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Joel Faintuch
Salomão Faintuch Editors

Integrity
of Scientific
Research
Fraud, Misconduct and Fake News in
the Academic, Medical and Social Environment
Integrity of Scientific Research
Joel Faintuch • Salomão Faintuch
Editors

Integrity of Scientific
Research
Fraud, Misconduct and Fake News
in the Academic, Medical
and Social Environment
Editors
Joel Faintuch Salomão Faintuch
Hospital das Clinicas Beth Israel Deaconess Medical Center
University of Sao Paulo & Harvard Medical School
Sao Paulo, São Paulo, Brazil Boston, MA, USA

ISBN 978-3-030-99679-6 ISBN 978-3-030-99680-2 (eBook)

https://doi.org/10.1007/978-3-030-99680-2

# The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specifically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this
book are believed to be true and accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, expressed or implied, with respect to the material contained
herein or for any errors or omissions that may have been made. The publisher remains neutral with
regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword

Research integrity concerns the consequences of the behaviour of researchers

on the validity of their findings and on the trust in their work among peers and
in society at large. This does not mean that the drivers of that behaviour solely
depend on individual virtuousness. Increasingly, it has become clear that the
research climate in the labs and research groups plus the—sometimes per-
verse—incentives within the system of science strongly influence research
integrity. Consequently, a diversity of perspectives and stakeholders is needed
to optimize research integrity. This book contains a multitude of chapters,
authors, and topics that reflect the emerging state of the art—with its occa-
sional confusion, inconsistency, and contradiction—quite well.
For most of us, the first association of research integrity is with research
misconduct, which is often framed as the three “mortal sins” of fabrication,
falsification, and plagiarism (FFP). Spectacular cases of research misconduct
typically get a lot of media attention and often serve as wake-up calls.
Increasingly, it has been recognized that a lack of research integrity can also
consist of minor misbehaviours which are often labelled rather euphemisti-
cally as questionable research practices (QRPs). Examples are selective
reporting, p-hacking, and HARK-ing (hypothesizing after results are
known). Arguably QRPs on the aggregate level do much more harm because,
while FFP seems to be relatively rare, QRPs turn out to be alarmingly
common.
It might be argued that we should look more at the positive side of the coin
and focus on the norms for good research. The behaviours at issue are usually
labelled as responsible conduct of research (RCR) or responsible research
practices (RRPs). The idea is that it is better to stimulate the good end of the
spectrum of researcher conduct rather than to focus solely on detecting and
sanctioning of research misconduct. Carrots are usually more effective than
sticks. This attitude is also reflected in recent codes of conduct for research
integrity, like the one for the Netherlands that specifies 61 norms for good
research. An allegation of research misconduct is only eligible for not follow-
ing one third of these norms. Recent codes of conduct try to be not only
positive and aspirational but also practical in the sense of being clear about the
do’s and don’ts of research.
Next to the researchers, important stakeholders in research integrity are
research institutes, scholarly journals, and funding agencies. When these
stakeholders act in concert, interventions aimed at promoting responsible

v
vi Foreword

research practices arguably will be more effective. To me the most important

drivers of improvement are the engagement in Open Science practices and
focussing the assessment of researchers on behaviours that strengthen
research integrity. Open Methods, Open Codes, and Open Data increase
transparency and enable checks on selective reporting, re-analyses of data
sets, and replication studies. Research and researchers need to be trusted for
their findings to have any impact on health, society, and nature. Trust needs to
be deserved by being trustworthy. Being open and transparent provides the
fundament for that.
Careers in research are determined by assessments for grants, promotion,
and tenure. It is important to use criteria for these assessments that reflect the
behaviours that matter for research integrity. Sadly, that is not always the case
and then assessment criteria can become perverse incentives. Such as having a
dominant focus on numbers of publications and citations, including its
derivatives like Impact Factors and the Hirsch Index. Recently, mutually
reinforcing initiatives like the San Francisco Declaration on research assess-
ment, the Leiden Manifesto for research metrics, and the Hong Kong
principles for assessing researchers have been launched, which urge for
using better assessment criteria like engaging in Open Science practices and
being a good peer reviewer and mentor.
The chapters of this book together form a rich source for exploring the
broad and expanding field of research integrity. Because the topic interests
you—why else would you read the foreword of the book—you should
consider participation in the next World Conference on Research Integrity.
When you want to learn more about ways to foster research integrity, I can
also strongly recommend the websites of the Standard Operating Procedures
for Research Integrity (SOPs4RI) project and the Embassy of Good Science.

Department of Epidemiology and Data Science Lex Bouter

Amsterdam University Medical Centers
Amsterdam, The Netherlands
Department of Philosophy
Faculty of Humanities
Vrije Universiteit,
Amsterdam, The Netherlands
Preface

From the thousands to the trillions, it´s the same slippery, treacherous road

The above sentence was not plagiarized from a “noir” novel or from the press
release of a B-rated horror movie. Even though the words look familiar, the
authors themselves concocted them, maybe inspired by an occasional novel or
movie. What do they actually mean?
Typical money involved in “contract cheating”, or students paying for third
parties to fake their thesis or dissertation, does not exceed a couple of
thousand dollars, and could be as little as a few hundreds. Predator journals,
books, and meetings charge in the same range, and gifts or trips offered by
pharmaceutical laboratories or medical device manufactures to professionals
often operate in this bandwidth, even though substantially higher values are
possible.
At the other extreme, the market valuation of the four digital multinationals
Google, Amazon, Facebook, and Apple (GAFA) comes close to the trillion-
dollar benchmark, if not beyond it. Are their disbursements with questionable
engagements also in the astronomical range? Technically, these organizations
are cleaner and more ethical than most, and they vow for a single cent spent in
extraneous or illegal activities. Yet it cannot be denied the colossal power they
are endowed with, in the form of detailed personal information accumulated
with millions or billions of customers all over the world. Even though
wrongdoing has rarely if ever been demonstrated, none of the GAFA
companies is transparent with regard to the degree of security awarded to
these datasets, the nature and purpose of the algorithms attached to them, and
particularly the organizations they share them with, both public and private.
Actually, nearly all large corporations nowadays use cookies and apps to
collect Olympic amounts of personal informations, almost never fully disclos-
ing the ethics and the governance behind so much sensitive data storage.
Academic misconduct has not been linked to breaches of commercial
privacy, only political meddling as demonstrated in the paradigmatic case of
Facebook–Cambridge Analytica, most prominently in the period of
2016–2018. Nevertheless, anti-vaccine campaigns and other direct or indirect
public health threats are more difficult to rule out.
Article publication is perhaps more meticulously scrutinized nowadays
than researcher integrity, laboratory records, or protocol funding and manipu-
lation. Indeed the ICMJE (International Committee of Medical Journal

vii
viii Preface

Editors) started requesting research registration, a procedure that substantially

enhances article reliability and transparency in 2005, before the Food and
Drug Administration/USA (2007) considered it mandatory.
One reason is that publication universally exposes the name of the journal
and the editor-in-chief, as indirect accomplices of the misdeeds in case of
fraudulent procedures. Even though they typically have no involvement with
authors or laboratories, and the worst accusation could be of a sloppy journal
review job, not of actual responsibility for cheating or deception.
Of course, the subject can become more shady depending on the business
context. In the last two decades, the emerging field of open access books,
congress proceedings, and notably journals has earned a bad name for the
so-called predator organizations. As discussed in several chapters of the book,
scores of international entrepreneurs offer prompt and seamless electronic
publication of any scientific material for a fee, in peer-reviewed indexed
journals. The catch is that both review and indexation are falsified and not
trustworthy. Those journals, books, and conferences lack endorsement from
reputable scientific and professional organizations and often promise publica-
tion in as short a period as weeks or even days, which is incompatible with
decent peer review, provided payment is received. They are also the culprit of
spam messages overflowing scientists’ mailboxes.
The worst risk is for the unaware reader in the healthcare professions, and
particularly for public health authorities who eventually trust those articles
and reports. Unsubstantiated and fallacious diagnostic and therapeutic
recommendations could be adopted, with unforeseen consequences. For the
naïve (or not so naïve) author who believes he or she is divulging the research
in a serious publication, financial waste and the wrong type of recognition
could arise. Also fooled (or careless) universities and research laboratories
which accept curricula built on predator publications could discover they
hired or promoted the wrong scientist, to the detriment of more serious
candidates.
Incidentally, traditional and respected publishers are under fire as well
because of the regular fees they charge for open access, as these companies
also offer this alternative, nor just dishonest competitors. There is no fraud or
misconduct implied, just criticism for their commercial practices. The stan-
dard bearer of the war is the Coalition S, established by a group of European
national research funders as well as other organizations, with the support of
the European Commission and the European Research Council (ERC) (www.
coalition-s.org). According to the official statement, all European research
results funded by any organization should be published in open access
journals, platforms, or repositories, without embargo (promptly and freely
available to all interested parties).
The original plan should become effective in 2021, and bypassed payment
considerations. Copyright barriers should be abolished in such circumstances.
Given the resistance of many publishers, who alleged major losses or even
risk of bankruptcy, a model for low-cost reimbursement was created, and the
deadline was postponed. At this moment, a number of publishers announced
full or partial compliance with the plan, typically with some degree of
copyright retainment, whereas others are reluctant.
Preface ix

Is money the link between this large and nominally incoherent spectrum of
facts and a book on integrity, fraud, and fake news? Financial profits and
personal benefits do not underlie the entire universe of academic or profes-
sional misconduct and lack of integrity, which is diverse and grows by the
day. Yet for many, it remains the quintessence in the fight for improved
human morals, behaviours, and deeds, especially in a twenty-first century
largely moved by material rewards. Such assumption notwithstanding, this
book does not adopt a market approach for assessing or valuating current
status of integrity or lack thereof in the sciences and professions.
Anti-vaccine activism is a major threat to responsible research and ethical
management of public health, even though the economic undertones are not
easily distinguishable. Science denialism as a whole, from “scholarly” con-
troversy till outright quackery, has similarly engaged the rich and the poor, the
gold diggers and the misguided idealists. Harassment, bullying, and sexual
misconduct are other examples of money blind immoral and dishonest
behaviours, even though those in the upper echelons of the social and eco-
nomic ladder seem more prone to them.
Economists are comparatively scarce in the pages of the book, and more of
them would unquestionably enhance the publication. Nevertheless, it is debat-
able whether a reductionist monetary focus would faithfully mirror the
myriads and often elusive shades of academic and professional integrity.
Respected ethicists and experienced professors with extensive medical and
scientific background were summoned as well, to complement the editorial
team and contribute with solid and deep-rooted expertise in their respective
fields.
It was not the purpose of the book to become encyclopaedic. The field is
constantly evolving, and it would be risky for any publication to advertise
itself as all-inclusive. Still this is arguably the most complete and authoritative
text to appear in recent times, delving with a variety of questionable practices
in healthcare and social sciences, professions, publications, the Internet, and
the academic environment. Plagiarism, misconduct, harassment, misrepresen-
tation, conflict of interest, informed consent, ethnic and sexual prejudice,
fraud, cheating, and fake news are addressed, of course. However, the text
did not shy away from less established or borderline topics such as data
sharing and biobanking, cyberbullying, image forgeries, body donation,
human rights, animal rights, telehealth, curbside consultations, artificial intel-
ligence, and other emerging technologies.
Corrective and preventive initiatives were especially sought after, as
millennia of legal experience have demonstrated that sanctions alone are rarely
sufficient. These are complemented by guidelines and recommendations from
several parts of the world, as well as useful Internet sites and a glossary. In
synthesis, no stone was left unturned in the effort to bring the latest and most
practical information.

Sao Paulo, Brazil Joel Faintuch

Boston, MA, USA Salomão Faintuch
x Preface

Additional Reading
https://www.coalition-s.org/about/
https://www.sciencemag.org/news/2019/05/meet-plan-s-open-access-man
date-journals-mull-setting-papers-free-publication
https://www.researchprofessionalnews.com/rr-news-europe-infrastructure-
2021-1-batch-of-elsevier-journals-given-transformative-plan-s-status/
https://www.nytimes.com/2018/04/04/us/politics/cambridge-analytica-scan
dal-fallout.html
www.icmje.org
Contents

Part I Introduction
1 Past and Current Status of Scientific, Academic, and
Research Fraud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Joel Faintuch and Salomao Faintuch
2 Research Integrity: The Roles of Academicians, Their
Institutions, and Other Agencies . . . . . . . . . . . . . . . . . . . . . . 9
Janet D. Robishaw, David L. DeMets, Scott M. Alter,
Joanne Krasnoff, Charles H. Hennekens, and Sarah K. Wood
3 Indictment or Information Can Lie: Post-Truth in Science . . 15
Mariella Scerri and Victor Grech
4 Legislation on Research Misconduct: Rationales and
Reflections—A Swedish Perspective . . . . . . . . . . . . . . . . . . . . 27
Kjell Asplund
Part II Accountability of Scientific Teams
5 Publishing, Perishing, and the Infodemic of Fake Science . . . 41
Alex W. Kirkpatrick and Thomas E. Randall
6 Policies and Ethical Challenges in Social Science Research . . 53
Henry Poduthase and Lisa Garza
7 Pseudoscience During the COVID-19 Pandemic . . . . . . . . . . . 61
Yutori Takai and Kenji Matsui
Part III Research Ethics
8 Lysenkoism: A Fine Line Between Formation of Scientific
News and Disinformation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Agata Strządała
9 Misconduct and Consent: The Importance of Informed
Consent in Medical Research . . . . . . . . . . . . . . . . . . . . . . . . . 81
Marton Gergely, Fida K. Dankar, and Saed Alrabaee

xi
xii Contents

10 Research Biobanks and External Researchers Under the

European General Data Protection Regulation:
Between Controller-Processor Relationship and Joint
Controllership . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Andrea Parziale and Ciara Staunton
11 Research Involving Human Participants and Their
Biological Material: A South African Perspective . . . . . . . . . . 101
Melodie Labuschaigne and Magda Slabbert
Part IV Research Misconduct
12 Ethical and Legal Risks of Artificial Intelligence in
Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Tugba Akinci D’Antonoli
13 Typhoid Fever as a Biological Nazi Weapon in the Terezin
Jewish Ghetto . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Kateřina Horáčková
14 Fraud, Misconduct, and Unethical Practices in Biomedical
Research in China . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Ruipeng Lei and Renzong Qiu
15 Misrepresentation of Scientific Figures . . . . . . . . . . . . . . . . . . 139
Davis M. Leaphart, Apryl C. Cronley, and Thomas E. Brothers
Part V Academic Institutions
16 Myths About Race and Racism on University Campuses . . . . 151
Dana Strauss, Monnica T. Williams, Muna Osman,
and Jade Gallo
17 Harassment as Scientific Misconduct . . . . . . . . . . . . . . . . . . . 163
Erika Marin-Spiotta, Linda Gundersen, Rebecca Barnes,
Meredith Hastings, Blair Schneider, and Janet Stemwedel
18 Sexual Harassment in Orthopedic Training: Personal
Perspectives and Outlooks for the Future . . . . . . . . . . . . . . . . 177
Rivka Ihejirika-Lomedico and Joseph Zuckerman
19 Institutional-Level Tracking to Combat Mistreatment of
Medical Students, Residents, and Fellows . . . . . . . . . . . . . . . . 191
Jessica Hane and Taj Mustapha
Part VI Sensationalistic Science
20 Misleading Research of So-Called Alternative Medicine . . . . . 207
Edzard Ernst
21 False Information and Mandatory Pediatric Vaccination . . . . 215
Giulia Spina, Sarah Barni, and Elena Bozzola
Part VII Clinical Trials
22 Regulatory, Ethical and Political Challenges of
Experimentation with LSD on Human Subjects . . . . . . . . . . . 227
Kristof Janos Bodnar and Szabina Peter
Contents xiii

