In the following subsections, we discuss the values that emerged from our analysis of the research codes, grouped into the four classes discussed above. We also discuss whether they are explicitly or implicitly attributed to individuals or to institutions, or whether they remain unspecified on this point. We first present a prima facie overview of the codes and then discuss the four classes of values. 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. Of the institutional codes, the longest (joint code of AMC and VUmc) is 64 pages in length and the shortest (Radboud UMC) is nine pages in length (no explanatory power is assigned to the number of pages: this remark is only intended to indicate their diversity; it should also be noted that the layout of all the documents was full-text A4 size with few 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 divided into three parts (academic integrity, intellectual property, and patient data and material). And while the code of UMC Utrecht is relatively short, at 31 pages, much of the territory is covered in the parallel 148-page Vision Document (bilingual). The fact that the codes are very different in terms of their length and the territory they cover makes it hard to compare them with respect to how strict they are, or how much attention they devote to specific issues. Moreover, if something is missing from a code, there is no reason to assume that the institution is indifferent to that issue: it might simply be resolved in a different way, through other means than this particular form of codification.
Compared with these institutional codes, the supra-institutional equivalents are very short; for example, the WMA code has only two pages, and the KNMG code only five, plus a two-page preamble. The main reason for this difference seems to be that the institutional codes contain much more specific implementation: exactly which committees and procedures are in place, what policy aims correspond to the expressed norms and values, and how the codes themselves are to be regularly monitored and revised by the institution and its members. We have no reason to assume that it is particularly “Dutch” to write long codes, and we attach no further significance to the number of pages than these broad-stroke observations.
After a first reading of all the codes, in parallel with the literature study reported above, we iteratively produced the classification of four value categories. In principle, this could result in some values being overlooked because they do not fit any of the four categories. Therefore, we first identified all value statements and only then imposed the categorization and ascertained that all of the 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 objects of research, how knowledge should be presented, how knowledge is corroborated, etc. While we use the single term “truthfulness” here, this is in fact a complex concept: in practice, it involves many constitutive principles and indeed potentially conflicting ones; and in codes it is usually made evident through more specific and substantive principles.
One way in which truthfulness typically manifests in codes is through an emphasis on rigour: scientists should do their work properly and according to the current standards of the field. It is not always explicitly defined under this heading, but the KNAW code (p. 8), for example, states: “Scrupulousness means using methods that are justified or seen as the standard within the discipline and exercising the best possible care in designing, executing, reporting and disseminating the research.” Expressions found in institutional codes include meticulousness, attention to detail, proper reporting and referencing, absence of deceit, and the fact that an individual should undergo appropriate training to achieve rigour. Other instances of this endeavour 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 clear.” And the MUMC+ code (p. 7, our translation) states: “Academic practitioners will not allow their research activities to be guided by non-scientific or non-scholarly considerations. […] They operate in a context of academic freedom and impartiality. Insofar as constraints on this freedom are inevitable, they will be disclosed.”
In a general sense, ideals of what is good may consist of absence and prevention of what is bad, and truthfulness is indeed often presented as the avoidance of untruthfulness. In fact, research codes largely consist of references to avoidance of fraud, defined as falsification, fabrication, and plagiarism (FFP), and avoidance of problems such as conflicts of interest, evasion of laws and regulations, and failure to remedy misconduct. For example, in the ALLEA code (chapter 3), FFP is explicitly described as the “traditional definition” of research misconduct; and in the Radboud code, it is a central focus of the appendix that defines violations of scientific integrity. It is striking that in this latter code the first seven of the nine pages are devoted to the formal arrangements and procedures for dealing with misconduct, while the last two pages concern the definition of misconduct, with five of the eight points relating to FFP or similar violations of the truth.
3.2.2 Colleagues, practice and community
The second class is collegiality: the obligations and entitlements that derive from membership of a research community, notably towards colleagues, the institution and the broader academic community. All the codes express in some way that research is a collective affair, and that the individual has a responsibility towards this collective nature. One value subsumed under collegiality is fairness about authorship. Most of the codes contain some reference to the duty to acknowledge other people’s work. For example, in the Radboud code, two points in the appendix concern 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, it is important to state that obtaining a grant, collecting data, and/or generally managing a research group is NOT sufficient to warrant authorship.” Thus, this institution claims at least some 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 of the codes make reference to fallback arrangements, such as confidentiality officers and protection for whistleblowers. For example, the UMCU code (p. 8), the AMC-VUmc code (p. 57), and the Radboud code (p. 1) all mention explicit arrangements for whistleblowers. The supra-institutional KNAW code (p. 14) explicitly stipulates that establishing such arrangements is the responsibility of institutions. While the above quotations provide ample reason to trust that institutions do indeed accept this responsibility, it is interesting to see that it was evidently deemed worthwhile to make this explicit.
