Whistle-blowers – morally courageous actors in health care?

Wiisak, J., Suhonen, R., & Leino-Kilpi, H. (2022).

Nursing Ethics, 29(6), 1415–1429.

https://doi.org/10.1177/09697330221092341

Abstract

Background

Moral courage means courage to act according to individual’s own ethical values and principles despite the risk of negative consequences for them. Research about the moral courage of whistle-blowers in health care is scarce, although whistleblowing involves a significant risk for the whistle-blower.

Objective

To analyse the moral courage of potential whistle-blowers and its association with their background variables in health care.

Research design

Was a descriptive-correlational study using a questionnaire, containing Nurses Moral Courage Scale©, a video vignette of the wrongdoing situation with an open question about the vignette, and several background variables. Data were analysed statistically and inductive content analysis was used for the narratives.

Participants and research context

Nurses as healthcare professionals (including registered nurses, public health nurses, midwives, and nurse paramedics) were recruited from the membership register of the Nurses’ Association via email in 2019. A total of 454 nurses responded. The research context was simulated using a vignette.

Ethical considerations

Good scientific inquiry guidelines were followed. Permission to use the Nurses’ Moral Courage Scale© was obtained from the copyright holder. The ethical approval and permission to conduct the study were obtained from the participating university and the Nurses’ Association.

Findings

The mean value of potential whistle-blowers’ moral courage on a Visual Analogue Scale (0–10) was 8.55 and the mean score was 4.34 on a 5-point Likert scale. Potential whistle-blowers’ moral courage was associated with their socio-demographics, education, work, personality and social responsibility related background variables.

Discussion and conclusion

In health care, potential whistle-blowers seem to be quite morally courageous actors. The results offer opportunities for developing interventions, practices and education to support and encourage healthcare professionals in their whistleblowing. Research is needed for developing a theoretical construction to eventually increase whistleblowing and decrease and prevent wrongdoing.

Here are some thoughts:

This study investigates the moral courage of healthcare professionals in whistleblowing scenarios. Utilizing a descriptive-correlational design, the researchers surveyed 454 nurses—including registered nurses, public health nurses, midwives, and nurse paramedics—using the Nurses' Moral Courage Scale, a video vignette depicting a wrongdoing situation, and open-ended questions. Findings revealed a high level of moral courage among participants, with an average score of 8.55 on a 0–10 Visual Analogue Scale and 4.34 on a 5-point Likert scale. The study identified associations between moral courage and various background factors such as socio-demographics, education, work experience, personality traits, and social responsibility. The authors suggest that these insights can inform the development of interventions and educational programs to support and encourage whistleblowing in healthcare settings, ultimately aiming to reduce and prevent unethical practices

Why Scientific Fraud Is Suddenly Everywhere

Kevin T. Dugan

New York Magazine

Originally posted 21 May 24

Junk science has been forcing a reckoning among scientific and medical researchers for the past year, leading to thousands of retracted papers. Last year, Stanford president Marc Tessier-Lavigne resigned amid reporting that some of his most high-profile work on Alzheimer’s disease was at best inaccurate. (A probe commissioned by the university’s board of trustees later exonerated him of manipulating the data).

But the problems around credible science appear to be getting worse. Last week, scientific publisher Wiley decided to shutter 19 scientific journals after retracting 11,300 sham papers. There is a large-scale industry of so-called “paper mills” that sell fictive research, sometimes written by artificial intelligence, to researchers who then publish it in peer-reviewed journals — which are sometimes edited by people who had been placed by those sham groups. Among the institutions exposing such practices is Retraction Watch, a 14-year-old organization co-founded by journalists Ivan Oransky and Adam Marcus. I spoke with Oransky about why there has been a surge in fake research and whether fraud accusations against the presidents of Harvard and Stanford are actually good for academia.

I’ll start by saying that paper mills are not the problem; they are a symptom of the actual problem. Adam Marcus, my co-founder, had broken a really big and frightening story about a painkiller involving scientific fraud, which led to dozens of retractions. That’s what got us interested in that. There were all these retractions, far more than we thought but far fewer than there are now. Now, they’re hiding in plain sight.

The info is here.

Here are some thoughts:

Recent headlines might suggest a surge in scientific misconduct. However, it's more likely that increased awareness and stricter scrutiny are uncovering existing issues. From an ethical standpoint, the pressure to publish groundbreaking research can create a challenging environment. Publication pressure, coupled with the human tendency towards confirmation bias, can incentivize researchers to take unethical shortcuts that align data with their hypotheses. This can have a ripple effect, potentially undermining the entire scientific process.

Fortunately, the heightened focus on research integrity presents an opportunity for positive change. Initiatives promoting open science practices, such as data sharing and robust replication studies, can foster greater transparency. Furthermore, cultivating a culture that rewards ethical research conduct and whistleblowing, even in the absence of earth-shattering results, is crucial.  Science thrives on self-correction. By acknowledging these challenges and implementing solutions, the scientific community can safeguard the integrity of research and ensure continued progress.