Community medicine chapters
Research ethics, referencing and plagiarism
The ethical principles and landmark codes for research on people, informed consent and ethics committees, research misconduct, the Vancouver and Harvard referencing styles, types of plagiarism and how to avoid it, and authorship rules.
- Research on people rests on respect for persons (autonomy), beneficence/non-maleficence and justice (Belmont Report), and on codes such as the Nuremberg Code (1947) and the Declaration of Helsinki (1964, revised).
- Every study needs ethics committee approval and voluntary, informed consent (with extra protection for vulnerable groups) and must protect confidentiality.
- Plagiarism (using others' words or ideas without credit) is research misconduct, alongside fabrication and falsification; medicine mostly uses the numbered Vancouver referencing style.
On this page
Overview
Research must protect the rights, safety and dignity of participants and be honest. Unethical research harms people and destroys trust; dishonest research misleads doctors and patients.
Landmark codes and guidelines
| Document | Year | Key points |
|---|---|---|
| Nuremberg Code | 1947 | After Nazi experiments on prisoners; voluntary consent is absolutely essential; research must avoid unnecessary suffering |
| Declaration of Helsinki | 1964 (World Medical Association), revised many times | Ethical principles for medical research on humans; ethics committee review; the participant's interests come first; rules on placebo use |
| Belmont Report | 1979 (USA, after the Tuskegee syphilis study) | Three principles: respect for persons, beneficence, justice |
| CIOMS guidelines | Updated 2016 | Applying ethical principles in low- and middle-income countries |
| ICH Good Clinical Practice | 1996 onwards | Standards for conducting clinical trials |
The Nuremberg Code first made voluntary consent essential. The Declaration of Helsinki is the World Medical Association's statement of research ethics.
Ethical principles
- Respect for persons (autonomy): people decide for themselves; informed consent; extra protection for those with reduced autonomy.
- Beneficence: maximise benefits.
- Non-maleficence: do no harm; minimise risks.
- Justice: fair selection of participants and fair sharing of burdens and benefits (do not exploit poor or vulnerable groups).
Informed consent
Valid consent needs:
- Disclosure of information: purpose, procedures, duration, risks, benefits, alternatives, confidentiality, compensation, contact details.
- Understanding: in the participant's own language (Urdu or the local language), without jargon.
- Voluntariness: no coercion or undue inducement.
- Capacity (competence) to decide.
- Documentation, usually a signed (or thumb-printed and witnessed) form.
Participants have the right to withdraw at any time without penalty.
Children: consent from a parent or guardian plus the child's own assent where possible. Waivers of consent are allowed only in limited situations approved by the ethics committee.
Ethics review
All research involving people must be approved before it starts by an independent ethics review committee (ERC) or institutional review board (IRB).
In Pakistan, institutional review boards in universities and hospitals review studies, and the National Bioethics Committee (NBC) Pakistan reviews national-level and multi-centre research.
Vulnerable groups
People less able to protect their own interests need extra safeguards: children, prisoners, pregnant women, people with mental illness or learning disability, the very poor or illiterate, refugees, and subordinates such as students or junior staff who may feel pressure to take part.
Confidentiality and data protection
- Collect only the data needed.
- Use codes instead of names; anonymise data for analysis and publication.
- Store data securely; share only as agreed in the consent.
Research misconduct
The three main forms (FFP):
- Fabrication: making up data or results.
- Falsification: changing, omitting or manipulating data, images or methods.
- Plagiarism: using others' words, ideas or results without proper credit.
Other questionable practices: duplicate (redundant) publication, salami slicing (splitting one study into many small papers), undisclosed conflicts of interest, gift or guest authorship (adding people who did not contribute) and ghost authorship (hiding real contributors).
Plagiarism
Plagiarism is presenting another person's work as your own.
| Type | Example |
|---|---|
| Direct (verbatim) | Copying sentences without quotation marks and citation |
| Mosaic (patchwriting) | Mixing copied phrases with your own words |
| Paraphrasing without citation | Rewording someone's idea without giving credit |
| Self-plagiarism | Reusing your own published text or data without citing the earlier work |
| Source-based | Citing a source you did not read, or wrong citations |
Reusing your own published work without citing it is self-plagiarism, and is still misconduct.
Avoiding plagiarism
- Cite every source of ideas, data, figures and quotations.
- Put exact words in quotation marks with a citation.
- Paraphrase properly (your own words and a citation).
- Keep careful notes of sources; use reference managers (Zotero, Mendeley, EndNote).
- Check your work with similarity software (for example Turnitin); in Pakistan, the Higher Education Commission (HEC) has a plagiarism policy for theses and papers.
Referencing styles
| Style | In the text | Reference list | Used by |
|---|---|---|---|
| Vancouver | Numbers in the order sources are first cited (1), (2)… | Numbered in citation order | Most medical journals (ICMJE) |
| Harvard (author-date) | Author's surname and year (Khan, 2020) | Alphabetical by author | Many social science and some health journals |
Vancouver example: Khan A, Ahmed S. Title of article. Journal Name. 2020;12(3):45-50.
Vancouver = numbered, in order of citation (medicine). Harvard = author and year, alphabetical list.
Authorship (ICMJE criteria)
An author must meet all four:
- Substantial contribution to the idea or design, or to data collection, analysis or interpretation.
- Drafting the work or revising it critically.
- Final approval of the version to be published.
- Agreement to be accountable for all aspects of the work.
People who contributed less (for example only collecting data or providing funding) are listed in the acknowledgements.
Expect: Nuremberg Code (1947, voluntary consent), Declaration of Helsinki (WMA, 1964), Belmont Report principles, the elements of informed consent and right to withdraw, vulnerable groups, ethics committee approval, fabrication vs falsification vs plagiarism, self-plagiarism, Vancouver vs Harvard styles, and ICMJE authorship criteria.
Quick revision
- Nuremberg 1947: voluntary consent. Helsinki 1964 (WMA). Belmont 1979: respect, beneficence, justice.
- Consent: information, understanding, voluntariness, capacity; right to withdraw.
- Ethics committee approval before starting; extra care for vulnerable groups.
- Misconduct: fabrication, falsification, plagiarism.
- Self-plagiarism and duplicate publication are misconduct too.
- Vancouver: numbered; Harvard: author-year.
- ICMJE authorship: all four criteria.
Written by The House Job from Excel Community Medicine and Park's Textbook of Preventive and Social Medicine (named in the UHS PGET syllabus), with the Declaration of Helsinki, the Belmont Report and ICMJE recommendations.
FAQ
What are the three principles of the Belmont Report?
Respect for persons, beneficence and justice.
What is informed consent?
A voluntary decision to take part in research, made by a competent person after receiving and understanding adequate information, with the right to withdraw at any time.
What is self-plagiarism?
Reusing one's own previously published text or data without citing the earlier publication.
What is the Vancouver referencing style?
A numbered style in which references are numbered in the order they are first cited in the text; it is used by most medical journals.