I was planning on writing about the article in the November 16, 2009 Chronicle of Higher Education, “Ethicists Prod NIH to Spend Money Investigating Conflicts of Interest,” (Paul Basken, Chronicle of Higher Education, 11/16/2009, accessed 11/17/2009). This article reports on a letter sent to Francis Collins, new director of NIH. This letter states, “”The recent disclosure of ghostwritten articles, physician payoffs, and the use of academic opinion leaders to increase markets for FDA-regulated products,… indicate that ethical lapses may permeate biomedical research.” I have touched upon some of the ghostwriting issues in previous blog postings.
Why does this matter to librarians? I think we often look to NIH funded research as a sort of gold standard that seems to be above the fray of pharmaceutical issues. As we teach evaluation, we might also need to focus on looking at all funding aspects and other sources of influence on the biomedical research and reporting process.
Then I became intrigued by an article in the Advice column, “Sorry I’m Late” (Michael Munger, Chronicle of Higher Education, 11/16/2009, accessed 11/17/2009). Now I have a confession to make, I’m chronically punctual. Once upon a time I was never ever late for anything and I had little if no tolerance for people who were late. Then my mother moved in with me. I’m learning in the world of being a caregiver that all things are not completely controllable and I’m letting go of time a bit. Just a bit. When I’m at work, however, for the most part I really really strive to be on time for meetings and other professional obligations.
This article is a cute characterization of types of people and reasons why people are late for meetings.
The Platonic traveler.
…Chronically late people live in the imperfect world, but believe they can travel inside their own minds. If their house is 11 minutes away from the campus, without traffic or stoplights, then they assume that they can actually travel from their home to the meeting room in 11 minutes. Of course, there are school buses, problems with parking, garbage trucks blocking the alley, and so on…
…You have to allow for the average length of the trip, not the trip in the world of Platonic forms.
The paradox of the busy.
The busier you are, the more likely you will be on time. Busy people manage their time well because it is valuable…
Incompetent people believe they are busy, but they are just inefficient…
For this group of latecomers, the closer their office is to the room, the later they arrive at the meeting.
The first will be last.
Mr. First shows up, parks his folders, sees the room is empty, and heads for the coffeepot…
This article concludes with the thought that, “We tend toward lateness because each of us hates waiting more than we feel bad about making others wait. But manners and conventions are precisely about solving that sort of problem. So let’s work together.”
In these times when issues of rudeness are in the news (a lot it seems to me), this was an interesting perspective on another aspect of rudeness. This may not be the largest ethical question of the day, but just think what a nicer world it would be if we could manage to start and hence end our meetings on time.
A couple of items from the Wired Campus in the Chronicle of Higher Education caught my eye this week (and its only Tuesday)…
“Columbia and Cornell Libraries Announce ‘Radical’ Partnership” (Howard, J. Chronicle of Higher Education, 10/28/2009)
This radical partnership relates to plans by the libraries of these two institutions to, “jointly transform their operations.” The project called 2CUL (pronounced too cool) will focus on 3 areas: “managing electronic resources and other nuts-and-bolts library work, building global-collecting capabilities, and creating a digital-preservation infrastructure.” They are planning on creating a shared library information management system to accomplish their goals.
What I find interesting isn’t that there is a collaboration like this happening, but that it has taken this long for this type of collaboration to emerge. I also find it interesting that this type of collaboration is being characterized as “radical”. To me it seems more logical. Then again this is the type of thing our AHEC libraries have been working on for the past several years. We have been moving to managing electronic resources centrally. This model just seems to make sense especially for smaller (compared to academics at any rate) hospital libraries. It will be interesting to see how the details of working with licensing and access and all the other publisher based specifics will play out. There is, of course, the difference between management and ownership. Even if publishers won’t work out joint purchases it could still be possible to centrally manage the collections.
“The Latest File-Sharing Piracy: Academic Journals” (Terris, B. Chronicle of Higher Education, 10/30/2009).
