Corruption in medicine

I regularly speak to medical audiences on research fraud. I always ask whether those in the audience have personal experiences of fraud. Usually more than half put up their hands. “In how many cases,” I ask, “was there a proper investigation, punishment given if necessary, and the scientific record corrected?” Hardly a hand goes up. Stephen Lock, my predecessor and a pioneer in alerting doctors to research fraud, found the same in a postal survey of academic friends.

Peter Wilmshurst, a consultant cardiologist and perhaps British medicine’s “champion whistleblower,” argues that British academic medicine is corrupt. He tells the story of Anjan Kumar Banerjee. A decade elapsed between the time when Banerjee admitted to senior doctors at King’s College Hospital that he had falsified research and when he was found guilty of serious professional misconduct. In the meantime, he had been awarded a degree based on the fraudulent research by the University of London (which is still not retracted), become a consultant, had his work published in Gut, been awarded a professorship by the Royal College of Surgeons of England, and become a fellow of one of the royal colleges of physicians. As Wilmshurst shows, many senior people knew of the many problems associated with Banerjee’s work. In September 2002 Banerjee was again found guilty of serious professional misconduct, this time for financial fraud. Policemen, unlike doctors, work on the assumption that once something is shown to be fraudulent everything else is fraudulent until proved otherwise.

The article by Wilmshurst has its origins in a seminar he gave to the BMJ in 1996. For years he had been informing us of misdemeanours. Fears of libel stopped us from publishing. Then we invited him to give his seminar, behind closed doors. Many BMJ advisers were there. We listened to his stories in rapt silence. I wondered how the audience would react. Would they drive him from the building? The opposite happened. People said things like: “I know that story, and it’s even worse than you think.”

He was advised to take his cases to the GMC, and a stream of convictions has followed. One case was decided last week. Cardiologist Clive Handler was found guilty of serious professional misconduct for financial dishonesty. He was the subject of an internal hospital inquiry and left the hospital in 1998. Documents that might have helped the GMC inquiry were destroyed at that time. The internal inquiry was carried out by Professor Peter Richards, who is now chairman of the GMC’s professional conduct committee.

Until very recently I thought of integrity as something you had and lost only through misbehaviour. Now I think of it as something you must struggle every day to sustain. Constantly we are presented with problems where a response that is less than wholly honest is the easiest response. Most of us succumb, but some people—like Peter Wilmshurst—work to a higher standard. Such people might be statistically odd, but medicine is lucky to have them.

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