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The evil impact of medical research misconduct

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BY Dr B. J. C. Perera
MBBS(Cey), DCH(Cey), DCH(Eng), MD(Paed),

MRCP(UK), FRCP(Edin), FRCP(Lon), FRCPCH(UK), FSLCPaed, FCCP, Hony FRCPCH(UK), Hony. FCGP(SL)

Specialist Consultant Paediatrician and Honorary Senior Fellow, Postgraduate Institute of Medicine, University of Colombo, Sri Lanka.
Joint Editor, Sri Lanka Journal of Child Health
Section Editor, Ceylon Medical Journal

The scholarly eye-opening article ‘Retracted research ~ 1’ by Amal Mandal, a former Associate Professor of Political Science from West Bengal, India, published in The Island Newspaper on 01-03-2024, and the follow-up article ‘Retracted research ~ 2’ by the same author, published on the following day, would have sent shock-waves and shivers down the spines of all involved in scientific publishing. Those newspaper items were primarily based on an index article titled “More than 10,000 research papers were retracted in 2023 — a new record.” published in the reputed scientific journal Nature on 12th December 2023(1). It reported on the unbelievable and gut-wrenching situation in 2023 when implausible numbers of so-called original research articles published in many journals, including those of tremendous pedagogic repute, were retracted (withdrawn) following publication, for a variety of reasons.

Amongst the whys and wherefores for retractions, academic research misconduct comes up pretty high in the ranking order. It has been known for quite a while but now it has really been put out into the open and the cat is most definitely out of the bag. As reproduced almost verbatim here from a communique from Imperial College London, UK(2), “research misconduct has been characterised as actions or questionable research practices that fall short of the standards of ethics, research and scholarship required to ensure that the integrity of research is upheld. It can cause harm to people and the environment, waste resources, undermine the research record and damage the credibility of research. It is often defined by ‘falsification, fabrication and plagiarism’ and can include making up data or results, incorrectly attributing authorship, gift authorship, manipulating research data, materials, equipment, or processes, or changing or omitting data, graphs, images, or results.”

In the main, many of those papers that have been retracted have published results and material that are not perfectly authentic and tenable from the point of view of a rigorous scientific appraisal. In other words, to put it in perspective and even to state rather bluntly, they are fraudulent attempts at securing scientific publications, even at the price of sacrificing intellectual honesty. All kinds of misdemeanours are known to occur in the many strata of people involved in the scholastic publishing industry. Amongst these, unscrupulous authors of so-called original research articles, which are of doubtful validity, take pride of place; certainly not a situation to be proud of, but only fit to be relegated into a contemptible bin of disgrace. The main worry of all these aspects is the fact that the inadequacy of scientific precision in many of these articles has been detected only after they had been accepted and published in the journals concerned. The articles had got into the published public record by the time the problems had been detected.

Bio-medical scientific publications are so very important because they attempt to provide the precise technical basis and erudite reasons for the causation of, as well as the accepted management strategies for human disease. Medical journals have an abiding impact on the diagnosis and treatment of human illnesses and the way we provide essential healthcare to unfortunate patients. They are the pivotal foundations of current knowledge on which up-to-date treatment of diseases and disorders affecting humans are based.

There is no room for two words or give-and-take provisions in that endeavour. Medicine and healthcare that are evidence-based should undoubtedly be the cardinal principles on which diagnosis, treatment and further management are unequivocally based. However, sadly for sure, if the fundamental principles of reliability in good quality research which ultimately percolates as benefits to sick humans are faulty and leaves a lot to be desired, there is no hope at all for progress in medicine.

The terrible consequences of research misconduct can be extremely severe and ever so grave. Such aftermath effects would include causation and propagation of preventable illnesses, the loss of human life due to misinformation in the literature as well as continued citing and usage of retracted work. It can also result in wasted resources, both human and financial when newer research processes or clinical work are based on previous flawed or fraudulent research. Deceitful research is the pits of the world and is fit only for guttersnipes.

Funding agencies often require that cases of research misconduct be reported to them which can be damaging to the careers of those who commit transgressions and there is a financial cost to the institution in investigating allegations as well. The retraction of papers and reputational risks of misconduct can be damaging to the research careers of those who commit misconduct as well as their academic institutions.

