A letter to the editor from reader A was received by our journal concerning a published case history from author B. Reader A questioned the choice of treatment and author B's conclusion regarding the reason why the patient died. We believe this case raises at least two interesting questions.
Firstly, the patient, or in this case the patient's relatives, could possibly suffer an additional burden by having their understanding of the course of events challenged. Speculations about treatment and course of events from health personnel or others, who do not know the patient beyond the published history, may expose the patient/relatives to groundless concerns. Our journal requires consent for publication from the patient/relative(s) when publishing case histories, but the consent applies to the published article as such. Hence it does not include further discussion or comments from others in the journal or elsewhere after publication. One could argue that this is implicit when giving consent, but one cannot expect patients to know or reflect upon such matters. In other words, is the consent truly informed?
Secondly, the authors have access to a lot more medical information about the patient than they have chosen to publish. The consent only applies to the published material. In further discussions, they cannot answer properly without breeching confidentiality or collect further consent. Hereby the risk of a delayed debate, a debate that gets too general and in which the opponents (who are only able to speculate about the further details) get the last word.
The case was resolved by carefully moderating the letter to the editor in cooperation with reader A.
Planned further steps by the journal for future cases:
• Such debates must be modified with the patient's interest in mind. • Include a sentence in the consent form informing the patient about the possibilities of post publication debate. • Possibly include a disclaimer on such debates, informing about the limits of such debate? • Possibly include a reminder about the patient's perspective in the author guidelines for debate?
Question(s) for the COPE Forum
• Is it justifiable, ethically, to let readers speculate on the patient's diagnosis, the choice of treatment, etc? • Have any of the Forum members had similar discussions in their respective journals? • Are the steps taken/planned reasonable? • Does the Forum have additional advice on how we can avoid such problems in the future?
The Forum suggested that the steps outlined by the journal as a way of proceeding are good and reasonable. If the post-publication comments are informed, then it may be fine to publish them but this must be done carefully. Peer review can be helpful here.
Letters to the editor commenting on case reports could include disclaimers, and it is important to remind people to think about the patient and their family.
While an ethical framework is needed, the journal also has a responsibility to encourage debate, but in a sensitive and cautious way. For example, this can be an opportunity to allow input from people with whom the patient might not ever have access. The framework within which this happens is important.
The most intriguing case reports often have an aura of ‘mystery’, treading a fine line between the ‘obvious’ versus the ‘suspense’ of whether the patient did get the right treatment but this should not compromise accurate reporting or condoning poor practice. Authors need to be upfront about the details of the case, including the diagnosis. Authors should not disclose additional information after publication. Post-publication speculation must be handled carefully as it can be distressing for the patient and the patient’s family.
Author A was an overseas PhD student who successfully completed the PhD, and then returned home to a country with considerable political and civil unrest. It had been intended to submit a paper before author A left but time ran out. Subsequently, authors B, C, D and E, who were all involved in the work in one form or another (experimental design, performing preliminary experiments, data interpretation and reanalysis, writing), have written the paper. However, authors B, C, D and E cannot track down author A.
Authors B, D and E have tried emailing author A using the email address that author A used before and during the stay in the UK. Authors B and E have tried contacting author A’s spouse (who also did a PhD under author E’s supervision) by email and Facebook, but the spouse is not responding. Author E has contacted a colleague of author A at the overseas university that author A worked in but that person does not know how to contact author A, nor does another student from that country who studied in author E’s laboratory at the same time. The university that author A worked in is not open due to hostilities, and their website gives no contact information
Authors B, C, D and E are very keen to publish this paper, because the science is good, and also it is important for some of the co-authors who are early career workers and who need publications on their CVs.
Clearly, authors B, C, D and E are unable to obtain permission to publish from author A, whom authors B, C, D and E would like to put as first author, as author A performed the experiments.
Question(s) for the COPE Forum • As the publisher of the journal where authors B, C, D and E wish the article to be published, would it be acceptable to publish the paper with a full statement about the authors’ contributions to the article, and the fact that authors B, C, D and E have not been able to contact A? Thus there would be complete transparency.
The Forum agreed that the suggested course of action by the editor is a reasonable way to proceed. This issue often arises with deceased authors. The Forum suggested approaching a senior member of the institution to guarantee that the work was carried out as described. Also, it would be advisable to have someone vouch for any conflicts of interest that the author might have. A full statement on the article covering these issues would be sufficient.
