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Scientific misconduct at an elite medical institute: The role of competing institutional logics and fragmented control (Papers: Christian Berggren and Solmaz Filiz Karabag | April 2018)0

Posted by Admin in on May 8, 2018
 

Abstract
The incidence of revealed fraud and dishonesty in academia is on the rise, and so is the number of studies seeking to explain scientific misconduct. This paper builds on the concepts of competing logics and institutional fields to analyze a serious case of medical and scientific misconduct at a leading research institute, Karolinska in Sweden, home to the Nobel Prize in Medicine.

The Paolo Macchiarini/Karolinska case highlights an uncomfortable reality: the speed, response and consequences of research misconduct by star researchers is often shaped by a powerful institution conflict of interest. The consequences can be dire. Of course the institutional impacts of being deemed later to be reticent to act are often worse. The internal processes for reflecting on the bona fides of an allegation and the institution’s social responsibility/risks need to be rethought. We have included links to the earlier items about this case.

By distinguishing between a market-oriented, a medical and an academic logic, the study analyzes how various actors − executives, research leaders, co-authors, journal editors, medical doctors, science bloggers, investigative journalists and documentary filmmakers − sustained or tried to expose the misconduct. Despite repeated warnings from patient-responsible doctors and external academic reviewers, Karolinska protected the surgeon, Paolo Macchiarini, until a documentary film at the Swedish national public TV exposed the fraud which led to public inquiries and proposals for a new national ethics legislation.
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The analysis illustrates the power of a market-oriented logic focused on brand and image at the research institute and at a leading journal, but also the perseverance of the logics of scientific scrutiny and medical care among practicing doctors and independent academics although the carriers of these logics were less well organized than the carriers of the market-oriented logic. Furthermore, the analysis shows the problem of fragmented control in the academic institutional field. The discussion of remedies compares the Karolinska case, where media actors were instrumental in sanctioning the perpetrators, with a similar instance of medical misconduct at Duke in the US where the government agency (ORI) intervened and shows the limitations of both types of actors. The conclusion highlights the importance of studying misconduct management and institution-building in different fields to develop effective remedies.
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Keywords
Institutional logics, Institutional actors, Scientific misconduct, Retraction, Academic dishonesty, Fragmented control.
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Berggren, C. and S. F. Karabag (2018). “Scientific misconduct at an elite medical institute: The role of competing institutional logics and fragmented control.” Research Policy.
Publisher: https://www.sciencedirect.com/science/article/pii/S0048733318300817

Should we try to manage non-financial interests? (Papers: Miriam Wiersma, et al)0

Posted by Admin in on May 2, 2018
 

Ideological biases influence medical research and practice and should be disclosed and managed, say Miriam Wiersma and colleagues. But Marc Rodwin argues that many of these interests are widespread and inherent to life and cannot be avoided or eliminated

Yes—Miriam Wiersma, Ian Kerridge, Wendy Lipworth

This is a great contribution to the discussion about non-financial conflicts of interest.

Non-financial conflicts of interest in medical research and practice, which include those of a political, ideological, individual, or religious nature,1 2 are often overlooked, denied, and even defined out of existence.3 4 The focus is directed instead towards financial interests, such as those stemming from drug industry sponsorship of research, or payments to doctors. But dismissing non-financial conflicts of interest is naive, empirically unfounded, and dangerous. It is also unnecessary because non-financial conflicts can be managed with nuance and sensitivity.
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Strong drivers
Research shows, and common sense dictates, that people are driven at least as much by non-financial motives as they are by financial gain. These motives, which include the desire to protect ourselves or our family from harm, to reinforce our deeply held beliefs and values, to reciprocate gifts or favours, to attain status, and to avoid social disapproval, unquestionably exert a powerful influence on human behaviour.5 6 As argued by Cappola and Fitzgerald in relation to academia, “the prospect of fame may be even more seductive than fortune.”7
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Wiersma, M., Kerridge, I,. Lipworth, W., Rodwin, M.. (2018). “Should we try to manage non-financial interests?” BMJ 361.
Publisher: https://www.bmj.com/content/361/bmj.k1240

Dark past of deep-brain stimulation – Nature (Christian Lüscher | March 2018)0

Posted by Admin in on April 1, 2018
 

Christian Lüscher considers an alarming career from the early days of psychiatry.

Many people consider deep-brain stimulation (DBS) to have begun in 1987 in Grenoble, France, when Pierre Pollak and Alim Benabid stopped a person’s tremor by delivering high-frequency pulses of electricity to her thalamus. In fact, more than three decades earlier, a psychiatrist called Robert G. Heath at Tulane University in New Orleans, Louisiana, had experimented with this approach. Now, science writer Lone Frank pulls Heath (1915–99) from obscurity for her exploration of DBS, The Pleasure Shock.

As AHRECS readers know, we believe there is a trap in using egregious ethical lapses/scandals in human research ethics professional development activities, but this awful story is a less commonly known example and a chance to talk about the ends not justifying the means.

Frank has traced and interviewed surviving patients, former collaborators, family members and current DBS scientists. The result is a rarity: a thrilling, well-researched read. Above all, it is a chilling reminder of how early neurosurgical experimentation knew few ethical boundaries — even firmly within the medical and academic establishment. Heath was chair of Tulane’s psychiatry and neurology department for 31 years, from 1949 to 1980.
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Today, DBS is an approved treatment for Parkinson’s disease, dystonia (uncontrollable muscle contractions) and essential tremor. Other indications, such as therapy for obsessive–compulsive disorder, depression and addiction, are the focus of intensive research. Just a few patients are treated ‘off label’, with mixed results.
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Read the rest of this discussion piece

Call for Papers: Complex ethical issues and consent to research in LMICs0

Posted by Admin in on March 31, 2018
 

“We are delighted to announce the launch of our thematic series, Complex ethical issues and consent to research in LMICs.

Valid consent is the accepted benchmark for research participation and ethical practise. Studies are moving beyond comprehensible explanations of research for participants and instead focusing on the proposed level of data required to ensure consent. Despite guidance at an international level offering advice on how to obtain consent, it remains a complex issue for low and middle income settings.

Call for Papers: Complex ethical issues and consent to research in LMICs
Submission deadline: May 31 2018

Guest Editors: Sassy Molyneux (KEMRI-Wellcome Trust Programme, Kenya) and Susan Ball (University of Oxford, UK).

Given the range and complexity of issues today, this thematic series aims to bring together research papers and conceptual analyses, in order to contribute to the development of conceptual frameworks for categorising issues; the development of policies; and to identify priorities for future research.

We invite you to submit papers relating to the complex ethical issues when seeking consent in low and middle income settlements. Papers can take the form of either empirical research submissions or theoretical/conceptual approaches.

Read more about the scope of the series here or contact us with any presubmission questions you may have.

Read the full scope

Ready to submit? You can submit your paper here.

About BMC Medical Ethics

BMC Medical Ethics is an open access journal publishing original peer-reviewed articles in relation to ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.

Impact Factor*: 1.618
SNIP: 0938
SCImago Journal Rank: 0.731

*The Impact Factor (IF) is just one measure used for evaluating the impact of research. For further information on the IF and alternative metrics used to measure the impact of research, please click here.

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