There are well-organised systematic initiatives such as “Paper Mills” that undertake certain nefarious academic activities for filthy lucre(3). These are money-making unethical commercial ventures which specialise in producing fake or fraudulent research papers. Very often the main parent organisations are in one country, the customers who pay a lot of money for these dubious services are in another country and the ‘ghostwriters’ who produce the papers for pretty high payments but are totally behind the scenes, are perhaps even in yet another country. It is extremely difficult to track down these miserable goings-on and bring the perpetrators to book.

There is also the distasteful spectre of Predatory Journals, also known as fraudulent, deceptive, or pseudo-journals(4) looming on the horizon. They are a mushrooming plethora of journals with questionable and scientifically unsatisfactory review, assessment and publication practices. They tend to play on the personal susceptibilities of authors such as securing publications to satisfy academic requirements of scholastic institutions where they work for considerable sums of money.

From a different perspective, one has to acknowledge that the current vogue of Artificial Intelligence (AI) has revolutionized various sectors, including biomedical research, bringing about promising breakthroughs in disease diagnosis, drug discovery, and treatment optimization. It is an undeniable truth that AI is here to stay. However, beneath the veil of optimism lies a darker reality; AI’s negative and even ugly effects on biomedical research. To all these things that are taking place now in the publication portals of biomedical research, if we add the potentially deleterious effects of AI, say even to enterprises such as Paper Mills, one would shudder at the likely consequences. The possibilities and the deleterious potential of the harmful usages of AI are suspected and somewhat known at present and are established to be quite disastrous.

The way things have panned out, while AI offers tremendous potential, its integration into this field has raised ethical, social, and practical concerns that cannot be overlooked. One of the foremost concerns is the perpetuation of biases. AI systems learn from data, and if this data is biased, the AI models will reflect and perpetuate these biases. In biomedical research, biased data could lead to skewed results, misdiagnoses, and unequal treatment. Moreover, the opaque nature of AI algorithms poses a challenge to transparency and reproducibility in research. Unlike traditional research methods where processes are transparent and results can be scrutinized, AI models often operate as ‘black boxes’, making it difficult to understand how decisions are made. This lack of transparency undermines the scientific method and hampers the ability of researchers to validate findings or identify errors, potentially leading to misguided conclusions and wasted resources.

Furthermore, overreliance on AI may diminish the role of human expertise and intuition in biomedical research. While AI algorithms can analyse vast amounts of data and identify patterns, they lack the contextual understanding and creativity that human researchers possess. This could lead to the neglect of valuable insights that cannot be quantified or captured by algorithms alone, thereby stifling innovation and limiting the potential for groundbreaking discoveries.

All the foregoing details and statements have a direct bearing on the work of editors of medical journals in the publishing industry. The author of this communique is very conscious of, and, in fact, seriously worried about, these implications concerning his work with editorial duties in two esteemed medical journals of Sri Lanka. Some of these potential consequences strike at the very core of the heart of medical publishing endeavours; namely the authenticity, veracity and unabridged reliability of the research material that is published in medical journals.

It has to be acknowledged that most medical journals have peer review systems in place which assess the different features, scientific quality, and many other components as well as implications of articles of research that are submitted to the journals. The research papers in medical journals are published after a rigorous process of such intense appraisal. However, as evidenced by the alarmingly increasing numbers of retractions, this system has perhaps most unfortunately not been all that successful in maintaining the very best standards of medical publications. It is getting progressively difficult to separate the grain from the chaff, especially for the editors of medical journals. This editor at least is well aware of the likely problems and constraints that would be placed on the venture of publishing well-tested and reliable scientific papers in the not-too-distant future.

References

1. Van Noorden R. More than 10,000 research papers were retracted in 2023 — a new record. Nature 2023;624:479-481.

2. What is research misconduct? Available from https://www.imperial.ac.uk/research-and-innovation/research-office/research-governance-and-integrity/research-integrity/what-is-research-integrity/what-is-research-misconduct/ Accessed on 01-03-2024.

