Case Studies for Participants in the Jordan RCR Program (Year 3)-2017-2018

1. Ethical concern in animal experiments (Blood sample collection from mouse orbital sinus)

By: Walid Al-Zyoud and Manar AlAzzam

After an IRB approval, a research assistant (RA) was appointed to collect blood samples from the orbital sinus in mice using a lab technique called: Retro-Orbital Venous Plexus Puncture, where a capillary tube is inserted in the proximal angles of the eyes of mice to drain orbital venous blood without damaging the tissues of the eyes. Unfortunately, the experiment time frame was relatively short, so the researcher did not have the required time to train the assistant sufficiently.

One day while the Principal investigator (PI) was checking the work, he noticed that the number of mice that are still a live is not the same they prepared at the beginning of the project. When the RA was interrogated by the PI to clarify that; the RA answer was: “Sadly from a total number of 20 mice I have damaged the eyes of 5 mice”. Out of curiosity the PI asked about the destiny of those ones that got blinded; the RA admitted that she terminated them by placing them in an anesthetic gar filled with ether and watched them until they were died.

The PI was upset by her inappropriate attitude and action. The RA tried to justify her action by the fact that there was nothing obvious mentioned in the protocol about how to deal with such cases where damaging the eyes of the mice during the experiment is taking place.

Ethical dilemma

• Insufficient training for the assistants
• Lack of sufficient information in the experiment protocol
• It is an incident of mistreated animals/Euthanized.
• Animal pain category was changed.
• Veterinary care might be needed.

 

The PI reported the incident to the IRB and stopped the RA from completing the task of blood collection and asked the RA to go through a recognized sufficient training in animal handling for research purposes before she is permitted back to the lab. In addition, the PI modified the protocol in a way to make it obviously to mention how to reproduce animals to another research experiments and even how to behave when damaging the eyes of the mice during blood collection, this is definitely after getting a professional veterinary medicine advice.

2. Leptin the magical weight loss hormone?

By: Samer Swedan and Fadwa Alhalaiqa

It is the year 2000, George recently completed his PhD and post-doctoral training at Trust University. In his last year as a post-doctoral fellow, he submitted a grant application to the NIH to study the newly discovered hormone leptin and its effects on weight loss. After successful funding of the grant he was appointed as an assistant professor at Trust University. George is a highly motivated young researcher and was determined to rise up in the academic ranks quickly and become famous. Initial reports following leptin’s discovery have indicated that leptin is secreted in the blood from fat tissues and it signals the brain to suppress appetite.

Based on these early reports George constructed a research hypothesis stating that “Intravenous administration of leptin in obese rats would result in a decrease in body weight”. George was quite confident about his hypothesis and he sought to prove it as soon as possible as it may become a magical bullet to suppress appetite and thus lead to weight loss, which consequently would propel him into academic stardom. George started the project by recruiting 2 young biology graduates to work in the lab and carry out the experiments with relatively minimal oversight and mentoring. After sometime, the results started coming in. Some obese rats demonstrated a borderline decrease in body weight due to leptin administration, while other rats demonstrated no change in body weight. Overall, the data showed no statistically significant association between leptin administration and weight loss. George was puzzled. He was extremely confident about his hypothesis. Thus, he started doubting the skill of the laboratory technicians and whether or not they followed the experimental protocols accurately. After some thought, he decided to consider the experiments showing no change in body weight as outliers. After the removal of this data, he got a statistically significant association between leptin administration and a very modest decrease in body weight. He published this data in a prestigious Journal.

News about the study circulated worldwide and was hailed as a new potentially easy way to lose weight. George became famous and was recognized by his university for his amazing accomplishment. However, worldwide many other research groups were also conducting animal studies on leptin and have published their findings several months after the publication of George’s paper. The published studies have found that the increased weight among obese animals was not reversed by leptin supplementation, as the animals suffered from leptin resistance and already had elevated leptin levels in the blood.

These reports have led Trust University to assemble a committee of senior researchers to investigate the issue. Upon going back to the original raw experimental data, they discovered that George had deliberately excluded several data points and selectively used results that supported his hypothesis. The committee raised the report to the Journal which retracted George’s paper, and also to the Dean of the Faculty who decided to terminate George’s employment due to data manipulation and falsification.

Ethical Issues:

• Minimal guidance of the unexperienced laboratory technicians (problem with mentoring).
• Data manipulation and falsification (research misconduct).
• Submission of falsified results for publication (research misconduct).
• Conflict of interest (prioritizing self-interest over scientific integrity).

 

3. Case study

By: Oriana Awwad and Kamal Al-Shami

MO is a researcher at X University currently working on colorectal cancer (CRC) cell lines. MO wanted to try to obtain primary colon cancer cells to do some antiproliferative studies that might enrich his study.

