The Center for Science in the Public Interest, one of a handful of consumer advocacy groups that takes no industry money, has called for medical journals to levy a three-year publishing ban on authors who omit declarations of conflicts of interest. Environmental Health Perspectives has imposed just such a ban.
In the August 7 issue of the Journal of the American Medical Association, however, editor Catherine DeAngelis favors education over punishment, arguing that medical journals cannot be responsible for ferreting out failures of disclosure and punishing miscreant authors. She makes the point that “it cleans our house by messing others,” meaning that an author punished by one journal would merely divert manuscripts elsewhere - although if journal editors shared information about cheaters this problem goes away. DeAngelis also writes that “those who suggest this approach have not considered the risk of an antitrust suit.” This seems far-fetched; antitrust litigation usually involves plotting for profits, not unpaid publications. Litigation paranoia aside, a secret blacklist of authors would be problematic because malicious, misleading, or mistaken entries could not easily be corrected.
So… don’t make it secret. Let’s out the perpetrators in public, where the merely naïve can apologize, the falsely accused can rescue their reputations, and the lying curs can bluster self-incriminating excuses. A forum where medical editors can describe nondisclosure incidents, and where others, including the implicated, can respond, would be a great service not only to editors, but to colleagues, the media, and consumers. Anyone receiving information from a source who stands to profit from that information deserves to know about conflicts of interest.
Without sanctions, a requirement is demoted to an easily-ignored request. If there is no downside to omitting conflicts of interest from an article submission, many authors will continue to omit information that could invite additional scrutiny of a manuscript.
CSPI’s proposal deserves support. A medical journal that identifies nondisclosure should ban an author from publishing in that journal for three years and should publish that information. And repeat offenders should receive the same sanction from the International Committee of Medical Journal Editors and the World Association of Medical Editors. Medical journals have an ethical obligation to their readers - and to the public - to expose misdeeds.
- Adriane Fugh-Berman
This commentary appears by arrangement with the American Society for Law, Medicine, and Ethics.