# Good practice in medicine and biology: scientific integrity needs global bioethics

Henri-Corto Stoeklé, Achille Ivasilevitch, Christian Hervé

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Henri-Corto Stoeklé, Achille Ivasilevitch, Christian Hervé. Good practice in medicine and biology: scientific integrity needs global bioethics. Journal of Translational Medicine, 2023, 21, 10.1186/s12967-022-03847-0. hal-04512880

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# Good practice in medicine and biology: scientific integrity needs global bioethics

Henri-Corto Stoeklé<fnref n="1" />, Achille Ivasilevitch<fnref n="1" />,<fnref n="2" /> and Christian Hervé<fnref n="1" />,<fnref n="3" />,<fnref n="4" />,<fnref n="5" />,<fnref n="6" />*

**Abstract**

We consider scientific integrity to constitute a new theory of morality of science, in a very specific deontological sense. Indeed, at least in practice, scientific integrity extends beyond scientific concerns, seeking to develop specific moral duties and/or procedures based on general moral values and/or standards, leading to common moral frameworks for usual scientific practices. This is, of course, necessary. Contemporary history has shown us only too well that usual scientific practices need common moral frameworks, especially in medicine and biology. However, like scientific practices, and medical and biological practices in particular, the persistence of certain moral values and/or standards and the priority attributed to them, can change significantly, due to changes in society, people, the times and/or environments, and they may be under strong tension. We therefore believe that a new theory of ethics of science, in a very specific teleological sense, may be required in this case, particularly in medicine and biology, in addition to scientific integrity. This ethical theory, through research, professionals and structures in ethics of science— also called medical ethics, research ethics or bioethics in the fields of medicine and biology—, should seek to identify and find specific ethical solutions to these tensions, applicable at a particular place and time, based on common ethical purposes and/or consequences. As a result, these specific ethical solutions may, or may not, lead to an evolution of common moral frameworks, which may, or may not, be developed on the basis of scientific integrity. In the fields of medicine and biology, this ethical theory is closely related to another theory, global bioethics, but with a number of new conceptual and methodological developments.

**Keywords** Scientific integrity, Research integrity, Ethics of science, Morality of science, Medicine, Biology, Bioethics, Medical ethics, Research ethics, Global bioethics

**Background**

Scientific integrity is a concept highly relevant to contemporary medicine and biology. The completely inhumane experiments performed by Nazi doctors during the Second World War alongside their extermination of several million Jews, gypsies, homosexuals, disabled individuals and political opponents led to a veritable awakening of conscience concerning the limits to be imposed on scientific practices. Major international declarations were proclaimed, beginning with the Nuremberg Code after the trial of Nazi doctors just after the war. The Nuremberg code was followed, in 1948, by the declaration of the United Nations, then the Declaration of Helsinki in 1964, the Declaration of Oviedo in 1997 and, finally, that of

<footnote>*Correspondence:
Christian Hervé
christian.herve@parisdescartes.fr</footnote>

<footnote n="1">¹ Department of Ethics and Scientific Integrity, Foch Hospital, Suresnes, France</footnote>

<footnote n="2">² Laboratory of Business Law and New Technologies (DANTE) (UR4498), Paris-Saclay University (UVSQ), Montigny-Le-Bretonneux, Paris, France</footnote>

<footnote n="3">³ Medical School, Paris Cité University, Paris, France</footnote>

<footnote n="4">⁴ Medical School, Versailles Saint-Quentin-en-Yvelines University (UVSQ), Montigny-le-Bretonneux, Paris, France</footnote>

<footnote n="5">⁵ International Academy of Medical Ethics and Public Health, Paris Cité University, Paris, France</footnote>

<footnote n="6">⁶ Veterinary Academy of France, Paris, France</footnote>
the United Nations Educational, Scientific and Cultural
Organization in 2005. France has had bioethics laws in
place since 1994, and many other organizations, includ-
ing the Council on International Organizations of Medi-
cal Sciences have also made similar declarations since
1949. Informed consent (e.g. explicit consent, etc.) and
ethics committees (e.g. national ethics committees, etc.)
have clearly emerged from all these declarations as two
absolute legal and moral rules in *healthcare* and *biomedi-
cal research*. However, despite attempts to enforce these
rules in hospitals and research institutes in many coun-
tries, it has proved impossible to punish all bad scientific
practices, especially scientific fraud. *Scientific integrity*
thus remains highly relevant to contemporary *medicine*
and *biology*, and has been the subject of much discussion
[1]. Nevertheless, theoretical and practical issues remain
unresolved and merit further clarification and proposals,
in our view.