The codes also express a responsibility for what it takes to become or remain a good researcher, possessing the skills needed to fulfil the values that constitute good science. We label this class professionalism. Given the responsibilities borne by researchers, it is not an entirely voluntary matter for them to work on their professionalism. In fact, it is the very condition for their acceptance to do this kind of work. While the aim of codes of conduct is to specify good research, they are usually not explicitly worded in terms of what a good researcher is. One exception that refers to a character trait is the LUMC code: under the heading “Profile of an honourable researcher” it explains many of the more operational values, such as being respectful, meticulous, impartial, and responsible. The codes also describe some more specific personal qualities, an important one being the need to engage in training. The ALLEA code (section 2.2) explicitly states that researchers should undertake training across their entire career path. The KNAW code (section 5.2) stipulates that institutions should ensure that education is provided, and particularly education in research integrity.
3.2.4 Values that benefit society
The final entity towards which medical research is said to bear a certain responsibility is society at large. This relates to the contribution made by science to the benefit of society. The values in this class explicitly address society as an actor or actor category that has a stake in the value being realized, while the first three classes of values contribute more indirectly to societal benefit.
Accountability and transparency are important guises in which societal responsibility is observed. Strictly speaking, accountability is quite different from transparency: the former involves 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 easy to see, and indeed the two are often aligned in their operationalization in codes. They both entail clear and complete communication (e.g. KNAW, p. 8; AMC-VUmc, p. 15; MUMC+, p. 7), make it possible for researchers to subject one another’s work to (constructive) discussion (AMC-VUmc, p. 5; UMCG, p. 7), require facilities for archiving material to make it available for cross-checking (UMCU, p. 16; UMCG, p. 19), and in a general sense enable researchers to explain and justify how research outcomes have been obtained.
Another value to nurture in relation to society is that of relevance, which in biomedical research primarily means clinical relevance. It appears in many codes, although there is rarely any clear specification of what exactly makes something relevant or not. One interesting remark is found in the LUMC code (p. 28), which suggests that involving patient organizations could help with determining research questions that are relevant. Thus, even if relevance itself is not directly expressed, 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 we found to be central to codes, and categorized them into the four classes: values serving truth, values serving colleagues, values upholding 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 main counterposition that the codes seek to combat. FFP is typically something an individual commits. Interestingly, nowhere 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 regarded as an individual responsibility. Similarly, the observed expressions of rigour as the main path to truthfulness – such as meticulousness, attention to detail, proper reporting and referencing, absence of deceit – are hard to see as anything other than individual qualities. However, particularly at the international level, the ALLEA code (section 2.1) specifies that institutions have a responsibility in creating the infrastructural conditions to actually deliver rigour, which includes provision of training. Moreover, establishing clear fallback procedures, such as an ombudsman and whistleblower protection if misconduct has occurred, is generally regarded as an institutional responsibility. Thus, even though truthfulness is primarily an individual duty, a broader view of the context of truthfulness shows that this is not strictly the case, and it can also be an institutional duty.
Regarding the research practice in which the community of colleagues operates, mentorship was emphasized as an important value to realize. While the practical action of mentoring is performed by an individual, many of the codes make clear that mentorship can only take place if the institutional conditions are conducive to it. Mentorship is described in several of the codes as an important instrument in ensuring research integrity. For example, the AMC-VUmc code includes “Good mentorship” as a chapter of its own, providing 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, it is also a separate chapter – albeit somewhat shorter – in the UMCG and MUMC+ codes. Mentorship is something that is “done” by an individual mentor, but at the same time it is “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 to others (chiefly related to authorship) and fairness about others (chiefly related to reporting misconduct), are typically framed as individual duties, although here again it is often recognized that the institutional conditions need to be conducive.
Duties towards the profession are mostly expressed as the need to maintain one’s ability to meet the standards of the field. This is primarily achieved through training, both before entering the professional field and after becoming a member. This is stipulated widely, both by higher-level codes (ALLEA, chapter 2; KNAW, section 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 training at the institutional level. But ultimately, of course, it is the individual researcher who has to take the relevant refresher courses, and we did not find any reference to means of coercion available to institutions.
The duties of research towards society are principally defined as beneficence, accountability, and transparency. For example, the LUMC code (p. 18) explicitly identifies relevance as something that individual researchers should ensure in their research. Another instance is found in the UMCU Vision Document (p. 60), where it is similarly framed as a duty for the individual researcher to have a realistic view of research outcomes and not to promise too much. An interesting point in this respect is that the LUMC (p. 28) recommends that patient organizations should be involved in research. Thus, the institution takes responsibility for setting a standard here, but it appears that the researcher is still ultimately responsible for actually organizing this engagement. The Radboud code (p. 8) states that academic misconduct damages society and the image of research in society, and that the researcher’s employer has primary responsibility for preventing such misconduct. The preamble to the VSNU code (p. 3) states that doing scientific research in service of society is a matter for individual researchers, but it is also important for “their managers and [the board members of] the institutions where they work.”
We did not find any direct or clear-cut relationship between the four beneficiaries and who is supposed to take responsibility for realizing these values, but we have nevertheless been able to reach the following conclusions:
- All the classes contain at least some reference to both individual responsibilities and institutional responsibilities.
- In the two classes of truth-related and society-related values, attributions to the individual are more prevalent 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, section 5.6; ALLEA, chapter 2) are generally much more articulate and explicit about the institutions’ responsibilities than the codes of institutions themselves are.