23 Controversies with Clinical Trial Regulations in Low- and

Middle-Income Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235
Bastian Rake
24 Dangers of FDA Oversight of Clinical Trials in Developing
Countries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 243
C. Michael White
25 Current Status of Research with Brain Organoids . . . . . . . . . 253
Sorin Hostiuc, Ioana Diaconescu, and Oana-Maria Isailă
26 Ending Clinical Trials Prematurely . . . . . . . . . . . . . . . . . . . . 261
David L. Streiner
Part VIII Corruption and Impropriety in the Healthcare
Environment
27 Curtailing Corruption in the Recruitment of Public Sector
Health Workers in Uganda . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Henry Zakumumpa, Everd Maniple,
and Monica Twesiime Kirya
28 Legal and Regulatory Issues in Selfie Telemedicine . . . . . . . . 281
Maurice Mars and Richard E. Scott
29 Healing the Healers: Addressing Moral Injury in Healthcare
Workers During COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . 297
Aliza Naiman, Doron Amsalem, Maja Bergman,
and Yuval Neria
30 Is Multi-level Marketing of Nutrition Supplements
Questionable? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307
Diana Cardenas and Vanessa Fuchs-Tarlovsky
31 Euthanasia Not On Trial: The Career of an Austrian Nazi
Doctor After 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Sonja Schreiner
Part IX Science and the Internet
32 Curbside Consultations in Pediatric Dermatology: Risks and
Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Emily Duffy and Robert Sidbury
33 Social Media and How to Overcome Fake News in Health . . . 335
Cristina M. Pulido and Sandra Racionero-Plaza
34 Cyberbullying in the University Setting . . . . . . . . . . . . . . . . . 341
María Carmen Martínez-Monteagudo and Beatriz Delgado
35 Categories of Fake News from the Perspective of Social
Harmfulness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 351
Kamil Mamak
xiv Contents

Part X The Ethics of Publications

36 Preregistration of Studies with Existing Data . . . . . . . . . . . . . 361
Gaëtan Mertens and Angelos-Miltiadis Krypotos
37 Preregistration in Animal Research . . . . . . . . . . . . . . . . . . . . 371
Céline Heinl, Gilbert Schönfelder, and Bettina Bert
38 Plagiarism in Philosophy Research . . . . . . . . . . . . . . . . . . . . . 379
M. V. Dougherty
39 Scientific Articles Retracted for Misconduct or Fraud in the
Dental Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
Antonio Rapani, Matteo Zotti, Federico Berton,
Riccardo Pasquali, Teresa Lombardi, Roberto Di Lenarda,
and Claudio Stacchi
40 Retraction of Scientific Papers: Types of Retraction,
Consequences, and Impacts . . . . . . . . . . . . . . . . . . . . . . . . . . 397
Cristina Candal-Pedreira, Mónica Pérez-Ríos,
and Alberto Ruano-Ravina
41 The Role of Peer Review in the Scientific Process . . . . . . . . . . 409
Henriette De La Garza and Neelam A. Vashi
42 Citation Misuses in the Biomedical Literature and Its Effects
on Public Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 417
Estelle Dumas-Mallet and François Gonon
43 Understanding Ghostwriting and Ghost Authorship As
Problems of Research Integrity . . . . . . . . . . . . . . . . . . . . . . . 427
Lisa DeTora
Part XI Conflicts of Interest
44 Funding of Clinical Trials Through Non-Profit and
Third-Party Organizations: A Case Study of the
CREATE-X Trial in Japan . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Akihiko Ozaki, Anju Murayama, and Tetsuya Tanimoto
45 Pharmaceutical Company Payments to Clinical Practice
Guideline Authors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
Anju Murayama, Akihiko Ozaki, and Tetsuya Tanimoto
46 How to Mitigate Unintentional Misconduct with Samples
and Data in Biorepositories . . . . . . . . . . . . . . . . . . . . . . . . . . 469
Daniel Simeon-Dubach and Zisis Kozlakidis
47 Combatting Corruption in the Pharmaceutical Sector . . . . . . 477
Marc-Andre Gagnon
48 Conflicts of Interest Between Neurologists and
Pharmaceutical and Medical Device Industries . . . . . . . . . . . 487
Nathaniel M. Robbins and Jade E. Smith
Contents xv

Part XII Predatory Practices

49 Predatory Journals and Conferences . . . . . . . . . . . . . . . . . . . 501
Andrea Cortegiani, Giulia Catalisano, and Andrea Manca
50 How Open Access Publishing Developed in the 2010s
and the Potential for Publishing Misconduct . . . . . . . . . . . . . 509
W. Angus Wallace and Ben Ollivere
51 The Challenges from Predatory Journals and Fake Medical
News . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515
W. Angus Wallace
52 Cheating in the Academic Environment . . . . . . . . . . . . . . . . . 523
Thomas Lancaster
Part XIII Corrective Interventions
53 Relevance and Challenges of Whistleblowing in the UK’s
National Health System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Megan Reitz and John Higgins
54 Professional Development Courses for Unprofessional
Physician Behavior . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541
Charles P. Samenow, Linda L. M. Worley, Charlene Dewey,
and William Swiggart
55 Is the Current Informed Consent Model Flawed? . . . . . . . . . 549
Bert Heinrichs and Serap Ergin Aslan
56 Perverse Incentives: A Psychoanalysis of Fraud . . . . . . . . . . . 559
Hub Zwart
57 Development and Implementation of a National Research
Integrity System: The Case of the Estonian Code of Conduct
for Research Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
Mari-Liisa Parder, Marten Juurik, Kristi Lõuk, Katrin Velbaum,
Kadri Simm, and Margit Sutrop
Part XIV Tools for Integrity Assessment, General Guidelines
and Supplementary Material
58 Scientific Electronic Library Online/SciELO: Good Practices
Guide for the Enhancement of Ethics in Scientific Publication
(Version 09/2018) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 587
Scientific Electronic Library Online SciELO
59 What Research Institutions Can Do to Foster Research
Integrity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591
Lex Bouter
60 Useful Online Resources and Guideline . . . . . . . . . . . . . . . . . 597
Joel Faintuch and Jacob J. Faintuch

Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 603
 Part I
Introduction
 Past and Current Status of Scientific,
Academic, and Research Fraud 1
Joel Faintuch and Salomao Faintuch

Abstract not necessarily the correct one. Fortunately,

In the quest to advance knowledge, researchers much institutional advance has occurred, and
publish approximately 2 million scientific current fraudsters exceptionally get away with
articles each year, in close to 30,000 peer- it. This chapter briefly reviews the state of the
reviewed journals. Even though there was art in academic research.
hardly a time when science was more
questioned, distorted, and defamed, this is
still the closest thing to the established body
of knowledge for universities, academic 1.1 Introduction
laboratories, and other government and private
organizations and agencies worldwide. Are It is tempting to state that fraud is as old as
plagiarism, fraud, and misconduct indeed science. However, in order to be coherent, one
infiltrating and rotting the revered shrines of has first to establish the initial milestone of sci-
wisdom? Or is alleged scientific decay a con- ence. Was it introduced by Pythagoras of Samos
sequence of relatively few overambitious, (571–490 BCE), the author of the classic Pythag-
incompetent, or truly rogue researchers, who orean theorem (a2 + b2 ¼ c2), about the sides of a
sooner or later are identified and banned from right triangle? This theorem is so highly regarded
the community? In the distant past, fraud was that it is not uncommonly included in time
often in the eye of the beholder. As experimen- capsules, notably space-time capsules aimed at
tal design was rarely adequate, measuring remote civilizations (?), based on the principle
instruments were primitive or nonexistent, that it is an easily recognizable universal truth.
and modern statistics were lacking, conflicts However, there is evidence that around
were often decided by the strongest side, 1900 BCE, well over one millennium before
namely, the one backed by the authorities, Pythagoras, the same theorem was familiar to
Mesopotamians and to Egyptians [1, 2]. Did mod-
ern science actually begin with plagiarism? Or are
J. Faintuch (*)
we insufficiently familiar with historical
Hospital das Clinicas, Sao Paulo University Medical
School, Sao Paulo, Brazil trajectories, so that we are unable to agree even
e-mail: j.faintuch@hc.fm.usp.br about the authorship of that theorem?
S. Faintuch This leads us to another possibility, namely,
Department of Radiology, Beth Israel Deaconess Medical that fraud, like beauty, is in the eye of the
Center, Harvard Medical School, Boston, MA, USA beholder. If a given behavior is deemed
e-mail: sfaintuc@bidmc.harvard.edu

# The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 3

J. Faintuch, S. Faintuch (eds.), Integrity of Scientific Research,
https://doi.org/10.1007/978-3-030-99680-2_1
4 J. Faintuch and S. Faintuch

fraudulent by contemporary academic and regu- indirect collaboration with abuses such as coer-
latory consensus, then it should be accepted as cion and bullying, are similarly being enrolled
such. Although too pragmatic and utilitarian for among academic misconducts.
some tastes, that’s how the concept has actually It is alleged that deception is so widespread in
evolved in recent decades. As recently as 1981, nature that some species would not survive with-
Patricia Woolf, a professor at Princeton Univer- out a number of tricks. Indeed, predator animals
sity, wrote with awe and astonishment about four not uncommonly display bright colors to attract
episodes of scientific fraud and misconduct in the and distract victims, whereas prey might similarly
USA, asking the community whether that was the appeal to such resources as color, environmental
rule or just a cluster of outliers [3]. camouflage, and even bad smell to evade capture.
Sadly, it was not as exceptional as estimated. Preverbal children, or those who at age three still
In a more recent survey of 2155 academic resent a limited vocabulary, can already be fully
psychologists at major US universities involved proficient in deception and manipulative
with research, nearly one in ten had introduced behavior [5].
false data into a study. Most admitted engaging in Every scientific investigation involving
selective reporting, omitting dependent measures, humans should in principle adhere to informed
collecting additional data after statistical analysis consent, particularly when some type of harm or
was conducted, converting unexpected findings damage can emerge (physical, emotional, profes-
into predicted ones, as well as excluding data if sional, social, financial). Informed consent forms
they did not fit the hypothesis [4]. are evolving all the time, often generating heated
Currently, scientific integrity and professional conflicts as each country and organization adopts
ethics are not being taken for granted any more. new rules and legislations, and authorities seem
They are being embedded in the bylaws and unable to agree with a perfect and universal
ostensibly enforced by scores of academic, gov- model. Yet it is obvious that some are openly
ernment, and private institutions worldwide. fallacious and misleading.
By the same token, nearly all protocols involve
expenses and require a budget and its
1.2 Variants of Fraud corresponding sponsor. When grants originate
and Misconduct from government agencies and other public
sources, suspicions of objectionable intentions
Brain adaptability and plasticity are miracles of by the funder are understandably rare. The same
nature that occur all the time. This means that may not be true for private financing, notably
man and woman are endless creators, inventors, when the study addresses such controversial and
and redevelopers, often for the good of humanity. highly profitable topics as smoking, alcohol,
No less frequently are these abilities employed for sugar-rich soft drinks, ultra-processed
less noble purposes, some of them downright industrialized foods, other consumer products
unacceptable and dishonest. If this happens in and services, and even standard new drugs,
the medical, scientific, and general academic vaccines, and devices to be licensed by the phar-
environment, repercussions can be exponential, maceutical or medical supply industries.
as honorable conduct is taken for granted within Within the realm of conflict of interest, a
these ecosystems. whole list of modalities can be found in the litera-
Classically, fraud is classified as fabrication, ture, both financial and nonfinancial. Cheating is
falsification, and plagiarism. However, forms of another title that encompasses multiple
deceit widely vary, including ghost writing, other categories, be it during research (participant
authorship improprieties, misrepresentation of cheating, investigator dishonesty) or academic
data, statistical concealing or “spin,” and fake career (student reports, theses, books, Internet
news. Moreover, harassment and prejudice, be it releases) [6–9].
sexual, professional, or ethnical, along with even
1 Past and Current Status of Scientific, Academic, and Research Fraud 5

1.3 Integrity in Scientific and trustworthy, except that it is viscerally fraud-

Publication ulent and unreliable. Open access is actually a
perfectly legitimate approach, conceived by tradi-
For most purposes, science only starts existing tional publishers and transparently conducted, as
from the moment it is publicly reported in full discussed in other chapters. Sadly, the concept
and acknowledged by the community, either pos- was also hijacked by rogue organizations, giving
itively or with restrictions. Secret research is not a it the bad image it undeservedly acquired.
novelty of course, within such domains as mili- All of these obscure organizations do need to
tary activities and sensitive industrial processes. invest in advertisement, mostly in the form of
However, at least in the biomedical field, without millions of daily spam messages, yet quite a few
publication in peer-reviewed journals, new drugs authors are more than willing to comply. Why
and invasive medical devices will hardly be would they do it?
approved for commercialization by regulatory At the scientist’s end, as well as that of the
agencies. pharmaceutical sponsor sometimes backing his
Scientific publication is big business and alleg- research, there are no less robust and often con-
edly a particularly profitable one. An estimated flictual drivers at play. Publication is not an
30,000 journals publish 2 million scientific option; it is a must in many circumstances.
articles annually [10], generating over 19 billion Should a standard route and conventional journal
pounds ($27 billion US dollars) in global publish- be selected, sometimes crowned with rejection
ing revenues and employing over 100,000 after multiple submissions and precious
workers. The range is comparable to the world- wasted time? Or maybe a shortcut will do as well?
wide music and movie industries, however, with a Given the critical and antagonistic forces from
much more enviable profit of 30–40% [11]. all sides, including not negligible doses of
In the show business, authors (musicians, cheating and deception, it is not difficult to under-
artists, scriptwriters, directors) have to be stand that imputations of conflict of interest, poor
rewarded with contracts, royalties, and other stewardship, dishonesty, and misconduct can be
benefits, which reach princely sums in the case sprinkled on most players, not just openly preda-
of first-class professionals. General production tor organizations and their preys. On occasions,
and marketing costs including labor, travel, and not even “bona fide” authors and journals escape
other budgetary items can also be staggering. unscathed from the blanket malevolence against
Worst of all, productions can simply flop and the entire scientific publishing system, fueled by
leave behind enormous losses. Scientists of the not very rare scandals.
highest caliber freely transfer full and irreversible Of course professional journal editors notably
copyright of their texts and images to the in the medical field have long adopted stringent
publishers or else have to pay in order to retain ethical standards, and universities as well as mul-
such rights, in the so-called open-access models. tiple funding agencies have not wasted time
Publication and marketing costs are considered either. Yet fraudsters are ubiquitous, creative,
moderate, and despite growing competition, few strongly motivated, and at the same time naive,
established publishers are driven out of the believing they will never be caught and will
market. somehow get away. Consequently, publication
Given the vast money involved, it is not retractions are becoming more prominent and
surprising that the industry has attracted a huge troublesome, not less so [12, 13] (Table 1.1).
following of less reputable competitors, best
known as predator journals (including books,
congress proceedings, and technical and scientific 1.4 Retractions in the Past
conferences). Their “modus operandi,” almost
invariably open access, looks uncannily familiar Calculation mistakes and overlooked details dur-
ing formal studies have occurred at all times and
6 J. Faintuch and S. Faintuch

Table 1.1 Common examples of academic or research impropriety [4–9]

