I would like your opinion on the following case:

We published an editorial on treatment of anxiety syndromes. The author was a well-known expert from another Nordic country.

Now, several months later, the author has been found guilty of serious professional misconduct-he had a sexual relationship with a patient. The incident happened in 1999, and the verdict (his medical license being withdrawn for 3 years) was upheld by the supreme court in 2005.

We had no knowledge of this. An antipsychiatric advocacy group posted the verdict on their Web site and also urged us to "take action."

Has anybody encountered a similar case? What do you think should be done?

The editorial was about a pharmacological treatment that is the author's area of expertise.

Joseph Milerad
Scientific-Editor-In-Chief, Journal of the Swedish Medical Association
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I believe a revocation of a medical license is just to prohibit practicing medicine and not publishing research. It was peer reviewed as usual, I assume, so the information is still sound. You are not obligated to do anything.

Kimberly Taylor
Publications Director, Journal of the National Medical Association

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I have not encountered a similar case, but as reprehensible as the author's conduct may have been, it does not appear to bear any relation to the contents of the editorial you published. As long as the contents are sound, I fail to see why your journal should take any action. It is up to the justice system to dictate the sentence, as has been done by revocation of the license to practice medicine, and the advocacy group should not impose its own agenda by putting pressure on you.

Naturally, the situation would be altogether different if you had published a research paper in which one or several of the study subjects had been forced by the author to engage in sexual activity or something of that kind. This not being the case, I do not think you are ethically or morally obligated to take punitive action of any sort.

María L. Clark
Managing Editor, Revista Panamericana de Salud Pública/Pan American Journal of Public Health
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I'd do nothing...

Barry Pless
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I think the same: forbidding someone from practicing medicine is not the same as forbidding them to investigate and publish, as that is not medicine's exclusive province.

So, if it's not related to the incident, just publish it.

Noel Rojas Bonet
Director de Protomedicos.com, Revista Virtual de Estudiantes de Medicina (http://www.protomedicos.com)

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In my personal opinion, finding a person guilty of professional misconduct does not in any way necessitate a journal to take any action unless it is related to fraud or plagiarism.

The withdrawal of a license only means he cannot practice; he can still be involved in active research, and publish.

Since the paper was reviewed, I personally feel no action need to be taken.

Vinod Scaria
Executive Editor, Calicut Medical Journal (www.calicutmedicaljournal.org)

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I agree with doing nothing. Taking action conflates a private life mistake with scientific fraud.

Nezih Oktar
JNS, Journal of Neurological Sciences (http://jns.dergisi.org)

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I have not seen the article. I have not known the author either. Also, I believe that personal issues should not affect the capability of researchers in doing research. And in this specific case the editor should do nothing (in my opinion).

But lets broaden the discussion and consider that when a doctor who knows he/she should not have this kind of misconduct in his professional life and does it deliberately, it is very probable that he/she repeat the behavior again and again.

Is it possible that this psychiatrist (doctor) assumed his relationship was a type of treatment (right or wrong)?

Is it possible that this psychiatrist (doctor) prescribed medication for his/her patients at the same time?

Is it possible that this psychiatrist (doctor) published an article about the efficacy of the drug he/she had prescribed?

If it is so, we cannot say "OK publish it. Judge will give his verdict. That is not our business."

Like to hear colleagues' opinion.

Behrooz Astaneh

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Professional misconduct is indeed reprehensible but the person has already been judged for that. I do not think the journal should take any action.

Ashok Shah
Editor, The Indian Journal of Chest Diseases & Allied Sciences
Associate Editor, The Indian Journal of Tuberculosis

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Professional Misconduct

There are 3 issues involved here:

1. The legitimacy of the editorial
2. The charge of professional misconduct and its bearing on the publication of the editorial
3. Standing among peers, post-professional misconduct

1. As far as the legitimacy of the editorial goes, the journal is answerable to the charge whether it went into the expertise of the author invited. We can rest assured that must have been taken care of, since no journal would invite a non-expert to write a guest editorial. Similarly, no journal would willfully invite a tainted researcher to write such a piece. So, the editorial stands as a legitimate piece from an expert, and need not be withdrawn at all, unless the editorial board has any doubts about the expertise of the writer. I see you have no such doubts, even today.

2. However, the second charge is worth a close look. Professional misconduct of an expert has come to light. If it is relates to the contents of the article under question, it has to be retracted. For example, if it is an editorial about anxiety, and the writer has not revealed a compromising conflict of interest, which comes to light later, the journal is well within its rights to retract such a piece. However, no such thing has happened here. No one in his wildest imagination would claim that a guest editorial on anxiety syndromes is in any way connected with sexual relationship with a patient. That claim can also be disposed of.

3. The final point must now be taken up. It cannot be dismissed that easily. In inviting a guest editorial, a journal not only goes in for a person's expertise, but also his standing among peers in the medical community. This standing, in the light of the Supreme Court judgment, is seriously compromised. If it were just a charge it would be different. Here this is a judgment from the supreme law of the land. In such circumstances, the journal will be well advised to write a small note to its readers about the news that has come to its attention, and when it got it, and allow the readers to formulate their opinion about the guest editorial.

Not to do so would mean keeping the readers in the dark, which is not pardonable in this age of greater transparency. The readers are free to formulate their opinion in their own best judgment.

Hence, a brief letter to the readers in this case would be appropriate. The editorial board may not stand by what the guest editor wrote. (It need not do so, in any other case too.) But, in this case it owes its readers a proper, judicious explanation. Not alarmist, not covering up. Just the facts, in as matter of fact a manner as possible.

Ajai

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One thing remains in my opinion. Though I agree with the idea of a note on the author's professional misconduct verdict, without going into unnecessary details, I am not sure that criminal laws in all countries would allow public announcement of decisions made in judiciary system, especially those related to professional misconduct. I think the last part must be left to the local regulations and judiciary policies.

Arash Etemadi
Scientific Writing and Publishing Advisor, Vice-Chancellor for Research, Tehran University of Medical Sciences

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