With Great Power Comes Great Responsibility: Ethical Dilemmas at the Top

Yeah, I know I stole the line from a Spider-Man comic!  But, recently an issue came up on one of the national committees I’m a part of, and it got me wondering about this issue. We all know which TV news stations have a Republican or Democratic slant.  Similarly, cardiovascular journals may have different slants. In our interventional community, a comparable pivot point might revolve around whether a journal is relatively conservative or aggressive in its outlook towards new technology, new procedures or the expansion of current procedural indications.

My question is whether research journals should be allowed to have a slant?  And if it’s there, should it be behind the scenes or right out in the open for all to see and understand before they open it up? I would very much favor the latter transparency, but the fact is that most journals evolve slowly into a particular slant, based on the nature and composition of its editorial board and in particular the editor-in-chief, and may not even realize they have a particular slant until someone else calls it out.  Meanwhile, the readership is looking at each manuscript’s merit in its own right, not knowing that they may be seeing the data through colored glasses.

Now, I’m not saying this happens all the time, but it certainly is something that people are starting to talk about more and more. And, no, I won’t mention any names of editors or journals (or even websites).  But, certainly I’ve heard of prominent journals asking authors to change the title of a submitted manuscript, or change the tone or conclusions, as “suggestions” towards resubmission and final acceptance. And yes, authors make modifications all the time in order to get a manuscript published, even these types of editorial license compromises.

The practice is not at all pervasive at the moment, just starting to show its ugly head.  Thus, this particular blog is more of a “wake up” call both to authors submitting manuscripts and those reviewing and accepting them. The ethical dilemma is on all of them. Let’s either keep a journal’s agenda out in the open for all to see, or make sure there is a firewall between any agenda (either intentional or unintentional) and the actual writing or manuscript modification process. Once again, lessons I learned as a youth reading comics pertain to how we do business as adults. Thank you Stan Lee!


Dr. Srihari S. Naidu is Director of the Cardiac Catheterization Laboratory, Interventional Cardiology Fellowship Program and Hypertrophic Cardiomyopathy Treatment Center at Winthrop University Hospital, and Assistant Professor of Medicine at SUNY – Stony Brook School of Medicine.