Fraud Context
Fabrication Nonexistent data, images, or study participants
Falsification Purposeful selection, misinterpretation, distortion, or adulteration of findings and conclusions
Plagiarism Undisclosed copying of ideas, methods, results, or images from self or from others, text
recycling
Misconduct
Data storage and Irresponsible or careless data manipulation, lack of data protection, confidentiality violation,
handling clandestine or illegal data access
Study participants Animal abuse, inadequate human consent regarding aims and benefits, concealment of risks
and harms of the study, coercion or exploitation of participants
Authorship Ghost writers, authorship bargaining or kidnapping, questionable personal credits
Study protocol Failure of registration and ethical approval, breach of good clinical practices (GCP), and
offensive, immoral, or unscientific projects
Conflict of interest Lack of transparency regarding relationships with funders, undisclosed commercial or personal
interests, nepotism
Publication Noncompliance with journal or publisher ethics, nonprofessional language (sensational
science), salami slicing (multiple articles from the same study)
Data sharing Lack of sharing with legitimate stakeholders (study participants, co-investigators, other
authorized parties), breach of data confidentiality, clandestine data disclosure or
commercialization
Personal misconduct Harassment, prejudice, bullying, disrespectful behavior or publications
Academic mentoring Malicious or dishonest mentoring of students, fellows, and junior staff, nepotism
Financial Misappropriation, misuse of research funds
misconduct
Academic career False or exaggerated academic titles, qualifications, publications, professional experience
Miscellaneous Cheating, deceit, fake news, scams, pseudoscience, malicious misconduct allegations,
retaliation against whistleblowers

eventually were brought to public attention by the

1.5 Do “Honest Mistakes” Exist?
authors themselves or by others. Two examples
from past centuries were relatively recently
There is evidence that no less eminent and
unveiled by library archeologists. One involves
revered names than Galileo Galilei (1564–1642),
the renowned French mathematician Henri
Isaac Newton (1643–1727), and Gregor Mendel
Poincaré (1854–1912), and the other has tangen-
(1822–1884) faked their data or at least were not
tial relationship with the electricity experiments
accurate in their descriptions [16–18]. The land-
of Benjamin Franklin (1706–1790). In the first
mark postulates by Robert Koch (1843–1910),
case, the author won a prize from Acta
the discoverer of the tuberculosis bacillus [19],
Mathematica in 1989 for a complex calculation
are not entirely original, as Friedrich Gustav
which was actually flawed. In the second case, the
Jakob Henle (1809–1885) had previously
investigator Benjamin Wilson wrote a letter to
expressed three of the four postulates [20]. Inci-
Philosophical Transactions of the Royal Society
dentally, they did not endure well the test of time
in 1756, aiming to clarify some possibly wrong
either.
details of his previous communication, which was
The first postulate, that the infectious agent
related to Franklin’s studies as well [14, 15]. It is
should be present in diseased organisms, not
important to emphasize that in none of these cases
healthy ones, was recognized as flawed by the
was intentional fraud suspected, and the
author himself, when he subsequently identified
retractions were spontaneous and transparent.
asymptomatic carriers. The second, that the
organism should be grown in pure culture, suffers
from the problem of unculturable bacteria as well
1 Past and Current Status of Scientific, Academic, and Research Fraud 7

as viruses, which do not form pure cultures. And 1.6 How Should Fraud Be
the third postulate, stating that the agent retrieved Managed?
from an ill person should precipitate the disease in
a healthy one, conflicts with the possibility of In the book by Ben-Yehuda and Oliver-
variable immune response and resistant Lumerman [22], which spans from the late nine-
individuals. teenth to early twenty-first centuries, about
Yet Koch’s proposals were received as honest 750 incidents of falsification, fabrication, plagia-
and valuable by the academic world at his time rism, and other academic misconducts were
and are cited till our days. Indeed, there is no documented. Repercussions, if any, mostly
evidence in his career that he was a plagiarist or occurred in recent times and were institution-
reckless investigator. As regards earlier authors, centered. Only in our times were scientific integ-
Harvard astronomer Owen Gingerich points out rity rules and administrations created, research
that it was relatively frequent for past scientists to procedures updated, misconduct prevention
cherry-pick data as they fitted their theories. In emphasized, and postgraduate courses or training
those days, such was quite acceptable or at least programs implemented, in some circumstances
was not stamped as malicious or fraudulent [21] specifically aiming at previous offenders.
(Fig. 1.1). Less stringent actions targeted the
perpetrators, with rare exceptions being at most
reprimanded or temporarily excluded from the
institution [23].
Nevertheless, in recent decades, even
authorities and geniuses have not been exempted
from integrity codes, and depending on the con-
text, the country, and the consequences, severe
penalties could affect those found guilty,
encompassing permanent loss of job or university
appointment, professional licensure, and even
fines and imprisonment [22, 23].
Of course not all punished assume guilt or take
it lightly. Vigorous reactions are not common yet
they tend to grow. A recent example occurred
with a New Zealand author, who had one article
retracted and two more flagged with “expressions
of concern.” He announced that he is initiating
legal process against the journal and its
publisher [24].

References
1. Friberg J (1981) Methods and traditions of Babylonian
mathematics: Plimpton 322, Pythagorean Triples, and
the Babylonian triangle parameter equations. Historia
Fig. 1.1 Until the middle of the twentieth century, the Mathematica 8(3):277–318
majority of drugs in clinical use lacked proper clinical 2. Neugebauer O (1969) The exact sciences in antiquity.
trials, and efficacy with occasional exceptions was ques- Dover Publications, New York
tionable (Picture from Wellcome collection.org). Repro- 3. Woolf P (1981) Fraud in science: how much, how
duction allowed by Creative Commons Attribution 4.0 serious? Hastings Cent Rep 11(5):9–14
International License (https://creativecommons.org/
licenses/by/4.0/)
8 J. Faintuch and S. Faintuch

4. John LK, Loewenstein G, Preiec D (2012) Measuring 14. Retractionwatch.com/2012/02/27/the-first-ever-

the prevalence of questionable research practices with english-language-retraction-1756
incentives for truth telling. Psychol Sci 23(5):524–532 1 5. Re t r a c t i on w a t c h . c om / 20 1 6/ 03 / 1 4 / w h a t - d i d -
5. Gongola J, Scurich N, Quas JA (2017) Detecting retractions-look-like-in-the-17th-century/
deception in children: a meta-analysis. Law Hum 16. Claudius Ptolemy. newscientist.com/people/claudius-
Behav. 41(1):44–54 ptolemy. Accessed 10 Nov 2020
6. Catano VM, Turk J (2007) Fraud and misconduct in 17. Kollerstrom N. The dark side of Isaac Newton.
scientific research: a definition and procedures for historicalnovelsociety.org/reviews/the-dark-side-of-
investigation. Med Law 26(3):465–476 isaac-newton-sciences-greatest-fraud/. Accessed
7. Janket SJ, Meurman J, Diamandis EP (2019) Advocate 10 Nov 2020
cultivation of academic ethics: why is it necessary? 18. Weeden NF (2016) Are Mendel's data reliable? The
F1000Res 30(8):1830 perspective of a Pea geneticist. J Hered 107(7):
8. Artino ARJ, Driessen EW, Maggio LA (2019) Ethical 635–646
shades of gray: international frequency of scientific 19. Koch R (1882) Die Atiologic der Tuberkulose (The
misconduct and questionable research practices in etiology of tuberculosis). Berlin Klin Wochenschr 15:
health professions education. Acad Med 94(1):76–84 221–230
9. The European Code of Conduct for Research Integrity. 20. Henle FGJ. Von den Miasmen und Kontagien
ec.europa.eu/info/fundingtenders/opportunities/docs/ (On miasmata and contagion). Bull Hist Med 1840
2021-2027/horizon/guidance/european-code-of-con 1938: 907 910
duct-for-researchintegrity_horizon_en.pdf. Accessed 21. Gingerich O (1993) The eye of heaven: Ptolemy,
10 Nov 2020 Copernicus, Kepler. Springer, USA
10. https://www.universityworldnews.com/post.php? 22. Ben-Yehuda N, Oliver-Lumerman A (2017) Fraud and
story¼20180905095203579. Accessed 5 May 2021 misconduct in research: detection, investigation, and
11. https://www.theguardian.com/science/2017/jun/27/ organizational response. University of Michigan Press,
profitable-business-scientific-publishing-bad-for-sci Ann Arbor, MI
ence. Accessed 5 May 2021 23. Dal-re R, Bouter LM, Cuijpers P, Gluud C, Holm S
12. ICMJE. Recommendations for the conduct, reporting, (2020) Should research misconduct be criminalized ?
editing, and publication of scholarly work in medical Res Ethics 16(1–2):1–12
journals. Updated December 2019. icmje.org/icmje- 24. retractionwatch.com/2020/11/18/author-initiates-a-
recommendations.pdf. Accessed 10 Nov 2020 legal-process-against-a-journal-and-its-publisher-
13. Retractionwatch.com. Accessed 10 Nov 2020 after-a-retraction-expressions-of-concern/
 Research Integrity: The Roles
of Academicians, Their Institutions, 2
and Other Agencies

Janet D. Robishaw, David L. DeMets, Scott M. Alter,

Joanne Krasnoff, Charles H. Hennekens, and Sarah K. Wood

Abstract 2.1 Introduction

While education and clinical pursuits are sub-
ject to challenges in achieving and maintaining Most academic institutions aspire to achieve
academic integrity, in recent decades, the scholarship and research. In addition, most aca-
majority of issues that have arisen concern demic medical institutions have a tripartite mis-
scholarship and research. sion that includes scholarship and research,
In this chapter, we review the principles to education, as well as clinical. All missions in all
guide academicians and their institutions with academic institutions, whether medical or not,
respect to the prevention and treatment of must be pursued with competence, compassion,
fraud as well as their collaborations with med- character, integrity, dignity, and grace. While
ical journals, the press, and industry. Finally, education and clinical pursuits are subject to
we discuss missed opportunities to achieve challenges in achieving and maintaining integrity,
and maintain research integrity at two distin- in recent decades, the majority of issues that have
guished academic institutions. arisen concern scholarship and research.
For the purposes of this chapter, the following
definitions are adopted:
• Scholarship is work that leads to peer-
reviewed commentaries, editorials, reviews,
books, and chapters.
• Contract research is clinical science which is
largely initiated by the funding agency in
J. D. Robishaw which the awardee enrolls subjects into multi-
Department of Biomedical Science, Charles E. Schmidt center investigations and the academic institu-
College of Medicine, Florida Atlantic University, FL, tion is remunerated based on each subject
USA
enrolled.
D. L. DeMets Discovery research is basic or clinical science
Department of Biostatistics and Informatics, University of
Wisconsin School of Medicine & Public Health, Madison, initiated by the investigator who writes
WI, USA proposals to obtain peer-reviewed funding
S. M. Alter · J. Krasnoff · C. H. Hennekens (*) · from the government, private foundations, or
S. K. Wood industry that provide direct costs to the acade-
Charles E. Schmidt College of Medicine, Florida Atlantic mician and indirect costs to the academic insti-
University, FL, USA tution that are usually funneled to enhance the
e-mail: chenneke@health.fau.edu

# The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 9

J. Faintuch, S. Faintuch (eds.), Integrity of Scientific Research,
https://doi.org/10.1007/978-3-030-99680-2_2
10 J. D. Robishaw et al.

future productivity of the discovery researcher. 2.2 Prevention and Treatment

The primary goal is to test hypotheses and of Academic Fraud
produce original articles or brief reports that
are published in the peer-reviewed literature. The achievement and maintenance of research
These endeavors may include collaborators integrity at academic institutions is both increas-
who are students, residents, and faculty. A ingly complex and an urgent necessity. This is
subsidiary goal is to submit abstracts to due, at least in part, to the fact that there are
national or local meetings to share the findings perceptions and realities that fraud, misconduct,
with other academics and secure their input and fake news in the academic, medical, and
about the findings. social environment are increasing [1–4].
Few would disagree with Ben Franklin’s state-
There are increasing requirements for ment that “an ounce of prevention is worth a
pre-medical and medical students as well as pound of cure.” In practice, however, there is
residents to be involved in scholarship and wide debate about the application of this wisdom
research activities, to learn the discipline, to to healthcare systems [5]. This wide debate
enhance their curricula vitae, as well as to develop includes achievement and maintenance of
strong applications whether for medical school, research integrity at academic institutions, which
residency, fellowship, or academic promotions. sometimes is driven by short-term necessities
Most medical schools support scholarship and rather than long-term prevention.
research opportunities for their students either Whether treatment or prevention, we believe
within the curriculum or extracurricularly, as the hierarchy of responsibilities begins with the
well as integrate teaching sessions that address principal investigator (PI) and includes the aca-
research ethics and principles underlying research demic institution, in particular, their Institutional
conduct. Academic institutions have the respon- Review Boards (IRBs), as well as the funding
sibility to provide appropriate education and agency whether governmental, foundational, or
development in the foundational tenets underly- industrial and, finally, the medical journals. On
ing the achievement and maintenance of research the one hand, academicians typically have the
integrity. autonomy to choose to work within their areas
Training on the importance of mentorship, of expertise as well as to devise their own
authorship responsibility, and accountability as research methods to achieve this goal.
well as research misconduct and the roles and Academicians hold a “sacred trust” that begins
responsibilities of Institutional Review Boards with their students, residents, and faculty and
(IRBs) and other research regulatory offices extends to the general public. Academicians are,
such as the Institutional Biosafety Committee and deserve to be, held in high esteem by the
(IBC), Institutional Animal Care and Use Com- public, but this brings greater responsibilities. Of
mittee (IACUC), and Office of Environmental concern to academicians, this trust may be erod-
Health and Safety (EHS) are also of increasing ing because research misconduct appears to be on
importance. Case-based learning used to high- the rise for several decades [6]. It is important to
light situations that have occurred intentionally note that misconduct does not mean honest
and unintentionally at all levels of the academic differences of opinion or even honest errors. It
enterprise should also be an adjunct to educate implies fabrication, falsification, or plagiarism.
students, residents, fellows, and faculty wishing Fabrication is defined as making up data, whereas
to pursue scholarship or research. falsification is defined as manipulating data, and
plagiarism is the appropriation of the work of
others.
2 Research Integrity: The Roles of Academicians, Their Institutions, and Other Agencies 11

The inability of academic institutions to full access to the disclosure statements of their
achieve and maintain research integrity leads to authors, preferably online. We also concur with
“outside policing” by funding agencies and an the ICMJE requirement for all investigators to
increasingly distrustful general public. Failure to register all randomized trials on clinicaltrials.
achieve these levels of oversight will cause finan- gov. The registration of the trial before beginning
cial, reputational, and legal consequences. We ensures that the stated hypotheses are, indeed, a
believe that academicians should have the pri- priori and not a posteriori and data derived. The
mary responsibility for the identification, preven- registration also contributes to achieving and
tion, and treatment of misconduct in medical maintaining research integrity with respect to ran-
research. We also believe that federal agencies domization, adherence, and follow-up of all
should not usurp the authority or responsibilities participants in the trial. There is a crucial need
of academicians and their institutions. This for independent and multidisciplinary data moni-
implies, however, that academicians and their toring committees (DMCs) [8, 9]. The primary
institutions are ready, willing, and able to do role of independent DMCs in Phase 3 trials is to
so. This, in turn, implies imperatives that are protect the safety of randomized subjects. To do
based both on ethics and self-interest [7]. We so requires frequent monitoring of safety data and
should not let the perfect be the enemy of the periodic monitoring of efficacy data. The utiliza-
good (“le mieux est l'ennemi du bien,” Voltaire, tion of these safeguards protects the patient,
1770). We believe that such leadership should investigator, and sponsor with respect to the per-
begin with academicians not governmental or ception and reality of research integrity.
other agencies.

2.4 Collaborations
2.3 Collaborations of Academician of Academicians and Academic
and Academic Institutions Institutions with the Press
with Medical Journals
Academicians must always avoid misstatements
The “sine qua non” of medical journals is the and overstatements to the press about their schol-
conduct of independent and rigorous peer review arship and research. While such misstatements
that include scientific accuracy and avoidance of and overstatements of benefit to risk ratios may
misstatements or overstatements. Peer-reviewed increase publicity, academic promotion, and grant
journals should require every coauthor to have support, the clear and present dangers include
contributed in meaningful ways. In additions, misinforming and confusing colleagues and
authors should sign statements of attestation fol- frightening patients and making it even more
lowing the recommendations of the International difficult to conduct the high-quality research nec-
Committee of Medical Journal Editors (ICMJE). essary to test the hypothesis.
Journals should ensure that research is free from With respect to interactions with the press, all
commercial bias. In addition, disclosure policies faculty members whether salaried, adjunct, affili-
for reviews and commentaries should be particu- ate, clinical, or visiting should be subject to the
larly rigorous because the authors are not publish- same stringent guidelines approved by the aca-
ing new findings, but are offering what are demic institutions. This is necessary for several
expected to be their unbiased opinions about the cogent reasons. First, the press will not generally
totality of evidence. Journals should ensure that be aware of these distinctions when media cover-
all of their authors and reviewers as well as their age occurs for scholarship or research. Second,
own editorial boards should have no financial the academic institution will have reputational
interests related to any manuscript. The imple- and legal liabilities. Each academic institution
mentation of these policies will facilitate indepen- should have clear guidelines for speaking with
dent peer review. Journals should allow readers the press or in the development of press releases.
12 J. D. Robishaw et al.