MO contacted a surgeon at the University Hospital that could provide him with pieces of colon from patients with CRC that undergo surgery for partial colonoctomy. The piece of colon would be part of the colon that will be given to the histopathology unit for analysis.

The possibility to obtain such primary cancer cells was uncertain so MO decided to do a pilot study with 3 samples and not to go through the IRB approval procedure.

In addition, MO did not obtain a valid written consent from the 3 patients from which he obtained the pieces of colon, only a verbal consent was obtained by the surgeon that explained to the patients all the needed information.

The pilot study failed as MO was not able to obtain the primary cells. No further experiments will be conducted.

Ethical dilemma and arguments present in the case:

• Obtain a retrospective consent from the patients that have already underwent surgery
• Obtain an IRB for such study retrospectively
• Do nothing since the sample was already taken for other purposes
• Do nothing since the study will not be completed

4. Poor authorship ethics and data manipulation

By: Maha Alkeilani and Ahmed Abu Siniyeh

Mr. K. H is a master graduate student at Jordan University of Science and Technology. His thesis project is on “Identifying biomarkers that assess the effect of pramlintide, a new antidiabetic agent, on the kidneys”. He is also a medical representative at “X” company and he is marketing for the same medication, which the advisor was not aware of, while K.H’s boss had the full information regarding his project.

An endocrinologist was the Co-PI and was involved in the process of patients’ recruitment. After completion of the IRB approval process blood samples at baseline (before taking pramlintide) and 3 months after therapy were collected from patients, after taking their consent to participate in the study. Further investigations include measuring gene expression levels using real-time PCR and protein levels using ELISA. Thus, K.H was required to learn and perform these experimental procedures, and the research assistant who is a close friend of K.H. trained him.

As is the case of several drug companies, K.H was required to achieve a certain selling target at the end of the year, at the same time he was under pressure from the advisor to finish fast for the advisor to finish the requirements of his tenure, which is due after nine months. Consequently, K.H and the RA agreed that the later performs all the experimental work instead of K.H and not to inform the advisor regrading that.

After one month, K.H analyzed all the data and the results suggested that pramlintide could be harmful of the patients because it has negative effects on the kidneys and the patients may proceed to kidney failure because of the medication. His conclusion contradicts with his company’s goals of achieving high sales of this new medication. He shared these results with his boss and he convinced him to reverse the results, “This way you are catching two birds with one stone; ; you show the protective effect of this agent as an evidence, and you graduate at the required by your advisor”, his boss said.

The advisor prepared the manuscript discussing these results as being novel, and he sent it to the endocrinologist for review before submission. It was surprising for the endocrinologist to witness such results, as patients who were taking the medication developed renal function abnormalities that started 7 months after therapy. He discussed that with the advisor, and the advisor told him that he would meet with K.H to make sure that these were the real results. During their discussion, K.H could not deny the data manipulation and admitted to the advisor that he was under pressure from his boss, who pushed him to manipulate the data; otherwise, he will be fired from his job.

 

Ethical dilemma and arguments present in the case:

1. Hide these information from the co-advisor (endocrinologist) and submit the manuscript to the journal so the advisor can apply for his tenure on time
2. Inform the co-advisor, rewrite the manuscript and discuss the real results, and postpone the application for the tenure
3. Dismiss K.H from the graduate program and report the company to the JFDA
4. Sympathize with K.H, don’t dismiss him from the program
5. Dismiss K.H from the program but do not report the drug company so he will not lose his job.

The advisor informed the endocrinologist directly and they decided to sympathize with K.H and not to dismiss him from the program, but they reported the drug company to the JFDA. The advisor also took the decision of postponing the application for his tenure, and thus rewrote the manuscript. K.H graduated from the master program, was fired from his company but was able to get a new job with a higher position and salary at another company, and he is now applying for a PhD degree in highly ranked universities in USA.

 

5. Case Study: Authorship

By: Alaa AbouElfetouh and Mehdi Ben Khelil

Dr. X worked on a multidisciplinary project about dose response of solar heating on gravity law in Saturn. He was post doc working for 2 years in the moon research lab of Dr. Y. He was working with a 6 person team in this project. His results were revolutionary that he was offered a prestigious position in his homeland that he took and left the lab of Dr. Y before finalizing the research paper drafting. The initial draft has already been circulated between the different team members before he left. The paper was submitted to a top journal 3 months after he left. Dr. Y sent him a copy of the final version of the article after its submission complete with the final authorship list. Dr. X discovered the name of Dr. Z (a 7^th researcher) who worked in the lab but was not involved in this study to the best of Dr. X knowledge. Dr. Z was presented as sharing first authorship with Dr. X who rightfully was the first author as agreed upon before he left.