Theory versus practice

Scientific integrity is becoming increasingly impor-
tant within the scientific community. The Dutch biolo-
gist Elisabeth Bik is one of the best-known contributors
to the field in medicine and biology [2]. Bik founded the
"Science Integrity Digest", a blog entirely dedicated to
scientific integrity and analyses of cases of real or sup-
posed misconduct. She is also a regular participant on
the computer platforms "Retraction Watch", and "Pub-
peer", which list and comment on scientific articles that
have been retracted (for Retraction Watch) and identify
the failings of publications in terms of scientific integrity
(Pubpeer). Bik may have been a pioneer in this field, but
many other individuals from the academic and institu-
tional world have also contributed to its development
[3]. Scientific integrity came to the fore in the United
States in 1989, with the creation of the Office of Scientific
Integrity, which was merged with the Office of Research
Integrity in 1992. At the start of this century, various
international declarations relating specifically to scientific
integrity were published, including the Singapore State-
ment on Research Integrity in 2010, and the European
Code of Conduct for Research Integrity in 2011. These
declarations relate to all branches of science, including
medicine and biology.

In our home country, France, the concept of *scientific integrity* first emerged in 1999, with the creation by the French National Institute for Health and Medical Research of a delegation for scientific integrity. This delegation related specifically to the fields of *medicine* and *biology*. Nowadays, most French universities and the French National Scientific Research Center, through its ethics committee, pay considerable attention to this issue, in *medicine*, *biology* and beyond. The Corvol Report,

entitled "Assessment and proposals for the implemen-
tation of a national scientific integrity charter" is one
of the latest French national and institutional elements
to be added in the construction of *scientific integrity* in
France, to establish a common moral framework for all
scientific practices, including medical and biological
practices. This report proposed relatively concrete and
relevant solutions for eradicating scientific fraud, which
may take various forms, such as the fabrication or falsifi-
cation of results, plagiarism, questionable research prac-
tices (QRPs), conflicts of interest and issues relating to
authorship.

Some philosophers differentiate between scientific integrity and research integrity, probably for etymological reasons (i.e. science vs. research), but, in some cases, they may wish to differentiate between strictly scientific concerns (i.e. true vs. false = scientific integrity) and moral concerns (i.e. good vs. bad = research integrity) [4]. However, these theoretical distinctions, made by philosophers, may be much less clear, in practice, to physicians, biologists, and other scientists [5]. In practice, the terms "scientific integrity" and "research integrity" may be interchangeable to a certain extent in medicine, biology and other fields of science [6]. Moreover, in France, scientific integrity and research integrity are grouped together under the single term "intégrité scientifique", which translates as "scientific integrity", in both practice and theory. Furthermore, the Corvol Report clearly stated that scientific integrity "should be based on universal moral principles, such as the notions that it is bad to lie or to steal".

Let us assume, for the sake of argument, that scientific integrity and research integrity are synonymous, at least in practice, and based as much on science as on morality. There remains another major theoretical and practical issue that is even more important: morality, like science, can change significantly over time and may differ between places, mostly due to societies, people, times and/or environment [7]. Even in Western societies, different countries, such as the United States and France, for example, have different views of the roles of public and private funding, with very different relationships between the state and markets. Private funding is favored in the United States, whereas public funding is favored in France, in many areas, including medicine and biology, and for biotechnologies in particular (e.g. genetic testing, etc.) [8]. Of course, scientific fraud, such as the fabrication and falsification of results, or plagiarism, is condemned both morally and legally in similar ways everywhere. However, the situation is more complex when it comes to conflicts of interest, precisely because the relationship between the state and markets, and, thus, the proportions of private or public funding, differ radically between countries, and no particular approach can
be considered morally superior to another. We therefore believe that it is important to take differences between societies, people, times and/or environments into account more effectively in scientific practices, especially in *medicine* and *biology*, without falling into extreme relativism. A very specific theoretical and practical distinction between *ethics* and *morality* would be helpful in this respect.