With respect to the former, the general guideline and with high adherence and follow-up. These
is to seek and obtain prior approval from the circumstances will facilitate the most reliable
media relations department of the institution quantitation of the benefit to risk ratio. These
before addressing any member of the press. As issues are relevant to device trials. In drug trials,
regards the latter, we believe that press releases dose is also a major consideration. Obstacles in a
should follow publications in peer-reviewed particular country may include changes in the
journals. Press releases accompanying prelimi- medical care delivery system that decrease the
nary analyses or even published abstracts should influence of healthcare providers and increase
generally be discouraged. Academics must the influence of legal and business interests [1].
remain cognizant that the mere mention of their
academic institution implies they are speaking on
their behalf. It could be argued that even 2.6 Missed Opportunities at Two
disclaimers may not be sufficient to avoid poten- Outstanding US Academic
tial reputational and legal liability. Institutions

Duke University is one of the most outstanding

2.5 Collaborations academic institutions in the USA and world.
of Academicians and Academic Nonetheless, at Duke, an instance of academic
Institutions with Industry fraud occurred in relation to developing genomic
predictors for cancer risk assessment and treat-
Academicians and their institutions are increas- ment. After external challenges were made about
ingly dependent upon outside funding. By the end the scientific validity of genomic marker research
of the twentieth century, there had been remark- conducted in the laboratory of Joseph Nevins,
able gains that emanated from large-scale MD, and his mentee Anil Potti, MD [12, 13],
randomized trials of treatment and prevention of Duke commissioned an investigation in the fall
cardiovascular disease [10], many of which had of 2009 to assess whether the markers were suffi-
been derived from industry funding. These land- ciently reliable to drive the selection of therapies
mark findings have resulted from equipoise and in three randomized trials. In July 2010, the
détente, namely, balanced and trusted interrela- National Cancer Institute (NCI) called into ques-
tionships between the investigators, the sponsor, tion both the reliability of the biomarkers and
and the regulatory authorities [11]. Duke’s 2009 investigation. Due, in part, to a
We believe that to achieve such détente failed audit, the National Cancer Institute (NCI)
requires awareness of the different specific goals and Duke invited the Institute of Medicine (IOM)
of these various factions. In our view, the industry to investigate the research process in the Nevins-
has a primary goal to prove the efficacy of their Potti lab, to identify flaws that may have led to the
drug to achieve approval by regulatory external challenges, and to make
authorities. Regulatory authorities, in turn, have recommendations about how to avoid such
a primary goal to approve only drugs or devices mistakes in the future [14–16]. The Office of
with favorable benefit to risk ratios in order to Research Integrity (ORI), within the US Depart-
minimize harm to the general public, so their ment of Health and Human Services (DHHS),
major emphasis is safety in the context of a favor- focused their report entirely on one individual
able benefit to risk ratio. The priority of faculty member and made no comment on the
academicians is to determine whether there is a institution’s responsibility and its failure to pro-
favorable benefit to risk ratio of the intervention vide adequate oversight and investigation. These
under investigation. This is achieved by actions missed an important opportunity to
maintaining their independence in the design, emphasize the institution’s critical responsi-
conduct, analysis, and interpretation of bilities in oversight of research integrity and the
randomized trials of sufficient size and duration
2 Research Integrity: The Roles of Academicians, Their Institutions, and Other Agencies 13

importance of institutional transparency and integrity and, as a corollary, maintain proper

accountability [4]. oversight. When, despite all efforts at prevention,
At Harvard, which is considered by some the the possibility arises of the occurrence of
beacon of academic institutions of the USA and violations, especially academic fraud, the
world, several decades ago, academic fraud was academicians and their institutions should
detected initially in relation to fabricated data by respond rapidly and sufficiently to adequately
John Darsee, MD, on experiments in cardiovas- diagnose and treat the issues whether the occur-
cular disease in dogs. Later, it was uncovered that rence results from inadvertent or intentional
these activities were of long-standing duration as misconduct [2].
they had occurred at Emory his previous institu- Academicians, their institutions, the funding
tion as well as Notre Dame, his undergraduate agency, and the medical journals should all
institution. The initial investigation was not of ensure that there is a prompt, thorough, and trans-
sufficient depth or breadth to uncover either the parent review process that results in appropriate
nature or the extent of the fraud, so this accountability at all levels. All academicians as
represented another missed opportunity [3]. well as their faculties and staffs engaged in
The striking resemblances of these two research must speak truth to power [17].
instances decades apart included the lack of integ-
rity of the investigator and a tendency of the
institution to limit the scope of the initial References
investigations. These cases also highlight the
need for courage and vigilance of the departmen- 1. Robishaw JD, DeMets DL, Wood SK, Boiselle PM,
Hennekens CH (2020) Establishing and maintaining
tal and medical school authorities in the early
research integrity at academic institutions: challenges
initiation and completion of comprehensive and and opportunities. Am J Med 133(3):e87–e90
transparent investigations, as well as holding lia- 2. DeMets DL (1997) Distinctions between fraud, bias,
ble all individuals involved regardless of their errors, misunderstanding, and incompetence. Control
Clin Trials 18(6):637–650
positions in the hierarchy of the academic
3. DeMets DL (1999) Statistics and ethics in medical
institution. research. Sci Eng Ethics 5(1):97–117
It may be of interest to note that DLD, the 4. DeMets DL, Fleming TR, Geller G, Ransohoff DF
second author of this chapter, was a member of (2017) Institutional responsibility and the flawed geno-
mic biomarkers at duke university: a missed opportu-
the committee that conducted the investigation at
nity for transparency and accountability. Sci Eng
Duke. In addition, Professor Howard Morgan, the Ethics 23(4):1199–1205
mentor of JDR, the first author of this chapter, 5. Faust HS, Menzel PT (eds) (2011)
was Chair and DLD a member of the committee Prevention vs. treatment: what’s the right balance?
Oxford University Press
that investigated Harvard.
6. Institute of Medicine (2012) Evolution of translational
genomics: lessons learned and a path forward.
National Academies Press
2.7 Conclusions 7. Dingell JD (1993) Shattuck lecture-misconduct in
medical research. N Engl J Med 328(22):1610–1615
8. DeMets DL, Furberg CD, Friedman LM (eds) (2006)
In addressing the goal of achieving and Data monitoring committees in clinical trials: a case
maintaining academic integrity, the responsi- studies approach. Springer
bilities must be shared. The primary responsibil- 9. Ellenberg SS, Fleming TR, DeMets DL (2019) Data
monitoring committees in clinical trials, 2nd edn.
ity should rest upon the principal investigator, Wiley
including each and every collaborator in all schol- 10. Hennekens CH (1998) Increasing burden of cardiovas-
arly or research activities. In addition, the cular disease; current knowledge and future directions
institutions, especially those in a position of lead- for research on risk factors. Circulation 97(11):
1095–1102
ership, must play a significant role. Academic 11. Hennekens CH, DeMets DL (2011) Data and safety
leaders in academic institutions must create and monitoring boards of randomized trials: emerging
maintain an environment to maintain and enhance
14 J. D. Robishaw et al.

principles and practical suggestions. Clin Invest 1(1): 15. Goldberg P (2010) By defending Potti, Duke officials
53–57 become targets of charges of institutional failure. Can-
12. Goldberg P (2009) A biostatistics paper alleges patient cer Lett 26(28):1–2
harm in two Duke clinical studies. Cancer Lett 35(36): 16. Goldberg P (2011) IOM Committee will probe Duke
1–2 scandal together with other “omics” case studies. Can-
13. Baggerly K, Coombes K (2009) Deriving chemosen- cer Let 37(1):1–2
sitivity from cell lines: forensic bioinformatics and 17. American Friends Service Committee. Speak truth to
reproducibility research in high-throughput biology. power: a quaker search for an alternative to
Ann Appl Stat 3:1309–1334 violence. 1955.
14. Institute of Medicine (IOM) (2012) Evolution of trans-
lation genomics: lessons learned and a path forward.
National Academies Press
 Indictment or Information Can Lie:
Post-Truth in Science 3
Mariella Scerri and Victor Grech

Abstract Post-Truth in Science

Misinformation and false news are the prove- Beware of false knowledge; It is more dangerous
nance of post-truth, a recent phenomenon than ignorance.—George Bernard Shaw.
whereby debate is framed by appeals to emo-
tion with repeated assertion of half-truths and
outright lies. While dubbed a modern concept,
3.1 Introduction
misuse of information and fake news have
their roots grounded in history. Indeed,
“False news is harmful to our community; it
scholars argue that even though certain
makes the world less informed, and it erodes
features of post-truth were foreshadowed in
trust. It’s not a new phenomenon, and all of us
earlier times, a combination of different factors
— tech companies, media companies,
has currently created a new set of
newsrooms, teachers — have a responsibility to
circumstances which justify its designation as
do our part in addressing it” [1]. This was part of a
a post-truth era. This chapter will therefore
media campaign created recently by Facebook, to
take a closer look at the origins of post-truth
admonish and warn its users and encourage their
and how it infiltrated science and medicine and
familiarisation with a guide on the fake news
negatively influenced debates about climate
phenomenon. This included scepticism towards
change, vaccine uptake and the COVID-19
headlines and checking story sources. Facebook
pandemic. This chapter argues the importance
alleges that it is actively engaged in fighting the
of utilising Fairclough’s critical discourse
proliferation of misinformation in main areas: to
analysis (CDA) approach in analysing dis-
disrupt economic motives as fake news is finan-
course which accompanies conspiracy theories
cially driven; to build new products to stem the
and fake news. Only after a thorough exami-
spread of misinformation; and to encourage peo-
nation of discourse can effective strategic
ple to make knowledge-based decisions regarding
planning to combat misinformation take place.
false news [1]. Misinformation and false news are
the provenance of post-truth, a recent phenome-
non whereby “debate is framed by appeals to
M. Scerri (*) emotion with repeated assertion of half-truths
University of Leicester, Leicester, UK and outright lies” [2].
V. Grech In 2016, the Oxford Dictionary named post-
Faculty of Medicine and Surgery, Mater Dei Hospital, truth the word of the year after a 2000% spike in
Msida, Malta
e-mail: victor.e.grech@gov.mt

# The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 15

J. Faintuch, S. Faintuch (eds.), Integrity of Scientific Research,
https://doi.org/10.1007/978-3-030-99680-2_3
16 M. Scerri and V. Grech

usage in the preceding year. As a broad phrase, earlier times, a combination of different factors
post-truth captures the zeitgeist [3]. has currently created a new set of circumstances
which justify its designation as a post-truth era”
[6]. Ironically, fake news and misinformation
3.2 Historical Roots of Fake News flourished and propagated in the twenty-first cen-
and Misinformation tury at a time when the Internet provides easy
access to information. The large fact-free cam-
The mid-1700s witnessed a spate of fake news, paign during Brexit; the growing use of disinfor-
when at the peak of the Jacobite rebellion in Great mation campaigns by politicians in Hungary,
Britain, in an attempt to subvert the establish- Russia and Turkey; and the deceit and lies
ment, printers incited false news reports claiming surrounding the US presidential election by
that King George II was ill. This fake information Trump gave rise to a “growing international
was picked up by other reputable printers and trend where some feel emboldened to try to
republished, making this piece of information bend reality to fit their own opinions” [3]. The
indistinguishable from fact. Indeed, Attorney false messages that are relayed have common
General Dudley Ryder responded to complaints features; they insist that they have inside informa-
in a letter: tion; however, they do not provide a reference to
As the publication of such false news of his Maj- support the alleged source. While the “motivation
esty, has a tendency to disquiet the minds of his behind creating these messages is unclear, it
subjects, hurt public credit, and diminish the regard might relate to attention seeking behaviour and
and duty which they owe him, I think the doing it conspiracist ideation” [7]. Political as well as
with such views is an offence punishable at Com-
mon Law, and for which an indictment or informa- cultural factors have been linked to the rise of
tion can lie. And the frequency of such publications post-truth where actual truth is relegated a sec-
is evidence of such wicked designs. But as every ondary position.
false report of this kind which may arise from
mistake only cannot be charged as a crime, so it is
very difficult to say how often it must be repeated in
the paper to make it criminal [. . .] I don’t know any 3.3 The Origins of Post-Truth
method to prevent this practice but by prosecuting
the offenders when they are guilty. [4] Postmodernism and the emergence of the philo-
Fast forward in time and two centuries later, sophical concept of relativism in the late twenti-
the fake news of an alien attack on America on eth century mark the inception of post-truth
Sunday, 30 October 1938, was indeed prototypi- [8]. Postmodernism has been an enabler of
cal. Broadcasting an adaptation of the 1898 novel power in “sustaining different regimes of truth”,
War of the Worlds by HG Wells, the Columbia often obscure and discreet [6]. This has led “the
Broadcasting Network aired a major part of the general public to question objective facts and
plot over the radio as a series of breaking news created a setting in which alternative facts are
alerts. The realistic attack alarmed many listeners legitimated”. The problem is aggravated when
and tricked them into believing that there was an relativist views are normalised and make way to
alien invasion taking place [5]. Towards the end lies which can be excused as “alternative points of
of the broadcast, doctors, nurses and soldiers view” or “legitimate opinions” and turned into a
were so panic-stricken that they reported for maxim in which everyone is entitled to their own
duty ready to fight the Martians. Police stations truth [9]. While postmodernist thinking has
across the country responded to a multitude of vocalised opinions of minority people in society,
calls, while newspaper reporters rushed to prepare dismissal of facts and theories by powerful elites
special editions [5]. gives rise to widespread dissemination of inaccu-
Indeed, scholars argue that even though certain rate discourses and half-truths. This is
“features of post-truth were foreshadowed in compounded by the “development of digital com-
munication tools and media which has led to a
3 Indictment or Information Can Lie: Post-Truth in Science 17

dramatic augmentation conducive to an informa- Brookie, directors of the Atlantic Council’s Digi-
tion overload” [10]. The cyber revolution tal Forensic Research Lab, highlight the negative
confronts the authority of conventional sources repercussions that these conspiracy theories
of information including scientific research [11]. would have and how they will “outlast the
The narrative of postmodernism and post-truth Trump administration” [18]. The violent rhetoric
is well illustrated in George Orwell’s Nineteen on online platforms and the convergence of dif-
Eighty-Four wherein the State deliberately ferent types of conspiracy theories surrounding
modifies and alters historic and archival records Trump’s administration will have lasting effects
to match the propaganda of the day [12]. Of note and, unfortunately, will also infringe on other
is Orwell’s entry in his diaries about war, “All political and scientific topics.
propaganda is lies even when one is telling the In A Democratic Staff Report Prepared for the
truth” [13]. The BBC induction course at the start Use of the Committee on Foreign Relations
of his career helped him to understand propa- United States Senate, Robert Menendez [19]
ganda machinations. Indeed, the stint at the argues that an even greater cause of concern is
BBC was influential in his inception of Nineteen the latest model of digital authoritarianism which
Eighty-Four, and he came to realise “how politi- is likely to alter the digital domain in the near
cally ignorant the majority of people are, how future. The Chinese Communist Party, in
uninterested in anything outside their immediate Orwellian fashion, is cultivating digital authori-
affairs” [14]. This provides a blank slate to tarianism within China’s borders through the
governments giving them access to language development of an obtrusive, ubiquitous surveil-
manipulation in order “to serve political agendas lance state that uses “emerging technologies to
and to re-shape language in the cause of a domi- track individuals with greater efficiency and to
nant ideology” [14]. bolster its censorship mechanisms to ascertain
Writing about the future is fraught with that information considered detrimental to the
difficulties and uncertainty. The task for any regime does not reach its citizens” [19]. Indeed,
writer is to sound the warning to his readers a fundamental respect for human rights is
about what could happen. The clout of totalitari- threatened; and in turn, such means of surveil-
anism in Nineteen Eighty-Four is an entangled lance and population control can negatively influ-
and complex motif, but the “novel’s narration — ence campaigns worldwide [19]. Furthermore, the
with its texts within texts — also enacts its own diversification of digital authoritarianism in
phantasmagoria, a world where both everything is China has far-reaching consequences for the free
true and nothing is true” [15]. As Lynskey [16] world at large because China is influencing and
avers, Orwell anticipates what Hannah Arendt shaping its own version of a censored Internet in
[17] explains in The Origins of Totalitarianism, its own political image [19].
published a year after Orwell’s demise: “The Despite China’s authoritarian governing narra-
ideal subject of totalitarian rule is not the con- tive, the country is a key player in major eco-
vinced Nazi or the convinced Communist, but nomic and political international spheres and is
people for whom the distinction between fact capable of “providing the communist regime with
and fiction (i.e., the reality of experience) and increased status among other nations” [19]. As
the distinction between true and false (i.e., the journalist Richard McGregor [20] avers, China’s
standards of thought) no longer exist”. Nowa- manifesto—“the idea that authoritarian political
days, this is in part due to circulating online systems are not only legitimate but can outper-
misinformation. form Western democracies”—is a valid concern.
For example, the events surrounding Donald The country’s growing influence on the digital
Trump’s impeachment which led to violent unrest sphere “to promote an alternative model for the
at the Capitol in January 2021 are “part of a digital domain based on state control, seems to
completely alternate reality” and have reached a support European illiberal democracies” as is
point of “radicalisation” [18]. Wardle and evidenced in Hungary and Poland [20].
18 M. Scerri and V. Grech

