A journal published ahead of print a peer-reviewed scientific letter by Drs A (corresponding), B, C, D and E with a description of four patients who underwent a certain procedure. One of the cases took place in hospital X. Dr C works at hospital X. However, the corresponding author (Dr A) and the other 2 authors (Drs B and D) do not work for hospital X.
The journal received an email from Dr Y (head of the unit in hospital X) claiming that the authors do not have the permission of hospital X to publish data (including images) related to this case and do not have the patient’s informed consent to publish one of the figures in the paper.
The journal contacted Dr A with the anonymised allegations. Dr A replied saying that they and Dr D had been invited to assist the patient by Dr Y in the context of a professional conference. Dr A sought permission from Dr T for the publication of the data and images. Dr A stated that Dr C, who works in hospital X, provided the data/images for this case.
The journal also specifically asked for the patient’s informed consent to publish images of their clinical records. Dr C emailed the journal saying hospital X did not grant permission to publish the case images. Dr A emailed the journal (copying Drs B and D) apologising for the situation and asking for the possibility of rewriting the paper leaving out the information and images related to this patient’s case. No mention is made to the patient’s permissions.
The authors state that permission from the patient was obtained. The authors put the denial of the hospital to use the images down to personal issues between Dr A and Dr Y.
At this point, the editors felt they should retract the paper given that:
1) the corresponding author confirmed upon submission that written informed consent from the patients had been obtained for publication, but the journal had not received it after requesting it; and
2) although Dr A stated that 'the permission of the treating physician' to use the data included in the clinical records was obtained, no formal confirmation has been provided.
Questions for COPE Council
- What reasons should be mentioned as the reason for retraction? Should it only mention that the authors do not have the permission of the centre for publication of an image? The journal still has no proof that the patient’s permission was sought—is it necessary that this point be clarified before issuing the retraction?
- Dr A notified the journal of a spelling mistake in one of the authors’ names. Should the journal issue a correction and a retraction, both?
- The journal does not have electronic only articles. The paper was published ahead of print, and was awaiting print publication. If a retraction is issued, does that mean the journal has to print publish the paper in order to issue the retraction?
- Should any action be taken regarding the authors’ behaviour?
- Is the authors’ claim to rewrite the article rightful? If so, should the rewritten paper appear as a correction to the original paper, or should this be submitted to the journal for peer review as a new paper?
- For future reference, if the authors had submitted the written permission of Dr T to use the images, what should the journal have done, being aware of Dr Y’s refusal to allow publication of the images?
Advice on this case is from a small number of COPE Council Members. Most cases on the COPE website are presented to the COPE Forum where advice is offered by a wider group of COPE Members and COPE Council Members. Advice on individual cases is not formal COPE guidance.
The role of the Editor (and COPE) is to protect the literature, but even before that, we must strive to minimize harm. For that reason, we insist that all research on human subjects be approved by an appropriately constituted institutional review board, and that separate permission needs to be sought for publication in cases where details of individuals are to be published. There seems to be no evidence of this here. The head of a hospital unit, Dr Y, is not an institutional review board, neither is Dr T. The relevant question to the authors is, therefore, to give evidence of approval by an institutional review board or similar body for publication, including evidence of informed consent.
The only grounds for retraction would seem to be if (at least) one of the patients did not give informed consent. Whether or not the treating physician gave his approval is irrelevant if the patient did not. So the editor needs to establish whether consent was obtained from all of the patients. If the authors are not able to provide proof of consent in some official format, then the editor should consider contacting the corresponding author's head of department and asking them to investigate. Not obtaining consent is a serious issue, and therefore it is appropriate (indeed imperative) to escalate so that it does not happen again.
COPE does not recommend having authors routinely provide copies of the signed consent forms to the journal because of confidentiality issues. We recommend that you have the authors sign a separate form attesting to the fact that the forms were obtained from the patient(s) and are on file.
In addition, COPE does not recommend sanctions against authors (ie, journals banning authors from submitting future manuscripts). This has legal implications and is especially complicated in the case of multiple authors.
Regarding the correction, even if the article is removed from the online repository it is still considered published and so retains its meta data and DOI. Hence a correction to the author information would be necessary.