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A look at ethics in orthopedics

Three years ago, the Board of the European Federation of National Associations of Orthopaedics and Traumatology set up an ethics committee.

The first aim of the committee was to prepare a document outlining how ethical considerations should apply in the very different countries of our federation. Its second aim was to support the Board when potential ethical problems arose. The first chairman of the Ethics Committee, Jean Puget, MD, sadly died. I replaced Dr. Puget and was supported initially by Nikolaus Böhler, MD, Miklos Szendroi, MD, and Luigi Zagra, MD, and later by Henri Coudane, MD.

Our paper, Ethical Orthopaedics for EFORT, was published in 2014. I do not propose just to restate its principles here, but rather wish to consider some of the issues we have learned from it.

A few ethical concerns have been brought to the committee’s attention. In one instance, for example, a submitted paper had been previously published and this was not acknowledged. In another case, results were included as original when they were, in fact, the work of another surgeon. In one submission, the main researcher was not included in the paper and it was attributed only to senior colleagues.

The Board of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT), not its Ethics Committee, decides action, if any, needs to be taken. This may range from a simple reprimand to a decision not to accept any further contribution from those authors for several years. Every surgeon should report instances of fact falsification, plagiarism and malpractice to the committee. Only if we all do this can we live up to the ideal of offering the best care to our patients.

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