Researchers and medical professionals have numerous ethical codes governing, or at least guiding our work. Some, like the Hippocratic Oath and human research subject protections are widely known, while other areas of our ethical practice may be determined by our employers or recommended by professional societies– sometimes with little clear data about whether these codes reflect our practice or only an ideal.
Ethical treatment of study workers– particularly around the issue of authorship– is an example of the latter area. Every young researcher I know has run into problems being fairly acknowledged or given authorship for their work. And while authorship disputes are widespread enough to merit guidelines from the ICMJE, WAME, and the Committee on Publication Ethics (PDF), “local customs and practice” [COPE] reinforce unethical and exploitative approaches to research work. This is surprising because publication ethics, far from being merely guidelines in how to mentor young researcher or avoid CV padding, reflect some of the same behavioral imperatives that should guide us as we attempt to protect our subjects and benefit the public.
1. Honesty & transparency
Transparency is a self-evident need in research involving human subjects: if our patients cannot understand our work and how it will affect them, or what it means to be a subject rather than a patient, then they can never truly provide informed consent to participate. They may even harmed by study interventions they should have avoided, but did not understand. If we fail to be honest in our reporting of our results, we also harm the public who may depend on them inappropriately.
If we cannot be honest with the public, our editors, and our colleagues about who performed the work on our studies, how can we expect them to trust us when we report our results?
While we struggle to convey to patients that research is not treatment, access to research participation is still a public good from which some groups may derive legitimate empowerment and pride. In areas such as oncology, subjects may also derive a treatment benefit. Volunteers have the opportunity to benefit their communities with which they share disease risk.
The widest possible access to our results has the potential to benefit patients, their caregivers, students, colleagues, and our society.
However, another type of access helps our students and colleagues as well: the ability to contribute substantively to biomedical research, and access to recognition for one’s work. Publication credit, rightly or wrongly, is a major component of a career in science or medicine. Therefore failure to recognize certain types of authors– especially new researchers and people in allied professions, penalizes them and may contribute over time to suppressing cognitive diversity. The more authorship decisions are private, idiosyncratic, or governed by tradition, the more likely they are to be discriminatory as well.
People who do research with human subjects are accustomed to asking themselves (or being asked by IRBs) whether their study disadvantages or exploits any potential group of subjects. The distinction between payment and reimbursement is vital to us, and we can be barred from providing too much reimbursement if it might constitute an undue incentive to our potential subjects. We are also expected to make clear to our subjects that they do not have to participate in research, and that study instructions are not personalized medical advice. We have an enormous knowledge advantage over most potential subjects, and often a large socioeconomic one as well, and we are expected to use this wisely.
Likewise, we should seriously consider whether our relationships with study workers are exploitative– or whether our work group, like our work, contributes to the public good. Unlike colleagues, trainees and staff may not have the option of choosing not to work on our projects, and they may not have the professional or financial security to leave a situation that is unacceptable to them. (If we habitually leave them off of author lists, they may never accumulate this security, either.)
The bottom line is that if we fail to approach our job– our whole job– with a commitment to ethically using our amazing resources, then we will do morally inadequate work whatever we do. As researchers, we either have a commitment to honesty, transparency, accessibility, and non-exploitation in our whole profession, or we don’t.