Why Dr. X felt there was something wrong:

• The final form was not that much different from the initial draft. Why adding the 7^th person who was not in the initial draft.
• X knew that Dr. Z (who was a close friend to Dr. Y’s) desperately needed one additional publication for his promotion. So Dr. X started thinking whether there was some kind of gift authorship going on.
• X was not presented with the final draft till after the submission. He was wondering whether the final form was withheld on purpose till it became too late.
• X was the only foreign member on the team and he started thinking that he was wronged on purpose out of racial discrimination

 

What can Dr. X do?

Dr. X first checked the literature to find out the definition of authorship and whether this was a recurrent problem in the research world. He found that this phenomenon referred to as gift or honorary authorship occurred in 39% of the papers¹.

 The options:

• Contact Dr. Y to make polite enquiries about the situation.
• Contact Dr. Z and talk to him about the situation.
• Contact the journal directly.
• Do nothing because he didn’t want to upset his old PI who is a very influential person in the field and he was afraid of his retribution.

What did he do?

Dr. X chose to contact his old PI out of respect for his old mentor and to make polite enquiries to ask for an explanation.

Dr. Y replied saying that Dr. Z who is an expert in statistical analysis, an area different from Dr. X’s expertise did all of the analysis of the paper after Dr. X left.

What is Dr. X thinking about?

He saw the initial and final versions of the paper and they were not that much different which questions the claim of Dr. Y. Besides, were 3 months enough time to make a major contribution warranting a first authorship status? However, since Dr. X is not an expert in this particular field he was not able to confirm or deny the claims of Dr. Y.

What can he do?

Believe Dr. Y and forget about the whole thing.

Report the incident to the journal without much evidence which might compromise himself and everyone else on the paper. Another consequence is that he might lose his current prestigious position that he got based on his work in his previous lab.

At the end, Dr. X decided to not report the issue to the journal because although he had his suspicions he was not sure that something unethical actually took place and he considered it unethical in itself to report unverified claim that was sure to affect the career of everyone involved.

¹ Mowatt G, Shirran L, Grimshaw JM, Rennie D, Flanagin A, Yank V, et al. Prevalence of honorary and ghost authorship in Cochrane reviews. JAMA 2002;287:2769-71.

 

6. Quality of research and authorship-related issues

By: Nour Al-Sawalha, Omar Al Omari and Samah Al-Shatnawi

Dr. Ali, an associate professor at university X in Jordan, was looking for a good institution to spend his sabbatical leave (paid leave). Actually Dr. Ali was also interested in finding another position as a faculty member at a better institution with a higher salary and he applied at one of the most prestigious universities in Jordan (university Y).

Before his official leave, Dr. Ali accepted an invitation from his departmental head to be a committee member (external examiner) for one of the master students at their department. Dr. Ali’s role includes evaluating the student’s research idea and methodology as well as providing critical comments and productive feedback. However, while Dr. Ali reviewing the student’s dissertation; he discovered a major flaw within the study methodology. He decided not to correct the student and not to report it to the committee. His decision was based on his intention to please his departmental head and to ease the defense process on the student. Dr. Ali reported minor comments and corrections and eventually he signed the required documents to let the student graduate.

Luckily, Dr. Ali was hired as a visiting scientist in university Y for one year. One of his old friends at university Y invited him to visit the main laboratory at their department, at which he would conduct his research and work with researcher team. During the visit, he noticed the presence of the departmental head at university Y, who was asking the researcher team about their projects and the challenges they confront when conducting their experiments and implementing their results. To impress his new research team and departmental head, with a full intention to promote his application for the full position at the university Y, Dr. Ali thought of disclosing some of his previous team’s project ideas and unpublished techniques.

Regardless of Dr. Ali’s efforts in pleasing his new boss and team, he was challenged by two major issues; (1) All of the new laboratory members required an authorship from him just for using their laboratory equipment and machines, (2) University Y policy does not allow for more than one disclosed affiliation when publishing from their institutional projects and he was still paid by university X.

Ethical dilemma and arguments present in the case:

• Ignoring, on purpose, the scientific content and quality of the master’s student research.

In this case Dr. Ali should have reported the major problem in the student’s thesis and provided his comments regarding the scientific content of her project. When possible he can provide suggestions to solve the issue in a timely manner.

• Disclosing unpublished data, techniques and ideas of the previous team projects. Although there are no copyrights for ideas, but his action violates the confidentiality issue in research.

In this case Dr. Ali had ignored the basic principle of confidentiality, which is completely unacceptable in the process of research conduct. If his previous researchers’ team comes to know by any chance about this issue, he might lose their trust and any chance for collaboration in the future.

