Issue 32 / 1 September 2014

ANAESTHETIST Scott Reuben was once an influential figure in pain management: his research showing the benefits of COX-2 inhibitors for postoperative pain in patients undergoing orthopaedic surgery was widely cited and influenced clinical practice around the world.

Problem was the former professor of anaesthesiology at Tufts University in Boston made a lot of it up, publishing papers on studies that were never actually conducted and naming other researchers as coauthors without their knowledge.

He got away with it for a decade or more before fellow researchers started to question why his industry-funded research was so uniformly positive about the drugs he studied.

The editor in chief of Anesthesia & Analgesia (which published 10 of Reuben’s fraudulent papers) told Scientific American the fake research would have affected postoperative treatment of millions of patients around the world.

A 2007 editorial in the journal had said Reuben’s carefully planned and meticulously documented studies had put him at the “forefront of redesigning pain management protocols”.

After the whole sorry mess was finally exposed in 2009, Reuben was charged with health care fraud, culminating in a substantial fine and six-month jail sentence.

That might not be a surprising outcome for a financial fraudster, but it’s rare for perpetrators of scientific fraud to end up in prison, or even to face criminal charges.

Disgraced doctor Andrew Wakefield has never faced criminal charges, despite the UK’s General Medical Council finding him guilty of serious professional misconduct and saying he had acted “dishonestly and irresponsibly” in the conduct of now-discredited “research” claiming to show a link between the MMR (measles–mumps–rubella ) vaccine and autism.

Should he have? Would criminal charges have undermined his credibility among those who continue to believe the claims? Would they have deterred others from perpetrating similar deceptions?

In a recent debate in the BMJ, New Zealand allergy specialist Professor Julian Crane argues research misconduct should not be considered a criminal matter.

“Criminalising research misconduct is a sad, bad, even mad idea that will only undermine the trust that is an essential component of research and requires good governance not criminal investigators”, he writes.

Rather than “calling the cops”, research organisations need to reduce opportunities for misconduct, encourage open and verifiable information on which trust can be built, investigate appropriately and correct misconduct, he says.

Those are good principles, but when a researcher manages to perpetrate serious fraud in spite of such measures should they really be beyond the reach of the criminal law?

On the other side of the debate, Canadian paediatrician Professor Zulfiqar Bhutta argues research misconduct belongs in the same category as criminal fraud.

“Research misconduct is not just related to instances of harmless manipulation of molecules and chemicals in laboratory settings: its consequences on health and society can be huge”, he writes.

“The damage to global vaccination coverage caused by the fraudulent and discredited research by Andrew Wakefield published 16 years ago and finally formally retracted by The Lancet in 2010 has been incalculable. Yet he lives a free man in Texas, raking in money from various support groups.”

A review of the 2047 retracted research papers listed on PubMed between 1977 and 2012 found only 21% of retractions were due to errors made by the researchers.

More than two-thirds were retracted because of misconduct (43% for fraud or suspected fraud, 14% for duplicate publication and 10% for plagiarism).

The researchers also found the percentage of papers retracted because of fraud had increased around 10-fold since 1975. So research fraud may be on the rise or, more optimistically, perhaps we are just getting better at detecting it.

Either way, it’s hard to see why those who practise deliberate deception should be beyond the reach of the criminal law — especially, as has been alleged with both Reuben and Wakefield, the perpetrators may stand to profit from their fraud.

 

Jane McCredie is a Sydney-based science and medicine writer.


Poll

Should medical research fraud be treated as a criminal offence?
  • Yes – ramifications can be huge (74%, 75 Votes)
  • Maybe – depends on harms done (23%, 23 Votes)
  • No – it’s a professional issue (4%, 4 Votes)

Total Voters: 102

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8 thoughts on “Jane McCredie: Health fraudsters

  1. Stephen Barnett says:

    Interesting to see the trend increase in plagiarism as a reason for retraction, is that perhaps because its much easier in an electronic age to check one paper against others?

  2. Guy Hibbins says:

    Pharmaceuticals are now a trillion dollar industry worldwide.  See http://www.imshealth.com/portal/site/ims/menuitem.d248e29c86589c9c30e81c033208c22a/?vgnextoid=4b8c410b6c718210VgnVCM100000ed152ca2RCRD 

    Research is thus worth a lot of money in terms of marketing as it forms the basis of a lot of prescribing decisions.  Yet industry sponsored research can be 20 times more likely than non-industry sponsored research to favour the drug in question.  See http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0040184

    If mining companies overreported their test results like this then this would be a serious offence under the Companies Act, likely to result in criminal convictions.  Why should medical research be any different?

  3. bruni brewin says:

    I think we underestimate the public who do their own research and talking with others on the Internet, not to mention their own common sense.  Those whose children were effected have now been given a sentance for the rest of their lives to cope with an autistic child.  The public health purse spending on group homes and salaries for therapists that are required to look after autistic children, all come into the equation.  What about those mothers who knew just as Dr Andrew Wakefield did, that their children were fine until they had the MMR vaccination, despite the false assertion that tests had been done that proved the MMR had nothing to do with autism?  They started a website that was endeavoured to be taken down.  Do we have to rely on a health Wiki-Leaks for transparency?  If so, how do we trust those that are honest?   

  4. Andrew Nielsen says:

    I disagree with Julian Crane’s view that there should not be criminal charges.  

    My own view is that the scientific process is in place, not to protect the public from shonky science, but to protect scientists from themselves.  Does Prof Crane have any evidence that scientific fraud would be increased if criminal sanctions were put in place?  I think not.  I think that there is good evidence that criminalising behaviour decreases it, although I claim no expertise in crimonology.  

    Whether or not something is criminal or not is a matter of law.  My understading was to obtain money by deception was fraud.  By that definition, academic fraud is fraud.  Full stop.

     

     

  5. Meryl Broughton says:

    Deliberate deception cannot be justified by strongly held beliefs or good intentions. Data may not be able to speak for itself but making up the data brings science into disrepute. Punishment is appropriate. Whoever said the human heart was incurably wicked was right!

  6. Randal Williams says:

    There are many examples of the immense damage that can be done by scientific fraud. Two that come to mind are the Wakefield vaccination/autism paper and the McBride paper linking Debendox to foetal abnormalities. The first did a lot of damage to vaccination promotion and arguably caused deaths from preventable diseases, while the second guaranteed that no drug company will ever market a drug again for morning sickness. Motivation is probaly a narcissistic desire for fame or to be seen as some kind of saviour of humanity.  If scientific fraud is proven, penalties should be severe, however irreparable damage to reputation is probably the ultimate penalty.

  7. Genevieve Freer says:

    Only someone who has never had an operation could believe that a Cox-2 inhibitor could relieve post-op pain.

    Is there any such thing as independent research?

     

  8. Alan A Jones says:

    A criminal event is no less criminal because it happens in medical circles. I believe the perpetrators should be treated as criminals, because they are criminals. The punishment, of course, should match the crime, with consideration of its potential or real damage to others, financial gain. etc.. Naming and shaming may take care of any professional gain aspirations. 

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