With respect to the truth-related values, this tendency towards individual responsibility might not seem surprising, as these values are much more connected with the practical work of scientific research. However, this tendency is less self-evident with respect to society-related matters. After all, many (but not all) of the science-society relationships are structured at the institutional level and not at the level of the individual researcher.
The attribution to institutions in the higher-level codes is comparatively well operationalized, and they specify such concrete measures as establishing ethics and integrity committees and facilities on institutional websites for information that needs to be published. To some extent this is unsurprising, as these are actually intended to inform individuals rather than institutions; this is simply a natural consequence of different levels of organization entailing different perspectives. Nonetheless, this could be taken to indicate a blind spot in institutional codes. It also appears that the codes are not entirely homogeneous across the board with respect to balancing individual and institutional duties.
3.3.2 Attributing responsibility to culture
In the foregoing we have discussed attributions of responsibility to either individuals or institutions and observed that the distinction between the two is not always clear. In addition, during the inductive content analysis we identified a third category, which is specifically situated between the individual and the institution: the notion of culture. It also goes by other names – including climate, atmosphere, and environment – and sometimes even remains implicit. It is apparent in 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 for the terms “culture”, “climate”, “atmosphere”, and “environment” and their Dutch equivalents (cultuur, klimaat, sfeer, and omgeving). It should be noted that lexically these terms refer to different things: culture is not the same as environment, for example. However, in our interpretation they do, in fact, refer to the same category when used in the codes. We have counted the (hypothetical) claim that “researchers should jointly establish a culture of integrity” as equivalent to the claim that “researchers should jointly establish an environment of integrity” and so on. This search yielded 92 quotations that referred to any of these terms (henceforth clustered under “culture”). We assessed these occurrences manually.
In the codes, culture is often linked to the existence of well-established values and procedures. For example, the codes sometimes mention the need to establish specific modes of operation, such as organized peer cooperation and evaluation, and placing integrity on the agenda of personal assessment cycles (UMCU code, p. 5). Several codes also refer to the importance of whistleblowing procedures and to ethics review committees and integrity committees (e.g. Radboud UMC, article 4). Combining values with procedures, the KNAW code (article 5) describes the habit of openly discussing dilemmas and the existence of 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 of the codes explicitly state that openness, psychological safety and safety of reporting contribute to such values (e.g. KNAW, article 5; UMCG, p. 27). It should be noted that this procedural approach to culture shows considerable overlap with what we earlier described as attribution to institutions. However, as the codes themselves refer to culture or its equivalents, we regard this as significant: it is apparent that the codes are pursuing something beyond the procedures and hence beyond the institutions themselves.
In addition, culture is sometimes operationalized as the selection of senior (and other) 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 (section 5.3), for instance, explains the notion of culture as establishing clear instructions and, insofar as persons are concerned, selecting “the right senior researchers” (section 5.3, point 9). The code does not define here what “right” specifically means. Several codes make reference to the effect that “senior researchers are the bearers of culture” in terms of mentorship, leadership, and the proper design of research projects (e.g. ALLEA, p. 5; UMCU Vision Document, p. 87; AMC-VUmc, p. 56). In a similar vein, the LUMC code (p. 10) devotes nearly a paragraph to creating an “honourable scientific environment” and sees this environment as closely bound up with the need to have the right kind of people in leadership positions. Mentorship is equally recognized as a vital mechanism for perpetuating any kind of “culture”. Collectively held norms are transferred through mentors, insofar as they are not written down on paper. One code regards senior researchers as the “conveyors of culture” (UMCU, p. 87). In the other codes, mentorship can be interpreted along the same lines, even though they do not always make explicit reference to culture. 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 few cases, culture is mentioned as something that is potentially bad. In one code at the supra-institutional level, for example, culture is depicted as the bearer of sloppy habits and worse. This code then states that particular attention should be given if “the conduct has occurred on more than an occasional basis, for example if the conduct forms part of the research culture in which the researcher works” (KNAW, p. 16). Another institutional code refers to today’s “culture of publish or perish” as a potential cause for researchers being seduced into misconduct (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 invoke environmental factors, including perceived pressure, to justify misconduct: “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 is referring to the existence of something beyond these entities, which 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 analyzed. 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 were selected or who were consulted in the writing process. As a rough definition, culture is something that appears to transcend the individual researcher but is too informal for the institution to set in stone with rules and regulations. Or conversely: it can be achieved in part by rules and regulations, but then it has to bring something “bigger” into existence. Despite the marked importance of positing general ideas about culture in research codes, most of the references to culture do not contain any substantial specification of how it is thought to operate. That is, there seems to be no coherent idea of how it emerges and “does” such things as coercing, enabling, or constraining. On a more interventionist note, these codes do not provide detailed guidelines for how to “do” a responsible research culture: their discussion of culture includes no hints about who should do what to foster responsible research practices. As such, it is unclear which specific good mentorship practices should be attributed to culture and which to individuals, or even to institutions. Moreover, in the case of bad research cultures, the codes slide from acknowledging potential cultural influence to emphasizing (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.