In the following subsections, we discuss the values that came out of our analysis of the included research codes, grouped in the four classes discussed above. We also discuss whether they are explicitly or implicitly attributed to individuals or to institutions, or whether they remain unspecific at this point. We first give a prima-facie overview of the codes. Then, the four classes of values are discussed. Finally, we look at how responsibilities within these four clusters are attributed.
3.1 Prima-facie Assessment of Research Codes of Conduct
The codes differ greatly in length and territory. Among the institutional codes, the longest (joint code of AMC and VUmc) is 64 pages in length, the shortest (Radboud UMC) is 9 pages in length (no explanatory power is attributed to the page numbers, this is just to sketch the diversity; it can be added that all texts were built-up of full-text A4 size with little or no graphics). The longer the codes are, the broader the range of issues they cover. For example, the Erasmus MC code (47 pages) is explicitly split into three parts (academic integrity, intellectual property, and patient data and material). And while the code of UMC Utrecht is comparably modest at 31 pages, a lot of the territory is covered in the parallel Vision Document of 148 pages (bilingual). The codes being highly different in terms of their length and the territory they cover makes them hard to compare with respect to how strict they are, or how much attention they devote to specific issues. Also, if things are missing from a code, there is no reason to assume that the institution is indifferent to that issue – it might just be resolved otherwise, through other means than this specific form of codification.
In comparison to the supra-institutional codes, the institutional ones are very long. For example, the WMA code consists only of two pages, and the KNMG code only 5 plus a 2-page preamble. The main difference seems to be that the institutional codes contain much more concrete implementation: which committees and procedures are exactly in place, what policy aims the expressed norms and values correlate to, and how the codes themselves are under the permanent care and revision of the institution and its members. We have no reason to assume that it is a particularly “Dutch” thing to write long codes. Also, we do not attach any stricter meaning to page numbers than these broad-stroke observations.
A first reading of all the codes, in parallel with the literature study reported above, interatively produced the classification of four value categories. In principle, this may result in certain values falling out of scope because they do not fit any of the 4 categories. Therefore, we have first identified all value statements, and only then imposed the categorization, and ascertained that all value statements were indeed covered by one of the four categories.
The first class of values consists of those principles that are conducive to producing “true” knowledge. They thus specify how researchers should engage with their research objects, how knowledge should be presented, how knowledge is corroborated, etc. While we use the single term of “truthfulness” here, this is in fact a complex concept: in practice, it involves many constituting principles and potentially conflicting ones at that; and in codes, it usually appears through more specific and substantial principles.
One way in which truthfulness typically emerges in codes is in an emphasis on rigour: scientists should do their work properly and according to the current standards of the field. This is not always literally defined under this denominator, but for example the KNAW code (p. 8) states: “Carefulness means that one deploys methods that count as standard or are justifiable, and that one practices utter meticulousness in the design, execution, reporting and dissemination of the research.” Substantiations in institutional codes include meticulousness, attention to detail, proper reporting and referencing, the absence of deceit, and the fact that an individual should take appropriate training to achieve rigour. Other appearances of this strive for truthfulness are values such as disinterestedness and impartiality. As the UMCU code (p. 4) states: “Research is to be independent of commissioning or interested parties, ideological or political pressure groups, and economic or financial interests. Any limitation of academic freedom needs to be made visible.” And the MUMC+ code (p. 7, our translation) states: “The research scientist lets his or her research activities be guided by no other interest than the scientific interest. […] Scientists conduct their work in a context of academic freedom and impartiality. Insofar as constraints of this freedom are inevitable, they shall be revealed.”
In a general sense, ideals of the good may consist of absence and prevention of the bad. In this way, truthfulness indeed appears often as the avoidance of untruthfulness. In fact, references to the avoidance of fraud understood as falsification, fabrication and plagiarism and the avoidance of problems such as conflicts of interest, the evasion of laws and regulations, and failure to remedy misconduct make up a great part of research codes. For example, in the ALLEA code (art. 3), FFP is explicitly listed as the “traditional definition” of research misconduct. And in the Radboud code, it is central to the appendix that defines violations of scientific integrity. In the same code, it catches the eye that the first 7 of 9 pages are about the formal arrangements and procedures that deal with misconduct. The last 2 pages are about the content of misconduct, where 5 out of 8 articles are about FFP and similar crimes against the truth.