3. Perera BJC. ‘Paper mills’: a detestable blot like no other. Sri Lanka Journal of Child Health 2021;50(2):185-187.

4. Elmore SA, Weston EH. Predatory Journals: What They Are and How to Avoid Them. Toxicologic Pathology 2020;48(4):607-10



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Features

Civilizational dialogue proving a remote possibility as realpolitik rages

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Political leaders at the Shanghai Cooperation Organization Summit 2026. (Photo by PROKOFYEV / POOL / AFP)

Looking back over the years since the 9/11 catastrophe, it could be said that barring former Iranian President Mohammad Khatami no world political leader of note has made an earnest effort to change the nature of global political discourse for the better. Khatami won world acclaim for his pronouncement that the time is right to launch and sustain a ‘Dialogue among Civilizations’.

This was in marked contrast to US political scientist Samuel P. Huntingdon’s epochal theses, formulated in the wake of 9/11 and other global political tumults that the Post Cold War era is essentially one of conflicts among civilizations. That is, people’s identity markers, such as culture and religion, are the prime shaping forces of international conflicts.

From a Political Realism standpoint, Huntingdon’s theory may seem to have gained in credibility over the years but it is Khatami’s pronouncement that has evoked an empathetic response in the hearts and minds of publics world wide. So much so, 2001 was proclaimed by the UN General Assembly as the ‘Year of Dialogue among Civilizations’.

It could be said that the latter proclamation was an endeavour to give back to humans their essential identity of peace-makers. It was an eschewing of the position that war and conflict are central to the human condition and amounted to upholding constructive dialogue among peoples and civilizations as a path to peace.

That things have not worked out in the world in keeping with the expectations of peace makers does not in any way invalidate the thesis that peace is the essential propensity of humans.

If peace-making is seemingly ineffective it is primarily because the path to peace is narrow, tortuous and time-consuming. On the other hand, violence usually misleadingly recommends itself to the human as the more expedient, cost-effective way out of a conflictual situation. However, the ultimate cost of the latter approach is prohibitive because it brutalizes the human beyond recognition.

Some of the evidence is before our eyes. The Trump administration, for example, has, minus much forethought, unleashed what may be described as a ‘quick-fix’ war against Iran but is now finding that it is in a veritable military quagmire in West Asia. The priority for the administration now seems to be a face-saving escape strategy. Such are the costs of the war option.

However, there is no denying that much remains to be done by the world community to bring peoples and cultures together with a view to enabling them to work as one for the cause of a less dangerous world.

Meanwhile, the broad divisions in international politics continue and past political polarities are lingering to the detriment of enhanced international understanding. The East and the West and the South and the North, for instance, are continuing to work in separate collectives, more or less, and no notable efforts are being made by the international community to bring these sides together for the purpose of united constructive action that could usher greater international well being.

The recent Shanghai Cooperation Organization Summit, 2026, held in Kyrgyztan was a replication of the above broad trends but there were some statements at the forum by Indian Prime Minister Narendra Modi that deserve special scrutiny and comment.

Modi was quoted saying among other things: ‘The land of Gandhi and the land of Buddha share a single message: the path to peace!..We must move away from endless war towards an end to the war. This is essentially for the well being of humanity. A peaceful resolution to all issues at the earliest is the call of humanity, and this is India’s message.’

The above is the language of international peace and unity. It is such language that will help in building bridges among civilizations and advance the cause of world peace. Besides, it will help bring a measure of understanding between North and South.

In this regard, the Trump administration could take a leaf or more from the Modi government. Unless it makes a ‘U turn’, as it were, in the direction of peace and reconciliation it is very unlikely that the US and the world would experience any stability worth speaking of.

Right now the US is savaging the sovereignty of Venezuela. It is a question of the ‘Empire striking back’ but Venezuela is a far cry from Iran. Iran has outsmarted the US on the battle field and is in a position to influence broad trends in the world economy since it still has control over the Hormuz Straits. That is, Iran could exercise a determining influence over world oil, gas and energy prices. In short, the US consumer’s future peace of mind is very much in the hands of Iran.

Given the above backdrop it should have dawned on the US political leadership that working towards cordial relations with Iran is the most advisable option. The US, simply, has too much to lose otherwise.

Likewise, Russia too needs to take a leaf from India. It is plain to see that its invasion of Ukraine is proving totally ineffective. It has not brought any measure of peace for the Russian people. Russia is right now experiencing a rerun of its military misadventure in Afghanistan. On the other hand, sections of the peoples concerned have been victimized and even brutalized.

