On beginning his recent sabbatical at the Mayo Clinic, Professor Michael O’Rourke, a renowned academic from the University of New South Wales, was handed a slim volume entitled Honor in science. First published in 1984, it is recommended reading for research trainees as a guide to ethics and the values of research. Significantly, there are now more than 50 000 copies in circulation.1

Activities such as the dissemination of this booklet are central to ensuring society’s trust in the integrity of research. More than 20 years ago, Al Gore Jr (then a United States congressman, and later Vice President in the Clinton administration), as chairman of the first congressional hearing into scientific misconduct, noted: “At the base of our involvement in research lies the trust of American people and the integrity of the scientific exercise.”2 There is no reason to believe that this would be any different in Australia.

But trust in our research enterprise has recently been shaken by the “Hall affair” at the University of New South Wales (UNSW). At the end of 2001, complaints of research misconduct were levelled at Professor Bruce Hall, a Professor of Medicine at UNSW, and an internationally acclaimed scientist in immunology. The complainants were members of Hall’s research laboratory and it has taken more than 2 years to resolve their allegations. During this time, there were four different inquiries and reports, which reached different conclusions (see Box). From the beginning of the affair, all the allegations have been vigorously denied by Hall.

Sadly, as it unfolded, the Hall affair illustrated the reality that allegations of research impropriety affect the careers of both the accused and the accusers and, in the process, can divide an institution and damage its reputation.11 Most importantly, such allegations jeopardise public trust in the integrity of research. Further, they provide fuel for a media that feeds on human discord, and, dealing in perceptions and innuendo, accelerate this corrosion.

The Hall affair was first publicly dramatically exposed on the Australian Broadcasting Corporation (ABC) Radio National’s Science Show,4 and then clinically dissected by ABC television’s Four Corners9 (see Box). The media also covered the investigation as it progressed and, on the release of the UNSW Vice-Chancellor’s Report on the affair,8 one journalist commented, “Let me get this straight. Plucking data from thin air, recycling old research in new papers and telling porkies in a grant application is OK. Funny, I thought such doings were serious no-nos, construed at best as scientific misconduct, or at worst scientific fraud. Apparently not . . .”12

Looking back over the Hall affair, we are forced to ask ourselves how we can move forward. Are there any lessons to be learned?

Scientific misconduct and fraud may well be seen as an illness, requiring not only diagnosis but also treatment. The diagnosis involves a fast and fair inquiry which, at the same time, must assure the public of its propriety. Unhappily, the Hall affair dragged on for more than 2 years and involved at least four inquiries (see Box).

The initial inquiry by the UNSW’s Dean of Medicine should not have moved beyond a prompt and preliminary process to establish whether there was a case to be answered. In any event, it went on, patently crippled by perceptions of conflicts of interest — including an institution investigating allegations of improprieties carried out in its own backyard! Herein lies lesson number one — once allegations of scientific misconduct and fraud have been made, these should be addressed from the beginning by an external and independent inquiry.

The external inquiry must establish the evidence for misconduct. From the publicly available details of the Brennan Inquiry,7 it appears the inquiry had its hands tied in testing the evidence. Herein lies lesson number two — the external inquiry should have statutory power to investigate and inquire. Defining this power will not be straightforward, as the inquiry should not be hijacked by obfuscating and delaying legal tactics.

The Brennan Inquiry was made up of legal and scientific experts, with the latter in the majority. Despite the fact that the framework of research conduct is generic, professional criticisms surfaced in the Four Corners program9 and elsewhere about the inquiry panel’s lack of expertise in immunology.10,13 To allay public concerns about the lack of relevant “expertness” — inquiries into allegations of scientific misconduct and fraud should consider having on the panel of inquiry at least one expert from the same scientific discipline as the scientists under investigation — lesson number three!