The Forum discussed whether the author qualified for authorship as he did not contribute to the writing of the article. However, as the study was part of the author's PhD, the paper would necessarily have been based on the author's write up and so he does fulfil the criteria for authorship.
The case was submitted to the internal publications ethics committee, along with the comments from the COPE Forum. The committee were extremely supportive of publishing, and suggested that the PhD examiner of the thesis from which the paper derived should provide a letter confirming that the work was carried out as described and that there would be no conflict of interest for the author in publishing the work in this form. As suggested by the COPE Forum, a senior member of the university—the head of school—also wrote a letter confirming that the work was carried out as described. A full statement covering these issues was placed at the end of the article.
An article was submitted by corresponding author (CA) on 19 December 2011. After several revisions the article was accepted for publication on 23 March 2012. The article was published online 8 May 2012. At the time of submission, CA was a PhD student at a research centre (X). On 21 November 2012, co-author A (also head of the research group) contacted the publisher and editor-in-chief of journal A with a request to retract the published article claiming the following: • Co-author A claims that this paper was submitted to journal A by CA during her absence (maternity leave). • Co-author A claims that she and the other 7 co-authors (authors B, C, D, E, F, G and H) were not informed about the publication in journal A by CA. • Co-author A claims that 90% of the data presented in this paper were obtained during work performed in the laboratories at research centre X, are the property of X, and can only be published by an X staff member and cannot be distributed or published without X’s consent. According to co-author A, CA knows this as he signed a contract with centre X. • Co-author A mentions that she recently submitted an updated version of the same paper to another journal. For this submission, co-author A is the corresponding author. All authors (including CA!) agreed to this publication. (NB: Journal B is a journal with a higher impact factor than journal A.)
On 3 December 2012, the editor-in-chief of journal A informed co-authors A and CA and all of the other co-authors (B, C, D, E, F, G and H) of the possibility of publishing an erratum.
On 6 December 2012, the Legal and Contracts Officer (LCO) of research centre X replied to the editor-in-chief that CA violated contractual obligations with X by submitting the article and transferring the copyright to the copyright owner of the journal. LCO seems to mix up ‘ownership of copyright’ and ‘ownership of results (data)’. So far, no reply from any of the other co-authors has been received although they were copied in on the correspondence.
On 14 December 2012, the publisher contacted CA directly, asking him for his point of view. CA replied on 17 December 2012. From his reply it was not clear whether he completely understood the situation. He stated that he had asked co-author A for permission to submit the article but “had no answer for one year”. He states that the research was done by him and that co-author A also contributed.
On 19 December 2012, the publisher again asked CA the following points: — Did you get the approval of the other co-authors before you submitted the article? Are there, by chance, documents that prove this? — Co-author A said that she was away from work for one year of maternity leave. Were you aware of this when submitting the article? — Are there contractual obligations between you and research centre X that were not observed by submitting the article?
On 20 December 2012, the corresponding author replied that “after a long discussion with the Legal Officer (LO) of research institute Y” he remembered the document/contract that he had signed at research centre X and that he now agrees to retract the article, and he asks the publisher to do so.
However, the published article itself presents sound science. Furthermore, the legal issue between CA and research centre X needs to be separated from the case for retraction of a scientifically correct article. (A minor mistake in the published article that co-author A found in the meantime could be corrected by an erratum.)
On 20 December 2012, the publisher informed CA, co-author A and LCO that any contractual obligations between them and centre X will not be part of this issue. LCO corresponded separately with the LO of research institute Y on how to find an ‘amicable’ solution. This ‘amicable’ solution focused solely on the contractual obligations between research centre X and CA. One step in this solution would be submission of the article to the ‘correct’ journal (journal B) by co-author A.
LCO agreed to the amicable proposal of the LO of institute Y, and sent the publisher a statement on 21 December 2012 in which he disagreed that the case is merely an authorship dispute, but states that the foremost concern is the declaration that the corresponding author signed with research institute X which in his eyes is “wider than the ownership of copyright and results”. He also states that together with the LO from institute Y they came to an agreement NOT to publish. And he will launch a formal compensation claim.