• The new team’s request of authorship only because of using their equipment and machines. However, co-authorship requires more than only using laboratory facilities, actually this part does not qualify any researcher for authorship.

In this case Dr. Ali should discuss his concerns about authorship issues with the head of the new department and he can ask for consultation from their IRB office.

• Affiliation issues; single versus double.

In this case Dr. Ali can ask for more details from both institutional research committees on how to manage the dual affiliation issue. If not solved, the affiliation should belong to the institution that funded the research while the second can be acknowledged.

7. Case Study

By: Linda Tahaineh and Abdelwaheb Ben Othmen

ML is a researcher who was studying primary prevention of cardiovascular disease in a primary care setting. The inclusion criteria of the study included adult patients without clinical cardiovascular disease, who attended the Healthcare Center at least twice in the past year. A research assistant, who was trained to conduct interviews and administer questionnaires interviewed patients who gave their consent. After the completion of data collection in Center 1, ML thought that involving more than one center will give more insight to this issue and will improve the study’s chances of publication. ML submitted a new IRB form to the Center 2 IRB committee which approved it. ML worked with a new research assistant who was willing to work in another city. The new research assistant was trained to conduct interviews, administer questionnaires and the research methods and goals were explained to her. ML has to pay for the new research assistant and other research expenses for the part conducted at Center 2. After the completion of data collection ML knew by chance that the new research assistant did not pay attention that the inclusion criteria specified patients who attended the primary care setting twice in the past year.

Ethical dilemma and arguments present in the case:

• Most patients who attended the family medicine clinics came for refill or follow up which means that they come more than one time per year and so there data can be included in the study.
• Change in the inclusion criteria to fit form the two centers.
• Delete the data that came from Center 2 and publish as a short communication.

ML decided to delete the data that came from the second center and published the study as short communication.

Part 2:

In order to submit the IRB application to Center 2, ML had to invite another researcher from Center 2 to be a co-investigator and promised him/her to be coauthor when publishing the results of the study. The new co-investigator only contribution was calling the employees in the archives department and asked them to facilitate the research assistant work.

Does the new co-investigator qualify to be co-author in the publication after the deletion of Center 2 data?

Ethical dilemma and arguments present in the case:

• The new co-investigator does not qualify to be co-author based on his/her contribution according to the International Committee of Medical Journal Editors Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations 2013) because the data were deleted.
• The new co-investigator does not qualify to be co-author based on his/her contribution according to the International Committee of Medical Journal Editors Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (ICMJE Recommendations 2013) whether the data were deleted or not.
• The new co-investigator qualify to be a co-author because his/her name was on the IRB application

ML called the new co-investigator and informed him/her that the second part was deleted and he/she will not be a co-author when publishing the study results.

8. Case Study

By: Zouhour Ouanes and Fahmi Al-Ashwal

H.H is a master student in the faculty of pharmacy. He is doing his thesis project in the lab of Dr. G. His thesis about the association between polymorphism in (ACYP1 gene) and the severity of neuropathy in patients newly diagnosed with stage 3 colorectal cancer that are currently on oxaliplatin-based regimen. H.H obtained the IRB approval. A dynamic informed consent was obtained from each patient before blood sampling and filling the validated questionnaire with a 6 month follow up. It takes him a year to collect 100 samples. Both the questionnaire (which include the contact information and the blood samples are coded). After he finished collecting them, another student called M.M started to work at the same lab, she is a master student in the faculty of biomedical science. M.M is working on the same disease (her project about frequency of SNPs in APC gene in colorectal patients). Assuming the inclusion criteria for her project is the same as H.H’s project, doctor G tells her that instead of wasting a year collecting blood, she can take the subjects’ contact information from H.H and ask them for re-consent. H.H agreed but in exchange for being a co-author in her paper. She contacted them and all agreed. After H.H’s graduation, H.H was employed in Dr. Grey’s lab as R.A and he started to write the manuscript. After he completed it, he sent it for Dr. G. One month later, Dr. Grey has submitted the paper. It went under revision.  The journal editors comment just on the reference style. Dr. G sends the paper to H.H to change the style. But he found that some data about an experiment was added, this experiment was supposed to be done but due to technical and financial issues they didn’t do it.

Ethical challenges:

• Confidentiality: Is it ethical to give the contacts information for M.M to ask the subjects for re-consent?
• Informed consent: In this case, is it acceptable to take a verbal re-consent?

 

• Authorship: Is it ethical for H.H to be a co-author in exchange for collecting the blood samples?

 

• Fabrication: G added new data? Should H.H tells Dr. G about it and ask him to remove it? Or just instead of losing his position in the lab, he should ignore it? And if he tells Dr. G and he refuse to remove it, should he report it to the journal?

