Date Published: February 27, 2007
Publisher: Public Library of Science
Abstract: PLoS Medicine’s external advisory committee is now two years old. What has the committee achieved and how has it helped to shape policies at the journal?
Partial Text: In March 2005, we announced the appointment of an external advisory committee “to advise us on individual cases for which we are concerned about competing interests or broader ethical questions” . Two years on, what has the committee achieved and how has it helped to shape policies at the journal?
From its very first issue, PLoS Medicine asked all authors to declare any competing interests (http://journals.plos.org/plosmedicine/competing.php), which we placed prominently alongside the authors’ biographical information. Initially we allowed authors to acknowledge their funding sources at the end of the article. This policy meant that some authors would declare that “no competing interests exist,” and yet in the funding statement at the end of their article would state that they had received funding from pharmaceutical companies.
PLoS Medicine adheres to the principle that a case report that arises from the confidential doctor–patient relationship cannot be published unless the patient (or family) has given written consent. But sometimes authors say that they are simply unable to obtain consent (for example, the patient has moved to a different country) and they offer to anonymize the report. If there are educational benefits in publishing such a report, and these benefits outweigh the risks of harm (for example, patients identify themselves and feel that their privacy has been violated), would it be ethically acceptable to publish the report without patient consent?
The most recent—and most contentious—ethical dilemma that we have faced concerned a paper that fell in the grey area between research and a programmatic description. The authors wished to describe their experience of delivering an innovative health care program under extremely difficult conditions. The authors made no mention of Institutional Review Board (IRB) approval, and so we asked the committee whether it considered this sort of paper as a “study” that required prior IRB approval.
We believe that the external advisory committee has provided a valuable service, guiding, educating, and helping us to set policies that we hope have made the journal more “ethically robust.” We have particularly valued the fact that the different committee members bring such a diversity of views, and that the committee is able to give very rapid advice. We would like to thank the committee members, who are listed in Table S2 of reference , and we look forward to our ongoing collaboration.