Accordingly, there needs to be a coming together of democratic opinion worldwide for a fresh consideration of the options facing humanity. There is a dire need for value-based politics to take the place of Realpolitik. Besides, the language of peace and humanity needs to replace current divisive discourse with its stress on polarities and antagonisms.

International organizations of the stature of the UN need to take the lead in spearheading the above initiatives. Right now the UN gives the impression of being a spent force. This columnist hopes that he would be proved wrong on this score because the UN remains the only hope of the poor and victimized. It will be in the interests of all peoples for the UN to rejuvenate itself and dedicate itself increasingly enthusiastically to the cause of international peace.

Whether it be the South or North, dynamic, visionary political leadership and direction emerges as essential. The need is for voices that would espouse peace and accord across boundaries and divisions. For South Asia, India and Pakistan have the potential to fill this lacuna.

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Sri Lanka’s constitutional test: Judicial independence beyond immediate political moment

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Superior Court Complex, Colombo

by Shelton Dharmaratne

Sri Lanka has reached an important constitutional moment.

The proposed 22nd Amendment has moved beyond political debate and into the constitutional process through which its validity will be examined. That development should change the character of the national discussion.

That is understandable in a politically contested environment. But Sri Lanka should now resist reducing a question of constitutional design to a contest over political positions.

The deeper issue concerns the relationship between constitutional reform, judicial independence and public confidence in the institutions of the State.

The Supreme Court will determine the constitutional questions before it. Public commentators should therefore exercise restraint in predicting, interpreting or seeking to influence that determination. But restraint does not require silence. It requires a more rigorous discussion of the institutional principles at stake.

A narrower constitutional question than the political debate suggests

The proposed amendment principally concerns the retirement ages of judges of the Supreme Court and Court of Appeal, together with an increase in the maximum number of judges permitted on the Court of Appeal.

Under the proposal, the retirement age of Supreme Court judges would rise from 65 to 67 and that of Court of Appeal judges from 63 to 65. The maximum number of Court of Appeal judges would also increase from 19 to 24.

Other proposed changes concerning the retirement ages of judges in the lower courts arise under separate legislation. This distinction matters because the public debate has sometimes treated the wider package of judicial reform as though it formed a single constitutional proposal.

Nor should the central issue be reduced to whether retaining experienced judges is inherently good or inherently dangerous. Both propositions are too simplistic.

Sri Lanka faces a substantial burden of pending litigation, and delays in the administration of justice impose significant costs on citizens, businesses and the State. Experienced judges represent an institutional resource. Continuity, accumulated knowledge and familiarity with complex areas of law cannot always be replaced immediately.

Those are legitimate policy considerations.

But the opposing concern is equally important: judicial tenure is not merely an employment condition. It is a structural component of judicial independence.

The real question is institutional

The critical question is not whether an individual judge is capable of acting impartially. It is whether the constitutional structure provides adequate protection against circumstances in which judicial tenure could become connected, directly or indirectly, with political authority.

That is an institutional question, not an accusation against individual judges.

A judge may be entirely conscientious and independent while the institutional arrangements surrounding the judiciary nevertheless create public doubts about independence. Constitutional democracies therefore cannot depend solely on the personal integrity of office-holders. They must construct institutions capable of preserving independence even when governments, individuals and political circumstances change.

This is particularly relevant when constitutional reform concerns the tenure of serving members of the superior judiciary.

The institutional sensitivity of such a proposal should neither be exaggerated into an allegation of improper motive nor dismissed as irrelevant. The appropriate response is transparency, procedural fairness and confidence in constitutional safeguards.

Legitimate objectives do not settle constitutional questions

The government has stated that its objectives include strengthening the administration of justice, addressing delays, retaining judicial experience and increasing institutional capacity.

Those objectives deserve serious consideration. Sri Lanka needs judicial reform. Citizens waiting years for their cases to be concluded experience the justice system very differently from those discussing it in Parliament, courtrooms or universities.

A government is therefore entitled to propose reforms designed to improve judicial efficiency.

But legitimate objectives do not automatically resolve constitutional objections. The relevant question is whether the means chosen are compatible with the constitutional structure and whether sufficient safeguards exist against unintended institutional consequences.

That is precisely why constitutional scrutiny matters.

