Trust and professionalism in science: medical codes as a model for scientific negligence?

Abstract

Background
Professional communities such as the medical community are acutely concerned with negligence: the category of misconduct where a professional does not live up to the standards expected of a professional of similar qualifications. Since science is currently strengthening its structures of self-regulation in parallel to the professions, this raises the question to what extent the scientific community is concerned with negligence, and if not, whether it should be. By means of comparative analysis of medical and scientific codes of conduct, we aim to highlight the role (or lack thereof) of negligence provisions in codes of conduct for scientists, and to discuss the normative consequences for future codes of conduct.

Methods
We collected scientific and medical codes of conduct in a selection of OECD countries, and submitted each code of conduct to comparative textual analysis.

Results
Negligence is invariably listed as an infraction of the norms of integrity in medical codes of conduct, but only rarely so in the scientific codes. When the latter list negligence, they typically do not provide any detail on the meaning of ‘negligence’.

Discussion
Unlike codes of conduct for professionals, current codes of conduct for scientists are largely silent on the issue of negligence, or explicitly exclude negligence as a type of misconduct. In the few cases where negligence is stipulated to constitute misconduct, no responsibilities are identified that would help prevent negligence. While we caution against unreasonable negligence provisions as well as disproportionate sanctioning systems, we do argue that negligence provisions are crucial for justified trust in the scientific community, and hence that there is a very strong rationale for including negligence provisions in codes of conduct.

Full text

Desmondand Dierickx BMC Med Ethics (2021) 22:45
https://doi.org/10.1186/s12910-021-00610-w
RESEARCH ARTICLE
Trust andprofessionalism inscience: medical
codes asamodel forscientic negligence?
Hugh Desmond1,2* and Kris Dierickx1
Abstract
Background: Professional communities such as the medical community are acutely concerned with negligence: the
category of misconduct where a professional does not live up to the standards expected of a professional of similar
qualifications. Since science is currently strengthening its structures of self-regulation in parallel to the professions,
this raises the question to what extent the scientific community is concerned with negligence, and if not, whether
it should be. By means of comparative analysis of medical and scientific codes of conduct, we aim to highlight the
role (or lack thereof) of negligence provisions in codes of conduct for scientists, and to discuss the normative conse-
quences for future codes of conduct.
Methods: We collected scientific and medical codes of conduct in a selection of OECD countries, and submitted
each code of conduct to comparative textual analysis.
Results: Negligence is invariably listed as an infraction of the norms of integrity in medical codes of conduct, but
only rarely so in the scientific codes. When the latter list negligence, they typically do not provide any detail on the
meaning of ‘negligence’.
Discussion: Unlike codes of conduct for professionals, current codes of conduct for scientists are largely silent on the
issue of negligence, or explicitly exclude negligence as a type of misconduct. In the few cases where negligence is
stipulated to constitute misconduct, no responsibilities are identified that would help prevent negligence. While we
caution against unreasonable negligence provisions as well as disproportionate sanctioning systems, we do argue
that negligence provisions are crucial for justified trust in the scientific community, and hence that there is a very
strong rationale for including negligence provisions in codes of conduct.
Keywords: Research integrity, Medical professionalism, Trust, Science policy, Negligence
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Background
Science has long left its amateur and gentleman-scientist
past behind [1], yet it isonly relatively recently, in the past
two decades, that the scientific community has started
strengthening its structures of professional self-regula-
tion. Codes of conduct have been introduced; research-
ers are increasingly given research integrity training; and
integrity commissions are being set up to deal with trans-
gressions of the codes of conduct [2, 3]. However, as will
be documented in this paper, professional communities
such as the medical community are acutely concerned
with negligence: the category of misconduct where a
professional does not live up to the standards expected
of a professional of similar qualifications. It is unclear to
what extent the scientific community is or should be con-
cerned with negligence. Despite its importance for pro-
fessional codes of conduct, the category of negligence is
rarely mentioned and has not received systematic analy-
sis in the literature on the definitions of research miscon-
duct [4–7].
What is negligence? For instance, if a construction
company fails to meet all the latest safety guidelines, and
Open Access
*Correspondence: hugh.desmond@uantwerpen.be
1 Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
Full list of author information is available at the end of the article
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Page 2 of 11
Desmondand Dierickx BMC Med Ethics (2021) 22:45
one of its employees suffers a workplace accident, then
the company can potentially be held liable—not because
it knowingly put the employee in danger, but because it
did not do everything reasonably expected of it to safe-
guard employees’ safety (i.e., remain abreast of latest
guidelines). In general, negligent transgressions are those
that do not involve a conscious intention (or even acon-
scious disregard ofthe risks), but a failure to takerea-
sonable precautions.1
Negligence is interesting for philosophers of law and
jurisprudence scholars because it challenges the tradi-
tional voluntaristic way of conceiving culpability, because
an agent is not only held responsible for actions under
their actual control [9], but also for actions which would
have been under their control if they had behaved as
expected of “a reasonably prudent person” [8]. However,
the general implications of negligence for moral culpabil-
ity [2, 3] or legal culpability [12] fall outside the concern
of this paper. As will be documented in this paper, negli-
gence plays a crucial role in justifying trust in profession-
als, and hencethe purpose here will be to draw lessons
for research integrity and scientific professionalism.