## Ethics versus morality

*Ethics* has a much longer history than *scientific integrity*, dating back to the Classical era. Nowadays, we can distinguish *normative ethics* (i.e. a moral judgment of an action or attitude according to an ethical theory) from *applied ethics* (i.e. a practical application of *normative ethics* to a particular field, such as *medicine* and *biology*) and *meta-ethics* (i.e. a conceptual analysis of *normative ethics*) [9]. There are also at least two large families of *normative ethics*. The first is *deontological ethics*, which judges the morality of an action or attitude as a function of its conformity to specific moral duties and/or procedures, as in *Kantism* (i.e. an ethical theory), where specific moral duties are categorical imperatives. The second is *teleological ethics*, which judges the morality of an action or attitude according to common ethical purposes and/or consequences, known as *Consequentialism*, as in *Utilitarianism* (i.e. another ethical theory), in which the ethical consequences most frequently considered are the amount of pleasure or suffering.

But is there a difference between *ethics* and *morality*? Again, in Western societies, from Classical times right up to the Middle Ages, the difference between these two terms was purely etymological (i.e. Greek vs. Latin = *ethics* vs. *morality*). It was not until the modern epoch, and the contemporary period in particular, that the meanings of these two words and the semantic distinction between them gradually changed, leading to their definitive adoption by certain contemporary philosophers, such as the

French philosopher Paul Ricoeur, for whom *ethics* relates to questioning and an openness of spirit, whereas *morality* relates to a closed system of standards. The work of the Canadian anthropologist Raymond Massé runs along the same lines. In practice, *ethics* and *morality* might be distinguished as follows: *morality* conceptualizes and applies general moral values and standards, whereas *ethics* calls them into question [10].

In our view, we could go further. We could say that *morality*, in addition to conceptualizing them, asks “how” to apply these general moral values (i.e. good attitudes = *to be*) and/or standards (i.e. good actions = *to do*), or, “how” to *be* this and/or *to do* that in the face of usual social practices (i.e. real attitudes = *what is* / real actions = *what is done*). It develops specific moral duties and/or procedures in response, thereby generating common moral frameworks (Table 1a). By contrast, *ethics* asks “why” certain moral values and/or standards should be respected in the face of new social practices, “why” is it important *to be* this and/or *to do* that. Its decisions are based on common ethical purposes and/or consequences (Table 1b). *Morality* confers common moral frameworks on social practices, whereas *ethics* considers these frameworks when tensions develop between new social practices and certain moral values and/or standards, generating ethical issues, for which specific ethical solutions are required. In the end, these specific ethical solutions may, or may not, lead to a change in the common moral frameworks. In this way, *deontological ethics* has clearly been transformed into *morality* (Table 1a), and *teleological ethics* into *ethics* (Table 1b), because *morality* focuses on specific moral duties and/or procedures, whereas *ethics* relates to common ethical purposes and/or consequences.

Thus, *scientific integrity* corresponds to a new theory of *morality of science*, in a very specific deontological sense (Table 2a). At least in practice, it extends beyond purely scientific concerns, seeking to develop specific moral