Emerging innovative tools enable China to specialised, and this curtails the comprehension
categorise and label individuals and and acumen that can realistically be expected
pre-emptively take necessary action against from any lay person. Moreover, scientific knowl-
those considered problematic to the regime edge is in a constant state of flux. For this reason,
[21, 22]. The banning of US social media scientific experts tend to rely on the knowledge of
platforms such as Facebook, Instagram, Twitter, their peers to conduct their research, particularly
WhatsApp, Pinterest and YouTube from China’s in interdisciplinary research. Studies also show
servers [23] has two main advantages for the that misinformation causes people to abandon
dictatorial state: censoring these platforms is suc- facts altogether. A study by van der Linden
cessful in withholding information that would be et al. [27] concludes that participants who were
considered derogatory to the Party and it also presented with both a persuasive fact and a simi-
allows Chinese platforms with similar services lar piece of inaccurate information held tight to
to thrive and expand [19]. China’s digital efforts their original belief—the misinformation can-
need to be examined against a global backdrop celled out the fact. The campaigns and conspiracy
and the ramifications this will have on other theories about climate change and against vacci-
countries explored. “At best, China is selling dig- nation programmes are inarguably the greatest
ital technology that has remarkable capacity for challenges that science and medical communities
surveillance and control to authoritarian or had to face in the last few decades. Indeed, the
authoritarian-leaning countries with no second COVID-19 pandemic compounded an already
thought for the consequences. At worst, China is fraught situation.
pairing its economic investment with aggressive
outreach and training on Internet governance and
domestic regulations to further inculcate authori- 3.4.1 The Environmental Cost
tarian values and methods of social control” [19]. of Misinformation

Climate change is the biggest environmental story

3.4 The Effect of Post-Truth and arguably one of the toughest challenges to
on Science and Medicine tackle misinformation. Not only is it scientifically
complex but also politically perfidious, making it
Unfortunately, the incursion of fake information, an impossible endeavour to correct and counter-
conspiracy theories and emerging digital authori- act the misinformation from media sources.
tarianism have infiltrated science and medicine. Objectivity—a key component of climate change
While science constitutes the “last metanarrative conventional equilibrium—led both journalists
with any significant cachet in the post- and the general public astray. The problem arose
postmodern condition” [24], it continually falls when firms dealing with public relations and
prey to post-truth after certain significant events scientists funded by the fossil fuel industry were
which occurred in the last several decades. Once the seat of doubt and misinformation about the
respected for the authority of its method, scien- reality of human-caused climate change. This led
tific results are now openly questioned and journalists to repeat the information in an attempt
doubted by squads of non-experts. Perceived as to be “balanced” [28], thereby leading the media
potentially offering a haven of truth for the gen- to create an appearance of significant scientific
eral public, the distinguished probity of this pillar debate over anthropogenic climate change,
is being undermined by post-truth utterances [25]. when, in fact, there was little disagreement.
One of the rudimentary challenges in fake Such a disparate coverage, particularly evident
news and conspiracy theories’ identification in up until 2004 [29], falsely framed climate change
science is that it is prevalent in many different as a “debate” in the public eye [30]. Not long after
specialties of scientific knowledge. Norris [26] Boykoff and Boykoff’s [31] influential study,
argues that scientific knowledge is complex and coverage changed to reflect more closely
3 Indictment or Information Can Lie: Post-Truth in Science 19

scientific consensus. By 2010, Block [32] noted strong in the face of conflict and threat” [34]. Peo-
that most journalists had stopped covering cli- ple want to be reminded that they are headed
mate change as a scientific controversy. towards a bright future and that they should be
Such a debate is particularly problematic optimistic about their prospects [35]. This “feel
because its repercussions can be great. When lay good” factor is part of the psychological appeal of
persons lack the necessary knowledge and skills climate change conspiracy theories. “Denial of
to interpret data themselves, they seek guidance climate change is likely to do a lot more for
and knowledge from trusted experts. Climate people’s general sense of equanimity”, and there-
sceptics create mistrust, suspicion and doubt, fore, these conspiracy theories discredit the
and while they may not be responsible for the “overwhelming evidence that humans are
conspiracy theories, theories abound that assert contributing to the destruction of their own
that climate scientists are faking their data to environment” [33].
finance their research through funding [33]. Cli- Two mainstream explanations also contribute
mate change conspiracy theories are uniquely to an idiosyncratic feature of climate change con-
harmful because they can steer public opinion spiracy theories. The official version—that
and hamper efforts to adapt to and reduce the humans are inducing dangerous levels of climate
impact of global warming. To aggravate the situ- change—is disputed and countered by others.
ation, climate change can be considered as an Indeed, organisations such as Greenpeace [36]
example of “proportionality bias”; there is a try to counter-argue and suggest that a thorough
large discrepancy between what is a large-scale explanation is lacking. This allows industrialists
event with enormous significance and what is to orchestrate and fund campaigns in which mis-
portrayed by scientists and governments as a con- information is presented to the public [37]. The
sequence of small every day events such as other important elucidation is that other conspir-
transportation. acy theories are led by backroom political
This proportionality bias therefore becomes machinations. A classical case is the withholding
the seat of many conspiracy theories about cli- of important information about greenhouse gas
mate change. Such theories typically postulate emissions in China which was removed from the
that there is no occurrence of global warming summary for policy makers in the fifth Intergov-
and instead claim that scientific findings are ernmental Panel on Climate Change assessment
fabricated lies by researchers who have some- [38]. This raises concerns about the global poli-
thing to gain. Due to this common thread, they tics involved in climate change—specifically, that
are often referred to collectively as the great the gravity of the situation and the culpability of
global warming conspiracy. Douglas and Sutton humans are undermined.
[33] identify four of these conspiracy theories: Both conspiracy and counter-conspiracy
scientists are involved politically; to get research theories are therefore represented as “insincere,
funding; global warming is a green scam; and and scientific data are represented as political
global warming is an attempt to promote nuclear tools rather than value-free observations of the
power. As with other conspiracy theories, in these world” [33]. This creates uncertainty and mutual
examples, the alleged conspirators are driven by distrust, which, when politicised, compromises an
either political power or money. However, com- evidence-based approach of scientific findings by
paring climate change conspiracy theories with the general public [39]. Perhaps most corrosive is
other popular conspiracy theories reveals some that the politicisation of climate change leads to a
crucial differences. choice to be made between competing conspiracy
One notable difference is that people “prefer to theories.
believe that they are part of an enduring and
moral social group that can be confident and
20 M. Scerri and V. Grech

3.4.2 Conspiratorial Beliefs suggests group discussions on vaccination tend

of Anti-vaccination to promote such conspiracy theories [44].

Similarly, misinformation and conspiracy 3.4.2.1 The Role of the Social Media
theories surrounding vaccination programmes The potential for disseminating harmful health-
create uncertainty in public discourse; “even related information through social media has
worse conspiratorial ideation can lead to outright increased exponentially as “thought influencers”
opposition to and rejection of the scientific in the anti-vaccine movement attract a large fol-
method” [40]. Mistrust and conspiratorial beliefs lowing. A study conducted in Italy found an
are endemic in anti-vaccination groups, with inverse correlation between MMR vaccine cover-
those advocating the scientific and medical con- age and Internet search activity, Facebook posts
sensus often regarded as agents of some “omi- and tweets [45]. In another study of 153 YouTube
nous interest group bent on concealing the truth” videos about immunisation, the results show that
[41]. Inarguably, the development of vaccines has negative videos are more likely to receive a
been an important discovery in the history of rating, have higher mean star ratings and have
medicine. However, many global regions have more views [46]. Vaccine objectors reject
witnessed a decline in vaccination programmes, evidence-based information in favour of vaccina-
particularly the combined measles, mumps and tion because misinformation is simply their ver-
rubella (MMR) vaccination [42]. sion of information. Unfortunately, social media
This particular decline is attributed to the pub- acts as a “postmodern Pandora’s box”, releasing
lication of Andrew Wakefield’s article in The arguments that are not easily dismissible. Once in
Lancet in 1998 in which he linked autism to circulation, misinformation is not easily
MMR vaccination [43]. Although the article has retracted [47].
since been retracted, the research discredited and
the author is no longer permitted to practise med-
icine, the repercussions are still felt nowadays. In 3.4.3 The Infodemic on COVID-19
2008, measles was declared to be endemic in the
United Kingdom, 14 years after its spread was The global COVID-19 pandemic is the perfect
halted in the population [42], while MMR vacci- storm for aggravating a situation encumbered by
nation rates lie well below the recommended 95% misinformation and conspiracy theories. During a
uptake [42]). pandemic, the risk of contagion, alongside alarm-
Fundamental to the anti-vaccine conspiracy ist publicity stoked by social media, induces fear
movement is the argument that large pharmaceu- more than the disease itself [48], resulting in
tical companies and governments conceal infor- potential patients to panic and to succumb to
mation about vaccines to meet their own sinister unlikely offerings of prophylactic agents,
objectives [44]. Anti-vaccine conspiracy theories treatments and cures [49]. The infodemic
therefore reflect suspicion and mistrust of scien- surrounding the COVID-19 pandemic has led
tific research and try to undermine vaccine effi- the general public to question mask-wearing, to
cacy and safety [44]. In particular, parents faced opt for fake treatment and to question vaccines as
with the decision to have their children vaccinated a safe preventive method. This was perpetuated
may be more likely to seek vaccine-related infor- by a plethora of news articles which have
mation through the Internet than through their documented the insouciant attitude of several
doctor or paediatrician [44]. Unfortunately, male leaders who diminished the importance of
websites which propagate anti-vaccine conspir- the “little flu” or claim it to be of “moderate risk”.
acy theories are usually some of the top “hits” This incited citizens to imitate the diminishment
[44]. Although many people are sceptical of anti- discourse and encouraged them to flout local
vaccine conspiracy allegations, recent research government guidelines for self-isolation, social
distancing and mask-wearing.
3 Indictment or Information Can Lie: Post-Truth in Science 21

The careless attitude of leaders such as John- clinical trials revealing the safety and efficacy of
son, Putin, Bolsonaro and Trump is a spectacular coronavirus vaccines, a good proportion of soci-
feature of coronavirus emo-truth political ety remain hesitant about being administered with
performances and became a widely recognised the newly developed vaccines, thereby making
sign of toxic masculinity in reporting around the the fight against the COVID-19 disease even
world [50]. Emo-truth is a particular form of more difficult.
“aggressive masculine performance of trustwor-
thiness, corresponding to a code for recognizing
it, resulting in a legitimated status of the popular 3.5 A Critical Discourse Analysis
truth-teller, and at odds with more official scien- Approach to Post-Truth
tific, institutional truth-tellers” [50]. Arguably,
the most disturbingly spectacular performance of Identifying the root of conspiracy theories and the
unmasked toxicity was waged by armed men, effect of post-truth in medicine is not enough, if
who stormed the Michigan (USA) state capitol the deleterious effects on science and medicine
to intimidate lawmakers before a vote to extend are to be counteracted. A proper understanding of
the lockdown. They alleged that their individual how social media discourse is constructed
freedon was “threatened”, and they opposed becomes vital, as it will provide a deeper investi-
“government tyranny” manifest in lockdowns, gation of the invested meaning in post-truth. Nor-
social distancing and mask “imposition” man Fairclough’s critical discourse analysis
[51]. These men demonstrated a disregard for (CDA) approach offers a framework which
truth claims about the seriousness and/or dangers promises a deeper inquiry into a “communicative
of the virus or, perhaps more prominently, a dis- event” [54]. Fairclough’s CDA has three basic
regard for the collective danger the virus poses. properties: “it is relational, it is dialectical and it
is transdisciplinary”. CDA provides a point of
3.4.3.1 Unproven Therapeutic Protocols contention between “discourse and other objects,
Recently, in the United States, media attention elements or moments, as well as analysis of the
focused on the possible therapeutic benefit of internal relations of discourse” [54]. Narratives in
chloroquine derivatives. Although they are not social practice constructed in this transdisciplin-
approved treatments for COVID-19, notable ary way allow for various “points of entry” for
increases in inhalation exposures as well as discourse analysis as well as sociological, eco-
exposures to bleach products and alcohol-based nomic, political and cultural analysis. The three-
sanitisers are documented. In Madagascar, claims tiered framework, namely, the close textual and
of a herbal coronavirus “cure” produced from the linguistic analysis in the first level, the analysis of
Artemisia plant were also circulating, compelling discursive practices in the second level and the
the WHO to state that the tonic is not evidence- deep study of the social practice and sociocultural
based and is potentially toxic [52]. The WHO is phenomena in the third level [54], is eminent in
also trying to combat the political polarisation and the framing and examination of conspiracy
online misinformation that threaten to undermine theories.
COVID-19 vaccination programmes worldwide. As meanings move from text to text, they are
Indeed, multiple sources of health information altered and therefore become open to transforma-
may fuel vaccine hesitancy [53]. As access to tion. This gesticulation of meaning called “medi-
technology has improved, social media has ation” involves “the constant transformation of
attained global penetrance. Two lingering doubts meanings, both large scale and small, significant
in social media conspiracy theories about the and insignificant, as media texts and texts about
safety of the COVID vaccines are the speed media circulate in writing, in speech and audiovi-
with which they have been developed and sual forms, and as we, individually and collec-
approved and whether the mRNA vaccines may tively, directly and indirectly, contribute to their
alter DNA in some of the body’s organs. Despite production” [55]. Movement of meanings
22 M. Scerri and V. Grech