In particular, this paper will focus on the functional
role that negligence plays in professional codes of con-
duct (“professional codes”), and what role it should play
in codes of conduct for scientists (“scientific codes”). Two
questions in particular will structure the enquiry:
(1) to what extent are codes of conduct for scientists
currently concerned with negligence, compared to
professional codes of conduct?
(2) what negligence provisions should be included in
codes of conduct for scientists?
e first question concerns the empirical state of affairs
of how codes of conduct are currently constructed, and
in this paper it is tackled by analysing codes of conduct
for physicians and for scientists in nine OECD countries.
Codes of conduct for physicians are chosen since sociolo-
gists often view the medical community as a paradigm of
a professional community [13]. e second question is
the normative question, and we will make positive rec-
ommendations for how negligence provisions should
be included. However, before we turn to these ques-
tions, first it is necessary to give some additional back-
ground: why are negligence provisions so important for
the professions, and why does this provide a prima facie
rationale for the science community to pay greater heed
to negligence provisions?
The rationale fornegligence provisions
In this background section we wish to argue in more
detail why negligence provisions matter: they fulfil a cru-
cial role for the principles of autonomy and trustworthi-
ness that characterize the logic of professionalism [13].
We will first sketch this rationale for professional negli-
gence provisions in general, and then for scientific negli-
gence provisions in particular.
The rationale forprofessional negligence provisions
e logic of professionalism is an approach towards
organizing work where the practitioner and the commu-
nity of practitioners are given a large degree of autonomy
to carry out the work as they see fit [13].2 Professional-
ism is an ideal-type to which real occupations partake to
varying degrees, and typically two rival logics are mixed
in as well: the logic of bureaucracy, where managers con-
trol how the work is carried out, and the logic of mar-
kets, where clients or customers control how thework is
carried out. Sociologists have often taken medicine to be
a paradigmatic example of an activity organized accord-
ing to professionalism in the sense that there is a large
degree of operational autonomy [14, 15]; however, it is
clear that also physicians operate under some bureau-
cratic control (e.g. audits) as well as market incentives
(and increasingly so in the previous decades: [16]).
In the logic of professionalism, professional autonomy
and trust in professionals are two sides of the same coin.
Trust in professionals means that relatively few demands
for control and transparency made of professionals (and
insofar as such demands are made, they can be inter-
preted as reflecting an erosion of trust; see also [17]).
Hence trust is what allows professionals to maintain
their autonomy. Conversely, professionals’ autonomous
decision-making does not mean that the decision-mak-
ing is voluntaristic, but rather that it is guided by what
Freidson called an ideal of service [13]. For instance,
physicians and medical professionals are typically ori-
ented to the ideal of care, and this implies, inter alia,
that in their decision-making they prioritize care for the
patient over followingself-serving incentives. In this way,
because professional autonomy is grounded on aservice
1 is understanding is continuous with the definition of negligence in Black’s
Law Dictionary, “e failure to exercise the standard of care that a reasonably
prudent person would have exercised in a similar situation …”[8]
2 It is important to emphasize that “professionalism” is thus a technical
concept, and should be distinguished from common uses of the word “pro-
fessional”, for instance: as being remunerated for a type of work (“they were
successful and subsequently did the activity professionally”), or as a synonym
for doing quality work (“they did a very good job, very professional”). e
logic of professionalism is what underlies these more common-place uses of
the word “professional”.
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
ideal, both patients/clients and wider society are justified
intrusting autonomous professionals. is trust, in turn,
allows professionals to maintain their autonomy.
is fundamental connection between trust and pro-
fessional autonomy is crucial for understanding the key
role that negligence provisions play in well-designed pro-
fessional codes of conduct. As indicated in the introduc-
tion, accusing someone of “negligence” presupposes that
a certain standard of prudence was expected from that
person. e person is culpable because they should have
known about the possibility of the bad outcome. In daily
life, adults can be held responsible because of negligence
simply because they did not act according to common
sense standards of prudence (think of,e.g., the category
of negligent homicide [8]). Finding someone to benegli-
gently culpable is typically the least serious form of cul-
pability (after ‘purposely’, ‘knowingly’, and ‘recklessly’),
and is the only form of intent where the undesirable out-
come was not known as a possible outcome by the trans-
gressor (for more discussion, see [9]).
Negligence provisionsare especially important for the
logic of professionalism because the level of prudence
expected of a professional—at least with regard to their
professional activity—is higher than that of a layperson.
Substantial trust is placed in (and autonomy is granted
to) a professional, and this trust goes beyond simply
trusting their good intentions: trustis also placedin their
knowledge and competence [19]. Any client or patient
who calls on the services of a professionalis placed in a
vulnerable position, and when the professional does not
live up to professional standards, thenthis is a sign that
trust in this particular professional was misplaced. In
other words, negligent action by a professional is tanta-
mount to a breach of the client’s or patient’strust.
Hence the importance of categorizing negligence as a
type of transgression in professional codes of conduct:
this is an explicit commitment by the professional body
that clients should by default place trust in professionals,
because when this trust turns out to misplaced because
of carelessness or imprudenceon behalf of the profes-
sional, then the clientis not atfault, for instance for being
naïve. On the contrary,the professional is culpable for
failing to live up tothat default trust.
