Judging the Medics' Science: Misconduct and Research Culture in Disciplinary Proceedings since 1990

What does 'bad science' mean?
In the UK and abroad, science investigators and medical doctors are increasingly subject to close scrutiny. But what happens when these are the same people: what does 'bad science' mean for medical doctors who pursue scientific research, and at the same time wear a professional hat as carers for patients under a public health system?

In a 2011 report the Science and Technology Committee of the House of Commons has characterised the governance of scientific conduct as 'unsatisfactory.' On the international scene, many organisations and committees are increasingly working to prevent and respond to research misconduct and fraud. This study will be designed to inform current policy debates on this issue of great public concern.

This project will help to democratize science, by enhancing public understandings of trust, professionalism, integrity but also misconduct, in science. It also seeks to broaden the terms of the debates on scientific research. It does so by examining the role of the General Medical Council (and closely related decision-making bodies) in securing legitimate research conduct in the area of UK medicine. The project will span two decades, ranging from the 'first' widely publicised science fraud case in the UK, a case of paper fabrication and improper authorship attribution involving obstetrician Malcolm Pearce, up until the saga of Andrew Wakefield's research on the link between MMR vaccines and autism, and other current developments.

The aims of the project include: 1. to offer the first comprehensive analysis of General Medical Council's decisions about scientific misconduct in medical research, for the period 1990-2010, and 2. more broadly speaking, to understand what constitutes misconduct, ethics, and integrity in medical science in their cultural contexts.

Through close reading, legal analysis and critique of the different cases, in this project I will thus explore the cultural aspects of scientific conduct and misconduct. These cultural aspects include the recent breakdown of trust in the medical profession's autonomy, and public expectations of transparency in science.

The project will provide 'thinking tools' to engage the public as well as practitioners and other stakeholders about issues of scientific conduct and misconduct. It will also enable the identification of good and bad practices in the area of research governance, and inform policy reforms to better tackle the problems of scientific misconduct.

The main output of this Fellowship will be an analytical map detailing disciplinary proceedings concerning UK medics' scientific activities over the last twenty years. The impact activities will utilise adapted versions of this analytical map to help to democratise science by improving public understandings of scientific conduct and misconduct.

1. Beneficiaries

The map will be structured to be of practical use to different stakeholders such as: legal practitioners, legal consultants and advisers, medical and professional ethicists, scientists, scientific advisors, medical writers, research coordinators, individual journal editors, and organisations of journal editors (e.g. Committee on Publication Ethics (COPE), European Association of Science Editors, and International Committee of Medical Journal Editors). I will build on my established collaboration with COPE (in the context of an ethnographic study of decision-making in the case of questionable scientific practice) to concretise the potential uses of the map: this collaboration has provided me with many contacts in the medical research milieu, and this will be useful in facilitating the impact of the map.
In addition, I will consolidate my already established contacts with policy-making bodies and stakeholders. In particular, the Medical Research Council, the General Medical Council, the National Research Ethics Service, and Medico-Legal Investigations Ltd have shown enthusiasm for my research and this network of collaborators has been growing naturally as my research becomes better known. Additional collaborators could include representatives from the Wellcome Trust, Research Councils UK, and the UK Research Integrity Office, which is now based at the University of Sussex.
Finally, it will be possible to adapt the map to make it accessible to the general public. Citizens are increasingly interested in the conduct of science and I believe there are ways to reach out to them (see below). For example, an adapted version of the map might be of interest to high-school, A-level, or university students who are interested in science in general and in the context of their career development. In this sense, the map seeks to lead to the greater democratisation of science, as well as the improvement of regulatory oversight.

2. How will the impact activities and milestones unfold:

My pathways and strategies for accessing these different stakeholders will vary depending upon the specific relevant audience. My analytical map will thus be adapted through the following pathways to impact (these are detailed in the 'Pathways to Impact'):

a. Publications (Ethical Editing, PLoS Medicine, PALS website and other blogs)

b. Practitioners/Policymakers Stakeholders Workshop: 'invitation only' forum involving a small number of key selected individuals, and providing a safe space for dissemination, networking, and sharing experiences (participants: NRES, MRC, Wellcome Trust, GMC, COPE, Medico-Legal Investigations Ltd, UK Research Integrity Office

c. Public engagement activities: media opportunities, as well as focused presentations for the Patient Advice and Liaison Services Office, NHS Stoke-on-Trent, Brighter Futures organisation (for people with mental health issues), Stoke-on-Trent; Madeley High School, Newcastle

3. How will the research impact the beneficiaries?

The impact activities described above will achieve three main things. First, to provoke broader debate and discussion about the ways in which we understand the values of integrity and trust in medical sciences; second, to enhance our understanding of how legal, regulatory and ethical tools have been, and can be, used to respond to breakdowns in integrity and trust; and third, to facilitate improvements in research integrity policy, where required.