink. [1] Looking through
volume 27, issue 3, there are a number of abbreviations better replaced by
the parent phrase or a contraction of it. Embryonic and f...
Could I make a request of the newly installed editor, whose first
editorial is titled 'Future directions of the journal'? A direction I
would not wish to see is towards more and more abbreviations. They serve
little purpose other than to save printer's ink. [1] Looking through
volume 27, issue 3, there are a number of abbreviations better replaced by
the parent phrase or a contraction of it. Embryonic and fetal tissue
transplantation can be referred to as 'transplantation' on later
occurrences, instead of the awkward EFTT. There is no reason why
Parkinson's disease should not be written out each time in full; in other
contexts PD means peritoneal dialysis. A topic so central to medical
ethics as informed consent must not be contracted to ICP, which in the
article stands for informed consent from patients, but is more commonly
intra-cranial pressure. Apart from its explanation on first use, AMI for
acute myocardial infarction was used only once.
It probably makes sense to use abbreviations for public bodies (eg,
NHS, RECs, PCGs, PCTs), and for abbreviations that are familiar throughout
medicine (eg, AIDS: although it is SIDA in French). There are some phrases
that repeat awkwardly, contract uneasily, and whose abbreviations (eg,
QALYs, CPR, DNR) are probably well enough known that readers will not have
to try to remember them just for the one article. But otherwise they
impede, rather than improve, communication.
To use examples from the new editor's own article, [2] they also
generate nonsense. Savulescu writes of "LTOP of pregnancies" and "ETOP of
early pregnancies". I am sure he would not have done this if, instead of
using the unnecessary abbreviations LTOP and ETOP, he had used the phrases
"late termination" and "early termination".
References
(1) Goodman NW, Kay C. Abbreviations impede communication. British
Journal of General Practice 1998;48:1204-1205.
(2) Savulescu J. Is current practice around late termination of
pregnancy eugenic and discriminatory? Maternal interests and abortion.
Journal of Medical Ethics 2001;27:165-71.
Neville W Goodman DPhil FRCA
Consultant Anaesthetist
Southmead Hospital
North Bristol NHS Trust
Bristol
BS10 5NB
Prof. Fulford endorsed Dr. Thomas Szasz's book THE MEANING OF MIND:
"Within the broad church of anti-psychiatry, Thomas Szasz has been
foremost in challenging a narrowly biological conception of human nature.
Provocative, thoughtful, and highly readable, The Meaning of Mind extends
his arguments to the bleak redunctionism implicit in modern neuroscience.
This is a timely stand against what C....
Prof. Fulford endorsed Dr. Thomas Szasz's book THE MEANING OF MIND:
"Within the broad church of anti-psychiatry, Thomas Szasz has been
foremost in challenging a narrowly biological conception of human nature.
Provocative, thoughtful, and highly readable, The Meaning of Mind extends
his arguments to the bleak redunctionism implicit in modern neuroscience.
This is a timely stand against what C.S. Lewis called the 'abolition of
man.' Thomas Szasz is a true Socratic gadfly of our modern Athens."
I don't know why Prof. Fulford endorsed a book whose premise he does
not agree with. Fulford's "plea for mental disorder" makes no sense if he
takes Dr. Szasz's contention seriously, that "mind" is only a metaphor.
There is no "mental disorder" if there is no "mind".
If Dr. Szasz is wrong then what is the meaning of mind?
"It is clear that in the strict meaning of 'disease' only the body
can suffer lesions; the intellect as such cannot be diseased, though it
can be affected by a diseased body."
This supports Dr. Thomas Szasz's interpretation of mental illness as
a metaphor.
Adler, M.J. 1937. WHAT MAN HAS MADE OF MAN, page 204
"It is clear that in the strict meaning of 'disease' only the body
can suffer lesions; the intellect as such cannot be diseased, though it
can be affected by a diseased body."
This supports Dr. Thomas Szasz's interpretation of mental illness as
a metaphor.
Adler, M.J. 1937. WHAT MAN HAS MADE OF MAN, page 204
Dear Editor
The authors should be congratulated with this paper which again shows how important it is to get ones facts right, before passing ethical judgement.
Dear Editor
Water used to be free. More than two-thirds of the planet is covered with water. Yet, American consumers (particularly) pay more for a bottle of water than they do for a soda, a bottle of juice, or even a beer (and yet all of these products are 90 % or more water in the first place). Cars cost more nowadays than a house did on twenty years ago. I remember going to see Star Wars (1977) for only about $...
Professor Williamson makes a valid point about the term "research fraud" and I agree that the term covers a number of different categories of unethical behaviour. I also pointed out that "Research fraud can take many forms" in the discussion section of my paper. For the purposes of my article I stated that consultants who had answered "Yes" to questions 1,2 or 3 of table 1 had reported "observed misconduct" and...
In this journal's recent symposium on disability Prof. John Harris vigorously defended his general view on "disability" and "harm" before a range of critics, including me. This letter is not offered as a rejoinder to his argument but instead presents a brief clarification of a point he obviously misinterpreted.
A part of my argument for the protection of persons of difference - especially tho...
I was not impressed by Dr Geggie’s article offering a survey of the attitudes of newly appointed consultants towards research fraud (J. Med. Ethics 2001; 27:344-346). Indeed, by mixing up categories of misconduct from what is at most “bad behaviour” to the very serious, he is not entirely beyond reproach himself. I remind readers that Dr Geggie suggested that 55.7% of the respondents had observed (from the tit...
Further research is needed into the effects of alcohol and drugs, and in particular opiates on suppressing morality. Alcohol is often involved in emotionally charged acts of violence where as opiates in calculated, 'callous' acts of violence. Therefore, substance misuse or susceptibility to dependency are factors that need specific attention when assessing the risk for unethical behaviour.
Sir,
Could I make a request of the newly installed editor, whose first editorial is titled 'Future directions of the journal'? A direction I would not wish to see is towards more and more abbreviations. They serve little purpose other than to save printer's ink. [1] Looking through volume 27, issue 3, there are a number of abbreviations better replaced by the parent phrase or a contraction of it. Embryonic and f...
Dear Editor,
Prof. Fulford endorsed Dr. Thomas Szasz's book THE MEANING OF MIND:
"Within the broad church of anti-psychiatry, Thomas Szasz has been foremost in challenging a narrowly biological conception of human nature. Provocative, thoughtful, and highly readable, The Meaning of Mind extends his arguments to the bleak redunctionism implicit in modern neuroscience. This is a timely stand against what C....
Dr. Mortimer J. Adler says:
"It is clear that in the strict meaning of 'disease' only the body can suffer lesions; the intellect as such cannot be diseased, though it can be affected by a diseased body."
This supports Dr. Thomas Szasz's interpretation of mental illness as a metaphor.
Adler, M.J. 1937. WHAT MAN HAS MADE OF MAN, page 204
Szasz, T.S. 1961 THE MYTH OF MENTAL ILLNESS...
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