Just to emphasize this point: imagine if a professional
body would not recognize negligence as a transgres-
sion. How could clients make the decision whether or
not to trust a professional? e onus would then be on
the client to do the necessary due diligence in order to
decide whether or not to place trust. Does the profes-
sional have sufficient competence? Does the professional
have the best interests of the client at heart? If the pro-
fessional cannot be held culpable for professional negli-
gence, then the principle of caveat emptor would apply
for the prospective patient or client. However, how can a
patient evaluate the competence of, for instance, a heart
surgeon? Not only are the services offered by profession-
als often urgent and essential, but by assumption patients
or clients lack the requisite knowledge and training they
would need in order to evaluate how competent a given
professional is. (If substantial knowledge and training
were not necessary, there would be no need to profes-
sionalize the activity in the first place: see [13].) “Buyer
beware” can work for purchasing second hand goods,
but it cannot for medical services or other important and
highly technical professional services.
In sum, giving (medical) professionals discretion with-
out holding them responsible for negligence incoherently
gives them rights without holding them to the naturally
associated responsibilities. Or in other words: if negli-
gence is not problematizedby professional bodies, this
implies nothing less than the collapse of the logic of
professionalism.
The rationale forscientic negligence provisions
Should the activity of scientific research adhere to a logic
of professionalism? Elsewhere it has been argued that it
in fact should [2], and the crux of Desmond’s argument
was to point to the unavoidable role played by individ-
ual judgment in the activity of scientific research (see
also [20, 21]). e day-to-day activities of formulating
hypotheses and developing methodologies, overcoming
challenges, analysing and interpreting data: in all of these,
scientists have a large degree of operational autonomy
whereby they cannot simply follow formulaic methodolo-
gies but must use their individual discretion. Moreover,
many other scientific activities that support the scientific
community—refereeing, supervising, editing—involve
scientists following their individual judgment rather than
a set of rules (as would be in a logic of bureaucracy).
is type of individual autonomy is not just desirable
for scientific research; it is also inevitable given the highly
technical nature of scientific knowledge. Sociologists
speak of the knowledge underlying professional activity
being “esoteric”, by which they mean that it is inaccessible
without education and training [13]. And science plays
a crucial role in developing the knowledge of the pro-
fessions—to such an extent that some have argued that
professions simply are science-based occupations [22]. In
any case, this line ofreasoning obviously also applies the
“occupation” of doing scientific research. If any body of
professional knowledge couldqualify as “esoteric”, then it
would be the body of knowledge necessary for a scientist
to do their research. In fact, a given research project may
be so specialized that may be difficult evenfor scientific
peers to fullyunderstandit, let alone non-scientists. In
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
this sense, the degree of autonomy of scientist is an inevi-
table consequence of the specialized, esoteric knowledge
required for doing scientific research.
In sum, an important dimension of the logic of profes-
sionalism, namely individual autonomy, is part and parcel
of scientific research. Note, however, that this does not
imply that individual autonomy is absolute and that the
decision-making of individual scientists cannot be influ-
enced by non-scientific factors. is is not the case: the
preferences of granting agencies, private companies, and
governments may influence scientific decision-making
(e.g., in choice of research topic).3 e lesson here is that
individual autonomy maybe curtailed—andthe logic of
professionalism may thusbe mixed in with other organi-
zational logics—but it cannot be eliminated sincescien-
tific research necessarilydepends on individual scientists
retaining a large degree of operational autonomy.
However, even if a lot of elements are in place for con-
sidering scientific research to bea professional activity,
there are challenges involved. One challenge is that it is
not immediate clear what “scientific negligence” could
mean. How scientific negligence should be understood is
exactly the purpose of this article, and will be addressed
in later sections. For the moment, however, we would like
to make the case that there should be a category of scien-
tific negligence. If negligence is not explicitly understood
as a transgression of integrity norms, then trust in scien-
tists is undermined. To show this, we disambiguate indi-
vidual trustworthiness from collective trustworthiness.
Individual trustworthiness
Consider the following scenario. Assume that scientist
A claims to know
ϕ
, for instance, some claim about the
degree of climate change. Under what conditionscan a
non-scientist B defaultlytrust A? One condition for trust
is that B should be able to assume that A is not negligently
claiming
ϕ
, i.e., that A has taken all reasonable precaution
to avoid being wrong. If A werenot to take reasonable
precautions to avoid error, and moreover, if it werecom-
mon knowledge that scientists do not take such reasona-
ble precautions, then defaulttrust in A’s assertions would
not bejustifiedand B could be considered as naïve if they
were to trust without any due diligence.
e issue of negligence comes especially to the
fore in connection to expert communication, such
as the communications concerning climate change or
COVID-19. ese communication can be considered
as crucial services a scientist provides to the commu-
nity [24]. Moreover,in such cases, A’s claim
ϕ
may have
far-reaching impact on social norms and thus B’s life. e
non-scientist B is placed in a vulnerable position, and
this increases the need for B to be able to trust A, and
thus to be able to assume that A has taken reasonable
precautions to avoid negligence. However, note that this
does not mean that B should have to assume that A has
avoided error. Error as such is inherent to anyscientific
activity, including expert communication, and errorneed
not implya lack of trustworthiness. Only negligent error
can play that role: a negligent error is one that a scientist
could have avoided if he or she had takenthe reasonable
precautions that areexpected of allscientists of compara-
ble training.
