Dual Publication and Manipulation of the Editorial Process

What purpose do medical journals serve? Ideally, they are conduits for the transmission of information useful in the understanding and treatment of disease. Realisticaiiy, they aiso serve a iess noble roie by providing a mechanism by which careers are advanced, reputations are made, and job security is enhanced. It is unfortunate that these two missions are not separabie. The very existence of the iatter may iead to the corruption of the former (i). Aithough fraudulent manipulation of scientific data is the most blatant example of "publication crimes," other more subtle, softer violations are increasing in frequency. Duplicate publication is possibly the most creative of the ethicai transgressions (2). This invoives the deiiberate transformation of a manuscript from an originai into an altered state in an effort to create the iilusion of two independent pubiications. The simiiarities between the two are biurred so that the paper can be submitted and pubiished in two or more journals rather than one. The rationale behind this effort is ciear: It has nothing to do with increasing the fund of medical knowiedge and everything to do with adding buik to an author's curricuium vitae. Aithough this practice has affected every aspect of organized medicine (3-5). several recent exampies from our own specialty iiiustrate the probiem.