Abstract
It is my sincere belief that all practising clinicians have at least one idea, observation, or case that could form the basis of a medical ethics article. It is a matter only of identifying what that is, and putting it on paper in the right form. Armed with the ability to identify and analyse an ethical problem, you are in a position to publish articles and to contribute to the literature. Potential outlets include general medical journals, specialty journals, medical ethics journals, and newspapers. This chapter provides guidance on how to publish in clinical ethics. Again, it is based on my own experience as an author, reviewer and editor. It does not purport to be beyond dispute.
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Notes
- 1.
“The idea or angle for an article is half the struggle”, one of my graduate school professors used to say. If writing about end-of-life ethics, for example, how will your article differ from the thousands of others? Wise is he who writes about less explored but important areas of medicine. Disaster medicine and military medical ethics have been relatively neglected by ethicists and provide rich opportunities for scholarship and publications (see Appendix 2), but every medical specialty has ethical issues that have been overlooked in the literature.
- 2.
Abbasi K, personal communication, 18 August 2011.
- 3.
Appendix 7 contains a short article in which I aimed to include a number of ‘aha’ moments in quick succession.
- 4.
An eminent professor of obstetrics and gynaecology found himself in hot water, and in the pages of tabloid newspapers, when he added his name to a publication written by one of his team (Jaffer and Cameron 2006). The lead author had fabricated the data. When the truth came out, the professor was forced to resign from the presidency of the Royal College of Obstetrics and Gynaecology (RCOG) and from the editorship of the RCOG journal.
- 5.
One clear and methodical approach is to address each reviewer’s comment as follows:
Reviewer’s comment 1: (insert the comments here either verbatim or in summary.)
Response 1: (include your response to the comment. Avoid the temptation to dismiss the comment as idiotic or to ignore it altogether. The editor may decide to send the document to the reviewer in question.)
Modification 1: (include the specific modification to your article here.)
Then continue with Reviewer’s comment 2, Response 2, Modification 2 and so on.
- 6.
For readers unfamiliar with those terms:
Utilitarianism is a type of consequentialist moral theory. Consequentialists believe an act is morally right or wrong based only on its consequences. What are good consequences? For classical utilitarianism, the ultimate good is pleasure or happiness, so the consequences of an act should be measured in terms of the amount of pleasure or happiness produced by the act. In short, for a classical utilitarian, morality is about maximising happiness and minimising unhappiness.
Deontology, unlike consequentialism, places duties (the ‘deon’ in deontology comes from the Greek word for ‘duty’) and rights at the centre of ethics. For a deontologist, morality cannot be reduced merely to consequences. Note that in France medical ethics is called ‘déontologie médicale’. For a succinct and lucid account of some key ethical theories, I recommend Piers Benn’s Ethics (Benn 1998).
- 7.
I once spent two years of my life forging a satisfactory definition of the word ‘deception’ and published it in a respected bioethics journal. Six months after publication, I had received no comments on the article. A year later, no comments. Two years later, no comments. I doubt five people have read that paper.
- 8.
Warry R, personal communication, 8 July 2011.
- 9.
Be aware, however, that some journals refuse submissions which include data already presented at conferences, or which appear in an abstract.
- 10.
Yet, do not expect invitations to come pouring in after only one or two publications, even if they appeared in ‘heavyweight’ journals. In his autobiography, Steve Martin described his elation at appearing on the renowned American TV programme The Tonight Show. He expected instant recognition.
Here are the facts. The first time you do the show, nothing. The second time you do the show, nothing. The sixth time you do the show, someone might come up to you and say, ‘”Hi, I think we met at Harry’s Christmas party.” The tenth time you do the show, you could conceivably be remembered as being seen somewhere on television. The twelfth time you do the show, you might hear, “Oh, I know you. You’re that guy.” (Martin 2007, pp. 125–126).
In my experience, the same is true in medical ethics. It takes time to get known, or at least sufficiently known that conference organisers and journal editors think of you when deciding who to invite or commission.
References
Benn P (1998) Ethics. Routledge, London
International Committee of Medical Journal Editors (2011) Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Ethical Considerations in the Conduct and Reporting of Research: Authorship and Contributorship. http://www.icmje.org/ethical_1author.html. Accessed 3 July 2011
Jaffer U, Cameron A (2006) Deceit and fraud in medical research. Int J Surg 4(2):122–126. doi:10.1016/j.ijsu.2006.02.004
Martin S (2007) Born standing up. Pocket Books, London
Nauert R (2011) Insights on the ‘Aha’ moment. Psychcentral.com. http://psychcentral.com/news/2011/04/01/insights-on-the-aha-moment/24906.html. Accessed 16 July 2011
Sokol D, Car J (2006) Patient confidentiality and telephone consultations; time for a password. J Med Ethics 32:688–689. doi:10.1136/jme.2005.01441
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Sokol, D.K. (2012). Clinical Ethics on Paper. In: Doing Clinical Ethics. SpringerBriefs in Ethics, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-2783-0_2
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