In the 2002 Reith Lectures for the British Broadcasting Corporation, Onora O’Neill stated that “. . . ‘Loss of trust’ is, in short, a cliché of our times.”14 Mistrust of professionals, politicians and public servants and their institutions permeates our society. The antidotes to this “culture of suspicion” are supposedly higher standards of accountability and greater transparency.14 As it progressed, the Hall affair was not the epitome of transparency and, to date, the details of its four inquiries remain cloistered within academia. Herein lies lesson number four — to preserve public confidence, inquiries into scientific misconduct should aim for the highest degree of transparency and accessibility of final reports.

Finally the Vice-Chancellor’s Report (see Box) makes judgements on the outcomes of the Brennan Inquiry, and also conveys opinions on the relative value of scientific abstracts and the nature of data in research-funding applications that are at odds with conventional scientific wisdom.

Even more intriguing is the rationale behind the action of the Vice-Chancellor in judging the findings of the Brennan Inquiry, yet not consulting its panel. Why bother with an external inquiry if its outcomes are to be subsequently interpreted and judged by an individual calling on his own wisdom along with the views of another battery of experts? Such action may be in accordance with and required by the UNSW enterprise agreement, but surely the integrity of research transcends any industrial agreement! Herein lies lesson number five — universities, research institutions, research societies, societies and funding bodies need to collectively define uniform processes and procedures for addressing and adjudicating on scientific research and fraud.15

But what about treatment? The emphasis in healthcare today has shifted from the management of diseases to their prevention, and herein lies lesson number six — there is a need to shift the emphasis from managing scientific misconduct and fraud to preventing them. This shift is thoroughly summarised in the recent report of the United States Institute of Medicine (IOM), Integrity in scientific research: creating an environment that promotes responsible conduct.16 Its central theme is the need to foster responsible research conduct, and it identifies the individual scientist as the most unpredictable variable in the equation. But it also throws back to institutions the responsibility of creating a culture that values research integrity through comprehensive and effective education, self-assessment and self-improvement, aimed at both the individual and the institutional level.

In short, the IOM report moves the prevention of research misconduct from focusing on what we should do in the conduct of research, as prescribed in guidelines, codes of conduct and other affirmations or declarations, to determining what we actually do through individual and institutional self-assessment, and moving to best practice through education and continuous improvement underpinned by a reward system. The IOM report lists desirable goals for both individuals and institutions in maintaining scientific integrity, but, ultimately, research is an intense and complex human exercise — one which sees young investigators and their mentors working in a “pressure-cooker” environment, where the only safety valves are open communication, mutual respect and mentors prepared to be actively involved.

In his 1982 Presidential Address to the American Society for Clinical Investigation, Phillip Majerus (Professor of Medicine, Biochemistry, and Molecular Biophysics at Washington University, and past editor of the Journal of Clinical Investigation) describes this ideal environment: “Students, postdoctoral fellows and junior colleagues are the future of medical research. They are our most valuable resource and should be treated as such. Senior investigators have a solemn responsibility to guide trainees to allow them to express their full potential. If because of clinical, administrative or other constraints, an investigator does not have time to participate in the ongoing progress of an investigation on a day-to-day basis, then he should dissociate himself from it . . . Work in progress should be discussed openly and the data should be reviewed, frequently, not just by the laboratory chief but also by disinterested parties. Group meetings of large laboratories where there is evaluation of data of individuals are important. Even better are presentations to departmental or other groups, where investigators not directly connected with the work, evaluate the data. These exercises require heavy applications of skepticism, the most important ingredient in scientific creativity.”17

Good advice then and good advice now.

The Hall affair has wreaked untold havoc, but, despite this, can be viewed in a detached, scientific sense as experiments in processes and procedures. The results of experiments need to be mulled over and interpreted to determine future directions. In this vein, the Hall affair should make a contribution to the pursuit of research integrity.

Ultimately, integrity in research requires leadership. If, in the wake of the Hall affair, our universities cannot ensure an enlightened and responsible ethos in their research enterprises they risk a loss of public confidence. The ball is in their court.