involves both continuity and change which are “Genres are regularly and predictably chained
both “contingent upon the nature of the events together such that meanings are moved and
and texts that mediated meanings move into” transformed along the chain, and recontextualised
[56]. Moreover, the possibility of transformation and transformed in regular ways in accordance
suggests that mediated meanings enter processes with recontextualising principles” [54]. In this
of meaning-making as part of the resources for case, accurate information about climate change,
meaning-making. Ultimately, these resources for vaccination programmes and COVID-19
meaning-making are both specific and general measures is lost or thwarted along the chain.
and concrete and abstract. Climate change and Therefore, understanding the semiotic principles
the coronavirus pandemic as specific events are of texts and how they are recontextualised to
surrounded by concrete representations regardless target specific groups is important for the scien-
of whether these representations are conspiracy tific and medical communities as it will help them
theories or evidence-based information. Indeed, to come up with effective strategies to counter
media texts are a “class of texts which are post-truth.
specialised for moving resources for meaning- Post-truth in science and medicine reflects the
making between texts, and more abstractly discursive struggle operating between misinfor-
between different social practices, fields, domains mation and the determination of truth.
and scales of social life” [56]. Fairclough’s conception of social practice based
Fairclough avers that social transformations in on a Marxist tradition is particularly relevant here.
life are extensively “discourse led” in the sense Fairclough sees the development of power
that it is discourses which change first. As new relations as a hegemonic struggle. He utilises the
discourses “enter and achieve salience or domi- terms “ideology” and “hegemony” as a way to
nance in particular social fields or domains and at theorise changes in power relations in society. For
different social scales, [. . .], or are recontex- Fairclough, hegemony is the power invested over
tualised within them, dialectical processes may a society as a whole; however, it is always par-
ensue in which discourses are enacted in ways tially attained and is more about winning consent
of acting” [54]. through ideological means rather than domina-
Social events (and texts) are shaped on the one tion. Discursive changes have their roots in tyran-
hand by social practices and social structures and nical struggles where uneven power relations are
on the other hand by social agents. Any social located [58]. Fairclough’s “understanding of ide-
media text has “causal effects on non-semiotic as ology focuses on the implicit and unconscious
well as semiotic elements of social life” [57]. It materialization of ideologies that are manifest in
figures in three main ways as part of events: in individual and collective life”. He uses
acting, representing and identifying. The writing Althusser’s concept of interpellation—the idea
(the text) is part of the action, while it simulta- that the individual internalises values and
neously represents aspects of the scientific world ideologies from the surrounding society and acts
(such as climate change, the pandemic and vacci- upon them—to explain how ideology constitutes
nation) and identifies other social actors (the gen- the subject [58].
eral public, patients and parents). As events do The two ideologies of a sustainable environ-
not exist independently but are “interconnected ment and good public health find resistance espe-
chains or, more loosely, networks which are in cially when interpellation comes from different
part chains or networks of texts” [54], participants ideological positions (such as misinformation
in chains or networks of events orient to ways of and conspiracy theories), and this leads to uncer-
chaining or networking which are parts of tainty and confusion causing discursive change to
networks of social practices, including, begin. The controversies surrounding climate
semiotically, what Fairclough calls “genre change, public trust in vaccines and the COVID-
chains” [54]. 19 pandemic are not only a power struggle
between the general public’s comprehension of
3 Indictment or Information Can Lie: Post-Truth in Science 23

facts and science’s factual knowledge. 4. Black J (1987) The English Press in the eighteenth
Disagreements in public between science and century. Routledge Revivals, London
5. Examples of fake news from history. The Social His-
medical experts over evidence-based facts have torian. https://www.thesocialhistorian.com/fake-news/
also created confusion. This has left the public . Accessed 8 Jan 2021
with difficult choices to make. The monopoly on 6. Foroughi H, Gabriel Y, Fotaki M (2019) Leadership in
truth which traditionally has been on the side of a post-truth era: a new narrative disorder? Leadership
15(2):135–151. https://doi.org/10.1177/
authorities backed up by a knowledgeable base 1742715019835369
has shifted and is now under pressure. 7. Wang Y, MA MK, Torbica D (2019) Stuckler system-
atic literature review on the spread of health-related
misinformation on social media. Soc Sci Med 240:
112552
3.5.1 New Channels and Messages 8. Gardner HE (2011) Leading minds: an anatomy of
leadership. Hachette, London
The scientific and medical communities are now 9. Pomerantsev P (2016) Why we’re post-fact. Granta
required to introduce new ways of communicat- Magazine. https://granta.com/why-were-post-fact/.
Accessed 22 Jan 2021
ing information to their populations and new 10. Knight E, Tsoukas H (2018) When fiction trumps
ways of adjusting to the mechanisms of public truth: what ‘post-truth’ and ‘alternative facts’ mean
decision-making. Authorities find their positions for management studies. Organ Stud 40:183–197
questioned in defining truth. Lay people are not 11. Gottfried J & Shearer E (2016) News use across social
medial platforms 2016. Pew Research Center http://
concerned or perhaps unaware of the intricate www.journalism.org/2016/05/26/news-use-across-
webs of social structures, relations of power and social-media-platforms-2016/. Accessed 17 Jan 2021
the nature of social practices. What is exceedingly 12. Orwell G (1949/1984) Secker & Warburg, London
worrying is that their practices leave an impact on 13. Orwell S & Angus I (1968) The collected essays,
journalism and letters of George Orwell; Volume 2:
the hegemonic struggles around them, which in my country right or left, 1940–1943 Secker and
turn create the perfect medium for conspiracy Warburg, London
theories to proliferate. Accurate and concise 14. Dale J (2020) What would nineteen eighty-four be like
knowledge sharing is therefore paramount in if it were written today? New Writing 17(1):19–30
15. Szalai J (2021) How Orwellian became an all-purpose
shaping the public attitudes whether it is about insult. The New York Times. https://www.nytimes.
measures needed to reduce the carbon footprint, com/2021/01/13/books/orwellian-1984.html.
attitudes towards vaccination or mitigation Accessed 12 Jan 2021
measures during a pandemic. Combating the 16. Lynskey D (2019) The ministry of truth. Doubleday,
New York
plenitude of misinformation generated on social 17. Arendt H (1951) The origins of totalitarianism. Merid-
media and the Internet is not an easy feat; how- ian Books, New York
ever, medical and scientific communities who are 18. Culliford E (2021) Online misinformation that led to
responsible for disseminating knowledge need to Capitol siege is ‘radicalization,’ say researchers.
Reuters https://www.reuters.com/article/us-misinfor
be cognizant of the power invested in discourse, if mation-socialmedia-idUSKBN29H2HM. Accessed
they are to counter-argue and reverse the adverse 18 Jan 2021
effects of conspiracy theories. 19. Menendez R (2020) The New Big Brother: China and
the new digital authoritarianism. A democratic staff
report prepared for the use of the committee on For-
eign Relations United States Senate. https://www.
References foreign.senate.gov/imo/media/doc/2020%20SFRC%
20Minority%20Staff%20Report%20-%20The%
1. Working to stop misinformation and false news (2020) 20New%20Big%20Brother%20-%20China%20and%
Facebook for media. https://www.facebook.com/ 20Digital%20Authoritarianism.pdf. Accessed
formedia/blog/working-to-stop-misinformation-and- 12 Jan 2021
false-news. Accessed 5 Jan 2021 20. McGregor R (2018) Xi Jinping’s ideological
2. Tesich S (1992) A government of lies. The ambitions. WSJ. https://www.wsj.com/articles/xi-
Nation:12–13 jinpings-ideological-ambitions-1519950245.
3. McIntyre L (2016) Post-truth. MIT Press, London Accessed 16 Jan 2021
24 M. Scerri and V. Grech

21. Mozur P (2019) One month, 500,000 face scans: How exposed-fueling-climate-denial-and-privatizing-
China is using A.I. to profile a minority. New York democracy/. Accessed on 16 Jan 2021
Times. https://www.nytimes.com/2019/04/14/technol 37. Fischer D (2013, December 23) Dark money’ funds
ogy/china-surveillance-artificial-intelligence-racial- climate change denial effort. Scientific American.
profiling.html. Accessed 19 Jan 2021 https://www.scientificamerican.com/article/dark-
22. Wang M (2019) China’s algorithms of repression: money-funds-climate-change-denial-effort/. Accessed
reverse engineering a Xinjiang Police Mass Surveil- 16 Jan 2021
lance App. Human Rights Watch. https://www.hrw. 38. Howard BC (2014, July 3) Data deleted from UN
org/video-photos/interactive/2019/05/02/china-how- climate report highlight controversies. Nat Geo.
mass-surveillance-works-xinjiang#:~:text¼The% https://www.nationalgeographic.com/news/2014/7/
20Human%20Rights%20Watch%20report,of%20its 140703-ipcc-climate-report-deleted-data-global-
%20%E2%80%9CStrike%20Hard%20Campaign. warming-science/. Accessed 18 Jan 2021
Accessed 18 Jan 2021 39. Cohen GL (2003) Party over policy: the dominating
23. Pham S (2017) China adds Pinterest to list of banned impact of group influence on political beliefs. J Pers So
sites. CNN. https://money.cnn.com/2017/03/17/tech Psych 85(5):808–822
nology/pinterest-banned-china/. Accessed 16 Jan 2021 40. Lewandowsky S, Gignac GE, Oberauer K (2013) The
24. Grech V (2011) Infertility in science fiction [disserta- role of conspiracist ideation and worldviews in
tion]. University of Malta predicting rejection of science. PLoS One 10(8):
25. Grech V (2017) Fake news and post-truth e75637
pronouncements in general and in early human devel- 41. Jacobson RM, Targonski PV, Poland GA (2007) A
opment. EHD 115:118–120 taxonomy of reasoning flaws in the anti-vaccine move-
26. Norris SP (1995) Learning to live with scientific exper- ment. Vaccine 25(16):3146–3152
tise - toward a theory of intellectual communalism for 42. Health Protection Agency (2008) Measles figures soar.
guiding science teaching. Sci Ed 79(2):201–217. The Guardian https://www.theguardian.com/society/
https://doi.org/10.1002/sce.3730790206 2008/feb/22/health. Accessed 20 Jan 2021
27. Van Der Linden S, Leiserowitz A, Maibach EW 43. Burgess DC, Burgess MA, Leask J (2006) The MMR
(2017) Scientific agreement can neutralize politiciza- vaccination and autism controversy in United King-
tion of facts. Nat Hum Behav 2:2–3 dom 1998–2005: inevitable community outrage or a
28. Gelbspan R (2005) Disinformation, financial failure of risk communication? Vaccine 24:3921–3928
pressures, and misplaced balance. Nieman Reports, 44. Kata A (2012) Anti-vaccine activists, Web 2.0, and the
pp 77–79 postmodern paradigm - an overview of tactics and
29. Antilla L (2005) Climate of skepticism: US newspaper tropes used online by the anti-vaccination movement.
coverage of the science of climate change. Global Env Vaccine 30:3778–3789
Change 15:338–352 45. Aquino F, Donzelli G, De Franco E, Privitera G,
30. Boykoff M (2010) U.S. climate coverage in the ‘00s. Lopalco PL, Carducci A (2017) The web and public
extra!. http://fair.org/extra-online-articles/u-s-climate- confidence in MMR vaccination in Italy. Vaccine 35:
coverage-in-the-00s/. Accessed 25 Jan 2021 4494–4498
31. Boykoff M, Boykoff J (2004) Balance as bias: global 46. Keelan J, Pavri-Garcia V, Tomlinson G, Wilson K
warming and the U.S. prestige press. Global Env (2007) YouTube as a source of information on immu-
Change 14:125–136 nization: a content analysis. JAMA 298:2482–2484
32. Block B (2010) Covering climate change. World 47. Stein RA (2017) The golden age of anti-vaccine con-
Watch 23.2. http://www.worldwatch.org/node/6373. spiracies. Germs 7(4):168–170. https://doi.org/10.
Accessed 25 Jan 2021 18683/germs.2017.1122
33. Douglas KM, Sutton RM (2015) Climate change: why 48. Debiec J (2020) Fear can spread from person to person
the conspiracy theories are dangerous. Bull At Sc faster than the coronavirus – but there are ways to slow
71(2):98–106. https://doi.org/10.1177/ it down. The Conversation https://theconversation.
0096340215571908 com/fear-can-spread-from-person-to-person-faster-
34. Wohl MJA, Branscombe NR, Reysen S (2010) Per- than-the-coronavirus-but-there-are-ways-to-slow-it-
ceiving your group’s future to be in jeopardy: extinc- down-133129. Accessed on 18 Jan 2021
tion threat induces collective angst and the desire to 49. Taylor S (2019) The psychology of pandemics: pre-
strengthen the in group. Per Soc Psych Bull 36(7): paring for the next global outbreak of infectious dis-
898–910 ease. Cambridge Scholars, Cambridge
35. FeyginaI JT, Goldsmith RE (2010) System justifica- 50. Harsin J (2020) Toxic white masculinity, post-truth
tion, the denial of global warming, and the possibility politics and the COVID-19 infodemic. Eur J Cul Stud-
of ‘system-sanctioned change’. Pers Soc Psych Bull ies 10:1177
36(3):326–338 51. Berlatsky N (2020) Michigan gunmen stormed the
36. Gibson C (2012) Koch brothers exposed: fueling cli- statehouse and proved these protests have never really
mate denial and privatizing democracy. Greenpeace been about coronavirus. The Independent. https://
https://www.greenpeace.org/usa/koch-brothers- www.independent.co.uk/voices/michigan-gunmen-
3 Indictment or Information Can Lie: Post-Truth in Science 25

statehouse-coronavirus-protests-trump-working-peo 55. Silverstone R (1999) Why study the media? Sage,

ple-a9494336.html. Accessed 20 Jan 2021 London
52. Coronavirus: caution urged over Madagascar’s ‘herbal 56. Lassen I, Strunch J, Vestergaard T (2006) Mediating
cure’ (2020) BBC News. https://www.bbc.com/news/ ideology in text and image: 10 critical studies. John
world-africa-52374250. Accessed 16 Jan 2021 Benjamins Publishing Co., Amsterdam
53. Vaccine confidence volatile, vulnerable to misinfor- 57. Fairclough N & Jessop B (2010) Critical realism and
mation (2020) The Straits Times. https://www. semiosis. Research Gate https://www.researchgate.net/
straitstimes.com/world/vaccine-confidence-volatile- publication/313037147_Critical_realism_and_semio
vulnerable-to-misinformation. Accessed 16 Jan 2021 sis. Accessed 25 Jan 2021
54. Fairclough N (2013) Critical discourse analysis: the 58. Fairclough N (1992) Discourse and social change.
critical study of language. Taylor and Francis, Polity Press, Cambridge
New York
 Legislation on Research Misconduct:
Rationales and Reflections—A Swedish 4
Perspective

Kjell Asplund

Abstract 4.1 Introduction: The

Prompted by the Macchiarini research fraud Macchiarini Case
case, an Act on Research Misconduct was
introduced in Sweden in January 2020. In Few scientists have had such a direct impact on
accordance with international convention, it Swedish legislation as the thoracic surgeon Paolo
defines unlawful research misconduct as Macchiarini. His scientific fraud prompted an Act
“. . .severe deviation from good research prac- on Research Misconduct covering not only medi-
tice in the form of fabrication, falsification or cal but all types of academic research. As a back-
plagiarism.” To qualify as severe, the miscon- ground to the Swedish regulation on research
duct must be either intentional or caused by misconduct, I will, throughout the chapter, return
serious neglect. Universities are obliged to to his story to illustrate why an Act on Research
report suspected cases for investigation by a Misconduct was regarded as necessary.
newly established governmental agency. The In comparison with other major research
Act does not include regulation of penalties or frauds, Macchiarini did not stand out in terms of
sanctions. The expected consequences of the number of articles retracted because of research
Act and its limitations are discussed. The cru- misconduct. But few other affairs have comprised
cial roles of universities and scientific journals such a stress test for large organizations.
in the prevention of misconduct remain, and In 2010, Paolo Macchiarini was appointed at
improved European legislation to protect the Karolinska Institute as guest professor and to
whistleblowers is described. Future directions the Karolinska University Hospital as consultant
in the struggle against research misconduct [6]. He had an international background with
include use of technical advances to detect research in Paris and London, and he had been
data and image manipulation. working as a thoracic surgeon in Florence,
Barcelona, and Hannover. During his work in
Barcelona, he was the first in the world to perform
transplantation of a cadaver trachea. This
Information in this chapter was modified from the author’s
achievement reported in The Lancet in 2008
Swedish popular science book—Kjell Asplund (2021)
Fuskarna: Om Macchiarinis och andras svek mot received worldwide attention. The intervention
vetenskapen (The frauds: On the betrayal of science by was described as bold and innovative, actually
Macchiarini and others). Fri Tanke, Stockholm, Sweden visionary—a new, intriguing possibility to treat
patients with advanced tumors and other severe
K. Asplund (*)
Department of Public Health and Clinical Medicine, Umeå tracheal diseases. During the twentieth century,
University, Umeå, Sweden several legendary surgeons had worked with
# The Author(s), under exclusive license to Springer Nature Switzerland AG 2022 27
J. Faintuch, S. Faintuch (eds.), Integrity of Scientific Research,
https://doi.org/10.1007/978-3-030-99680-2_4
Another random document with
no related content on Scribd:
Magasin de Blanc—blankets craftily dyed to match any bedroom; of
fine linen, and other expensive things, including the copper batterie de
cuisine, which latter, however, was left to Puddle. At last the army of
workmen departed, its place being taken by a Breton ménage—
brown-faced folk, strong-limbed and capable looking—a mother, father
and daughter. Pierre, the butler, had been a fisherman once, but the
sea with its hardships had prematurely aged him. He had now been in
service for several years, having contracted rheumatic fever which had
weakened his heart and made him unfit for the strenuous life of a
fisher. Pauline, his wife, was considerably younger, and she it was
who would reign in the kitchen, while their daughter Adèle, a girl of
eighteen, would help both her parents and look after the housework.
Adèle was as happy as a blackbird in springtime; she would often
seem just on the verge of chirping. But Pauline had stood and
watched the great storms gather over the sea while her men were out
fishing; her father had lost his life through the sea as had also a
brother, so Pauline smiled seldom. Dour she was, with a predilection
for dwelling in detail on people’s misfortunes. As for Pierre, he was
stolid, kind and pious, with the eyes of a man who has looked on vast
spaces. His grey stubbly hair was cut short to his head en brosse, and
he had an ungainly figure. When he walked he straddled a little as
though he could never believe in a house without motion. He liked
Stephen at once, which was very propitious, for one cannot buy the
good-will of a Breton.
Thus gradually chaos gave place to order, and on the morning of
her twenty-seventh birthday, on Christmas Eve, Stephen moved into
her home in the Rue Jacob on the old Rive Gauche, there to start her
new life in Paris.