In sum, given the inevitable autonomy with which
research (and supporting activities) must be conducted,
non-specialists often cannot evaluate scientific claims for
themselves, but must make the decision to trust or not to
trust. If the scientists do not take all reasonable precau-
tions to avoid error, then trust in their pronouncements
would not be justified. Hence safeguarding individual
trustworthiness is the first reason why it is important to
include aclear stance on negligence in scientific codes of
conduct.
Collective trustworthiness
One could respond that collective trustworthiness is
more important than individual trustworthiness. After
all, it would be reasonable to judge the claim of an indi-
vidual scientist to be trustworthy only whenit has been
vetted by peer-review. While of course peer-review has
its own discontents, it does illustrate how the trustwor-
thiness of individual scientists is bound up with the trust-
worthiness of the scientific community asa whole. While
the former depends explicitly on intentions and compe-
tences, the latter depends on the value norms and stand-
ards of competence of the community.
It may seem strange to claim that, despite the flux char-
acterizing any scientific state of the art, the scientific
community needs clear standards of competence. How-
ever, even if such standards are not always formulated
explicitly, they are often implicit. For instance,the prac-
tise of peer-review presupposes the existence of meth-
odological standards. Moreover, having such standards
is a precondition to being able to identify what precau-
tions can be “reasonably expected” of a scientist, and
hence to be able to distinguishbetween an “honest error”
and “negligent error” in a principled manner. us, with-
out standards of competence that can only be defined at
the level of the community, trust in scientists cannot be
placed defaultly.
e importance of collective value norms is also crucial
for collective trustworthiness. For instance, in “perverse”
research cultures, transgressions of integrity norms can
3 Note that the research funded by government and by private companies rep-
resents two thirds of research in the United States by amount of funding [23].
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
be normalized. Examples include the exaggeration of
research findings and authorship practises [25]: these
are questionable research practises (QRP) that yet do not
constitute flagrant transgressions (FFP). When thereare
recognizedintegrity norms, then engaging in aQRPthat
is normalized in a subcommunity would constitute a cat-
egory of negligence.is is important for collective trust-
worthiness, because the discovery of perverse research
cultures by thebroader public would undermine the jus-
tifiability ofpublic trust in science.
How do individual and collective trustworthiness
relate? When there are explicit standards of competence
and value norms, then the trustworthiness of individu-
als and that of the community can become dissociated
to a certain extent. If an individual commits some kind
of negligent misconduct, then this need only reflect on
the trustworthiness of the individual, since they are fail-
ing to liveup to collective standards and norms. By con-
trast, when collectivestandards and norms are absent or
not recognized, then the community can bear respon-
sibility for individual misconduct. For instance, if an
individual scientist publishes a fraudulent study, then a
certain degree of culpability could be attributed to the
peer reviewers and editors involved, if they did not have
appropriate standards or norms in place.
In sum, negligence norms enhance the scope of indi-
vidual and collective responsibility, and include taking
all reasonable precautions for delivering competent and
trustworthy research. By contrast, if negligence would
not be problematized by the scientific community, then
trust in assertions by scientists may not be entirely
unjustified, but the type of default trust implied by the
logic of professionalism would not be justified. is, in
turn, would motivate further curtailments of scientific
autonomyby the public. Hence the rationale for explic-
itly understanding scientific negligence as a form of mis-
conduct in codes of conduct is to help safeguard justified
trust in scientists and the scientific community.
Methods4
To what extent do current scientific codes of conduct
include negligence provisions? To map this issue, we col-
lected national codes of conduct in science and medi-
cine for eight countries (USA, AU, CA, UK, BE, FR, DE,
IT) plus any relevant Europe-wide code of conduct. e
search was carried out between February and May 2019,
and updated in October 2020. e primary sources of
information for the scientific codes of conduct were the
websites of national research councils, national agencies
on research integrity, national scientific fund, or national
academies of science. Results were cross-checked with
an internet search engine (Google) with search terms
((“research integrity” OR “scientific integrity” OR “sci-
ence integrity”) AND “ <name of country> ”). Only codes
of conduct or codes of ethics were included. Other
documents relevant to how science and the professions
are practiced were excluded, e.g., legal documents not
strictly pertaining to regulation of professions or sciences
(e.g., in copyright law, tort law, or privacy laws) and doc-
uments regulating scientific research on human and ani-
mal test subjects. In the cases where there were multiple
national-level codes of conduct, we followed the meth-
odology in [3] to select the “leading” document, which
refers to the document that is considered central and
authoritative within the relevant national context. For
the medical codes of conduct, primary sources of infor-
mation were national medical associations whose boards
confer licensing or registration to physicians. Due to the
centralized and unified nature of the medical profession,
there was no reasonable ambiguity involved in choosing
a code of conduct. In some countries there are minority
professional organizations (e.g. Association of Ameri-
can Physicians and Surgeon in the USA), which were not
accounted for in this study. However, since the purposes
here are not to conduct a systematic review, this limita-
tion in methodology was deemed not to affect the con-
clusions drawn from theresults. All details concerning
the selecteddocuments are provided in the supplemen-
tary materials.