A recent study published in the Journal of Medical Informatics examines a file sharing site used by medical students and professionals to obtain non-open access journals for free. According to the Chronicle there was an 83% success rate in finding articles. The ethical implications of this aren’t covered in the article but the article does hint at the ethical questions saying, ““In the field of medicine, ethics plays a pivotal role, and yet the site displays activities by medical students, teachers, and practicing professionals that are ethically dubious.”
I wish I could say I’m surprised by this, but given what I know about medical residents sharing subscriptions to some licensed resources, I’ve had inklings of these types of behaviors for quite a while. What will be interesting to watch is to see how publishers uncover the original source of the articles from personal subscriptions or from institutional subscriptions. Since most medical students have a good network of access to articles, I’m wondering why they would feel the need to resort to free sharing. Is it the time (they can’t wait for access from an article not owned by their institution) or is it the money (they can’t afford the what 8$ ILL fee??). As we seem to be noting of late there have been some ethical oddities in the relationship between medicine and publishing, so again this shouldn’t come as too much of a surprise. I guess the next logical question should be, what role can librarians play in shaping responsible behavior in our consitutents in regards to resource access?
During these times when social networking, web 2.0, and all things technology, technology, technology, its nice to celebrate banned books week.
ALA advertises Banned Books Week as a time to highlight, “the benefits of free and open access to information while drawing attention to the harms of censorship by spotlighting actual or attempted bannings of books across the United States.” A cornerstone of Banned Books Week is its emphasis not on the book for its own sake, but on the book as a vessel of intellectual freedom saying, “Intellectual freedom—the freedom to access information and express ideas, even if the information and ideas might be considered unorthodox or unpopular—provides the foundation for Banned Books Week. BBW stresses the importance of ensuring the availability of unorthodox or unpopular viewpoints for all who wish to read and access them.”
As we watch the debate over the Google books settlement we (meaning librarians) can’t help feel that we are on the front lines of a battle over the future of the book. No one yet knows what the implications are for the future of the book. Reading the statement about Banned Books week, I can’t help but wonder if in the future we shouldn’t be celebrating (or examining) some sort of week that celebrates not only the book, but also the notion of access.
I pondered writing about this a few weeks ago when I read an article about Ghostwriting practices at Elsevier involving HRT. You know how it goes, something else arose and I put it to the back of my mind. Today when I read another (several articles) about Ghostwriting; it seemed like a good time to higlight the issue (again).
Charles Grassley (Senator from New York) is moving to legislatively block the practice of medical Ghostwriting. An article in the August 18 New York Times begins saying, “A growing body of evidence suggests that doctors at some of the nation’s top medical schools have been attaching their names and lending their reputations to scientific papers that were drafted by ghostwriters working for drug companies — articles that were carefully calibrated to help the manufacturers sell more products.” (Senator Moves to Block Medical Ghostwriting, Natasha Singer, New York Times, August 18, 2009)
Additional revelations about a program at Glaxco point to a program that was particularly intertwined between the marketing and the research at the company. A particular concern seems to be that the pharmacy reps will often provide articles from peer reviewed journals as evidence of objective research favorable to their products. An AP article by Matthew Perrone describes the marketing nuances of this program: “According to ghostwriting expert Dr. Leemon McHenry, Glaxo’s program was unusually intertwined with its internal sales and marketing department.” (Glaxo Used Ghostwriting Program to Promote Paxil, )
Currently these practices are legal. It once again raises the issue that just because something is legal doesn’t make it right. There are huge ethical issues at stake. It might be asked why librarians should be concerned about this? (I’m not sure why anyone would question that but some might). As librarian/educators, I think we need to constantly need to remind students/readers to be skeptical of articles even appearing in highly ranked peer review journals. We also need to remind OA detractors (or skeptics) that there are ethical issues in play even in the current publishing model. I also think that in a time when there is so much information available online in packaging that is even more difficult to evaluate, that these serve as cautionary tales. As the publishing (librarian) world is grappling with building new models, the time is right to question and highlight the problems in the old models.