On 21 December 2012, the publisher received a message from a co-author (the first time that one has replied) in which he mentions that CA published a paper without his approval, that he does not want to be linked to the ‘criminal acts’ of a PhD student, he suggests retracting the paper, as asked by co-author A and the LCO, and he will sue the journal.
In summary, the issues are: • The corresponding author submitted an article without the knowledge of all or some of his co-authors. • The corresponding author was under contract with research centre X at that time. • The scientific content of the article is correct. A minor error that occurred since publication can be corrected by an erratum. • Research centre X seems to have put pressure on CA to retract the article because of contractual obligations only. The scientific content was never a case in the correspondence between the different parties
The Forum suggested that there is a lesson to be learnt here: when a journal receives a manuscript, an acknowledgement should be sent to all of the authors, not just the corresponding author, and all authors should be copied in on all correspondence. This will prevent a similar situation arising in the future.
There could be legal issues here, as the PhD student was under contract to the institute. So the issue may be taken out of the hands of the editor. Some suggested there was a lack of mentorship and failure of supervision—what was the PhD supervisor doing?
Most agreed that there were no grounds for retraction. An author dispute is not sufficient grounds to retract an article if there is no issue with the scientific content of the article. However, as the editor does not have documentation that all authors agreed to the publication, the authors do have some grounds to feel aggrieved and to want a retraction. If the editor can obtain signed consent from all of the authors, then he could consider retraction. Others suggested that the editor should do nothing.
Regarding the issue of the recently submitted updated version of the same paper to another journal, the Forum noted that the editor has a right to ask the author for a copy of this paper. Do the authors want the paper retracted so that they can submit to the other journal (which has a higher impact factor)? If the authors do go ahead with submission of a paper to the other journal, there must be clear linkage to the original paper.
There are also copyright issues to consider.
On a show of hands, half of the Forum suggested that the editor do nothing further, a few suggested publishing a correction or some form of note on the paper regarding the authorship dispute, and only two people suggested a retraction.
The editors never received any feedback from anyone involved. They count this as silent agreement to the way they handled this case—involving COPE and publishing the article. The editor considers this case as closed.
In November 2009, the Editor of Journal X received a letter complaining of a serious breach of publication ethics regarding an article already published a month earlier on the Journal’s website. The paper concerned had not yet been published in a full journal issue either online or in print. One of the authors of the letter, Professor X, was a named author on the published paper. His complaint was that he had never seen the article prior to publication and had not agreed to be an author.
Professor X stated that some years previously, a number of research groups around the world were invited to join a collaborative research effort. A late Dr Y made the suggestion to make the work a multicentre study and suggested Dr Z as one of the investigators. Professor X also stated that Dr Y asked him to manage all the multicentre groups and compile the work into one final paper. Professor X said that an agreement was made to use a research protocol developed by him across the whole multicentre study.
The published article has Dr Z as corresponding author in addition to a Dr W as first author. Drs W and Z are at the same research institution. Professor X claims that he tried to discuss the progress of work (using the agreed protocol) with Drs Z and W but without reply. Professor X feels that Dr Z has not followed the agreed research protocol and by not liaising with colleagues has made this publication appear as if it is his original work and taken credit for work which was not his original idea. Professor X also states that as the original research protocol was not followed, the findings in the paper are of poor credibility.
When asked about the situation, Drs Z and W stated that they thought each other had been in contact with Professor X to obtain his consent before submitting the manuscript to the Journal. They both apologised for the mis-communication and suggested that Professor X could be removed from the author list before the paper is published in a journal issue. Professor X replied saying that only a full retraction of the paper would be a satisfactory outcome for him because his reputation was damaged by the publication of work that had not followed the originally agreed research protocols that he had developed.
On gathering both sides of the story, the Publisher decided that the two parties (Professor X and Drs Z and W) should communicate with one another in order to find a resolution to the problem and agree how, or if, this paper should be published in a journal issue or whether it should be retracted outright. Dr Z has since written to Professor X saying that there was no agreed usage of the protocol or publication plan and that he was kept informed of the ongoing project. Dr Z reiterated an offer to change the list of authors including the removal of Professor X from the paper.