Possible Solutions:

• He should take permission from the subjects first before handing the contacts information, or he could himself ask for the re-consent.
• No, it’s not acceptable. The informed consent in this case should be written.
• No, it’s not ethical. Collecting data or samples doesn’t justify authorship.
• He should first inquire about it from his doctor. If Dr. G admits, he ask him to remove it, if he refuse to remove the fabricated data he could report it to the journal.

9. Case study

By: Manel Ben Fredj and Abdulhabib Alqubaty

Dr Ahmed is a post doc aiming to start his own epidemiology laboratory. He wants to conduct a five year study. The aim of the study was to conduct a study based population in order to assess the prevalence of hypertension and its risk factors in his country. He applied for funding at an international funding agency and his proposal was accepted.

He signed a contract with this agency to receive the funding in installments over five years contingent upon submission of scientific reports that are to be accepted by neutral reviewers nominated by the agency.  The initial contract did not contain details about data ownership. The study went well over the first three years and Dr Ahmed received his fund in time. However at the end of the third year, although his latest report was approved by the agency’s reviewers, he was informed that he had to submit all data to the agency that decided to cut the fund and to assign other researchers to carry out the analysis without giving any reason for changing the plans.

What can Dr Ahmed do? (Possible scenarios):

• Give them the data as they asked and try to reach an agreement to make sure he will be an author in the future paper.
• Refuse to give them the data and stop the study in this stage and forget it ever happened.
• Spreading the word in social media about the ethical misconduct of this agency to put some pressure on it.
• Keeping the data and try to find another funding agency to sponsor the rest of the study.

Dr Ahmed was frustrated and decided to give them the data as they asked because he felt he was not protected and the weakest in this conflict. Also, he cannot sue this agency because it is in other country and maybe they will oblige him to render the money if he refuses to give them the data.  On the other hand, Dr. Ahmed was more conscious about the interest of contract and that he should be more attentive when collaborating with funding agencies, in order to protect himself and to not be in similar situations ever again.

 

10. Intellectual property Case Study:

By: Omar Alomari and Moustafa Kardjadj

Ahmad, a second-year graduate student, was working on different in vitro experiments to test the effectiveness of nadolol, a β-blocker agent, in treating cultured bronchial epithelial cells from asthma patients.

As a graduate student, Ahmad was working under a direct supervision of advisor and he received a lot of help from the laboratory technicians and post-docs. The collaborative efforts resulted in providing preliminary evidence toward developing a potential therapeutic agent that should be further tested in other cultured models and eventually in murine model of asthma.

Ahmad’s advisor considered the preliminary results in preparing a new manuscript and he submitted this manuscript to an international journal. However, the advisor did not consider including Ahmad or any of the laboratory workers as co-authors.

Ahmad knew about the publication when he was looking for articles on PubMed and he was totally frustrated as the idea belonged to him and he conducted the majority of the published experiments and analysis. Ahmad discussed this issue with his advisor. However, Ahmad was told that he worked under the direct supervision of his advisor, in his lab, using his equipment’s and he received help from his staff. So, without his advisor the whole work would not be performed.

Ahmad was not convinced with his advisor answer. He decided to take one step ahead and he complained to the head of the department (HOD). However, HOD asked Ahmad to provide evidence. Ahmad told the HOD that he did not have any organized documents as he was used to save everything in his head but he had some shredded notes. The HOD decided that there is no enough evidence for Ahmad’s claims and he recommended Ahmad to leave this issue out.

Ahmad did not stop at this level, he contacted a local newspaper editor and announced that he discovered a new treatment to treat asthma and his invention was stolen by his advisor.

Ethical dilemma and arguments present in the case:

• The advisor did not share the intellectual property with his student
• The advisor did not include his student as co-authors in his publication
• The student did not have enough evidence to prove his rights
• The student misleads the mass media and makes a propaganda regarding his preliminary results.

The PI was mistaken because he did not include his student as a co-author. He should include him and discuss the order of authorship according to the size of contribution provided by each of them. The student was also mistaken because he did not keep and save his notes at the laboratory notebook at regular bases. His supervisor should teach him every day good practice. If the student keep laboratory notebook, he would not experience such situation. The head of department should advice the student to make a complain to the IRB to handle the situation rather than just telling the student to give up and drop the issue particularly because the student was keeping some notes. Student should not report this issue to mass media as he did not have enough evidence and his supervisor might suit him.

