An essay was submitted to a specialty medical journal. In the essay, the author described an ethical dilemma—involving patient care—encountered while in medical school. The manuscript received favourable reviews, although the reviewers expressed concern about the author’s career if the essay was published. The editor called the author to discuss the ramifications of publication, and then the author was sent a letter requesting revisions. The revised manuscript was submitted and accepted for publication. Upon publication, the chair of the university medical school department discussed in the essay called the editor to express dismay at the essay and disappointment in not receiving advance notice of publication.
The editor did not feel that advance notice was the correct procedure because the essay was considered confidential, as all manuscripts are considered prior to publication. The university was offered the opportunity to reply to the essay via a letter to the editor, which they have done.
- Was it correct (and ethical) to not notify the department because of the confidentiality of the manuscript? Or, was it incorrect (and unethical) to not notify the department because of possible damage to the department’s reputation upon publication of this essay?
- If the journal should have alerted the department or university, where in the scheme of things should this have occurred?
- Would the journal need the author’s permission prior to contacting the university?
- What if the author said no?
The Forum agreed with the editor’s course of action, in giving the university the opportunity to reply to the essay by way of a letter to the editor. The Forum agreed that the issue should be handled as you would any letter to the editor.
If the editor is confident in the review process and the review process is solid, then it would not be appropriate to notify the university in advance. Any issues with the data should hopefully come out in the review process. The editor’s duty is to the author. The fact that the authors were students may be important in specialised situations, such as those involving patients, but if the author has ownership of the data and it is their intellectual property, then there should be no issue here.
All agreed that the editor was right to give the university the right to reply. It is then up to the editor to decide if this is publishable.
The case was discussed at a recent editorial board meeting, and the editors consider the case now closed.