The Forum was told by the editor that the case has since been resolved. The paper has been published with the amended author list—Professor X’s name was removed. The Forum suggested tightening up the journal’s authorship and contributorship criteria and also copying all authors on all correspondence rather than just the corresponding author to avoid the occurrence of a similar case in the future. The Forum also stressed that it is essential to publish a correction to the published article and to ensure that there are not two versions of the article in circulation.
Following the advice from the Forum, we have tightened up the author and contributor criteria for our journal to try and prevent this happening again. We have also recommended that the editorial office copy in all authors on correspondence. Although the paper had been published online, it had not reached a full issue of the journal so we have been able to correct the paper prior to its formal publication in a journal issue.
I am the editor of an international clinical journal and am facing a very unusual problem that does not fit readily into COPE flowcharts.
Through a reviewer, I was informed that an author had submitted a paper without the approval of at least one of the other authors. This appeared to be confirmed by two other authors. In response to my bringing this possibility to the first author’s attention, he asserted that all coauthors had given informed consent to publish the work as it is. I have requested that he provides written corroboration of this. If this is not forthcoming I will send the paper to the other authors and seek permission to identify their views to him.
Another reviewer raised concerns about the ethics of a component of the submitted investigation. The author has responded that the work was investigated by the university to which at that time he was affiliated and received ethics approval. I have requested written confirmation of this. The author is no longer at the institution at which the work is reputed to have been conducted: he quotes as his current affiliation an institution that does not exist and gives only an email contact.
Additional criticisms of the work from a scientific perspective made it clear it was not acceptable for publication and I have informed the author of this. The author has two other manuscripts in submission and I have requested documented confirmation that the listed coauthors of these approve of their content. Furthermore, my attention has been drawn to items in four other journals raising issues about coauthors’ approval of other papers from the same first author and additional concerns about misappropriation of material from the publications of others.
In his response to my request for clarification of the issues raised with regard to the paper I rejected, the author stated his intention to “formally let open further legal steps against you”. Nevertheless, it seems clear that I have a responsibility to continue investigating the foregoing issues.
The journal has no established regular mechanism for this circumstance. A way of proceeding could be, after as much possible information has been assembled, to draw together a small panel, including appropriate experts and representatives from the sponsoring international society whose task would be to review the information (in anonymised form) and advise on any further action, both from the point of view of my journal and the wider issues. In the absence of an identified current employer, it may be that the institution at which the work was performed is the most appropriate to charge with responsibility for any further investigation and action.
Is the presumption correct that, in the event of the author translating his statement about legal steps into action, the editorial team and others involved on behalf of the journal would be indemnified by the publisher?
The Forum noted that this is a case that perhaps can never be satisfactorily resolved. It is very difficult for editors to intervene in authorship disputes. The advice was for the editor to contact the author’s institution and ask them to investigate the authorship dispute. As the editor suspects unethical research, that is another reason to approach the institution, report the matter and request an investigation. The Forum noted that this is as much as the editor can do with regard to the submitted papers. On the wider issue, the editor could publish an expression of concern for the papers already published and alert the other journals where the previous papers have been published. In the UK, a physician could be reported to the GMC for his conduct – there may be a similar body in other countries to whom the author’s behaviour could be reported.
May 2009 In brief, I took advice, based on an anonymised set of information, from the three chairmen of the relevant committees of the European Society of which the journal is the official journal. Their view was clear that the various concerns amounted to a serious departure from appropriate standards. They concurred with the recommendation that responsibility for action should include the employing institution. This was communicated to the main and co-authors. However, at this stage, communication was received from a lawyer on behalf of the main author and the matter has been taken up by the publisher’s lawyers.
We recently published article A by author group X on our website ahead of print publication and subsequently received a formal complaint from author group Y alleging that the paper constitutes a breach of their intellectual property rights.
Group Y state that the described work is based on a jointly developed concept, initially resulting in a joint report (published 2004). In their view, article A therefore contains their intellectual property, which is documented by frequent email exchanges, delivery of all relevant reagents and two visits by the senior author in group X to group Y's laboratory.
Group Y further state that there has been a previous unauthorised publication of a report that also contained their unacknowledged input (intellectual input and reagents), resulting in group Y prohibiting any further publication on the same topic by group X without their authorisation (!?).