The concerns of the Bar Association of Sri Lanka (BASL) should likewise be examined without political labelling. Opposition to the proposed changes should not automatically be characterised as opposition to judicial reform or an attempt to obstruct the government. At the same time, invoking judicial independence does not place any argument beyond scrutiny.

The appropriate questions are straightforward:

Does extending judicial tenure strengthen the administration of justice?

What risks, if any, could it create for judicial independence?

Are adequate institutional safeguards in place?

Does the proposal operate prospectively, or does it affect judges already serving?

Could the same objectives be achieved by filling vacancies, increasing judicial capacity, improving court administration and strengthening case management?

These questions can be examined rationally without attributing improper motives to either side.

Judicial vacancies and institutional confidence

Recent concerns raised by the BASL regarding judicial vacancies add another dimension to the debate. The BASL has argued that vacancies in the Supreme Court contributed to the retirement of a senior Court of Appeal judge without promotion to the Supreme Court, despite vacancies having existed. It has also raised concerns regarding forthcoming judicial retirements and the need for timely consideration of appointments.

Such matters should not be treated as evidence of the motives behind the proposed amendment. They do, however, illustrate a broader principle.

Judicial independence is shaped not only by the retirement age written into the Constitution. It is also influenced by how vacancies are filled, how promotions are determined, how seniority and merit are assessed, and whether judicial officers and the public believe that institutional decisions are made according to transparent and defensible criteria.

The government has an opportunity to address these concerns constructively.

Prompt appointments based on publicly defensible principles would strengthen confidence in the judiciary irrespective of the eventual outcome of the constitutional debate.

Seniority, merit and transparent criteria

The controversy also exposes a longstanding question concerning judicial appointments.

Seniority has traditionally carried considerable weight in judicial advancement. Yet seniority alone need not be the sole measure of merit. Conversely, replacing established practices with undefined assessments of “merit” could create another institutional problem.

If governments or appointing authorities can determine which judges are sufficiently meritorious without clear and objective criteria, uncertainty itself may become a source of institutional anxiety.

Sri Lanka would therefore benefit from clearer, objective and defensible standards governing judicial appointments and promotions.

Such standards would protect judges as well as appointing authorities. They would reduce opportunities for favouritism, strengthen institutional confidence and make it harder for political actors to portray every appointment as politically motivated.

Institutional rules are stronger safeguards than assurances of good intentions.

The State is larger than any government

One principle deserves particular emphasis: a government is not the State.

Governments are temporary. The constitutional State is continuing. Political parties change, parliamentary majorities change and political priorities change. The judiciary, however, must continue to function independently of whoever occupies the government benches.

The judiciary is neither a government institution in the political sense nor an Opposition institution. It is an institution of the State whose legitimacy depends upon its independence from both.

For that reason, governments should exercise particular caution when proposing constitutional changes affecting the judiciary, even where the policy objectives are legitimate.

The stronger a government is politically, the greater its responsibility to demonstrate institutional restraint.

That is not political weakness. It is constitutional maturity.

Public confidence is a constitutional asset

The most consequential issue may ultimately be neither retirement age nor judicial capacity, but public confidence.

Courts do not possess political power in the conventional sense. Their authority rests substantially on the acceptance of their decisions as legitimate.

Citizens will sometimes disagree with judicial decisions. But where the judiciary is perceived as independent, even unpopular decisions can command respect. If judicial institutions are perceived as being shaped by political convenience, even legally sound decisions may become vulnerable to suspicion.

Constitutional reform affecting judicial tenure must therefore be evaluated not only by its immediate administrative benefits but also by its effect on institutional credibility.

A reform that produces short-term efficiency while weakening confidence in judicial independence could impose a greater long-term cost. Conversely, reform that improves efficiency while preserving independence can strengthen both justice and public trust.

The challenge is not to choose between judicial efficiency and judicial independence. It is to achieve both.

If a referendum arises …

If the constitutional process ultimately requires approval by the people at a referendum, the debate should rise above the conventional government versus Opposition contest.

The electorate should be given a clear constitutional question and sufficient information to assess it.

Citizens should understand what problem the amendment seeks to address, why the proposed mechanism is considered necessary, what institutional risks have been identified, what safeguards exist and whether alternative measures could achieve the same objectives.

