Ethical dilemma involving religious beliefs
Case text (Anonymised)
The editor and co-editors of a book have a query concerning an ethical dilemma involving possible authors for a book chapter.
The book concerns certain diseases in pregnancy and the authors have been approached to contribute a chapter. Both authors are apparently deeply religious and have expressed a strong concern about contributing to a book in which views may be expressed that are against their religious beliefs, specifically that other authors may suggest termination of pregnancy as a possible choice of management. The editors would appreciate the advice of COPE as to what to do.
These are the options as the editors see them:
(1) Leave it to the authors to decide whether they wish to contribute to the book, with no reassurance by the editors as to the content of the rest of the book. This might mean the two authors concerned complain on publication of the book and bring unfavourable publicity to the book and/or demand that their names or chapter is withdrawn from the book, which would be breach of contract on their part and create great difficulties for the book.
(2) Allow the authors to see proofs of all chapters and let them decide whether they wish to contribute. This would make the drawing up of contracts difficult and might mean the editors have to find replacement authors for this chapter at the very last minute.
(3) Allow the authors to include a comment in their chapter that they do not approve of some of the content of the book on religious grounds. However, this would be an unusual comment in the context of this chapter and may be seen as the authors imposing their religious views on a patient’s management. One could argue that if this is the case, why are they writing a chapter in the first instance? The readership may feel the same.
(4) Find other authors.
The editors intend to include a chapter in the book on ethics in cases of certain diseases in pregnancy and so they in no respect plan to brush such issues under the carpet by not including them as authors.
The advice of the COPE Forum would be appreciated.
This case sparked much lively debate and comment. Some favoured option (1) but suggested contacting the authors, informing them of the content of the rest of the book, and leaving the decision up to them. Some advised getting assurances from the authors up front that they would not complain on publication of the book and bring unfavourable publicity to the book and/or demand that their names or chapter is withdrawn from the book, and if none is forthcoming then ask them not to contribute (ie, option (4)). Others thought option (4) was the most sensible. However, some Forum members suggested that from the point of view of the reader, option (3) was the most interesting. Some likened it to a conflict of interest. However, others questioned whether not mentioning termination of pregnancy as a possible choice of management would make the chapter clinically useless. Is the editor confident that the authors can present their subject in an unbiased and complete manner? All agreed that this was a very interesting case and all thought option (2) was inappropriate.