Medical research is intended to be an exploration of ideas and hypotheses regarding a myriad of disease states, ultimately culminating into insightful commentary that provides guidance for clinical care. Despite the ability of research to effect treatment and clinical outcomes for possibly millions of patients worldwide, most research studies go unpublished, says author Thomas Ploug, PhD, in the Journal of Medical Ethics, due primarily to the possible harmful effects associated with the publication of the studies’ findings.

There is growing concern regarding the power of the written word, specifically those words that are printed in medical journals. A study finding a benefit of antibiotic treatment for a disease, for instance, may result in the overprescribing of these already overutilized therapies. Considering the concern regarding antibiotic resistance, ethical standards may dictate the rejection of that research study from consideration of publication.

Dr Ploug, professor at the Centre for Applied Ethics and Philosophy of Science, Department of Communication at Aalborg University Copenhagen in Denmark, argues that editors of medical journals “have a moral responsibility for the potential harmful effects of publishing research” — yet simply denying publication of certain pieces of research is not enough to fulfill this responsibility. Therefore, it is proposed that international publication ethics codes be developed for editors in evaluating and reducing the effects of medical studies in general. Research ethics and publication ethics should merge, according to Dr Ploug, in an effort to permit the publication of research that provides a more balanced take on study conclusions.

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Journal editors are at the forefront of enforcing strict publishing ethics as they are in the capacity of deciding which article will confer a potentially harmful benefit to clinical practice. Since most journal editors are physicians and/or thoroughly understand research and its over-reaching impact, they are in a better position than most to curtail the publication of medical articles that may create more harms than benefits.

“An internationally adopted and enforced code of publication ethics with these elements would serve as a guide for editors and thus secure consistency in the relevant editorial decisions,” wrote Dr Ploug. “It would also be an important step towards creating transparency and thus underpinning accountability in such decisions.”


Ploug T. Should all medical research be published? The moral responsibility of medical journal editors [published online June 20, 2018]. J Med Ethics. doi: 10.1136/medethics-2018-104785