A constitutional referendum deserves a higher standard of public discussion than an ordinary election campaign.

The people would not merely be choosing a political side. They would be deciding the institutional framework within which political power and judicial authority operate.

Beyond who wins

The most important question arising from the proposed Twenty-Second Amendment is therefore not simply whether the government succeeds or whether the Opposition and BASL prevail.

Nor is it ultimately whether judicial retirement ages become 67 and 65 or remain unchanged.

Those are immediate constitutional questions. The deeper issue is what Sri Lanka learns from the controversy.

If the government seeks to modernise and strengthen the justice system, that objective deserves serious consideration. If the BASL and others warn that particular reforms may affect judicial independence, those concerns deserve equally serious examination.

Neither side strengthens the country by assuming that the other is acting in bad faith.

The constitutional system is strongest when legitimate disagreements are resolved through institutions rather than political pressure.

Whatever the eventual constitutional outcome, Sri Lanka will still face the underlying challenges of judicial vacancies, case delays, institutional capacity, judicial appointments and public confidence. Those problems will not disappear with a judicial determination, nor should the national conversation end there.

Sri Lanka should instead seek a broader consensus around a fundamental proposition:

Judicial reform and judicial independence are not competing objectives.

The real challenge is to pursue reform in a manner that strengthens the judiciary without placing its independence under suspicion.

That requires sound legislation, transparent appointments, adequate resources, efficient court administration, responsible political conduct and safeguards capable of surviving changes of government.

The present controversy will eventually pass. Political arguments surrounding it will fade.

But constitutional arrangements can endure for decades.

That is why Sri Lanka must look beyond the immediate political contest.

The ultimate test is not who wins today’s constitutional argument. It is whether, when the political moment has passed, Sri Lanka has a judiciary that is more efficient, more accessible and more trusted—while remaining sufficiently independent to hold every government, including future governments, within the boundaries of the Constitution.

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Farewell to a Fashion Icon

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Chula was very fond of The Island newspaper and kept in touch with us on a regular basis (L) / Chula: Sent us this photo for Glam Scene, just a couple of weeks ago (R)

Sri Lanka’s fashion world lost one of its brightest stars Monday morning – veteran model, actress, and elite pageant trainer Chulpadmendra “Chula” Kumarapathirana.

Her sudden demise has certainly come as a shock to many.

Chula had just completed a major event on Sunday (30th August), and was no more in the land of the living the following day (31st August).

Born in Colombo, she was an old girl of Buddhist Ladies’ College and later studied at the National Institute of Business Management, and has many awesome achievements to her credit.

In 2006, she won the “Miss Tourism Model of the World Press Award” in Tanzania.

She entered the entertainment industry, as an actress, and gained popularity through the teledrama “Wahinna Muthu Wessak.”

Chulpadmendra has been on TV, and many Sri Lankan hip-hop music videos, including “Hanthane” and “Heena Hirimal”, and has had several other minor acting jobs since then.

She hosted the Derana Miss Sri Lanka for Miss World 2008 and even participated in the reality TV show Sirasa Dancing Star.

For over 25 years Chula was active in local and international fashion and founded the Chulpadmendra Catwalk Studio to train young newcomers

She trained hundreds of models for runway, photoshoots, auditions, and international pageants.

She was known as a fierce mentor who believed in “not just learning to walk, but learning to command the runway”.

Many young models called graduating from her studio their “happiest moment.”

Chulpadmendra “Chula” Kumarapathirana: Many young models called graduating
from her studio their “happiest moment.” (L)/ Won the “Miss Tourism Model of the World Press Award” in Tanzania (R)

Chula was very fond of The Island newspaper and kept in touch with us on a regular basis.

Her last message to The Island was a ‘thank you’ note for the article ‘New benchmark in pageant industry’:

“Thank you, Ivan, for writing such a beautiful article about me. Your unwavering support, encouragement, and belief in me throughout my career mean more than words can express. I am truly grateful for your kindness and generosity.

“My heartfelt thanks also go to The Island newspaper for featuring the article. It is a great honour, and I sincerely appreciate the recognition and support.

“Thank you once again.”

In fact, just a couple weeks ago, she sent a photo of herself for our Glam Scene and that picture I publish today, as part of this story.

May she rest in peace. Our deepest condolences to her family, students, and all who loved her.

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