Charlatanes versus médicos honorables: el discurso profesional sobre la virtud y la buena praxis en España (1820-1860) / Charlatans versus honorable doctors: the professional discourse on virtue and good practice in Spain (1820-1860)

Los estudios sobre la corrupción, el fraude o las prácticas inmorales constituyen un área en expansión en la historiografía. Dentro de ese marco, el artículo se centra en el análisis del discurso médico sobre la charlatanería y la práctica profesional fraudulenta en España entre 1820 y 1860. Trazable al menos hasta la época de la Ilustración y enmarcado en una estrategia discursiva más amplia, el discurso contra la charlatanería aportaba un contra-modelo operativo para construir el ideal de profesional virtuoso, cuya labor profesional estaba avalada por una formación reglada y por el desarrollo de la medicina como «ciencia útil» para el país y para la Humanidad. La convivencia entre una medicina «legítima» y otras prácticas alternativas había sido una constante en la historia. Sin embargo, durante el siglo XIX tomó fuerza a nivel trans-nacional un discurso generalizado de denuncia contra los llamados charlatanes, personas que ejerciesen la medicina sin título o que llevasen a cabo prácticas entendidas como acientíficas o inmorales. Este discurso fue desplegado desde espacios de comunicación profesionales, en especial la prensa médica de la época, en un contexto que se caracterizaba por la transfor-mación de la profesión médica en España y en Europa (y más allá), por el afán de reafirmar la profesión médica como una ocupación honorable y por la pugna por los pacientes/clientes en un mercado con rasgos novedosos. Asimismo, resaltamos el papel del Estado a la hora de definir y reconocer la autoridad de experto de los médicos y, al mismo tiempo, ser interpelado por ellos para implicarse en la lucha contra la charlatanería (AU)

[Scientific misconduct: A major threat for medical research]. / Fraude scientifique : une menace majeure pour la recherche médicale.

Scientific misconduct (fabrication, falsification, and plagiarism) and detrimental research practices (selective reporting of data, inappropriate citation practice, ghostwriting) are admitted respectively by 2 % and 33 % of researchers. The consequences of scientific misconduct and detrimental research practices are disastrous, both for the doctors, who are the most affected researchers in view of the number of retracted articles, and for the patients, victims of false information that may have health consequences. In order to fight against the causes (promotion of doctors and allocation of resources to clinical wards and laboratories on purely quantitative research criteria, lack of training in scientific integrity in medical studies, heterogenous quality of reviewing, legal impunity), there are legislative, academic, technological and editorial solutions, but radical and urgent cultural change is needed first.

Enhancing reproducibility: Failures from Reproducibility Initiatives underline core challenges.

Efforts to address reproducibility concerns in biomedical research include: initiatives to improve journal publication standards and peer review; increased attention to publishing methodological details that enable experiments to be reconstructed; guidelines on standards for study design, implementation, analysis and execution; meta-analyses of multiple studies within a field to synthesize a common conclusion and; the formation of consortia to adopt uniform protocols and internally reproduce data. Another approach to addressing reproducibility are Reproducibility Initiatives (RIs), well-intended, high-profile, systematically peer-vetted initiatives that are intended to replace the traditional process of scientific self-correction. Outcomes from the RIs reported to date have questioned the usefulness of this approach, particularly when the RI outcome differs from other independent self-correction studies that have reproduced the original finding. As a failed RI attempt is a single outcome distinct from the original study, it cannot provide any definitive conclusions necessitating additional studies that the RI approach has neither the ability nor intent of conducting making it a questionable replacement for self-correction. A failed RI attempt also has the potential to damage the reputation of the author of the original finding. Reproduction is frequently confused with replication, an issue that is more than semantic with the former denoting "similarity" and the latter an "exact copy" - an impossible outcome in research because of known and unknown technical, environmental and motivational differences between the original and reproduction studies. To date, the RI framework has negatively impacted efforts to improve reproducibility, confounding attempts to determine whether a research finding is real.

Algunas reflexiones sobre la ciencia / Some thoughts on science

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Electromagnetic machines in cancer treatment: The "Priore affair".

