Origins of Fraud

1. How convincing are these primary reasons why people commit fraud in clinical research?
2. If competition prompts fraud, what steps might be taken to reduce it for medical students? For example, perhaps medical schools could identify and admit students who
are most cooperative rather than the most competitive. What else might be done in this regard?
3. Science is considered to be a self-correcting effort. That is, it will eventually uncover fraud because its methods require independent confirmation of research reports. How accurate is this characterization, and does it mean that fraud committed in clinical research is not especially worrisome?
Every so often a scandal involving fraudulent biomedical data occupies the news media. The commentary below offers a theory about why fraud occurs in the clinical sciences. Whether this account is complete, and whether the suggested remedies will prevent fraud, are key issues for discussion.
The origins of fraud in medical studies can be traced to three main causes. The first is hypercompetitiveness in medical school for grades and honors. Studies show that even in medical school, students cheat in various ways, not only on exams but also in aspects of patient care.
The second main source is the size of the scientific enterprise itself. There is so much science that it is impossible to provide the kind of oversight that is necessary to squelch the temptation to report false data. In particular, inexperienced junior researchers are often left to their own devices because senior researchers and administrators do not have time to review every research project.
A third source of fraud lies in competition for grants and academic rewards. Grants are essential to promotion, and they are fiercely pursued. But academic promotion only makes things worse, because researchers are always mindful of what new grants and publications will do to help their careers, especially when it comes to tenure.
None of these sources means that fraud is inevitable. On the contrary, it may be preventable if principal investigators take on more responsibility to ensure that their associates are committed to the truth, and if data are checked at several levels by competent people. Fraud is all the more reprehensible in scientists who by their career choice have committed themselves to the discovery and dissemination of truth. At the institutional level, mechanisms must be in place to sort out fraud, and administrators should be sufficiently familiar with laboratories under their direction to know how to investigate should a question of fraud arise.

Study Questions
1. How convincing are these primary reasons why people commit fraud in clinical research?
2. If competition prompts fraud, what steps might be taken to reduce it for medical students? For example, perhaps medical schools could identify and admit students who
are most cooperative rather than the most competitive. What else might be done in this regard?
3. Science is considered to be a self-correcting effort. That is, it will eventually uncover fraud because its methods require independent confirmation of research reports. How accurate is this characterization, and does it mean that fraud committed in clinical research is not especially worrisome?