Semin Plast Surg 2024; 38(01): 074-080
DOI: 10.1055/s-0043-1778045
Review Article

Ethical Principles in Plastic Surgery Research

Hannes Prescher
1   Division of Plastic Surgery, University of Michigan, Ann Arbor, Michigan
,
Christian J. Vercler
1   Division of Plastic Surgery, University of Michigan, Ann Arbor, Michigan
› Author Affiliations

Abstract

Research is an integral part of medical progress that leads to better understanding of disease processes and the development of therapies to improve patient care. The medical community has an obligation and societal responsibility to review its practices and advance its knowledge to optimize care for those who entrust it with their health and well-being. While ultimately intended to benefit patients specifically and society as a whole, every laboratory and clinical investigation inherently carries an element of uncertainty and has attendant risks. These can have unintended and, at times, harmful consequences that cannot justify the knowledge gained. In order to mitigate these risks and protect human subjects involved in clinical research studies, a basic framework of ethical principles has been developed to guide responsible experimental design, execution, and data dissemination. This article provides a review of these principles and the historical context from which they were derived and explores the persistent challenges and cognitive biases that can increase susceptibility to unethical research practices.



Publication History

Article published online:
08 February 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Susarla SM, Lopez J, Swanson EW. et al. Are quantitative measures of academic productivity correlated with academic rank in plastic surgery? A national study. Plast Reconstr Surg 2015; 136 (03) 613-621
  • 2 Ngaage LM, Elegbede A, McGlone KL. et al. Integrated plastic surgery match: trends in research productivity of successful candidates. Plast Reconstr Surg 2020; 146 (01) 193-201
  • 3 Emery SE, Gregory C. Physician incentives for academic productivity. An analysis of orthopaedic department compensation strategies. J Bone Joint Surg Am 2006; 88 (09) 2049-2056
  • 4 Zhang JQ, Herman SB, Tepper OM, Garfein ES, Weichman KE. Rank and research: the correlation between integrated plastic surgery program reputation and academic productivity. Ann Plast Surg 2018; 80 (05) 553-560
  • 5 Gast KM, Kuzon Jr WM, Waljee JF. Bibliometric indices and academic promotion within plastic surgery. Plast Reconstr Surg 2014; 134 (05) 838e-844e
  • 6 Relman AS. Economic incentives in clinical investigation. N Engl J Med 1989; 320 (14) 933-934
  • 7 Barhorst K, Singerman K, Moore MG, Dembinski D, Gobble R. Characterizing the top 1% of plastic surgeon recipients of industry payments. Plast Reconstr Surg 2023; 151 (04) 707e-708e
  • 8 Beecher HK. Ethics and clinical research. N Engl J Med 1966; 274 (24) 1354-1360
  • 9 Martinson BC, Anderson MS, de Vries R. Scientists behaving badly. Nature 2005; 435 (7043): 737-738
  • 10 Katz J. The Nuremberg Code and the Nuremberg Trial. A reappraisal. JAMA 1996; 276 (20) 1662-1666
  • 11 World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013; 310 (20) 2191-2194
  • 12 White RM. The Tuskegee syphilis study. Hastings Cent Rep 2002; 32 (06) 4-5 , author reply 5
  • 13 Beauchamp TL. “The Belmont Report.” The Oxford Textbook of Clinical Research Ethics. New York, NY: Oxford University Press; 2008: 149-155
  • 14 Freedman B. Equipoise and the ethics of clinical research. N Engl J Med 1987; 317 (03) 141-145
  • 15 Krugman S. The Willowbrook hepatitis studies revisited: ethical aspects. Rev Infect Dis 1986; 8 (01) 157-162
  • 16 Shamoo AE. Unethical medical treatment and research in US territories. Account Res 2023; 30 (07) 516-529
  • 17 Menikoff J, Kaneshiro J, Pritchard I. The Common Rule, updated. N Engl J Med 2017; 376 (07) 613-615