Does focusing on the medical profession (instead of
professions more generally) limit the scope of conclu-
sions? Not necessarily, because, as already noted, the
medical profession is often viewed by sociologists as a
paradigmatic instantiation of professionalism. So any
systematic difference found between scientific and medi-
cal codes of conduct has bearing on the general ques-
tion to what extent the scientific community currently is
adopting the logic of professionalism.
Each code of conduct was submitted to textual analysis
to identify passages pertaining to negligence. For this it
was necessary to operationalize of the concept of negli-
gence. e previous section sketched the general ration-
ale for negligence provisions; however, there are several
concrete ways in which professionals can act to avoid
negligence. In general,negligence is avoided by profes-
sionals having awareness of their competences and of
the standards expected of them. So, whenever possible,
the professional must take all reasonable measures to
assure they can act according to accepted standards of
competence: hence, for instance, the importance to keep
abreast of developments in the field, or to undergo addi-
tional training or education. If this is not possible, then
4 Methodology and results are based on, but further develop previous and
related work on competence provisions in codes of conduct; see Author 1
2020.
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
the response to a lack of requisite competence is either to
refrain from undertaking services, and to refer to client
or patient to a colleague.
Given this reasoning, we judged a code to view “negli-
gence” as a violation of the norms of integrityif there was
at least one of the following:
• A provision emphasizing the responsibility for pro-
viding competent services only.
• A provision designating a responsibility to recognize
absent competence in oneself: if lacking requisite
competence, a practitioner must not carry out the
work, and refer to a colleague who doespossess the
requisite competence.
• A provision designating a responsibility for maintain-
ing competence: a practitioner has the responsibility
for keeping up-to-date on the standards in theirfield.
• A provision designating a general responsibility to
uphold “standards of professionalism”, which are
assumed toincludestandards of competence.
us, for instance, the UK “Good Medical Practice”
code stipulates that physicians must be competent in all
aspects of their work (principle 7); keep their professional
knowledge and skills up to date (principle 8); and work
within the limits of their competence (principle 14). Sim-
ilarly, albeit in different wording, the “Professional Code
for Physicians in Germany” stipulates that physicians
must possess the requisite qualifications and remain up
to date on the medical state of the art (article 2); they also
must maintain and develop their competences by con-
tinuing medical training (article 4). us, a single code of
conduct may include multiple negligence provisions.
Results
We found a striking difference between codes of con-
duct in the two communities (Table 1): while negli-
gence is invariably listed as an infraction of the norms of
integrity in codes of conduct for physicians, it is rarely
so in codes of conduct for scientists. Moreover, in the
few cases where negligence is listed as an infraction of
a scientific code, no detail is provided on what precise
responsibilities scientists have for avoiding negligence:
thisraises questions on how suchnegligence provisions
shouldactually translate into conduct.
All examined medical codes of conduct contain pro-
visions that, according to the operationalization of the
concept of negligence above, can be judged to be provi-
sions that explicitly proscribe negligent behavior. In other
words, negligence is an infringement of medical codes
of conduct, regardless of national context. Other stud-
ies have indicated a focus on competence (first condi-
tion for negligence) in codes of other professions, such as
those for legal professionals or psychologists [2], so the
widespreadinclusion of negligence provisions in medical
codes of conduct is unsurprising.
By contrast, most of the examined codes of conduct
for scientists either explicitly exclude negligence as a
category of infringement, or are silent on the issue. e
former is the case, for instance, for the Federal Research
Misconduct Policy, which stipulates that “a finding of
research misconduct requires that: […] the misconduct
be committed intentionally, or knowingly, or recklessly.”
e Federal Policy also limits the definition of research
misconduct to falsification, fabrication, or plagiarism, or
FFP (OSTP 2000, p. 76262), which are in fact the cate-
gories of misconduct most likely to be committed inten-
tionally, knowingly, or recklessly.
Some codes of conduct do explicitly mention the pos-
sibility of negligent misconduct. For instance, the UK
“Concordat to Support Research Integrity” includes
“gross negligence” as a potential form of misconduct
in misrepresenting data or when the duty for care for
human test subjects is breached. However, these negli-
gence provisions concern only specific types of behav-
ior,and thus do not apply to negligent infringements
ofany integrity norms(for instance, regarding authorship
norms). In Sect.4 we argue why this is problematic.