 

11. Data Falsification Case Study:

By: Tamam  El-Elimat, Ruba Darweesh and Nasr Al-Rabadi

Salma is a MSc student working in her research project under the supervision of Dr Thomas at Anemone University in a low-income country. She faced a lot of challenges in her research project, which involved isolation and structural elucidation of anticancer compounds from a medicinal plant due to the lack of modern instrumentation. Salma did the extraction and fractionation, but unfortunately she could not isolate any single pure compound. Her adviser has collaborators in the US and he seeks their help. He asked his student to prepare aliquots of the most promising fractions for shipping to the US. Marie, a postdoc in Dr Mark’s lab in the US was assigned to purify the bioactive compounds from the shipped fractions. She was able to isolate 4 pure compounds and to assign their structures using modern spectroscopic and spectrometric techniques. However, two of the isolated compounds were registered anticancer drugs of natural origin. Marie sends all the NMR and MS data of all the isolated compounds to Salma. Salma defended her MSc thesis and passed without any troubles. A manuscript based on the findings was prepared and submitted.

The isolation of two anticancer drugs made Dr Thomas to feel suspicious. The medicinal plant under study and for biosynthetic reasons cannot biosynthesize such compounds. He discussed his concerns with Marie and agreed to ship freshly prepared extract from the plant raw material without informing Salma or discussing this issue with her about their concerns. Marie analyzed the new shipped sample; however, none of the anticancer drugs could be detected in the freshly submitted extract. Dr Thomas faced Salma with his findings and she admitted that she purposefully added the anticancer drugs to the fractions that were shipped to the other lab. She said that she did that under much stress and frustration that she will never get her MSc degree without the isolation of anticancer compounds.

Ethical dilemma and arguments present in the case:

• The rush in submitting the manuscript
• Stop the publication process
• Proceed with the publication process, but consider to withdraw the anticancer drugs from the manuscript during the revision process
• Ignore the whole problem
• Repeat the whole project
• Withdraw the MSc thesis and report the student to the Faculty of Graduate Studies

Dr Thomas, Salma’s adviser, made his decision to stop the whole publication process. He contacted the editor and retracted the manuscript. He withdrew the thesis from the University and reported the student to the Faculty of Graduate Studies. He restarted the whole project and succeeded in isolating a bunch of bioactive compounds that were published in a good journal. The Committee of the Faculty of the Graduate studies decided to retract the Master degree that was conferred to Salma.

 

12. Hypothetical case scenario

By: Nidal Eshah & Nadia Alkadmiri

Dr. X. is the principle investigator for a project that aims to assess stressors experienced by pregnant women in a rural area located in southern Jordan. This project was funded by an agency called “Women Advocate”. Dr. X. hired 3 female data collectors, and trained them to use a self-reported questionnaire to gather information about physical, social, and psychological stressors affecting the pregnant women. To avoid under reporting of exposure to physical abuse, the data collectors were trained to observe and detect any evidence of physical abuse while performing regular physical examination.

Ethical debate:

• To avoid miss conduct, what should Dr. X. do about the fund received from the agency called “Women Advocate”?
• Do you think collecting data about physical abuse through observation while doing regular physical examination is acceptable in this case?

Case study progress

The study recruited 200 women who gave the consent to participate in the study. Findings revealed that 20 women (10%) declared being exposed to physical abuse, and 15 of the abused women excuse their husband for their aggressive behaviors. Based on observation; data collectors reported additional 10 abused cases (5%).

In the final report, it was described that the prevalence of physical abuse among the Jordanian pregnant women is 15%.  Dr. X. and his team prepared the final draft of the manuscript and gave a copy of it to “Women Advocate”.

Ethical debate:

• Are there any ethical concerns about reporting the level of physical abuse among Jordanian women as 15%?
• Do you think that Dr. X. should report the physically abused cases to the family protection unit at police department?
• Do you think that Dr. X. should tell a trusted family member about the physically abused cases?

Case study progress

Next week while reading the newspaper, Dr. X. noticed a bold title “75% of Jordanian women accepting physical abuse by their husbands” written by a reporter who met with “Women Advocate” staff.

Ethical debate:

• Are there any ethical concerns about reporting that 75% of Jordanian women accepting physical abuse?
• What should Dr. X. do at this stage to correct the announced exaggerated findings?

Resolving ethical concerns

• The source of fund was clearly acknowledged in the final draft of the manuscript.
• The primary investigator decided to ignore observed data about physical abuse since women not consented about this.
• The study reported the prevalence of physical abuse among the study sample as 10%.
• The primary investigator contacted the newspaper and claimed that data about physical abuse among women either magnified or misunderstood, and request writing a correcting report directly.
• Next day the newspaper wrote under a bold title “A sample of rural Jordanian women revealed that 7.5% of them accepting physical abuse by their husbands”.

