Publishing Case Reports and Case Series in Indian Biomedical Journals - Ethical Issue Often Neglected

In recent times data generation in human subjects has become a major concern across the world. But most data revolves around randomized controlled trials. The ethical issues involved in observational studies, questionnaire based studies etc. in general receive less attention. At the other extreme interesting observation and a rare observation in a rare clinical setting often encourage the physician to report and publish in the form of case report and case series. The ethical issues involved in data capture in case studies are often not addressed sufficiently. Personal communication with the member of different ethics committees in the countries reveals that very rare if ever; the prospective author of a case report approaches the ethics community for ethics review. Neither do the ethics committee have clear guidelines on their stand on ethics review (perhaps retrospective) of case series and case reports manuscript, while there is at least one major ethics element involved, namely patients right to confidentiality and privacy and non disclosure of identity to a third party. In an article published earlier the informed consent and confidentiality in a case report is given great importance [1]. Striking a balance between protecting patients and providing sufficient detail to make case studies useful with prior informed consent is a central ethical challenge of case study publication [2]. No wonder a preliminary search on requirement of the editorial committee of different biomedical journals published from India to look for editorial requirements [Table/Fig-1] reflects that this issue is not quite adequately addressed.

A random search on 43 Indian Biomedical Journals [Table/Fig-1] in the internet revealed that almost one third (33.33%) of them does not mention any informed consent submission for case report/case series publication in author’s guideline. Almost another one third (30.95%) of the journals has made it mandatory for submission of informed consent and the rest kept the option open and does not mandate. Although esteemed journal demand for furnishing informed consent documents in reporting of case report/series and other articles at the final stage of submission of the manuscript but these issues is not very clearly dictated in the author’s guideline published in their website. There is a natural expectation from the publishing authors to perceive this issue with greater clarity by the editorial board of various journals while attempting for publication. The issue of index or non indexed journal does not relate any way with compulsory informed consent process for reporting of case series/case reports. There is still much disharmony between the various journals although perhaps there is intense effort in creating uniformity on the part of the various journal editors. With the current scenario it is beyond the scope of evaluation whether the journals are really putting effort to enforce this ethical issue for publishing case reports/case series.

[1]. Michael IS, The ethics of case reports Paediatr Child Health 2004 9(2):83-84.  [Google Scholar]

[2]. McCurdy DB, Fitchett G, Ethical issues in case study publication: “making our case(s)” ethically J Health Care Chaplain 2011 17(1-2):55-74.  [Google Scholar]