I’ve recently been reading posts by Scott Plutchak, Marcus Banks, and Roy Tennant that all more or else touched on the themes of values. Scott Plutchak kicked things off in his posting, The Future is a Playground when he discussed making decisions in difficult budget times. I was happy to see that I too find the Peter Drucker quote, “Planning is an exercise in predicting the future. The odds are you’re going to be wrong more than half the time.” (the paraphrase taken from the T.Scott Blog) … comforting. I like the notion that often times no matter how well prepared that we might make a wrong decision. It seems to take the pressure off. Maybe there often is no one right or one perfect answer.
Marcus Banks posted a reply to this in his blog posting, “Values are More Important than Data or Evidence“(Marcus’ World Blog, July 25, 2009). Marcus Banks says that there is a risk of decision making paralysis when there is not enough good data to support a decision. His solution is to rely on the core values of librarianship. He characterizes these values as, “Partnership; collaboration; innovation; service; respect for privacy; “no information problem is too big to be solved.” At the end of the day it is these values that should guide our decision making process. (not that we shouldn’t strive to gather as much data, evidence, information that we can to aid our decision making process).
Together I find these 2 posts to be comforting. We are at the point in our year when our big licenses are up for renewal. We are trying to figure out how to negotiate our licenses. What should we keep? What can we drop? Which vendor should we favor (if its a choice of leaning towards one offer over another one)? Do we favor the vendor that has been consistently fair and upright? We don’t have good data to steer us one way or another in our decisions, but we do have our values.
So here is where I tie in Roy Tennant’s posting in his Library Journal blog, “Fighting the Losing Battle“. He lays out several questions to ask ourselves when we are facing “losing battles”. (I do have to wonder about the back story on this one). His questions are:
Are you fighting alone? …
Is the issue something that strikes at the very core of your beliefs? …
Is there something more important you could be doing? A fight that you may wish to leave behind is one that takes your time and attention away from something more important. What might this be? Only you can decide. There are times when you get distracted — the only error is to not correct this distraction in a timely fashion.
I don’t know that I’m fighting any battles right now. I do like these questions. They seem to me to apply to other situations at the very least I like the notion of creating a framework or questions that help us tease out or core values or beliefs.
In an odd twist I’m currently watching a re-run of West Wing, where the question of personal values underlies much of the story line. I feel like the universe is sending me a message about being guided by values and using that as my North Star.
Primary Care Shortage Makes the News — At last
Our local paper, the News & Observer, ran an article on July 5th titled, “Family doctor’s become rarer“. This article highlighted several facts which the AHEC Program had been tracking for years. One of these facts is that, “From 2001 through 2005, 46 of the state’s 100 counties lost ground in the ratio of primary-care doctors to residents, according to the most recent data from the Cecil G. Sheps Center for Health Services Research at UNC-Chapel Hill.” What was surprising in this article was the fact that Wake County was among the counties losing primary care doctors. The articles that have been written about these recently are too numerous and easy to find to list here.
The June 25, 2009 issue of the New England Journal of Medicine contains 2 articles on this topic.
- T. Bodenheimer, K. Grumbach, and R. A. Berenson “Health Care 2009: A Lifeline for Primary Care” (this article is currently available free online)
- R. Steinbrook “Health Care 2009: Easing the Shortage in Adult Primary Care — Is It All about Money?” (this article is currently available free online)
Is There a Solution?
Western North Carolina recently witnessed the beginning of a pilot program that establishes (essentially) a branch program of UNC Chapel Hill School of Medicine that has students spending their 2 clinical years in rural Western North Carolina. The Asheville Citizen Times reports that this program, “will use a new model of teaching that educates students from the perspective of the patient, allowing students to follow patients throughout the course of their medical care.” (Asheville Citizen Times posted July 7, 2009). There are other pilot programs and solutions in the works beyond those being discussed in Washington.