<table><caption>**Table 1** a Morality (eq. deontological ethics); b Ethics (eq. teleological ethics)</caption><tbody><tr><td>(a) Morality<br>eq. Deontological ethics</td><td><table><tbody><tr><td>General moral values<br>i.e. good attitudes = to be</td><td rowspan="2">- "How" to be this or to do that?<br>ys. what is, what is done</td></tr><tr><td>General moral standards<br>i.e. good actions = to do</td></tr><tr><td>vs. Usual social practices<br>i.e. real attitudes = what is</td><td></td></tr><tr><td>i.e. real actions = what is done</td><td></td></tr></tbody></table></td><td>- Specific moral duties and/or procedures</td><td>- Common moral frameworks</td></tr><tr><td>(b) Ethics<br>eq. Teleological ethics</td><td><table><tbody><tr><td>→ Ethical issues<br>i.e. certain moral values and/or standards</td><td rowspan="2">- "Why" is it important to be this and/or to do that?<br>ys. new social practices</td></tr><tr><td>vs. new social practices</td></tr></tbody></table></td><td>- Common ethical purposes and/or consequences</td><td>- Specific ethical solutions</td></tr></tbody></table>
<table><caption>**Table 2** a Morality of science (eq. scientific integrity); b Ethics of science (eq. global bioethics)</caption><thead><tr><th></th><th></th><th></th><th></th><th></th></tr></thead><tbody><tr><td>(a) Morality of science<br/>&gt; Scientific integrity<br/>→ Science</td><td><ul><li>→ General moral values<br/>e.g. to be free, to be fair, etc.</li><li>→ General moral standards<br/>e.g. not to lie, not to steal, etc.</li><li>vs. Usual scientific practices<br/>eq. usual social practices<br/>e.g. experimentation, observation, etc.</li></ul></td><td><ul><li>→ "How" to be free, etc. and/or not to lie, etc.?<br/>vs. experimentation, observations, etc.</li></ul></td><td><ul><li>→ Reliability, honesty, etc. and/or punishment, etc.<br/>eq. Specific moral duties and/or procedures</li></ul></td><td><ul><li>→ Singapore Statement on Research Integrity, etc.<br/>eq. Common moral frameworks</li></ul></td></tr><tr><td>(b) Ethics of science<br/>&gt; Global bioethics<br/>→ Medicine<br/>→ Biology</td><td><ul><li>→ Bio-ethical issues<br/>i.e. Certain moral values and/or standards<br/>e.g. to be free, etc. and/or not to lie, etc.</li><li>vs. New medical and/or biological practices<br/>eq. New social practices<br/>e.g. COVID-19 vaccination, etc.</li></ul></td><td><ul><li>→ "Why" is it important to be free, etc. and/or not to lie, etc.?<br/>vs. COVID-19 vaccination, etc.</li></ul></td><td><ul><li>→ Happiness* and/or survival*<br/>eq. Common ethical purposes and/or consequences<br/>*Individual/collective criteria<br/>e.g. culture, personality, etc.<br/>*Environmental concerns<br/>e.g. climate change, pollution, etc.</li></ul></td><td><ul><li>→ Bio-ethical solutions<br/>eq. Specific ethical solutions</li></ul></td></tr></tbody></table>

duties (e.g. reliability, honesty, respect, accountability, etc.) and/or procedures (e.g. enforcement, punishment, etc.) based on general moral values (e.g. *to be free, to be fair*, etc.) and/or standards (e.g. *not to lie, not to steal*, etc.), leading to common moral frameworks (e.g. Singapore Statement on Research Integrity, European Code of Conduct For Research integrity, Corvol Report, etc.) for usual scientific practices (e.g. *experimentation, observation, calculation*, etc.). This is, of course, necessary. Usual scientific practices need common moral frameworks, especially in *medicine and biology*, as we have learnt from contemporary history. However, as pointed out above, the meaning, priority or the very existence of certain moral values and standards, just like scientific practices (e.g. *COVID-19 vaccination*, etc.) can change significantly over space and/or time, and be strongly in tension (i.e. ethical issue), due to changes in societies, people, times and/or environments. We, therefore, believe that a new theory of *ethics of science*, in a very specific teleological sense, may be required, particularly in *medicine and biology*, in addition to *scientific integrity* (Table 2b).

This theory would seek to identify ethical issues and to find specific ethical solutions to these issues (i.e. these tensions between certain moral values and/or standards and new scientific practices, particularly medical and/ or biological practices), in a given spatial and/or temporal context (i.e. societies, people, times and/or environments), based exclusively on common ethical purposes and/or consequences, while taking into account individual and collective criteria (e.g. culture, personality, etc.). As a result, these specific ethical solutions could potentially lead to the evolution of common moral frameworks that could be developed on through *scientific integrity*, on a case-by-case basis, at national and/or international level. In practice, this would involve research (e.g. empirical research, interdisciplinary study, etc.), teachings (e.g. masters, PhD, etc.), structures (e.g. ethics committee,

academic department, etc.) and professionals (e.g. bioethicist, full professor, etc.) — who should also be scientists, such as physicians or biologists, specializing in ethics (e.g. academic degree, scientific publication, etc.) — in *ethics of science*.