In article A, the authors state that they used commercial reagents, although group Y allege that their reagents were available to group X at this time. Group Y are seeking what they perceive to be correct acknowledgement for their contribution, and there is an ongoing legal dispute, which they are threatening to expand to include article A unless a suitable solution is found.
We approached group Y to clarify if they thought they should be acknowledged on the paper, or even included as authors, but they did not answer, as they believe that group X should be asked to clarify their position.
We approached group X for their response to these allegations. Group X maintain that their collaboration with group Y was their idea, as an obvious extension to their previous clinical publications. Group Y are chemists and had not published on any clinical topic prior to the collaboration with group X. Group X state that the collaboration came to an end in 2006 when the senior collaborator in group Y demanded that either s/he should be named as the last author or one of the junior members of group Y named as first author on any manuscript resulting from the collaboration. Group X considered this to be unreasonable and continued their studies using commercial reagents.
The editors of the journal in question believe group X's response to be appropriate and complete, and find no grounds for taking group Y's complaint any further. The editors would like to proceed with print publication of article A.
Is proceeding with publication at this stage appropriate? The editors are concerned about the threat of legal proceedings, so should they therefore be more cautious in accepting one version of events above another—do they need to request “proof” and, if so, what would this proof consist of? The Forum’s advice on the next steps that they should take would be appreciated.
The Forum agreed that the paper should be considered published. It is irrelevant whether this is online or in print. Although one suggestion was to let group Y have their say, perhaps in a letter to the editor, others cautioned against this approach in the light of unresolved legal issues. If legal proceedings are threatened, the editor should withdraw from the dispute and not investigate the matter further. The response from group X could be shared with group Y only after explicit consent from group X. The advice of the Forum was to go ahead with the print publication of the paper but the editor should not get involved in correspondence between the two groups and should seek legal advice.
The Editor took COPE’s advice and no further action resulted. The editor considers the case now closed.
Three papers concerning one hospital problem had been submitted to three different journals. Before publication the three editors of the journals became aware of the three different papers and the substantial overlap between them. The three editors communicated with each other and realised that they had four concerns: 1. There was very considerable overlap among the three papers. There didn’t seem to be any justification for publishing three papers rather than one or two. 2. The authors of the papers had not disclosed the existence of the other papers to any of the editors. 3. The three papers all had different sets of authors, and it seemed most unlikely that all authors met the definition of authorship devised by the International Committee of Medical Journal Editors. It also subsequently emerged that at least one author was unaware that he had been listed as an author on one of these papers. 4. There were inconsistencies among the papers. One particular patient was described in all three papers, and there were inconsistencies in the nationality of the patient, the readmission date, the results of a particular test, and the final diagnosis. The three editors took a very long time to decide what action to take, and in the end differed in their responses. One editor decided simply to notify the authors that she would not publish the paper and that she was concerned about the circumstances of the paper. The two other editors decided to ask for an investigation. One editor wrote to the chief executive of the institution where the authors had worked some ten months ago, but no explanation of what happened had been received. What should the editor do now?
_ The chief executive has now responded and agreed there were problems with redundant publication and as a result they will be revising their policies. Reasonable answers had been given that explained the discrepancies raised. _ A letter should be published in all of the journals regarding the redundant publication. _ A common agreement between all of the editors should be obtained, noting that it could be a prolonged procedure.
The matter was investigated by the chief executive, who agreed that the overlap was evident on re-review. But he believed there was no deliberate intention to deceive.
In 1995 a group of nine authors published a paper in a leading general medical journal. Copyright was granted by all authors to the journal. In 1998 the senior author received a complimentary copy of a recently published book. One of the chapters was essentially a reprint of the original paper. It was attributed to the sixth, first and second authors. Neither the first nor second author (the guarantor) had ever heard of this chapter or the book. They had not consented to the publication or the authorship of the chapter. The remaining six original authors were acknowledged for their help with the study, but were not listed as authors of the chapter. The chapter acknowledged that the data it contained had been published before. Enquiries to the publisher of the textbook revealed that the sixth author had applied for and, for £60, had been granted permission to use the original article by the medical journal in which it was first published. What are the professional, ethical and legal issues? What should be done?
The editor was advised to write a conciliatory letter to the publishers and a letter of complaint to the author who had reproduced the article without permission.
The author admitted he had made a mistake and apologised profusely.