3.2.2 Colleagues, Practice and Community
The second class is collegiality: the obligations and entitlements that derive from one’s membership of a research community, notably towards colleagues, the institution and the broader academic community. All codes express in some way that research is a collective affair, and that the individual has a responsibility towards this collective nature. One value that subsides under collegiality is fairness about authorship. Most codes contain some reference to the duty to acknowledge the work of others. For example, in the Radboud code, 2 articles are about authorship issues. Interestingly, the UMCU code (p. 19, our translation) also specifies what is not a sufficient ground for authorship: “For the sake of clarity, we stipulate that the acquisition of funding, the acquisition of data, and/or the overall management of a research group are insufficient grounds to claim authorship”. Thus, this institution claims at least part of the responsibility in setting the standards for authorship. There is also a generally recognized duty to take responsibility for the conduct of others. Most codes make reference to fall-back arrangements such as confidentiality officers and protection for whistle-blowers. For example, the UMCU code (p.8), the VUMc-AMC code (p. 57) and the Radboud code (p.1) mention explicit arrangements for whistle blowers. The supra-institutional KNAW code (p. 14) explicitly stipulates the installation of such arrangements as the responsibility of institutions. While the aforementioned quotations provide ample reason to trust that institutions do indeed take this responsibility, it is interesting to see that there is apparently a point in making this explicit.
Codes also express a responsibility on what it takes to become or remain a good researcher, who has the abilities needed to produce the values that make up good science. We label this class professionalism. Given the responsibilities a researcher carries, it is not a strictly voluntary thing for researchers to work on their professionalism. In fact, it is the very condition under which it will be accepted that they do this kind of work. While the idea of codes of conduct is that they specify good research, they are usually not literally phrased in terms of what such a good researcher is. One exception that makes a reference to a trait of character is the LUMC code: it talks about the “Profile of an honourable researcher”, which is the heading under which many of the more operational values are explained such as respectfulness, meticulousness, impartiality, and responsibility. Also, some more concrete personal qualities emerge from the codes. One important shape in which it comes is the need to take training. The ALLEA code (sec. 2.2) explicitly states that professionals should take training throughout their entire career. The KNAW code (sec. 5.2) states explicitly that institutions should put in place the provision of education, and notably education in research integrity.
3.2.4 Values to the benefit of society
The last entity we observe towards which the medical research bears a certain responsibility, is society at large. This is about science’s contribution to the benefit of society. The values in this class explicitly address society as an actor or actor class that has stake in the realization of the value, in comparison to how the values in the first three classes contribute more indirectly to societal benefit.
Accountability and transparency are important guises in which societal responsibility emerges. Strictly, accountability is something quite different than transparency: the former is about placing oneself in a position where one can be held responsible, while the latter is about providing information on the process underlying specific knowledge outcomes. However, the connection between them is straightforward to see, and indeed the two often align in their operationalization in codes. They both come with clear and complete communication (e.g. KNAW, p.8; VUmc-AMC, p. 15, MUMC+, p. 7), with the possibility and ability for people to put each other’s work up for (constructive) discussion (VUmc-AMC, p.5; UMCG, p.7), facilities for archiving material so as to avail it for cross-checking (UMCU, p.16; UMCG, p.19), and in a general sense with the ability to explain and justify how research outcomes have come about.
Another value to hold dear towards society is that of relevance, which in biomedical research predominantly means clinical relevance. It appears in many codes, but at the same time, it is often not clearly specified what exactly makes something relevant or not. One interesting remark is found in the LUMC code (p. 28), which suggests that the involvement of patient organizations helps setting research questions that are relevant. Thus, even if relevance itself is not directly substantiated, its procedural definition provides guidance. The connection with society as the recipient of relevant knowledge is stipulated as a criterion here.
3.3 Attributions of responsibility
In the previous section, we inventoried the values that appear central to codes, and captured them in the four classes: values serving the truth, values serving colleagues, values preserving the profession, and values benefiting society. Within each of these four classes, we now further explore how the values are presented as responsibilities of individuals or institutions.
3.3.1 Attributing Responsibility to Individuals and Institutions
In truth-related values, FFP is the most prominent anti-position against which is argued. FFP is typically something an individual commits. Interestingly, at no point in the codes did we see any indication that an institution can be found guilty of such conduct, which suggests that it is indeed always ultimately reckoned an individual responsibility to take care of. Similarly, the appearing substantiations of rigour as the main road to truthfulness – such as meticulousness, attention to detail, proper reporting and referencing, the absence of deceit – are hard to see as anything different than individual qualities. However, particularly at the international level, the ALLEA code (sec. 2.1) specifies that institutions have a responsibility in setting the infrastructural conditions to actually deliver rigour, which includes provision of training. Also, the installation of clear fall-back procedures such as an ombudsman and whistle-blower protection in case misconduct has taken place, is generally reckoned an institutional responsibility. Thus, even though truthfulness is predominantly an individual duty, a broader view on the context of trustfulness shows that it is not strictly so and can also be an institutional duty.