All alone in the brown and white salle à manger, Stephen and
Puddle ate their Christmas dinner. And Puddle had bought a small
Christmas tree and had trimmed it, then hung it with coloured candles.
A little wax Christ-child bent downwards and sideways from His
branch, as though He were looking for His presents—only now there
were not any presents. Rather clumsily Stephen lit the candles as
soon as the daylight had almost faded. Then she and Puddle stood
and stared at the tree, but in silence, because they must both
remember. But Pierre, who like all who have known the sea, was a
child at heart, broke into loud exclamations. ‘Oh, comme c’est beau,
l’arbre de Noël!’ he exclaimed, and he fetched the dour Pauline along
from the kitchen, and she too exclaimed; then they both fetched Adèle
and they all three exclaimed: ‘Comme c’est beau, l’arbre de Noël!’ So,
that after all the little wax Christ-child did not very much miss His
presents.
That evening Pauline’s two brothers arrived—they were Poilus
stationed just outside Paris—and they brought along with them
another young man, one Jean, who was ardently courting Adèle. Very
soon came the sound of singing and laughter from the kitchen, and
when Stephen went up to her bedroom to look for a book, there was
Adèle quite flushed and with very bright eyes because of this Jean—in
great haste she turned down the bed and then flew on the wings of
love back to the kitchen.
But Stephen went slowly downstairs to her study where Puddle
was sitting in front of the fire, and she thought that Puddle sat there as
though tired; her hands were quite idle, and after a moment Stephen
noticed that she was dozing. Very quietly Stephen opened her book,
unwilling to rouse the little grey woman who looked so small in the
huge leather chair, and whose head kept guiltily nodding. But the book
seemed scarcely worth troubling to read, so that presently Stephen
laid it aside and sat staring into the flickering logs that hummed and
burnt blue because it was frosty. On the Malvern Hills there would
probably be snow; deep snow might be capping the Worcestershire
Beacon. The air up at British Camp would be sweet with the smell of
winter and open spaces—little lights would be glinting far down in the
valley. At Morton the lakes would be still and frozen, so Peter the swan
would be feeling friendly—in winter he had always fed from her hand
—he must be old now, the swan called Peter. Coup! C-o-u-p! and
Peter waddling towards her. He, who was all gliding grace on the
water, would come awkwardly waddling towards her hand for the
chunk of dry bread that she held in her fingers. Jean with his Adèle
along in the kitchen—a nice-looking boy he was, Stephen had seen
him—they were young, and both were exceedingly happy, for their
parents approved, so some day they would marry. Then children
would come, too many, no doubt, for Jean’s slender purse, and yet in
this life one must pay for one’s pleasures—they would pay with their
children, and this appeared perfectly fair to Stephen. She thought that
it seemed a long time ago since she herself had been a small child,
romping about on the floor with her father, bothering Williams down at
the stables, dressing up as young Nelson and posing for Collins who
had sometimes been cross to young Nelson. She was nearly thirty,
and what had she done? Written one good novel and one very bad
one, with few mediocre short stories thrown in. Oh, well, she was
going to start writing again quite soon—she had an idea for a novel.
But she sighed, and Puddle woke up with a start.
‘Is that you, my dear? Have I been asleep?’
‘Only for a very few minutes, Puddle.’
Puddle glanced at the new gold watch on her wrist; it had been a
Christmas present from Stephen. ‘It’s past ten o’clock—I think I’ll turn
in.’
‘Do. Why not? I hope Adèle’s filled your hot water bottle; she’s
rather light-headed over her Jean.’
‘Never mind, I can fill it myself,’ smiled Puddle.
She went, and Stephen sat on by the fire with her eyes half closed
and her lips set firmly. She must put away all these thoughts of the
past and compel herself to think of the future. This brooding over
things that were past was all wrong; it was futile, weak-kneed and
morbid. She had her work, work that cried out to be done, but no more
unworthy books must be written. She must show that being the thing
she was, she could climb to success over all opposition, could climb to
success in spite of a world that was trying its best to get her under.
Her mouth grew hard; her sensitive lips that belonged by rights to the
dreamer, the lover, took on a resentful and bitter line which changed
her whole face and made it less comely. At that moment the striking
likeness of her father appeared to have faded out of her face.
Yes, it was trying to get her under, this world with its mighty self-
satisfaction, with its smug rules of conduct, all made to be broken by
those who strutted and preened themselves on being what they
considered normal. They trod on the necks of those thousands of
others who, for God knew what reason, were not made as they were;
they prided themselves on their indignation, on what they proclaimed
as their righteous judgments. They sinned grossly; even vilely at
times, like lustful beasts—but yet they were normal! And the vilest of
them could point a finger of scorn at her, and be loudly applauded.
‘God damn them to hell!’ she muttered.
Along in the kitchen there was singing again. The young men’s
voices rose tuneful and happy, and with them blended Adèle’s young
voice, very sexless as yet, like the voice of a choirboy. Stephen got up
and opened the door, then she stood quite still and listened intently.
The singing soothed her over-strained nerves as it flowed from the
hearts of these simple people. For she did not begrudge them their
happiness; she did not resent young Jean with his Adèle, or Pierre
who had done a man’s work in his time, or Pauline who was often
aggressively female. Bitter she had grown in these years since
Morton, but not bitter enough to resent the simple. And then as she
listened they suddenly stopped for a little before they resumed their
singing, and when they resumed it the tune was sad with the sadness
that dwells in the souls of most men, above all in the patient soul of
the peasant.
 ‘Mais comment ferez vous, l’Abbé,
Ma Doué?’

She could hear the soft Breton words quite clearly.

‘Mais comment ferez vous, l’Abbé,
Pour nous dire la Messe?’
‘Quand la nuit sera bien tombée
Je tiendrai ma promesse.’

‘Mais comment ferez vous, l’Abbé,

Ma Doué,
Mais comment ferez vous, l’Abbé,
Sans nappe de fine toile?’
‘Notre Doux Seigneur poserai
Sur un morceau de voile.’

‘Mais comment ferez vous, l’Abbé,

Ma Doué,
Mais comment ferez vous, l’Abbé,
Sans chandelle et sans cierge?’
‘Les astres seront allumés
Par Madame la Vierge.’

‘Mais comment ferez vous, l’Abbé,

Ma Doué,
Mais comment ferez vous, l’Abbé,
Sans orgue résonnante?’
‘Jésus touchera le clavier
Des vagues mugissantes.’

‘Mais comment ferez vous, l’Abbé,

Ma Doué,
Mais comment ferez vous, l’Abbé,
Si l’Ennemi nous trouble?’
‘Une seule fois je vous bénirai,
Les Bleus bénirai double!’
Closing the study door behind her, Stephen thoughtfully climbed the
stairs to her bedroom.

CHAPTER 33

W ith the New Year came flowers from Valérie Seymour, and a
little letter of New Year’s greeting. Then she paid a rather
ceremonious call and was entertained by Puddle and Stephen.
Before leaving she invited them both to luncheon, but Stephen
refused on the plea of her work.
‘I’m hard at it again.’
At this Valérie smiled. ‘Very well then, à bientôt. You know where
to find me, ring up when you’re free, which I hope will be soon.’ After
which she took her departure.
But Stephen was not to see her again for a very considerable
time, as it happened. Valérie was also a busy woman—there are
other affairs beside the writing of novels.
Brockett was in London on account of his plays. He wrote
seldom, though when he did so he was cordial, affectionate even;
but now he was busy with success, and with gathering in the
shekels. He had not lost interest in Stephen again, only just at the
moment she did not fit in with his brilliant and affluent scheme of
existence.
So once more she and Puddle settled down together to a life that
was strangely devoid of people, a life of almost complete isolation,
and Puddle could not make up her mind whether she felt relieved or
regretful. For herself she cared nothing, her anxious thoughts were
as always centred in Stephen. However, Stephen appeared quite
contented—she was launched on her book and was pleased with her
writing. Paris inspired her to do good work, and as recreation she
now had her fencing—twice every week she now fenced with
Buisson, that severe but incomparable master.
 Buisson had been very rude at first: ‘Hideous, affreux,
horriblement English!’ he had shouted, quite outraged by Stephen’s
style. All the same he took a great interest in her. ‘You write books;
what a pity! I could make you a fine fencer. You have the man’s
muscles, and the long, graceful lunge when you do not remember
that you are a Briton and become—what you say? ah, mais oui, self-
conscious. I wish that I had find you out sooner—however, your
muscles are young still, pliant.’ And one day he said: ‘Let me feel the
muscles,’ then proceeded to pass his hand down her thighs and
across her strong loins: ‘Tiens, tiens!’ he murmured.
After this he would sometimes look at her gravely with a puzzled
expression; but she did not resent him, nor his rudeness, nor his
technical interest in her muscles. Indeed, she liked the cross little
man with his bristling black beard and his peppery temper, and when
he remarked à propos of nothing: ‘We are all great imbeciles about
nature. We make our own rules and call them la nature; we say she
do this, she do that—imbeciles! She do what she please and then
make the long nose.’ Stephen felt neither shy nor resentful.
These lessons were a great relaxation from work, and thanks to
them her health grew much better. Her body, accustomed to severe
exercise, had resented the sedentary life in London. Now, however,
she began to take care of her health, walking for a couple of hours in
the Bois every day, or exploring the tall, narrow streets that lay near
her home in the Quarter. The sky would look bright at the end of
such streets by contrast, as though it were seen through a tunnel.
Sometimes she would stand gazing into the shops of the wider and
more prosperous Rue des Saints Pères; the old furniture shops; the
crucifix shop with its dozens of crucified Christs in the window—so
many crucified ivory Christs! She would think that one must surely
exist for every sin committed in Paris. Or perhaps she would make
her way over the river, crossing by the Pont des Arts. And one
morning, arrived at the Rue des Petits Champs, what must she
suddenly do but discover the Passage Choiseul, by just stepping
inside for shelter, because it had started raining.
Oh, the lure of the Passage Choiseul, the queer, rather gawky
attraction of it. Surely the most hideous place in all Paris, with its roof
of stark wooden ribs and glass panes—the roof that looks like the
vertebral column of some prehistoric monster. The chocolate smell of
the patisserie—the big one where people go who have money. The
humbler, student smell of Lavrut, where one’s grey rubber bands are
sold by the gramme and are known as: ‘Bracelets de caoutchouc.’
Where one buys première qualité blotting paper of a deep ruddy tint
and the stiffness of cardboard, and thin but inspiring manuscript
books bound in black, with mottled, shiny blue borders. Where
pencils and pens are found in their legions, of all makes, all shapes,
all colours, all prices; while outside on the trustful trays in the
Passage, lives Gomme Onyx, masquerading as marble, and as likely
to rub a hole in your paper. For those who prefer the reading of
books to the writing of them, there is always Lemerre with his
splendid display of yellow bindings. And for those undisturbed by
imagination, the taxidermist’s shop is quite near the corner—they
can stare at a sad and moth-eaten flamingo, two squirrels, three
parrots and a dusty canary. Some are tempted by the cheap
corduroy at the draper’s, where it stands in great rolls as though it
were carpet. Some pass on to the little stamp merchant, while a few
dauntless souls even enter the chemist’s—that shamelessly
anatomical chemist’s, whose wares do not figure in school manuals
on the practical uses of rubber.
And up and down this Passage Choiseul, pass innumerable idle
or busy people, bringing in mud and rain in the winter, bringing in
dust and heat in the summer, bringing in God knows how many
thoughts, some part of which cannot escape with their owners. The
very air of the Passage seems heavy with all these imprisoned
thoughts.
Stephen’s thoughts got themselves entrapped with the others,
but hers, at the moment, were those of a schoolgirl, for her eye had
suddenly lit on Lavrut, drawn thereto by the trays of ornate india-
rubber. And once inside, she could not resist the ‘Bracelets de
caoutchouc,’ or the blotting paper as red as a rose, or the manuscript
books with the mottled blue borders. Growing reckless, she gave an
enormous order for the simple reason that these things looked
different. In the end she actually carried away one of those inspiring
manuscript books, and then got herself driven home by a taxi, in
order the sooner to fill it.

That spring, in the foyer of the Comédie Francaise, Stephen

stumbled across a link with the past in the person of a middle-aged
woman. The woman was stout and wore pince-nez; her sparse
brown hair was already greying; her face, which was long, had a
double chin, and that face seemed vaguely familiar to Stephen. Then
suddenly Stephen’s two hands were seized and held fast in those of
the middle-aged woman, while a voice grown loud with delight and
emotion was saying:
‘Mais oui, c’est ma petite Stévenne!’
Back came a picture of the schoolroom at Morton, with a battered
red book on its ink-stained table—the Bibliothèque Rose—‘Les
Petites Filles Modèles,’ ‘Les Bons Enfants,’ and Mademoiselle
Duphot.
Stephen said: ‘To think—after all these years!’
‘Ah, quelle joie! Quelle joie!’ babbled Mademoiselle Duphot.
And now Stephen was being embraced on both cheeks, then
held at arm’s length for a better inspection. ‘But how tall, how strong
you are, ma petite Stévenne. You remember what I say, that we
meet in Paris? I say when I go, “But you come to Paris when you
grow up bigger, my poor little baby!” I keep looking and looking, but I
knowed you at once. I say, “Oui certainement, that is ma petite
Stévenne, no one ’ave such another face what I love, it could only
belong to Stévenne,” I say. And now voilà! I am correct and I find
you.’
Stephen released herself firmly but gently, replying in French to
calm Mademoiselle, whose linguistic struggles increased every
moment.
‘I’m living in Paris altogether,’ she told her; ‘you must come and
see me—come to dinner to-morrow; 35, Rue Jacob.’ Then she
introduced Puddle who had been an amused spectator.
The two ex-guardians of Stephen’s young mind shook hands with
each other very politely, and they made such a strangely contrasted
couple that Stephen must smile to see them together. The one was
so small, so quiet and so English; the other so portly, so tearful, so
French in her generous, if somewhat embarrassing emotion.
As Mademoiselle regained her composure, Stephen was able to
observe her more closely, and she saw that her face was
excessively childish—a fact which she, when a child, had not
noticed. It was more the face of a foal than a horse—an innocent,
new-born foal.
Mademoiselle said rather wistfully: ‘I will dine with much pleasure
to-morrow evening, but when will you come and see me in my
home? It is in the Avenue de la Grande Armée, a small apartment,
very small but so pretty—it is pleasant to have one’s treasures
around one. The bon Dieu has been very good to me, Stévenne, for
my Aunt Clothilde left me a little money when she died; it has proved
a great consolation.’
‘I’ll come very soon,’ promised Stephen.
Then Mademoiselle spoke at great length of her aunt, and of
Maman who had also passed on into glory; Maman, who had had
her chicken on Sunday right up to the very last moment, Dieu merci!
Even when her teeth had grown loose in the gums, Maman had
asked for her chicken on Sunday. But alas, the poor sister who once
made little bags out of beads for the shops in the Rue de la Paix,
and who had such a cruel and improvident husband—the poor sister
had now become totally blind, and therefore dependent on
Mademoiselle Duphot. So after all Mademoiselle Duphot still worked,
giving lessons in French to the resident English; and sometimes she
taught the American children who were visiting Paris with their
parents. But then it was really far better to work; one might grow too
fat if one remained idle.
She beamed at Stephen with her gentle brown eyes. ‘They are
not as you were, ma chère petite Stévenne, not clever and full of
intelligence, no; and at times I almost despair of their accent.
However, I am not at all to be pitied, thanks to Aunt Clothilde and the
good little saints who surely inspired her to leave me that money.’
When Stephen and Puddle returned to their stalls, Mademoiselle
climbed to a humbler seat somewhere under the roof, and as she
departed she waved her plump hand at Stephen.
Stephen said: ‘She’s so changed that I didn’t know her just at
first, or else perhaps I’d forgotten. I felt terribly guilty, because after
you came I don’t think I ever answered her letters. It’s thirteen years
since she left. . . .’
Puddle nodded. ‘Yes, it’s thirteen years since I took her place and
forced you to tidy that abominable schoolroom!’ And she laughed.
‘All the same, I like her,’ said Puddle.

