We have received a paper in which the authors have exposed a group of babies to physiologically unnatural circumstances. These circumstances do however arise quite regularly in some peoples’ lives. None of the babies had anything wrong with them, but some of them were siblings of babies who had died. Some of the babies showed physiological changes in the unnatural circumstances, which raised the possibility that they might suffer severe consequences if exposed to those circumstances in their ordinary lives. The exact meaning of this research is hard to interpret, but it does suggest that these physiologically unnatural circumstances might have severe consequences for babies. The hospital ethics committee approved the research, and the parents of all the children gave informed consent. Our editorial committee was, however, worried that this was non-therapeutic research and that the parents of the children whose siblings had died might find it very difficult to refuse consent for the research. We therefore commissioned an ethical commentary, in which the author argues that the research is unethical—partly because of the problem of consent we had identified and partly because the researchers had no clear prior hypotheses and had not done a power calculation. They have thus produced research that is very hard to interpret. (1) Is the research sufficiently unethical that we should not publish it? (2) Can we publish the research with a commentary arguing that it is unethical? If we so, should the authors be given the right of reply? (3) Or should we, as the authors argue, write the commentary ourselves rather than commission an outsider? In our commentary we could voice our ethical doubts, but say that we thought the paper was nevertheless publishable.
(1) The ethics committee have approved this study, but there is dissonance among the committee, editor and commentator. The paper has been accepted and the authors told that a commentary and editorial would be commissioned which they will see before publication. (2) This is a case of having one’s cake and eating it. (3) Ideally the chairman of the ethics committee should write the commentary.
The paper was published with a commentary on the ethical aspects.