In the 1960s and 1970s the Italian born scientist Antonio Priore, working in France, amazed the public and divided the scientific world with his invention, a machine which could cure a variety of illnesses, including cancer. Gaining the support of the French government and several scientific organizations, Priore received a great amount of money in funds to sustain his research. Without exposing his exact method, the scientific world questioned the legitimacy of Priore's research. For almost two decades scientists, institutes, journalists and cancer patients were implicated in a sensational case, known as the "Priore affair".

Dummheit.

Immunizing against influenza is tricky; against measles is not. Influenza comes in many constantly evolving strains, but one measles shot in childhood confers lifelong immunity. Unlike the flu, measles was wiped out. Its return represents an outbreak not of disease, but of stupidity. The matrix of stupidity is, however, reinforced by strong strands of malice, as when Andrew Wakefield's fraudulent 1998 paper linked the MMR vaccine to autism. The fraud was unmasked and the vaccine-autism link disproven, but the evil influence continues. Measles offers an illustration of Virchow's insights that medicine is a social science and that politics is medicine writ large. It is this "inconvenient truth" that is being suppressed by muzzling the Chief Public Health Officer (CPHO) and attacking public health for addressing "social determinants."

On Corporate Accountability: Lead, Asbestos, and Fossil Fuel Lawsuits.

This paper examines the use of lawsuits against three industries that were eventually found to be selling products damaging to human heath and the environment: lead paint, asbestos, and fossil fuels. These industries are similar in that some companies tried to hide or distort information showing their products were harmful. Common law claims were eventually filed to hold the corporations accountable and compensate the injured. This paper considers the important role the lawsuits played in helping establish some accountability for the industries while also noting the limitations of the lawsuits. It will be argued that the lawsuits helped create pressure for government regulation of the industries' products but were less successful at securing compensation for the injured. Thus, the common law claims strengthened and supported administrative regulation and the adoption of industry alternatives more than they provided a means of legal redress.

Sugar industry influence on the scientific agenda of the National Institute of Dental Research's 1971 National Caries Program: a historical analysis of internal documents.

BACKGROUND: In 1966, the National Institute of Dental Research (NIDR) began planning a targeted research program to identify interventions for widespread application to eradicate dental caries (tooth decay) within a decade. In 1971, the NIDR launched the National Caries Program (NCP). The objective of this paper is to explore the sugar industry's interaction with the NIDR to alter the research priorities of the NIDR NCP. METHODS AND FINDINGS: We used internal cane and beet sugar industry documents from 1959 to 1971 to analyze industry actions related to setting research priorities for the NCP. The sugar industry could not deny the role of sucrose in dental caries given the scientific evidence. They therefore adopted a strategy to deflect attention to public health interventions that would reduce the harms of sugar consumption rather than restricting intake. Industry tactics included the following: funding research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay with questionable potential for widespread application, cultivation of relationships with the NIDR leadership, consulting of members on an NIDR expert panel, and submission of a report to the NIDR that became the foundation of the first request for proposals issued for the NCP. Seventy-eight percent of the sugar industry submission was incorporated into the NIDR's call for research applications. Research that could have been harmful to sugar industry interests was omitted from priorities identified at the launch of the NCP. Limitations are that this analysis relies on one source of sugar industry documents and that we could not interview key actors. CONCLUSIONS: The NCP was a missed opportunity to develop a scientific understanding of how to restrict sugar consumption to prevent tooth decay. A key factor was the alignment of research agendas between the NIDR and the sugar industry. This historical example illustrates how industry protects itself from potentially damaging research, which can inform policy makers today. Industry opposition to current policy proposals-including a World Health Organization guideline on sugars proposed in 2014 and changes to the nutrition facts panel on packaged food in the US proposed in 2014 by the US Food and Drug Administration-should be carefully scrutinized to ensure that industry interests do not supersede public health goals.

Historical model for editor and Office of Research Integrity cooperation in handling allegations, investigation, and retraction in a contentious (Abbs) case of research misconduct.

Cooperation between a journal editor and the federal Office of Research Integrity (ORI) in addressing investigations of research misconduct, each performing their own responsibilities while keeping each other informed of events and evidence, can be critical to the professional and regulatory resolution of a case. This paper describes the history of one of ORI's most contentious investigations that involved falsification of research on Parkinson's disease patients by James Abbs, Professor of Neurology, University of Wisconsin, published in the journal Neurology, which was handled cooperatively by the authors, who were the chief ORI investigator and the Editor-in-Chief of Neurology, respectively.