Rules for authorship must be clarified

April 11, 2018

Pär SegerdahlRecently, I wrote a post on honorary authorships in the academia. When I in that post tried to render the ICMJE criteria for academic authorship, I felt dull since I could not figure out how to express in my own words the fourth criterion:

”Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.”

To count as an author of an academic publication, it is not sufficient to contribute to the research, to drafting or revising the intellectual content of the text, and to approve the final version. You must also satisfy this fourth criterion, which has to do with responsibility for research misconduct.

What does the criterion actually say? After reading an opinion piece by Gert Helgesson and Stefan Eriksson in Learned Publishing, I realize that it was not just my stupidity that caused my difficulties to summarize the fourth criterion. The formulation is ambiguous, which may be due to disagreement among the authors of the authorship criteria!

Helgesson and Eriksson find three possible interpretations of the fourth criterion:

  1. Emphasizing the initial ten words (until the first instance of “work”), the criterion seems to say that all authors are responsible, or should be held responsible, for all parts of the article. If the work was fraudulent in some way, all authors should be held responsible, even if they were unaware of what was going on.
  2. Continuing to read the whole criterion, its meaning changes. The criterion then seems to say that if fraudulence is suspected, then all authors have the responsibility to facilitate the investigation of the suspicions (regardless of what part of the work the suspicions concern).
  3. A third interpretation goes further than the second interpretation. It says that an author should support investigations of fraudulence not only after the article was sent to a journal. An author should initiate such investigations him- or herself already during the research and drafting phase, if he or she suspects fraudulence.

It is impossible to determine which interpretation holds. Helgesson and Eriksson consider the third interpretation most reasonable from a research ethical point of view. If this is the intended interpretation, it should be made linguistically unmistakable in the next revision of the authorship criteria, the opinion piece concludes.

Pär Segerdahl

Helgesson, G. and Eriksson, S. Revise the ICMJE Recommendations regarding authorship responsibility! Learned Publishing 2018. doi: 10.1002/leap.1161

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Risks of discrimination in population-based biobanks

April 4, 2018

Pär SegerdahlEven good intentions can cause harm. Considerately treating certain groups as “vulnerable,” such as pregnant women and children, can cause discrimination against them. If we protect them from participation in clinical research, we know less about how they respond to medical treatments. They are therefore exposed to greater risks when they are patients in need of medical treatment. Thanks for your concern.

Deborah Mascalzoni points out possible discrimination patterns in population-based biobank research. She particularly highlights people with psychiatric conditions, who often are excluded from such studies. However, she also mentions children, who rarely are included in population-based biobanks, as well as people with early forms of dementia or addiction problems.

Mascalzoni thus asks how representative population-based biobanks really are. This is important, as results from such research are increasingly used in the planning of care. We need to see these potential discrimination patterns more clearly, so that people suffering from psychiatric conditions, for example, have similar opportunities to benefit from research as others.

However, the patterns are caused not only by how we think of certain groups as “vulnerable.” Even practical difficulties, to which you may not give much thought, can cause discrimination. It is ethically and legally cumbersome to recruit children as research participants. People suffering from depression may have suicidal thoughts, which requires special efforts. People with early symptoms of dementia may have difficulty understanding complex information, which complicates the process of informed consent.

Some groups are in practice more difficult to recruit to population-based biobanks. Not only our consideration of certain groups as “vulnerable,” then, but also practical obstacles to which we do not pay attention, may cause biased research results, which may lead to poorer care for certain groups. There is therefore reason to ask about representativeness.

Pär Segerdahl

Mascalzoni, D. 2017. Reverse discrimination for psychiatric genetic studies in population-based biobanks. European Neuropsychopharmacology 27: 475-476

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To become aware of something

March 29, 2018

Pär SegerdahlThe phenomenon I want to highlight in this post has many descriptions. Here are a few of them: To become conscious of something; to notice; to observe; to realize; to see; to become aware of something.

We all experience it. Every now and then, what these descriptions indicate occurs in us. We realize something; we become aware of something. It can be elementary, such as being struck (another similar description) by how blue the sky is. It may be painful, such as realizing how self-absorbed we are or how ungenerously we treat someone.

What is the point of living if we do not occasionally become aware of living?

Insights can also be philosophical, such as becoming aware of what it means to forgive someone. We cannot order someone to forgive, just as we cannot order someone to be happy. The words “I forgive you” may resemble an act of volition that a person can be ordered to perform; but only deceitfully empty words will obey the order. Genuine forgiveness comes spontaneously, or not at all. I say, “I forgive you,” when I notice, with relief, that I already have forgiven you; that I no longer harbor unforgiving thoughts about you, etc.