What is the Role of the Medical Librarian is This?
There truly doesn’t have to be a role for the medical librarian in this, I could just be posting on this because it is something that everyone needs to be concerned about. I do, however, think that there is something for librarians to ponder. As new models emerge for Medical Education like the pilot program in WNC, librarians will need to be involved in the planning (as they were with this pilot project). To be accredited a program must include provisions for student support including a level of library support. We are fortunately in North Carolina to have a system of AHEC libraries across the state that can be leveraged to extend library services to these students across the state. Not every state has this system in place, but in any circumstance it is vital that librarians become involved in the process of any extension of Medical Schools (or additional primary care offerings).
According to the Nextgov.com, a New Hampshire nurse has filed a lawsuit claiming that the, “health information technology sections of the 2009 stimulus bill violate her privacy protections in federal and state laws, including the Health Insurance Portability and Accountability Act and the Hippocratic oath.” In light of some of my past blog postings about the EHR requirments for stimulus money and my concern that librarians have a role, I never considered the personal privacy implications of the act. Librarians have always been at the forefront of privacy protections. Many state’s even have laws protecting the privacy of library records. We all bemoaned the US Patriot Act provisions that would require libraries to provide certain information to law enforcement (that seems so long ago now.) It seems that librarians could be caught (not literally but metaphorically) between 2 ends of the spectrum on the EHR implementations. As medical librarians we see the need to be included in the EHR. We understand the importance of including links to the Evidence and research. On the other hand as I look over some of the provisions of the law, I could be personally concerned about the privacy implications of mandating the capability of sharing our personal health information across systems. As a consumer I do think that there is much benefit in having standardized storage and sharing capability of our health information across sytems, but I can also see how this can have privacy implications. I agree with Dr. Deborah Peel of the Patient Privacy Rights out of Austin TX, when she says that, “Congress must ensure consumer control over electronic health information.” (as posted on Nextgov.com). If congress is going to mandate electronic health information then they must also guard the privacy implications in the storage and standardization of the information. While I’m advocating for changes to the law, I will put in one last appeal to include a provision for including library type information in the EHR somewhere.
Economic Impact Statements
We were meeting today to discuss our journal cancellations project and someone shared the Duke University Medical Center Library’s June 2009 Newsletter where there was a brief article about their budgetary constraints. As were are grappling with the need to potentially cut $360,000 from our serials budget which could result in the cancellation of up to 250 journal titles, I was interested to read that Duke’s perceptiontion of the situation with publishers matched my own.
Pat Thibodeau writes that one of their strategies has been to ask, “publishers to keep their price increases to a minimum …unfortunately, most journal publishers are not willing to recognize the current fiscal pressures on university and library budgets and are projecting their usual increases.” In my other resources hat, we have had similar experiences with some of our vendors. One of our vendors gave us a 15% price increase claiming it was only %8 (I’m not sure what kind of math they were using). Our sales rep. smiled when we had mentioned that we had NO money for any price increase and said, but its only an %8 increase (like that was a good thing). I’m thinking to myself what part of we have no money for any increase do they not understand. Some of you might be confused when I talk about facing a $360,000 decrease and also a no increase situation; this is because I wear 2 different hats and am discussing 2 different institutions.
When the ICOLC published their Statement on the Global Economic Crisis and Its Impact on Consortial Licenses, I have to confess that I honestly had a glimmer of hope that there might be some reason as we worked with our vendors for the coming year. In all honest 2 of our vendors have been great!! I wish I could throw more business their way; to give them a reward for their excellent business practices. I was going to write here also about the MLA News (or was it Focus) item about the ICOLC economic statement, but I had filed that email in a local folder on my computer at work. Alas I don’t keep my mlanet login information handy so have no way to get into it from home tonight (here’s a chance for me to advocate once again for MLA to change its authentication to something a bit more intuitive or user driven — allow us to set our own username/password perhaps??)