  • 18 Emanuel EJ, Wendler D, Grady C. What makes clinical research ethical?. JAMA 2000; 283 (20) 2701-2711
  • 19 Ascha M, Ascha MS, Gatherwright J. The importance of reproducibility in plastic surgery research. Plast Reconstr Surg 2019; 144 (01) 242-248
  • 20 Agha RA, Camm CF, Doganay E, Edison E, Siddiqui MRS, Orgill DP. Randomised controlled trials in plastic surgery: a systematic review of reporting quality. Eur J Plast Surg 2014; 37 (02) 55-62
  • 21 Chung KC, Kalliainen LK, Spilson SV, Walters MR, Kim HM. The prevalence of negative studies with inadequate statistical power: an analysis of the plastic surgery literature. Plast Reconstr Surg 2002; 109 (01) 1-6 , discussion 7–8
  • 22 Loiselle F, Mahabir RC, Harrop AR. Levels of evidence in plastic surgery research over 20 years. Plast Reconstr Surg 2008; 121 (04) 207e-211e
  • 23 Soteropulos CE, Poore SO. Navigating the gray of academic publication: avoiding predatory publishers and creating your “whitelist”. Ann Plast Surg 2021; 87 (06) e171-e179
  • 24 Asaad M, Elmorsi R, Winocour S. et al. Impact of predatory journals in plastic surgery literature: researchers beware. Plast Reconstr Surg 2022; 149 (06) 1234e-1243e
  • 25 Johnson AL, Torgerson T, Skinner M, Hamilton T, Tritz D, Vassar M. An assessment of transparency and reproducibility-related research practices in otolaryngology. Laryngoscope 2020; 130 (08) 1894-1901
  • 26 Begley CG, Ellis LM. Drug development: raise standards for preclinical cancer research. Nature 2012; 483 (7391): 531-533
  • 27 Ascha M, Katabi L, Stevens E, Gatherwright J, Vassar M. Reproducible research practices in the plastic surgery literature. Plast Reconstr Surg 2022; 149 (04) 810e-823e
  • 28 Cyranoski D. Woo Suk Hwang convicted, but not of fraud. Nature 2009; 461 (7268): 1181
  • 29 Normile D. Scientific misconduct. Hwang convicted but dodges jail; stem cell research has moved on. Science 2009; 326 (5953): 650-651
  • 30 Rohrich RJ, Sullivan D. Plagiarism and dual publication: review of the issues and policy statement. Plast Reconstr Surg 2009; 124 (04) 1333-1339
  • 31 Hwang K, Wu X. Retracted or withdrawn publications in journals relating to plastic surgery. J Craniofac Surg 2018; 29 (05) 1114-1116
  • 32 Kant I. Critique of Practical Reason and Other Writings in Moral Philosophy. Beck LW. ed. Chicago: University of Chicago Press; 1949: 346-350
  • 33 Nuzzo R. Fooling ourselves. Nature 2015; 526 (7572): 182
  • 34 Thompson DF. Understanding financial conflicts of interest. N Engl J Med 1993; 329 (08) 573-576
  • 35 Luce EA. Financial conflicts of interest in plastic surgery: background, potential for bias, disclosure, and transparency. Plast Reconstr Surg 2015; 135 (04) 1149-1155
  • 36 Lopez J, Lopez S, Means J. et al. Financial conflicts of interest: an association between funding and findings in plastic surgery. Plast Reconstr Surg 2015; 136 (05) 690e-697e
  • 37 Lopez J, Prifogle E, Nyame TT, Milton J, May Jr JW. The impact of conflicts of interest in plastic surgery: an analysis of acellular dermal matrix, implant-based breast reconstruction. Plast Reconstr Surg 2014; 133 (06) 1328-1334
  • 38 DeGeorge Jr BR, Holland MC, Drake DB. The impact of conflict of interest in abdominal wall reconstruction with acellular dermal matrix. Ann Plast Surg 2015; 74 (02) 242-247
  • 39 Moses III H, Martin JB. Academic relationships with industry: a new model for biomedical research. JAMA 2001; 285 (07) 933-935
  • 40 Singer P. All animals are equal. Applied Ethics: Critical Concepts in Philosophy 4. New York, NY: Oxford University Press; 1986: 51-79
  • 41 Díaz L, Zambrano E, Flores ME. et al. Ethical considerations in animal research: the principle of 3R's. Rev Invest Clin 2020; 73 (04) 199-209
  • 42 Ellul J. The Technological Society. New York, NY: Vintage; 1964