Finally, some codes, like the DFG “Guidelines for pro-
tection good scientific practice” and “Netherlands Code
of Conduct for Research Integrity” do make a general
provision regarding “gross negligence”:
“Only deliberate or grossly negligent infringements
defined in a set of regulations are considered scien-
tific misconduct.” (DFG 2019)
“When it amounts to gross negligence, a questiona-
ble research practice or ‘sloppy science’ is more than
a matter of mere error or carelessness but rather
Table 1 Is negligence listed as an infringement of the code
of ethics? Scientific versus medical codes of conduct. Y = yes;
N = no; / = code not available. For all relevant passages, see
supplementary materials
Country Code of Conduct
Scientific Medical
USA N Y
Canada N Y
Australia Y Y
UK Y Y
Europe N /
Belgium N Y
France N Y
Germany Y Y
Italy N Y
Netherlands Y Y
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
something that can undermine the very integrity of
research.” (KNAW 2018)
However, the category of “gross negligence” is ambigu-
ous: sometimes it is understood as negligence, butother
times as recklessness. Black’s Law Dictionary notes this
polysemy, and distinguishes between a first meaning
of gross negligence as “a lack of slight diligence or care”
and a second meaning, “a conscious, voluntary act or
omission in reckless disregard of a legal duty” (i.e., reck-
lessness) [8]. In the context of prosecutions of medical
misconduct, the first meaning of gross negligence is the
more common one [26]. e DFG and KNAW codes, as
written, do not offer resources to disentangle these two
meanings of gross negligence. For instance, the Nether-
lands Code of Conduct for Research Integrity, contrasts
“gross negligence” with “carelessness or ignorance”5: this
is confusing since “recklessness” always involves careless-
ness and “negligence” may either involve carelessness or
simple ignorance. Hence this contrast does not allow one
to infer what precisely the understanding of “gross neg-
ligence” is (i.e., as negligence or as recklessness) in the
Netherlands Code of Conduct for Research Integrity.
e only examined code where negligent infractions
of the code are included as a category of misconduct is
the Australian Code for the Responsible Conduct of
Research. Even though the code does not offer any pre-
cise definition of scientific negligence, nor any detail on
how scientists should act in order to avoid negligence,we
conclude that this code is the only one of the ten exam-
ined where a general negligence provision, pertaining to
all types of infringement of integrity norms, is included.
From this brief, non-exhaustive overview, one can infer
(1) scientific negligence is often not stipulated as a type of
transgression of integrity norms, and (2) when it is, the
meaning of negligence is oftenleft unclear, and without
exception (at least, for the codes reviewed) the concomi-
tant responsibilities for avoiding negligent behavior are
not stipulated.
Discussion: principles fornegligence provisions
How should the absence of negligence provisions in sci-
entific codes of conduct be evaluated? One could accept
the general rationale for negligence provisions, namely to
justify trust in the scientific community, and still reject
that they should be included in scientific codes of con-
duct. For instance, one could hold that such provisions
would be very difficult to enforce. One could also hold
that providing rules on sanctioning is not the primary
purpose of a code of conduct, but that it is rather meant
as an ethical guide for scientists in their work (see also
Sect.4.3 in [3]). In this discussion section we sketch how
negligence provisions should be designed: how stand-
ards of competence should be approached, as well as how
to avoid pitfalls in overemphasizing enforcement and
indefining negligence too broadly.
Standards ofcompetence
A finding of negligence means that a mistake was made
even though a “reasonable precaution” could have
avoided that mistake. Such “reasonable precautions”
are defined relative to the standards of competence that
can be expected of similarly certified professionals (or
scientists). Hence, stipulating responsibilities to avoid
negligence is only possible if there are also standards of
competence to which the work of the professional or sci-
entist can be held.
One could be tempted to reject any attempt to stipu-
late “standards of competence” for scientific research.
After all, a lot of analytic philosophy of science in the
twentieth century searched for a universally applica-
ble andvalid methodology (falsification, confirmation,
etc.)—a methodology that moreover was to distinguish
legitimate scientists from their pseudo-scientific rivals
[27]. ese efforts failed, and while one need not go so
far, as some did, as to reject all scientific methodology
and hence standards of competence [28], one could
remain skeptical of efforts to include generalstandards
of competence in a code of conductmeant for scientists
across all domains.
Nonetheless, similar remarks could be made of profes-
sional standards: different specializations have different
standards, and many such standards may not be codi-
fied with precision or may even betacit. Yet that has not
prevented negligence provisions from being included
in professional codes of conduct. Negligence provisions
communicate the message that, whatever the stand-
ards are within a specialization, the practitioner has the
responsibility to know and follow them.
Similarly, while one must surely grant that there is
no universally applicable standard scientific method-
ology, this does not mean one could not identify scien-
tific standards of competence that aremore limited in
scope. In fact, as previously noted, such standards are
in fact implicitly invoked in the process of peer review:
without such standards, submitted work could not be
judged to be of “good quality” or “poor quality”. One
could plausibly surmise that standards of competence in
fact are tacitly known by practitioners of a sub-field: each
sub-field has particular expectations on what a well-writ-
ten or well-constructed article looks like, what the appro-
priate level of specificity of the argumentation should be
5 See p. 24: “e level to which non-compliance was intentional and whether
it was a form of gross negligence or was the result of carelessness or igno-
rance” (p. 24).
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
(if relevant), how the data are to berepresented (if rel-
evant), what types of literature should beengaged with,
and so on.
One question facing authors of codes of conduct is
thus how precise to make negligence provisions. Pre-
cisely defined provisions, based on explicit standards of
competence,would allow for verification, i.e., to answer
the question: does a certain action constitute negligence
or not? By contrast, a vaguelydefined provisionremains
ambiguous, would not allow for findings of negligence,
and thus would be unenforceable. As an illustration,
consider a competence like “critical thinking”. is isan
example par excellence of a competence that would be
difficult or impossible to define by means of verifiable
criteria. is would mean that third parties could never
verify whether a particular scientist or project lived up to
the relevant standards of critical thinking. e prospect
of setting up an investigation to examine whether some
scientist respected standards of critical thinking is, of
course, absurd; the manifest absurdity reflects how some
scientific ideals remain aspirational and non-enforceable.