Regarding the practice in which the community of colleagues operates, mentorship was found to be a prominent value to realize. While the practical action of mentoring is done by an individual, it is also visible in many codes that mentorship can only take place if the institutional conditions are conducive to it. In many codes, mentorship is appreciated as an important device in warranting research integrity. For example, in the AMC-VUmc code, “Good Mentorship” is a chapter of its own, and provides a host of specific, operational guidelines for what good mentors (including, but not limited to PhD supervisors) should do on a day-to-day basis. Similarly, in the UMCG and MUMC+ codes, it is a chapter of its own, be it slightly shorter. Mentorship is something “done” by an individual mentor, but at the same time it is something “enabled” or “stimulated” by the institution, for example by setting standards for mentorship arrangements and providing training to mentors. Two other important duties towards the community, namely fairness towards others (chiefly about authorship) and fairness about others (chiefly about reporting mishaps), are typically framed as individual duties, be it that also here it is often recognized that the institutional conditions should be productive.
Duties towards the profession mostly emerge as the need to preserve one’s abilities to live up to the standards of the field. This is primarily achieved through training, both prior to entering the work field and after one has become a member. This is stipulated widely, both by higher-level codes (ALLEA, ch. 2; KNAW, sec. 5.3), and by institutional codes (UMCU, p.14). Especially the codes at the supra-institutional level stipulate that there is an important duty to facilitate this at the institutional level. Ultimately, it is of course the individual researcher who has to take the relevant refresher courses, and we have not found any reference to means of coercion from the sides of institutions.
Towards society, research principally holds the duties of beneficence, accountability and transparency. For example, the LUMC code (p.18) explicitly stages relevance as something that individual researchers should warrant in their research. Another appearance is in the UMCU vision document (p. 60), where it is similarly framed as a duty for the individual researcher to have a realistic view on research outcomes and not to make overpromises. Interesting in this respect is the fact that LUMC (p. 28) stipulates that patient organizations should be involved in research. Thus, the institution takes responsibility in setting a standard here, but it seems still the researcher who is ultimately responsible for actually shaping this engagement. In the Radboud code (p. 8), it is stated that mishaps harm society and the image of research in society, and that in the very first place the employer of the researcher is responsible for preventing such mishaps. The preamble to the VSNU code (p. 3) states that doing science in service of society is an individual affair, while it is also a matter for “those who carry managerial and governing responsibility”.
We observe that there is no direct and univocal relation between the four beneficiaries and who is supposed to take the responsibility for realizing those values. Nevertheless, we are able to conclude to the following statements:
- All classes contain at least some references to individual responsibilities as well as institutional responsibilities.
- In the two classes of truth-related and society-related values, attributions to the individual are more incident than attributions to institutions.
- Obligations towards the profession and obligations towards the research community are more evenly balanced between individual and institutional responsibilities.
- Codes at the supra-institutional and international levels (e.g. KNAW, sec. 5.6; ALLEA, ch. 2) are in general much more articulate and explicit about the responsibilities of institutions than the codes of institutions themselves are.
With respect to the truth-related values, this bend towards individual responsibility might be found to be unsurprising, as these values are much more connected to the handwork of science. However, with respect to society-related matters, it is not so self-evident. After all, many (but not all) of the science-society relations are shaped at the institutional level, not the level of the individual scientist.
Also, the attribution to institutions in the higher-level codes is comparably well-operationalized, pointing at such concrete measures as the installation of ethics and integrity committees, and facilities at institutional websites for matters that require publication. To some extent this is unsurprising as the latter are actually meant to inform individuals, not institutions, which is just a natural consequence of different levels of organization coming with different perspectives. Nonetheless, this might be taken to signal a blind spot in institutional codes. And, apparently, codes are not entirely homogeneous across the board with respect to balancing individual and institutional duties.
3.3.2 Attributing Responsibility to Culture
So far, we have discussed attributions of responsibility to either individuals or institutions, and observe that the distinction between them was not always clear. In addition, during the inductive content analysis we identified a third category that is particularly situated between the individual and the institution: the notion of culture. It goes alternatively by names such as climate, atmosphere and environments, and sometimes even remains implicit. It appears as references such as:
“As a medical and biomedical scientific research institute, the LUMC is more than the sum of the individual LUMC researchers. Mutual trust between LUMC researchers and research groups is the foundation on which joint research projects are set up, synergy is generated and bigger steps towards knowledge increase can be taken. In this kind of environment, medical and biomedical science and education can flourish, and the LUMC can stand out among its competitors in the Netherlands and abroad.” (LUMC, p. 10; our emphasis)
“The UMCG aims to establish a safe climate for reporting and acknowledging violations of academic integrity.” (UMCG, p. 27; our emphasis)
We decided to search the documents on “culture”, “climate”, “atmosphere” and “environment” and their Dutch equivalents (cultuur, klimaat, sfeer and omgeving). It needs pointing out that lexically, these terms refer to different things: culture is not the same as environment, for one. However, in our interpretation they do refer to the same category when they emerge in the codes. We have reckoned the (hypothetical) claim that “researchers should jointly establish a culture of integrity” equivalent with the claim that “researchers should jointly establish an environment of integrity”, etc.. This search yielded 92 quotations that referred to any of these notions (henceforth clustered under culture). We assessed those occurrences manually.