## Perspectives

At least in *medicine* and *biology*, this ethical theory is closely related to another theory, *global bioethics*, but with several new conceptual and methodological developments [11]. We believe that, within *medicine* and *biology*, these common ethical purposes and/or consequences relate principally to improving the happiness and/or survival of people and/or societies, taking into account different individual and/or collective criteria of happiness and/or survival (e.g. culture, personality, etc.), and environmental concerns (e.g. biodiversity loss, global warming, etc.) (Table 2b). In this way, through a greater pragmatism and pluralism at the conceptual level than for the initial theory, *global bioethics* may be better adapted than other ethical theories (e.g. *principism*) to the considerable cultural diversity and real needs of humanity, both material (e.g. food, health, etc.) and non-material (e.g. love, spirituality, etc.). It should, therefore, also be better equipped to address (bio-)ethical issues. At the methodological level, interdisciplinary studies (i.e. combining *life sciences, human sciences*, etc.), empirical research (i.e. qualitative research, quantitative research, etc.) and conceptual analyses (i.e. *meta-ethics, descriptive ethics, comparative ethics*, etc.) should be favored. In practice, at Foch Hospital, in France, we made use of this ethical theory during the COVID-19 pandemic, to study different (bio-)ethical issues in *oncology* [12], especially the policy concerning anti-COVID-19 vaccination for cancer patients [13]. We are working on the further conceptual and methodological development of this ethical theory in our department, with the aim, in particular,
of differentiating between the study of macro-(bio-)ethi-
cal issues (eq. issues at large scales = societies, countries,
etc.), and micro-(bio-)ethical issues (eq. issues at local
scales = individuals, hospitals, etc.) [14],

Theoretically, *global bioethics* could be developed along
more than one route to ensure good practice in *medi-
cine* and *biology* without ever justifying the worst types
of behavior (e.g. murder, torture, etc.), even in a multi-
cultural world. However, in practice, even new decla-
rations or organizations in *ethics of science —medical
ethics, research ethics, bioethics, etc.* — would not be suf-
ficient to achieve this end. More training in *global bio-
ethics* is required, within biology faculties and medical
schools, right from the start of university education, or
even before, together with more research programs and
scientific publications, with the creation of more teams,
laboratories, departments, and professional positions in
*ethics of science*, in academic institutions, research insti-
tutes and hospitals, to put this ethical theory into prac-
tice more widely. *Medicine* and *biology* will undoubtedly
continue to evolve both scientifically and morally. If we
consider animal experimentation as an example, it seems
likely that this practice will one day be banned or that
the specific moral duties and/or procedures that already
apply to human experimentation will be extended to
animal experimentation [15]. However, we believe that
only collective and academic (bio-)ethical reflections will
make it possible to move beyond individual and militant
moral convictions.

Furthermore, in the exponential technological pro-
gress occurring in *medicine* and *biology* will also neces-
sitate major educational actions, beyond the training of
physicians and biologists. Improvements in patient edu-
cation and literacy would also be required. At the indi-
vidual level, this would improve the identification and
evaluation of the dangers and risks of these technolo-
gies, and at societal level, it would improve their use,
both by patients, and by physicians and biologists. We
see dynamic consent as a pertinent way of improving
patient education and literacy [16]. Modern healthcare
administrators and executives in hospitals and research
institutes would have a key role to play in this process.
However, the recent shift towards *global health* means
that patient education and literacy are not the only key
ethical issues here [17]. There are also social and/or
economic disparities between people and/or societies
in terms of access to these technologies. An absence of
these technologies in some countries or societies can
lead to medical tourism, further deepening these dis-
parities. Moreover, the even more recent shift towards
the concept of *one health* means that the spatial and
temporal impacts of technologies on ecological (e.g.
biodiversity loss, etc.) and environmental (e.g. global

warming, etc.) aspects must be also integrated into
what is becoming a very complex ethical reflection [18].
*Global bioethics*, with appropriate research methodolo-
gies (e.g. action research, systemic modeling, etc.), may
prove extremely useful in this context.