Yet non-enforceability does not mean it should not or
cannot beaffirmed as an important standard. We come
back to this in the next subsection in connection to the
tension between the ethical function of negligence provi-
sions and their legal function (enforcement).
Yet some standards lend themselves to explicit defini-
tion, especially those concerning procedures. Actions
whereby such procedures were not followed, whether
by conscious intention or not, would then be culpable
as negligence. Examples of such procedural negligence
include:
(1) Making easily avoidable errors when handling data,
such as mislabeling samples.
(2) Publishing without first trying to replicate one’s
results when such replications are relatively easy to
do.
(3) Carrying out statistical analysis despite not hav-
ing the requisite competences, with the danger
ofwrong statistics being applied, P-values not being
interpreted correctly, etc.
Many of the support activities in the scientific commu-
nity also follow relatively clear standards of competence.
Institutions have responsibilities, and when these are not
met, institutions may be found to have acted negligently.
Individual researchers acting in capacities of referee, edi-
tor, or supervisor also must follow relatively definable
standards, with associated negligences. For instance, a
referee may review an article or proposal negligently
when, for instance: insufficient time or energy is devoted
to the task, thus not taking reasonable precautions to
avoid forming egregiously wrong judgments of the article
or proposal; not refusing to review the article or proposal
if lacking in competence. An editor may neglect their
responsibilities by, for instance: accepting peer-reviews
by scientists who clearly lack the necessary competences;
asking peer-reviewers to make editorial judgments; not
specifying reasonablyclear standards or expectations for
referees. Finally, a supervisor may be negligently culpa-
bleif, for instance: they do not take reasonable precau-
tions to avoid members of the research team from taking
large risks; or if they do not offer sufficient guidance to
supervisees.6
In sum, the elucidation of standards of competence
may not be easy or even always possible. However, this
does not preclude affirming the importance of negli-
gence, and moreover, it seems possible to define stand-
ards of competence for following scientific procedures
as well as for support activities such as acting as referee,
editor, or supervisor. Formulating these standards, and
integrating them into codes of conduct would play an
important role in emphasizing the importance of avoid-
ing negligence.
Pitfalls andunintended consequences
We would like to close the discussion with addressing
some of the dangers of negligence provisions. Negligence
broadens the scope of culpability of scientists, and intro-
ducing negligence as a norm may produce unintended
consequences if not done with prudence. Inappropri-
ate standards of competence, where unwitting scientists
would be found guilty of misconduct in harsh and inap-
propriate ways, could have a similar “chilling effect” that
criminalizing even egregious research misconduct would
likely have [29]. After all, when faced with increased per-
sonal risk due to negligence provisions, scientists may
simply decide to not to expose themselves to risk and
tonot undertake certain activitieswhich are nonetheless
crucial forthe scientific enterprise. Alternatively, a scien-
tist may respond with heightened distrust, taking inap-
propriate measures to control outcomes and tominimize
error. We discuss each in turn.
Diminishment ofscientic activity
It is important to emphasize that the function of codes
of conduct is primarilyto provide clarity about theethi-
cal principles underlying scientific activities, and only
secondarily (if at all)togive detail about the sanctioning
system attached to integrity transgressions. A sanction-
ing system is constrained by a whole host of other ethical
6 See the ICMJE (International Committee for Journal Editors) or COPE
(Committee on Publication Ethics) for further examples of standards expected
from scientists acting in these roles.
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Desmondand Dierickx BMC Med Ethics (2021) 22:45
and legal principles, such as the principle of proportion-
ality. Hence, evenif an act of negligent research could be
considered a transgression against the norms of integrity,
great care would be needed in choosing the appropri-
ateresponse to that transgression, to avoid doing even
greater damage to the scientific enterprise.
Here is an example: if a researcher (likely) exagger-
ated theirresearch findings, this does not mean that a
formal institutional procedure regarding negligence
should be started. Even the starting of such proceduresis
harsh: they are fraught with uncertainty, often involve
reputation-loss for the accused, can lead to an erosion
of trust in theresearch partnersof the accused scientist
(who blew the whistle?), and can erode collegial relations
within research institutions. Moreover, the line between
sensationalizing claims and making them engaging and
digestible (i.e., “selling”) is a fine one. A overly harsh
sanction could have the unintended effect of discourag-
ing future scientific activity.
e sanctions would not even need to be harsh for neg-
ligence provisions to have a chilling effect. For instance,
if referees or editors were under the impression that they
would need to go to an unreasonable degree of scrupulous-
ness (at the pain of being found culpable of negligence),
they may decide that taking up reviewing or editing duties
is simply not worth the risk or effort. In this way, inappro-
priate negligence provisions can express a distrust towards
individual scientists, who then respond by pulling back.