I also read with interest the UC Libraries Open Letter to Licensed Content Providers. I hope they are having a better response than the Duke Libraries and some of our consortial members are finding.
The Hoax Article
There was a bit of a buzz on the liblicense list about a hoax article that was accepted by an Open Access Bentham journal: the Open Information Science Journal (see Library Journal, “Hoax Article Accepted by “Peer-Reviewed” OA Bentham Journal“. This comes at an interesting time in the OA movement. On the heels of the “fake” journal debacle (well actually a journal paid for by the pharmaceutical industry), the calls for increased ethical standards are going to become stronger and stronger. An editor at Bentham has resigned over this hoax. The Open Access Scholarly Publisher’s Association posted on its blog about, “Publishing ethics, open access, and OASPA“.
In an interesting side bar, there has been a bit of back and forth on the liblicense list about the use of the word “prank” in the OASPA blog posting.
Despite having several articles written on this topic (Library Journal, The New Scientist, The Scientist.com, boston.com to name a few), there was an odd posting on the liblicense list from Mahmood Alam the director of publications at Bentham Science Publications where he states that such an article was not published. His exact note is as follows, “I refer to your following message. Please note that this is not correct that Bentham Science Publishers has published any such article.” I have checked the OASPA web site and blog as well as Library Journal and some of the other sites that had covered this story but have found no retractions. Maybe I misunderstood this posting on the liblicense list.
These are certainly interesting times. What is the role of peer reviews in the OA model? What are concerns about funding sources for OA journals? What is the role of OA in libraries as they struggle with budetary concerns/constraints? How will emerging budgetary difficulties impact the OA movement? There has been much written by many people far wiser in these issues than myself, and I’m not going to attempt to encapsulate all of that discussion here. I merely write here to highlight another interesting story in the world of publishing.
I would include something here about the MLA ethics statements, but as mentioned above don’t have access to the members only section of MLANET this evening.
Merck Published Fake Journal
I was going to write about the “Merck Published Fake Journal” thread that had been burning up the liblicense listserv wires, but the Krafty Library covered it very well in a posting yesterday. For the NC AHEC ILS Network librarians, we are also beginning a thread on our blog (thanks Beth A.). If you have a chance to check out the Krafty Librarian or the liblicense list thread (to follow the thread go to the liblicense listserv and search for the term fake journal (or Merck))These are very thorough coverings of the topic. I’m adding a link to the Eagle Dawg Blog who also posted on this. She raises some evocative questions and is well worth the read as well.
I’d like to say I’m shocked or somehow surprised by this, but it comes as no surprise to me (am I more cynical than most? maybe). Given the pricing practices of many of these big publishing houses– nothing comes as a surprise. Although it is an ethical concern, what I found to be a bigger concern was the problem highlighted at the end of the Krafty Librarian’s post about (citing the Scientist posting)doctors perhaps not being able to discern the difference between a peer reviewed article and a “fake” marketing piece. This for me is the real concern.
A New Chapter in Web Piracy
A headline in our paper today (News & Observer) from the New York Times writer Motoko Rich caught my eye. This article is about the problem of “digital piracy” in the literary world. Although this isn’t directly relevant to my day to day work. It is a fascinating article and raises many interesting questions about the ever changing relationship between technology and copyright and other intellectual property infringements. This had been a known problem in the music and film industry and is just getting to be a problem in the literary world as new devices like the Kindle are growing in popularity. It has also become easier to acquire digital content as publishers are producing more digital editions. We hear about the economic problems in the publishing world and this could impact publishing models. It will be interesting to see how the digital piracy impacts the literary world. I still love to read a print book, but I do love my iTunes. I embrace the digital music revolution but am reluctant to go that route with my pleasure reading. Will the print strong hold continue in book-land? I wonder why digital piracy hasn’t been a bigger issue for online textbooks (probably because the universities are already licensing the content).