Mademoiselle Duphot admired the house in the Rue Jacob, and

she ate very largely of the rich and excellent dinner. Quite regardless
of her increasing proportions, she seemed drawn to all those things
that were fattening.
‘I cannot resist,’ she remarked with a smile, as she reached for
her fifth marron glacé.
They talked of Paris, of its beauty, its charm. Then Mademoiselle
spoke yet again of her Maman and of Aunt Clothilde who had left
them the money, and of Julie, her blind sister.
But after the meal she quite suddenly blushed. ‘Oh, Stévenne, I
have never inquired for your parents! What must you think of such
great impoliteness? I lose my head the moment I see you and grow
selfish—I want you to know about me and my Maman; I babble
about my affairs. What must you think of such great impoliteness?
How is that kind and handsome Sir Philip? And your mother, my
dear, how is Lady Anna?’
And now it was Stephen’s turn to grow red. ‘My father died. . . .’
She hesitated, then finished abruptly, ‘I don’t live with my mother any
more, I don’t live at Morton.’
Mademoiselle gasped. ‘You no longer live . . .’ she began, then
something in Stephen’s face warned her kind but bewildered guest
not to question. ‘I am deeply grieved to hear of your father’s death,
my dear,’ she said very gently.
Stephen answered: ‘Yes—I shall always miss him.’
There ensued a long, rather painful silence, during which
Mademoiselle Duphot felt awkward. What had happened between
the mother and daughter? It was all very strange, very disconcerting.
And Stephen, why was she exiled from Morton? But Mademoiselle
could not cope with these problems, she knew only that she wanted
Stephen to be happy, and her kind brown eyes grew anxious, for she
did not feel certain that Stephen was happy. Yet she dared not ask
for an explanation, so instead she clumsily changed the subject.
‘When will you both come to tea with me, Stévenne?’
‘We’ll come to-morrow if you like.’ Stephen told her.
Mademoiselle Duphot left rather early; and all the way home to
her apartment her mind felt exercised about Stephen.
She thought: ‘She was always a strange little child, but so dear. I
remember her when she was little, riding her pony astride like a boy;
and how proud he would seem, that handsome Sir Philip—they
would look more like father and son, those two. And now—is she not
still a little bit strange?’
But these thoughts led her nowhere, for Mademoiselle Duphot
was quite unacquainted with the bypaths of nature. Her innocent
mind was untutored and trustful; she believed in the legend of Adam
and Eve, and no careless mistakes had been made in their garden!

The apartment in the Avenue de la Grande Armée was as tidy as

Valérie’s had been untidy. From the miniature kitchen to the
miniature salon, everything shone as though recently polished, for
here in spite of restricted finances, no dust was allowed to harbour.
Mademoiselle Duphot beamed on her guests as she herself
opened the door to admit them. ‘For me this is very real joy,’ she
declared. Then she introduced them to her sister Julie, whose eyes
were hidden behind dark glasses.
The salon was literally stuffed with what Mademoiselle had
described as her ‘treasures.’ On its tables were innumerable useless
objects which appeared for the most part, to be mementoes.
Coloured prints of Bouguereaus hung on the walls, while the chairs
were upholstered in a species of velvet so hard as to be rather
slippery to sit on, yet that when it was touched felt rough to the
fingers. The woodwork of these inhospitable chairs had been coated
with varnish until it looked sticky. Over the little inadequate fireplace
smiled a portrait of Maman when she was quite young. Maman,
dressed in tartan for some strange reason, but in tartan that had
never hob-nobbed with the Highlands—a present this portrait had
been from a cousin who had wished to become an artist.
Julie extended a white, groping hand. She was like her sister only
very much thinner, and her face had the closed rather blank
expression that is sometimes associated with blindness.
‘Which is Stévenne?’ she inquired in an anxious voice; ‘I have
heard so much about Stévenne!’
Stephen said: ‘Here I am,’ and she grasped the hand, pitiful of
this woman’s affliction.
But Julie smiled broadly. ‘Yes, I know it is you from the feel,’—she
had started to stroke Stephen’s coat-sleeve—‘my eyes have gone
into my fingers these days. It is strange, but I seem to see through
my fingers.’ Then she turned and found Puddle whom she also
stroked. ‘And now I know both of you,’ declared Julie.
The tea when it came was that straw-coloured liquid which may
even now be met with in Paris.
‘English tea bought especially for you, my Stévenne,’ remarked
Mademoiselle proudly. ‘We drink only coffee, but I said to my sister,
Stévenne likes the good tea, and so, no doubt, does Mademoiselle
Puddle. At four o’clock they will not want coffee—you observe how
well I remember your England!’
However, the cakes proved worthy of France, and Mademoiselle
ate them as though she enjoyed them. Julie ate very little and did not
talk much. She just sat there and listened, quietly smiling; and while
she listened she crocheted lace as though, as she said, she could
see through her fingers. Then Mademoiselle Duphot explained how it
was that those delicate hands had become so skilful, replacing the
eyes which their ceaseless labour had robbed of the blessèd
privilege of sight—explained so simply yet with such conviction, that
Stephen must marvel to hear her.
‘It is all our little Thérèse,’ she told Stephen. ‘You have heard of
her? No? Ah, but what a pity! Our Thérèse was a nun at the Carmel
at Lisieux, and she said: “I will let fall a shower of roses when I die.”
She died not so long ago, but already her Cause has been
presented at Rome by the Very Reverend Father Rodrigo! That is
very wonderful, is it not, Stévenne? But she does not wait to become
a saint; ah, but no, she is young and therefore impatient. She cannot
wait, she has started already to do miracles for all those who ask
her. I asked that Julie should not be unhappy through the loss of her
eyes—for when she is idle she is always unhappy—so our little
Thérèse has put a pair of new eyes in her fingers.’
Julie nodded. ‘It is true,’ she said very gravely; ‘before that I was
stupid because of my blindness. Everything felt very strange, and I
stumbled about like an old blind horse. I was terribly stupid, far more
so than many. Then one night Véronique asked Thérèse to help me,
and the next day I could find my way round our room. From then on
my fingers saw what they touched, and now I can even make lace
quite well because of this sight in my fingers.’ Then turning to the
smiling Mademoiselle Duphot: ‘But why do you not show her picture
to Stévenne?’
So Mademoiselle Duphot went and fetched the small picture of
Thérèse, which Stephen duly examined, and the face that she saw
was ridiculously youthful—round with youth it still was, and yet very
determined. Sœur Thérèse looked as though if she really intended to
become a saint, the devil himself would be hard put to it to stop her.
Then Puddle must also examine the picture, while Stephen was
shown some relics, a piece of the habit and other things such as
collect in the wake of sainthood.
When they left, Julie asked them to come again; she said: ‘Come
often, it will give us such pleasure.’ Then she thrust on her guests
twelve yards of coarse lace which neither of them liked to offer to
pay for.
Mademoiselle murmured: ‘Our home is so humble for Stévenne;
we have very little to offer.’ She was thinking of the house in the Rue
Jacob, a grand house, and then too she remembered Morton.
But Julie, with the strange insight of the blind, or perhaps
because of those eyes in her fingers, answered quickly: ‘She will not
care, Véronique, I cannot feel that sort of pride in your Stévenne.’

After their first visit they went very often to Mademoiselle’s modest
little apartment. Mademoiselle Duphot and her quiet blind sister were
indeed their only friends now in Paris, for Brockett was in America on
business, and Stephen had not rung up Valérie Seymour.
Sometimes when Stephen was busy with her work, Puddle would
make her way there all alone. Then she and Mademoiselle would get
talking about Stephen’s childhood, about her future, but guardedly,
for Puddle must be careful to give nothing away to the kind, simple
woman. As for Mademoiselle, she too must be careful to accept all
and ask no questions. Yet in spite of the inevitable gaps and
restraints, a real sympathy sprang up between them, for each
sensed in the other a valuable ally who would fight a good fight on
behalf of Stephen. And now Stephen would quite often send her car
to take the blind Julie for a drive beyond Paris. Julie would sniff the
air and tell Burton that through smelling their greenness she could
see the trees; he would listen to her broken and halting English with
a smile—they were a queer lot these French. Or perhaps he would
drive the other Mademoiselle up to Montmartre for early Mass on a
Sunday. She belonged to something to do with a heart; it all seemed
rather uncanny to Burton. He thought of the Vicar who had played
such fine cricket, and suddenly felt very homesick for Morton. Fruit
would find its way to the little apartment, together with cakes and
large marrons glacés. Then Mademoiselle Duphot would become
frankly greedy, eating sweets in bed while she studied her booklets
on the holy and very austere Thérèse, who had certainly not eaten
marrons glacés.
Thus the spring, that gentle yet fateful spring of 1914, slipped into
the summer. With the budding of flowers and the singing of birds it
slipped quietly on towards great disaster; while Stephen, whose
book was now nearing completion, worked harder than ever in Paris.

CHAPTER 34

W ar. The incredible yet long predicted had come to pass.

People woke in the mornings with a sense of disaster, but
these were the old who, having known war, remembered. The young
men of France, of Germany, of Russia, of the whole world, looked
round them amazed and bewildered; yet with something that stung
as it leapt in their veins, filling them with a strange excitement—the
bitter and ruthless potion of war that spurred and lashed at their
manhood.
They hurried through the streets of Paris, these young men; they
collected in bars and cafés; they stood gaping at the ominous
government placards summoning their youth and strength to the
colours.
They talked fast, very fast, they gesticulated: ‘C’est la guerre!
C’est la guerre!’ they kept repeating.
Then they answered each other: ‘Oui, c’est la guerre.’
 And true to her traditions the beautiful city sought to hide stark
ugliness under beauty, and she decked herself as though for a
wedding; her flags streamed out on the breeze in their thousands.
With the paraphernalia and pageantry of glory she sought to disguise
the true meaning of war.
But where children had been playing a few days before, troops
were now encamped along the Champs Elysées. Their horses
nibbled the bark from the trees and pawed at the earth, making little
hollows; they neighed to each other in the watches of the night, as
though in some fearful anticipation. In bystreets the unreasoning
spirit of war broke loose in angry and futile actions; shops were
raided because of their German names and their wares hurled out to
lie in the gutters. Around every street corner some imaginary spy
must be lurking, until people tilted at shadows.
‘C’est la guerre,’ murmured women, thinking of their sons.
Then they answered each other: ‘Oui, c’est la guerre.’
Pierre said to Stephen: ‘They will not take me because of my
heart!’ And his voice shook with anger, and the anger brought tears
which actually splashed the jaunty stripes of his livery waistcoat.
Pauline said: ‘I gave my father to the sea and my eldest brother. I
have still two young brothers, they alone are left and I give them to
France. Bon Dieu! It is terrible being a woman, one gives all!’ But
Stephen knew from her voice that Pauline felt proud of being a
woman.
Adèle said: ‘Jean is certain to get promotion, he says so, he will
not long remain a Poilu. When he comes back he may be a captain
—that will be fine, I shall marry a captain! War, he says, is better
than piano-tuning, though I tell him he has a fine ear for music. But
Mademoiselle should just see him now in his uniform! We all think he
looks splendid.’
Puddle said: ‘Of course England was bound to come in, and
thank God we didn’t take too long about it!’
Stephen said: ‘All the young men from Morton will go—every
decent man in the country will go.’ Then she put away her unfinished
novel and sat staring dumbly at Puddle.

England, the land of bountiful pastures, of peace, of mothering hills,

of home. England was fighting for her right to existence. Face to face
with dreadful reality at last, England was pouring her men into battle,
her army was even now marching across France. Tramp, tramp;
tramp, tramp; the tread of England whose men would defend her
right to existence.
Anna wrote from Morton. She wrote to Puddle, but now Stephen
took those letters and read them. The agent had enlisted and so had
the bailiff. Old Mr. Percival, agent in Sir Philip’s lifetime, had come
back to help with Morton. Jim the groom, who had stayed on under
the coachman after Raftery’s death, was now talking of going; he
wanted to get into the cavalry, of course, and Anna was using her
influence for him. Six of the gardeners had joined up already, but
Hopkins was past the prescribed age limit; he must do his small bit
by looking after his grape vines—the grapes would be sent to the
wounded in London. There were now no men-servants left in the
house, and the home farm was short of a couple of hands. Anna
wrote that she was proud of her people, and intended to pay those
who had enlisted half wages. They would fight for England, but she
could not help feeling that in a way they would be fighting for Morton.
She had offered Morton to the Red Cross at once, and they had
promised to send her convalescent cases. It was rather isolated for a
hospital, it seemed, but would be just the place for convalescents.
The Vicar was going as an army chaplain; Violet’s husband, Alec,
had joined the Flying Corps; Roger Antrim was somewhere in
France already; Colonel Antrim had a job at the barracks in
Worcester.
Came an angry scrawl from Jonathan Brockett, who had rushed
back to England post-haste from the States: ‘Did you ever know
anything quite so stupid as this war? It’s upset my apple-cart
completely—can’t write jingo plays about St. George and the dragon,
and I’m sick to death of “Business as usual!” Ain’t going to be no
business, my dear, except killing, and blood always makes me feel
faint.’ Then the postscript: ‘I’ve just been and gone and done it!
Please send me tuck-boxes when I’m sitting in a trench; I like
caramel creams and of course mixed biscuits.’ Yes, even Jonathan
Brockett would go—it was fine in a way that he should have enlisted.
Morton was pouring out its young men, who in their turn might
pour out their life-blood for Morton. The agent, the bailiff, in training
already. Jim the groom, inarticulate, rather stupid, but wanting to join
the cavalry—Jim who had been at Morton since boyhood. The
gardeners, kindly men smelling of soil, men of peace with a peaceful
occupation; six of these gardeners had gone already, together with a
couple of lads from the home farm. There were no men servants left
in the house. It seemed that the old traditions still held, the traditions
of England, the traditions of Morton.
The Vicar would soon play a sterner game than cricket, while
Alec must put away his law books and take unto himself a pair of
wings—funny to associate wings with Alec. Colonel Antrim had
hastily got into khaki and was cursing and swearing, no doubt, at the
barracks. And Roger—Roger was somewhere in France already,
justifying his manhood. Roger Antrim, who had been so intolerably
proud of that manhood—well, now he would get a chance to prove it!
But Jonathan Brockett, with the soft white hands, and the foolish
gestures, and the high little laugh—even he could justify his
existence, for they had not refused him when he went to enlist.
Stephen had never thought to feel envious of a man like Jonathan
Brockett.
She sat smoking, with his letter spread out before her on the
desk, his absurd yet courageous letter, and somehow it humbled her
pride to the dust, for she could not so justify her existence. Every
instinct handed down by the men of her race, every decent instinct of
courage, now rose to mock her so that all that was male in her
make-up seemed to grow more aggressive, aggressive perhaps as
never before, because of this new frustration. She felt appalled at the
realization of her own grotesqueness; she was nothing but a freak
abandoned on a kind of no-man’s-land at this moment of splendid