What would human life be without these insights into how we live? What would ethics be?

Just as forgiveness cannot be enforced, awareness cannot be demanded. “Realize this!” is not an order, but sheer desperation. Awareness is as shy as forgiveness. It comes spontaneously, or not at all. As soon as a certain form of awareness is required, enforced, or presumed, it contracts to a mere norm of thought. That is how communities of ideas arise, or churches, or philosophical schools: through narrowing consciousness. Loyal members will confirm each other while they deride “the others” who supposedly lack insight and must be rejected.

Considering how awareness does not obey orders, it can be seen as radical, as revolutionary. It takes us beyond all norms of thought and all communities of ideas! Suddenly we realize something that surpasses everything we thought we knew. However, if we try to force our insights onto others by proving them as facts, we reduce our spacious awareness to narrow binding norms. Our radical freedom is unnoticeable on the surface; we cannot display it without losing it.

If awareness is free and impossible to catch as a fact, do we have to remain quiet about these shy insights? No, philosophical work aims precisely at attracting shy insights into the light. By using fresh examples, considerations, similes and striking words, we try to entice what does not obey orders. This is the secret of a genuine philosophical investigation. It does not prove truths, but attracts truths. Whether the investigation succeeds, each one must assess for him- or herself. In philosophy, we cannot say, “Elementary, my dear Watson”. Nevertheless, many professional thinkers dream of saying it. They dream of the pure authority of binding norms of thought. Faith in reason is sheer desperation.

This post may seem to contain quasi-oracular pronouncements about forgiveness (and other matters). However, the intention is not that you should believe me or use the post as a norm of thought. Ultimately, my statements are queries from human to human: Do you also see the features I see in forgiveness and awareness? Otherwise, we continue the investigation together. For in philosophy we can never enforce the truth, we can only attract it. It comes spontaneously, or not at all.

Pär Segerdahl

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Intellectual habits prevent self-examination

March 21, 2018

Pär SegerdahlThe intellect is worldly-minded and extrovert. It is busy with the facts of the world. Even when it turns inwards, towards our own consciousness, of which it is a part, the intellect interprets consciousness as another object in the world.

The intellect can never become aware of itself. It can only expand towards something other than itself.

The Chinese philosopher Confucius gave a wonderful image of a self-examining person: “When the archer misses the center of the target, he turns around and seeks the cause of his failure within himself.”

The intellect is like an archer who cannot turn around. If the intellect were to examine itself, it would interpret itself as another target in the world to hit with its pointed arrows! The intellect is incapable of wisdom and knows nothing about self-knowledge. The intellect can only shoot projectiles at the world; it can only expand and conquer.

I am writing philosophy. That means I always turn around to seek the cause of our failures within ourselves. I rarely shoot arrows, and certainly not at external targets.

At the same time, this inner work meets obstacles in academic habits and ideals, which are largely intellectual and aim at the facts of the world. For example, I cannot examine our ways of thinking without citing literature that supports that these ways of thinking actually occur in the world (in authors x, y, and z, for example).

Such referencing transforms ways of thinking into worldly targets at which I am supposed to shoot. But I wanted to turn around and seek the cause of our failures within ourselves!

What do we truly need today? Something else than just more facts! We need to learn the art of turning around. We need to learn to seek the cause of our failures within ourselves. The persistent shooting of projectiles at the world has become humanity’s most common disease – virtually the human condition.

Do you think that the intellect can shoot itself out of the crises that its own trigger-happiness causes? Do you think it can expand out of the problems that its own expansions produce?

If Elon Musk takes us to Mars, surely he will solve all our problems!

Pär Segerdahl

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Two measures against the culture of honorary authorships

March 13, 2018

Pär SegerdahlIt is important in the academia to know who actually contributed as author to scientific publications. Partly because authorship is meritorious when researchers seek positions and funding. Partly to facilitate investigations of suspected research misconduct.

These are two important reasons why there are guidelines for academic authorship. These guidelines state that an author should not only contribute to design, data collection, or analysis behind the publication. An author should also contribute to writing and revising the text. An author should moreover approve the final version of the text, and agree to be accountable if there are issues of accuracy or integrity.

The number of authors listed on academic publications tends to increase. As an extreme example, I might mention that in 2011, 140 scientific articles were published listing more than 1,000 authors!

One reason for the larger numbers of listed authors is, of course, that research is becoming increasingly complex and requires collaborations that are more extensive. However, much suggests that the number of undeserving authors increases. One could speak of a culture of honorary authorships within the academia.