13. Case Study:

By: Mohammad Alsaggar, Iman Amrani, Saddam Aldemour and Ata Ali

Dr. Majed is a professor in cell biology department at World University of Biomedical Sciences. He is teaching a graduate level journal club class where research papers are discussed and criticized. As an assignment for that class, Dr. Majed asks students to look for unanswered questions in biology research related to papers topics, propose hypotheses and a summarized methodology to test these hypotheses. One time, the topic was about enzymes linked to endoplasmic reticulum (ER) having roles in lipid droplet formation and fat storage in cells. Omar is a graduate student in cell biology department taking that class. Omar came up with an idea about perilipin protein present in ER. He proposed that perilipin is lipid synthase enzyme that is involved in lipid biogenesis. He presented his idea (hypothesis and methods) in class.

 

Dr. Majed found the idea promising and could have implications for obesity treatment. He offered Omar to test the hypothesis in his own lab. However, Omar refused the offer because he planned to use it for a post-doctoral grant application year later. Dr. Majed went ahead and started working on the idea on his own lab, thinking that Omar has no exclusive rights on the idea because it was publically disclosed. Among experiments he went through, a confocal microscope was needed, which he doesn’t possess in his lab. He asked his friend Riad who is working on pathology department in city hospital to let him use the microscope (experiment will be run by Dr. Majed himself using hospital’s microscope). Riad asked back any authorship as a prerequisite for letting Dr. Majed to use the microscope. The work went fine and a manuscript came out of the work having Dr. Majed and Riad as authors. Omar discovered that his idea was tested and published, and lost his chance for postdoc fund.

Ethical Questions:

Q1: Does Omar have exclusive rights on ideas (It was an assignment in Majed’s class)?

Q2: Are ideas patented?

Q3: Is class presentation considered public disclosure (defies ownership)

Q4: Is Dr. Majed’s justification reasonable?

Q5: Does Riad have rights to use public facilities for his own benefits? What if it was a teaching hospital rather than a public one?

Q6: If Riad didn’t ask for authorship in return, would his behavior be ethical?

Q7: Is offering an instrument or workspace (even if it was owned) is enough contribution for authorship?

Q8: Does Omar have the right to sue Dr. Majed for stealing his idea?

Comments:

This scenario presents a case of intellectual property ethics. In this case, Omar certainly have the exclusive rights of his idea, even though it was a class assignment. However, ideas are not inventions to be protected by patents. Public disclosure deprives the exclusive rights on ideas because ideas can’t be patented, unless they are indeed unique and supported with some prelim evidence. In this case, as it is widely accepted, class presentation is not considered a public disclosure, and therefore, Dr. Majed’s argument is not valid. His behavior is unethical because he worked on the idea in spite of Omar’s refusal of the offer.

Another ethical issue in this case is the violation of authorship criteria by Dr. Majed and Riad. In the first place, Riad unethically used properties of public facility (the microscope of the public hospital) for his own benefit, which is irresponsible career conduct. Even, with teaching hospital, Riad still doesn’t have the right to use hospital property without the permission from the relevant administration in charge. Riad’s request for the authorship is also unethical, because doesn’t have enough contribution to claim authorship. According to ICMJE criteria, sharing instruments doesn’t qualify for authorship, therefore, Dr. Majed and Riad had authorship misconduct by listing Riad as an author.

Lastly, Omar has all rights to sue Dr. Majed for stealing the idea. Yet, Omar has to provide conclusive evidence that he owned the idea before Dr. Majed had started working on it. Omar needs to contact publishers of the article and submit his evidence for ownership.

 

14. Case study (Mentoring)

By: Fadia Mayyas and Mariam Abbas

You are a faculty member at department of cancer biology. A newly enrolled graduate student (Beth) at the molecular biology program was doing her last research rotation at your lab in January. Three months after, Beth approached you to be her thesis principal advisor, and you agreed. During the next semester, you found that she was taking more of your time than you realized or able to give. She was not at a point where she could effectively and correctly contribute to any of the calculations that you had in hand. She would frequently give you her own calculations for comment and, because of time constraints you usually were not able to read them in a timely way or find enough time to carefully re analyze them. Although you preferred an independent student who could contribute to the work effectively, you thought that the situation might improve over time. In September, a colleague in your department moved to another institution, and his advanced graduate student (Kate) decided to stay at your university rather than to accompany your colleague. Since you were working on the same research area where your colleague was working on, you were pressured by your department to take this student. As time progressed, it was clear that you could not effectively deal with both students and do all of the research that was needed in order to help them toward their degree or to help you present at a good tenure profile. Your options seem to be either to terminate the first student (Beth) or to keep both students.