In the codes, culture is often connected to the existence of well-established values and procedures. For example, sometimes, the codes mention the establishment of specific modes of operation, such as organized peer cooperation and evaluation and putting integrity on the agenda of personal assessment cycles (UMCU code p. 5). Multiple codes, moreover, make reference to the importance of whistle-blowing procedures, to ethical review committees and to integrity committees (e.g. RadboudMC, article 4). Combining values with procedures, the KNAW code (art. 5) considers the habit of openly discussing dilemmas and the existence data management facilities as essential elements of a good research culture. In this procedural sense, culture and its equivalents are sometimes linked to specific values such as transparency, independence and trust (e.g. AMC-VUmc, p. 54; LUMC, p. 10). Most codes explicitly state that openness, psychological safety and safety of reporting contribute to such values (e.g. KNAW, art. 5; UMCG, p. 27). It needs saying that this procedural approach to culture shows a great overlap with we earlier saw as attribution to institutions. Yet, as the codes themselves refer to culture or its equivalents, we deem this significant: apparently something beyond the procedures and hence beyond the institutions themselves is pursued.
In addition, culture is at some points operationalized as the selection of (senior) researchers with the right leadership and mentorship characteristics to convey the importance of these values and procedures to a future generation of researchers. The KNAW code (sec. 5.3), for instance, explains the notion of culture as the establishment of clear rules and states, insofar as persons are concerned, and as making sure that “the right senior researchers should be selected” (sec. 5.3, art. 9). The code does at that point not define what a “right researcher” is. Several codes make references to the effect of “seniors being the bearers of culture”, in terms of mentorship, leadership, and the proper design of research projects (e.g. ALLEA p.5, UMC Utrecht Vision Document, p. 87; AMC-VUmc, p. 56). In similar vein, the LUMC code (p.10) spends about a paragraph on setting an “honourable scientific environment” and sees that environment as closely bound up with the need to have the right kind of people in leadership positions. Mentorship relations are equally recognized as a vital mechanism to perpetuate any sort of “culture”. Collectively held norms are transferred through mentors insofar as they are not written down on paper. One code sees seniors as the “conveyors of culture” (UMC Utrecht (p. 87). In the other codes, mentorship is to be interpreted along the same lines, even though explicit reference to culture is not always made. Much like the procedural approach to culture discussed above, this mentorship-based approach seems to suggest something that exists beyond the individual and his or her actions.
In a small number of cases, culture appears as something potentially bad. In one code at the supra-institutional level, for example, culture is depicted as the bearer of sloppy habits and worse. It is then stated that attention should be paid when “the incident occurs more than incidentally, for example when the incident belongs to the research culture in which the researcher operates” (KNAW p. 16). Also, one institutional code refers to today’s “culture of publish or perish” as a potential cause why people are seduced into misbehaviour (LUMC, p.18). However, the same code also refers to individuals’ responsibilities saying that the institution “expects its researchers to take the following steps to avoid scientific fraud, misconduct and plagiarism”. In an interesting parallel move, the UMCU Vision Document (p. 14) stipulates that a researcher with integrity will never appeal to environmental factors such as high pressure to justify misbehaviour: “A researcher with integrity will never shift the blame to others, nor appeal to environmental factors such as performance pressure, in order to justify their actions.” Interestingly, this is not so much an attribution of responsibility to something beyond individuals and institutions, but rather the existence of something beyond those, that has to be countered by individual and institutional responsibilities.
All in all, there are frequent references to culture and its equivalents in the codes of conduct we analysed. This is an indication that a responsible research culture is an important concern to the writers of the codes and to the wider community of biomedical scientists from which these writers have been selected or that have been consulted in the writing process. As a rough definition, culture appears as something that seems to transcend the individual researcher but is too informal for the institution to carve in stone through rules and regulations. Or conversely: it can be achieved in part by rules and regulations, but then it has to bring into existence something “bigger”. Despite the marked importance of positing general ideas about culture in research codes, the vast majority of references to culture contain no substantial specification of how this it is thought to be operating. That is, there seems to be no coherent idea on how it emerges and it “does” things such as coercing, enabling or constraining. On a more interventionist note, these codes do not provide detailed guidelines for how to “do” such a responsible research culture. That is, the discussion of culture includes no hints about who should do what to foster responsible research practices. As such, it is unclear what part of good mentorship practices and should be attributed to culture and what part to individuals, or even to institutions. Moreover, in the case of bad research cultures, the codes slip from the acknowledgement of potential cultural influence to the emphasis on (mostly) individual responsibilities. If we were to push this to a conclusion, it could in fact mean that all references to culture are actually concealed individual attributions.