Abbreviations

COVID-19 Coronavirus disease 2019

QRPs Questionable research practices

Acknowledgements

We thank Foch Hospital for support.

Author contributions

HCS and CH contributed to the conception of the paper, drafting sections and discussing how different sections should be refined and integrated. AI made substantial contributions. All authors read and approved the final manuscript.

Funding

None.

Availability of data and materials

Not applicable.

Declarations

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

None.

Received: 21 September 2022 Accepted: 23 December 2022

Published: 20 January 2023

References

1. Kimmelman J. What is human research for? reflections on the omission of scientific integrity from the belmont report. Perspect Biol Med. 2020;63(2):251–61.

2. Shen H. Meet this super-spotter of duplicated images in science papers. Nature. 2020;581(7807):132–6.

3. Hervé C, Stanton-Jean M, Mamzer-Bruneel MF. Around scientific integrity, loyalty and probity. In aspects cliniques, éthiques et juridiques. Dalloz, France 2016. https://www.boutique-dalloz.fr/autour-de-l-integrite-scientifique-la-loyaute-et-la-probite-p.html

4. Shaw D. The quest for clarity in research integrity: a conceptual schema. Sci Eng Ethics. 2019;25(4):1085-93.

5. Horbach SPJM, Halffman W. Promoting virtue or punishing fraud: mapping contrasts in the language of 'scientific integrity.' Sci Eng Ethics. 2017;23(6):1461-85.

6. Mialon M, Ho M, Carriedo A, Ruskin G, Crosbie E. Beyond nutrition and physical activity: food industry shaping of the very principles of scientific integrity. Glob Health. 2021;17(1):37.

7. Bunyamin MAH. Morality and science teaching: expanding the idea of giving zakah. Cult Sci Edu. 2019;14(2):355–60.

8. Cassier M, Stoppa-Lyonnet D. Federal judge and government of the United States against gene patenting. Med Sci. 2011;27(6–7):662–6.

9. Kimera S, Mlangwa J. Veterinary ethics. In: ten Henk H, editor. Encyclopedia of Global Bioethics. Cham: Springer International Publishing; 2015.
10. Stoeklé HC, Ivasilevitch A, Marignac G, Hervé C. Creation and use of organoids in biomedical research and healthcare: the bioethical and metabioethical issues. Cell Adh Migr. 2021;15(1):285-94.

11. Stoeklé HC, Sekkate S, Ayoubi JM, Beuzeboc P, Hervé C. An ethics of HPV vaccination: beyond principlism. Hum Vaccin Immunother. 2022;1:2082793.

12. Stoeklé HC, Ladrat L, Landrin T, Beuzeboc P, Hervé C. Bio-ethical issues in oncology during the first wave of the COVID-19 epidemic: a qualitative study in a French hospital. J Eval Clin Pract. 2022. https://doi.org/10.1111/jep.13766.

13. Stoeklé H-C, Sekkate S, Angellier E, Kennel T, Benmaziane A, Mabro M, et al. From a voluntary vaccination policy to mandatory vaccination against COVID-19 in cancer patients: an empirical and interdisciplinary study in bioethics. BMC Med Ethics. 2022;23(1):88.

14. Stoeklé H-C, Hervé C. Bioethics after the COVID-19 pandemic: more research, fewer committees? Clin Ethics. 2022;17(4):327-30.

15. Simmonds RC. Bioethics and Animal Use in Programs of Research, Teaching, and Testing. In: Weichbrod RH, Thompson GAH, Norton JN, eds. Management of Animal Care and Use Programs in Research, Education, and Testing. Taylor & Francis 2018. https://www.ncbi.nlm.nih.gov/books/NBK500418/

16. Stoeklé H-C, Hulier-Ammar E, Hervé C. Data medicine: 'broad' or 'dynamic' consent? Public Health Ethics. 2022. https://doi.org/10.1093/phe/phac0 14.

17. Godard B, Haddad S, Huish R, Weinstock D. Introduction to ethics and global health. BMC Med Ethics. 2018;19(1):51.

18. Gruetzmacher K, Karesh WB, Amuasi JH, Arshad A, Farlow A, Gabrysch S, et al. The Berlin principles on one health—bridging global health and conservation. Sci Total Environ. 2021;764: 142919.

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