Ethical Discussion

The two levels of ethical concern in this case scenario are:

• The decision made by the faculty member and how this decision would affect the student’s progress toward his degree and his tenure profile
• The behavior of the department when they pressured the faculty member to accept the new student.

Ethical questions that the faculty member might consider before making a decision:

• Is it ethical to terminate the younger student?
• What commitments did you make to the younger student?
• Did you discuss a timeline toward a degree?
• What is the attrition rate for graduate students in this department?
• Was this student given any indications that you were considering dropping your commitment to thesis supervision?
• If the faculty member elects to terminate the student, would she be treated fairly by the department after she was terminated?
• Was it ethical to pressure the faculty member to accept the second student?
• Is it ethical to keep both students?
• Was the new accepted student informed about the evolving situation?
• Did your department behave fairly (ethically) in pressuring you to take the second student?
• Were you promised any extra resources for accepting her? Were you told that it would help your tenure?
• As the situation deteriorated, did you discuss the problem with your department chair?

Other points that might be considered

• Does this department provide the support and the commitment to developing graduate students into professional PhD holders?
• Does this department have a strong commitment to helping assistant professors achieve good academic tenure?
• What kind of pressure was applied by the department? Was this ethical!
• Many departments require a thesis advisor for advanced students to be in good standing and to receive support. When the student was recruited for this graduate program, what kind of assurances was she given about departmental support? Would these assurances be honored if she were terminated?

Suggested solutions and alternatives

We think that the faculty member cannot take a decision before he informs both graduate students and the department chair as well as the thesis committee about the evolving situation. The mentor should discuss with his mentees what expectations he is waiting in order to be able to deal with both of them; both the mentor and the mentees should have realistic and well understood goals for the timing and the product of this relationship. This should involve a time line toward any research activities and tasks that will help the students to complete the requirements of their degrees. The mentor should make it clear to the younger student that she should provide more effort and contribution to be able to graduate and she might be dropped if she cannot do the expected work effectively and on timely manner. The newly accepted student should be fully aware of the situation and could be offered an option to find another advisor if she is not satisfied with this situation. The Mentor could also assign co-advisors for both students to help doing all the research work needed. It would be good idea if the mentor completes a graduate student progress report and report it to the department and thesis committee to be involved in such decision.

Mentoring is a relationship that should provide resources to promote healthy growth. Working in a mentoring atmosphere is very important. Department chairs and research directors, have an ethical obligation to create a healthy and relaxing environment that supports ethical and fair treatment and provides professional development opportunities for all group members. It seems unethical for the department to pressure the mentor to accept the recent student without justification or agreement from the mentor and the mentee. The department should provide the resources for the mentor and mentee to help them reaching their goals. The department should always be informed about any research obstacles and should try to solve these issues rather than creating new ones.

 

15. Self –Plagiarism

By: Rana Eljaber and Rawan Ababneh

Dr. Adam is looking for promotion in his job this year which totally depends on having published manuscript in prestigious journal.

He finished writing and reviewing his manuscript which was about using intravenous iron monotherapy for the treatment of non-iron deficiency anemia in cancer patients undergoing chemotherapy.

Dr. Adam had no time to send the manuscript and wait the editors’ responses for editing and acceptance, so he had decided to send the manuscript for more than one journal at the same time to save his time and once it is accepted in any of them he will withdraw it from the others.

Let’s assume that you are a coauthor in this study:

 Q1-What is the ethical issue that you are facing in this situation?

• The ethical issue is dual publication (self-plagiarism)
• Redundant and duplicate publication is defined as:
• The publication of what is essentially the same paper in more than one journal, but without any indication that the paper has been published elsewhere.
• The new publication may differ only slightly from the original by, for example, changes to the title, abstract, and/or order of the authors OR a slightly different interpretation of the data or the introduction to the paper.

Q2- What will your response be?

As a coauthor you have four scenarios:

• Write a report to the journals that he sent his publications for acceptance.
• Talk to him about that and request to withdraw it from one journal that he sent to.
• Write a report to the IRB committee describing the dual publication issue.
• Ignore the problem and go with him in this attitude as he is your colleague.

Q3: When may dual publication be acceptable?

• Summaries or abstracts of papers that are published in conference proceedings are often subsequently published in expanded form as a journal article.
• When an article published in one language is translated into a different language and published in a different journal.
• When a manuscript extends an original database by 50% or more.

Q4: What are the consequences of dual publication?

• It violates copyright, the copyright for the paper lies with the journal and not with the authors.
• It could distort empirical evidence because researchers studying the subject may count the same set of results twice.
• It leads to a waste of editorial and review resources.
• It denies other authors the chance to publish their work by unjustly taking up limited/competitive journal space.

In our case Dr. Adam reported to the IRB committee explaining the dual publication that was done by his colleague.