One positive suggestion in this regard would be to
embed principles about negligence in what in profes-
sional contexts is known as “just culture”, which is often
described as an organizational culture where the guiding
response to mistakes is not “who is to blame” but “what
went wrong” [30, 31]. It is clear that, if many QRPs would
be classified as (negligent) misconduct, then the scien-
tific community would need to avoid a blame culture
and take all reasonable steps to strengthen a just culture.
Developing such a just culture would alsoentail moving
away from the emphasis on FFP in many scientific codes
of conduct, since these almost always involve conscious
intentions (and are thus concern “who is to blame”).
A sanctioning system such as that within a just cul-
ture—where sanctions are aimed at behaviors rather
than persons—is thus one candidate for how to include
negligence provisions while avoiding a diminishment
of scientific activity. In a just culture, the sanctioning of
negligence does not suppress individual scientific agency
and thus does not diminishthe ethical function of integ-
rity norms.
Negligence provisions anddistrust
e rationale for negligence provisions is to safeguard
justified trust in a scientific or professional community;
however, ironically, if too much precaution is expected,
this may have the perverse effect of increasing distrust.
As an illustration, consider a situation where scientific
institutions can be held responsible for negligent conduct
of an individual member of the institution. en such
institutions, fearful of prosecution in courts of law, would
have an incentive to exact greater degrees of bureaucratic
control of individual scientists. is would be an example
where too much responsibility is expected of institutions,
and that this has the perverse effect of curtailing individ-
ual autonomy.
Another, similar example would be a negligence pro-
vision where supervisors would be expected to double
check thework of lab members. us, if a lab member
were found to be guilyof misconduct, then the supervi-
sor, if they had not doublechecked the lab member’s
work, could be considered negligentlyculpable. In such
an environment, supervisors would be incentivized to
exert a very highlevel of control on lab members, with
much wasted time and energy.
It is also crucial for the effectiveness of RI training
that negligence provisions be reasonable. Such train-
ing, at least when effective, establishesintegrity norms
asintersubjective social norms: I know the norm, you
know that I know the norm, I know that you know that
I know the norm, and so on. By coordinating expec-
tations in this way, setting norms—even in a code of
conduct—can impact patterns of behavior even with-
out explicit sanctioning systems. Yet, if the specified
norms are unreasonable, and if it becomes intersubjec-
tive knowledge that they are unreasonable, then integ-
rity norms lose all their normative force and become
merewindow dressing, divorced from actual research
culture.
In sum, great care should be made when adding neg-
ligence provisions to make sure that the associated
expectations are reasonable, and in particular that set-
ting such standards would not have detrimental effects
on trusting relationships between colleagues and
that theyinstead can foster a healthy and flourishing
research culture.
Conclusions
Scientific negligence should be problematized much
more than it currently is in codes of conduct for scien-
tists. Problematizing negligence is part and parcel of the
logic of professionalism, and is key for keeping and deep-
ening the trust of thewider society in the scientific com-
munity. In fact, if the scientific community is to genuinely
adopt professionalism as an organizational structure, it
must find a way to include negligence provisions in codes
of conduct. Without these provisions, the rationale for
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Page 10 of 11
Desmondand Dierickx BMC Med Ethics (2021) 22:45
trust in the scientific community and for scientific auton-
omy cannot be justified.
Yet at the same time, it is not easy to discern what pre-
cisely should be the path towards including negligence
provisions. For some scientific activities—following pro-
cedures, or support activities such as reviewing—it may
be relatively easy to identify standards compared to the
core activity of innovative research. Nonetheless, even
then there are considerable pitfalls, because, if done
poorly, negligence provisions can lead to a drive towards
control, which in turn can damage trust between scien-
tific agents (both individuals and institutions). In this
article we discussed pitfalls regarding the sanctioning
system and expectations of precaution. In sum, negli-
genceprovisions shouldbe included in scientific codes of
conduct, butit is paramount this should be done in a rea-
sonable way, as a means to enhance rather than diminish
trust between scientists.
Abbreviations
FFP: Fabrication, falsification, plagiarism; QRP: Questionable research practises;
RI: Research Integrity.
Supplementary Information
The online version contains supplementary material available at https:// doi.
org/ 10. 1186/ s12910- 021- 00610-w.
Additional le1: The supplementary materials give additional informa-
tion on: (1) the search and selection of the analyzed documents, (2) all
identifying data of the documents, and (3) what precise negligence provi-
sions were identified.
Acknowledgements
Not applicable.
Authors’ contributions
HD conceived of the study, designed the study, collected and analyzed
the documents, interpreted the results, and wrote the successive drafts of
the paper. KD commented on important intellectual content in successive
drafts of the paper. Both authors read and approved the final version of the
manuscript.
Funding
This research was supported by funding from the European Union’s Horizon
2020 Research and Innovation program under Grant Agreement No. 741782
(ENTIRE consortium). The funders had no role in the study design, data collec-
tion and analysis, decision to publish, or preparation of the manuscript.
Availability of data and materials
All consulted documents are available in the supplementary materials.
Declarations
Ethics approval and consent to participate
Not applicable.Consent to publish.Not applicable.
Competing interests
The authors declare that they have no competing interests.
Author details
1 Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium. 2 Depart-
ment of Philosophy, University of Antwerp, Antwerpen, Belgium.
Received: 12 November 2020 Accepted: 30 March 2021
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