There are strong driving forces behind the culture of honorary authorships. It can be about supporting cohesion in a research group by avoiding the uncomfortable decision to exclude team members who contributed minimally to the work being published. It can be about creating good relationships with influential people in the research community by giving them authorship; which they sometimes demand. It can be about increasing the chances of being published by having a famous researcher’s name in the author list. And since big research projects are prestigious, a long author list looks good. It creates pressure on the journals to publish what apparently required the contribution of so many skilled researchers – one thinks.

What can we do about it? In a recent article with the, nowadays, modest number of four authors, it is emphasized that guidelines for academic authorship, which have been around for a long time and are well known, obviously do not suffice. In the journal Insights, Stefan Eriksson, Tove Godskesen, Lars Andersson and Gert Helgesson write that we probably need to create psychological incentives against the culture of honorary authorships.

More specifically, two simple measures are suggested that can reduce undeserving authorships within the academia:

  1. When researchers seek positions, interview them about their contributions to publications that they include in the list of qualifications. If they are only honorary authors, they may not be able to account for the articles or how they contributed to them. Knowing that this is part of the recruitment process can create a psychological pressure to avoid undeserving honorary authorships.
  2. Divide authorship and citations scores with the number of authors. Awareness that scores ​​are calculated in this way creates a psychological pressure not to include undeserving authors in the author list.

One might object that this proposal instead risks excluding collaborators from contributing as authors, although they could very well be invited to function as well-deserved co-authors. This objection is addressed in the article. Instead of explaining the authors’ defense, I hope that my silence on this point will motivate readers of the Ethics Blog to read the important article. So that I do not lure you into some sort of honorary readership! How often do we not intimate that we have read something very interesting, which we in fact only skimmed through or heard summarized?

The academic culture of honorary authorships will not disappear easily. Ethical guidelines are obviously not enough. Of course, the best thing would be if we all became saints. While waiting for it to happen, psychological incentives may be needed to behave well.

Pär Segerdahl

Eriksson, S., Godskesen, T., Andersson, L., Helgesson, G. (2018). How to counter undeserving authorship. Insights. 31(1), p.1. DOI:

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Prepare for robot nonsense

February 26, 2018

Pär SegerdahlAs computers and robots take over tasks that so far only humans could carry out, such as driving a car, we are likely to experience increasingly insidious uses of language by the technology’s intellectual clergy.

The idea of ​​intelligent computers and conscious robots is for some reason terribly fascinating. We see ourselves as intelligent and conscious beings. Imagine if also robots could be intelligent and aware! In fact, we have already seen them (almost): on the movie screen. Soon we may see them in reality too!

Imagine that artifacts that we always considered dead and mechanical one day acquired the enigmatic character of life! Imagine that we created intelligent life! Do we have enough exclamation marks for such a miracle?

The idea of ​​intelligent life in supercomputers often comes with the idea of a test that can determine if a supercomputer is intelligent. It is as if I wanted to make the idea of ​​perpetual motion machines credible by talking about a perpetuum mobile test, invented by a super-smart mathematician in the 17th century. The question if something is a perpetuum mobile is determinable and therefore worth considering! Soon they may function as engines in our intelligent, robot-driven cars!

There is a famous idea of ​​an intelligence test for computers, invented by the British mathematician, Alan Turing. The test allegedly can determine whether a machine “has what we have”: intelligence. How does the test work? Roughly, it is about whether you can distinguish a computer from a human – or cannot do it.

But distinguishing a computer from a human being surely is no great matter! Oh, I forgot to mention that there is a smoke screen in the test. You neither see, hear, feel, taste nor smell anything! In principle, you send written questions into the thick smoke. Out of the smoke comes written responses. But who wrote/generated the answers? Human or computer? If you cannot distinguish the computer-generated answers from human answers – well, then you had better take protection, because an intelligent supercomputer hides behind the smoke screen!

The test is thus adapted to the computer, which cannot have intelligent facial expressions or look perplexed, and cannot groan, “Oh no, what a stupid question!” The test is adapted to an engineer’s concept of intelligent handling of written symbol sequences. The fact that the test subject is a poor human being who cannot always say who/what “generated” the written answers hides this conceptual fact.

These insidious linguistic shifts are unusually obvious in an article I encountered through a rather smart search engine. The article asks if machines can be aware. And it responds: Yes, and a new Turing test can prove it.

The article begins with celebrating our amazing consciousness as “the ineffable and enigmatic inner life of the mind.” Consciousness is then exemplified by the whirl of thought and sensation that blossoms within us when we finally meet a loved one again, hear an exquisite violin solo, or relish an incredible meal.

After this ecstatic celebration of consciousness, the concept begins to be adapted to computer engineering so that finally it is merely a concept of information processing. The authors “show” that consciousness does not require interaction with the environment. Neither does it require memories. Consciousness does not require any emotions like anger, fear or joy. It does not require attention, self-reflection, language or ability to act in the world.

What then remains of consciousness, which the authors initially made it seem so amazing to possess? The answer in the article is that consciousness has to do with “the amount of integrated information that an organism, or a machine, can generate.”

The concept of consciousness is gradually adapted to what was to be proven. Finally, it becomes a feature that unsurprisingly can characterize a computer. After we swallowed the adaptation, the idea is that we, at the Grand Finale of the article, should once again marvel, and be amazed that a machine can have this “mysterious inner life” that we have, consciousness: “Oh, what an exquisite violin solo, not to mention the snails, how lovely to meet again like this!”

The new Turing test that the authors imagine is, as far as I understand, a kind of picture recognition test: Can a computer identify the content of a picture as “a robbery”? A conscious computer should be able to identify pictorial content as well as a human being can do it. I guess the idea is that the task requires very, very much integrated information. No simple rule of thumb, man + gun + building + terrified customer = robbery, will do the trick. It has to be such an enormous amount of integrated information that the computer simply “gets it” and understands that it is a robbery (and not a five-year-old who plays with a toy gun).

Believing in the test thus assumes that we swallowed the adapted concept of consciousness and are ecstatically amazed by super-large amounts of integrated information as: “the ineffable and enigmatic inner life of the mind.”

These kinds of insidious linguistic shifts will attract us even more deeply as robotics develop. Imagine an android with facial expression and voice that can express intelligence or groan at stupid questions. Then surely, we are dealing an intelligent and conscious machine!

Or just another deceitful smoke screen; a walking, interactive movie screen?

Pär Segerdahl

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Inequalities in healthcare – from denial to greater awareness

February 14, 2018

Pär SegerdahlSwedish law prescribes healthcare on equal terms for the whole population. Complying with this law is more difficult than one might believe, since discrimination tends to happen unknowingly, under our own radar.

Telephone nursing has been thought to increase equality in healthcare, because it is so easily accessible. However, research has demonstrated inequalities in telephone counseling. Callers are not treated equally.

Given the role of unawareness in the drama, this is not surprising. Despite the best intentions, treating people equally is very difficult in practice. What can we do about it?

If unawareness is a factor and discrimination largely happens unintentionally, I do not think we can conclude that it must be the result of a “bad system.” Even if discrimination arises unintentionally, it is humans who discriminate. Humans are not just their awareness, but also their unawareness.

In an article in the International Journal of Equity in Health, Anna T. Höglund (and four co-authors) investigates awareness of discrimination in healthcare, especially in telephone nursing. Swedish telephone nurses responded to a questionnaire about discrimination and equal treatment. The nurses’ answers could then be analyzed in terms of four concepts: denial, defense, openness and awareness.

Denial: some nurses denied discrimination. Defense: Some acknowledged that care was not always given on equal terms, but said that measures were taken and that the problem was under control. Openness: some of the nurses found the problem important and wished they could learn more about care on equal terms. Awareness: Some clearly saw how discrimination could occur and gave examples of strategies they used to avoid complex discriminatory patterns of which they were aware.

Rather than explaining unintended discrimination as the result of a “bad system,” these four concepts provide us with tools that can help us handle the problem more responsibly.

Anna T. Höglund proposes two complementary ways of viewing the four concepts. You can see them as positions along a line of development where a person can mature and move from denial or defense, through openness, towards the ultimate goal, awareness. But you can also imagine a person moving back and forth between positions, depending on the circumstances.

One recognizes oneself in these positions; unfortunately, not least in the positions denial and defense. The conceptual model developed in the article increases awareness of discrimination as largely a matter of our awareness and unawareness.

The authors add a fifth concept to the model: Action. If I understand them, they do not mean by “action” correcting a “bad system,” thereby controlling the problem. On the contrary, that would appear very much like expressing the defensive position above. (This indicates how much unawareness there is in many bureaucratic attempts to “control” societal problems through “systems,” to which one later refers: “We have taken appropriate measures, the problem is under control!”)

No, we need to continuously work on the problem; continually address ourselves and our patterns of acting. The conceptual model developed in the article gives us some tools.

Pär Segerdahl

Höglund, A.T., Carlsson, M. Holmström, I.K., Lännerström, L. and Kaminsky, E. 2018. From denial to awareness: a conceptual model for obtaining equity in healthcare. International Journal for Equity in Health 17. DOI 10.1186/s12939-018-0723-2

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