The Erosion of Healthcare and Scientific Integrity: A Growing Concern.

Bj��rn L D M Br��cher
Author Information
  1. Bj��rn L D M Br��cher: European Academy of Sciences and Arts (EASA), Salzburg, Austria. ORCID

Abstract

Background: Tremendous achievements in healthcare and science over the past 200 years have enhanced life expectancy in parallel with a shift from dogma to humanistic liberal education. Advancements in cancer have included vaccines treating causes of cancer (eg, hepatitis C- induced liver cancer and human papillomavirus-induced cervical cancer) along with improved cancer survival in children. In contrast, developments in cancer, frequently touted as "discoveries" or "breakthroughs" in media headlines, have been demonstrated to be ephemeral rather than game changers. In reality, cancer incidences are increasing, and relapse and mortality rates have not changed substantially. By this, we are experiencing today similar challenges to those before the so-called Humboldt reform. The trend towards managerialism with a focus on quantity in health care and science endangers their integrity.
Methods: Due to the complexity of integrity of healthcare and science, in-depth contemplation of this review contains foundations of actions in healthcare and science, information regarding cancer, as an example, quantity focus of healthcare, technology, publishing, marketing and media, predatory publishers, followed by psychologic and sociologic aspects which influence our perception.
Results: A complex paradoxical transformation has occurred, in which quality and humanism have been replaced by quantity, revenue, and marketing, together with "citation silence", (ignoring original findings), and increased corruption and misconduct. This shift explains why the integrity of healthcare and science is being eroded.
Conclusion: Countries and societies are only as strong as their healthcare and science, both of which are only as strong as their emphasis on quality and integrity. Awareness of this situation may represent a first step toward a renewed focus on accountability.

Keywords

References

  1. Nature. 2023 Apr;616(7955):159-167 [PMID: 37020004]
  2. BMC Cancer. 2014 Mar 14;14:186 [PMID: 24629025]
  3. JAMA Intern Med. 2023 Nov 1;183(11):1196-1203 [PMID: 37639247]
  4. Sci Adv. 2017 Jul 12;3(7):e1700006 [PMID: 28706991]
  5. J Natl Cancer Inst. 2019 Dec 1;111(12):1279-1297 [PMID: 31145458]
  6. BMJ Open. 2017 Sep 24;7(9):e017266 [PMID: 28947456]
  7. Naunyn Schmiedebergs Arch Pharmacol. 2024 Jun;397(6):3995-4011 [PMID: 37994948]
  8. Nature. 2021 Oct;598(7879):19-20 [PMID: 34594025]
  9. J Clin Oncol. 2018 Jun 20;36(18):1805-1812 [PMID: 29688832]
  10. Nature. 2021 Dec;600(7887):8 [PMID: 34853464]
  11. J Med Internet Res. 2011 Dec 19;13(4):e123 [PMID: 22173204]
  12. J Cancer. 2014 Mar 16;5(4):272-80 [PMID: 24790655]
  13. Pancreas. 2013 Oct;42(7):1157-63 [PMID: 23867367]
  14. PLoS One. 2013 Nov 04;8(11):e79696 [PMID: 24223999]
  15. Nat Rev Clin Oncol. 2021 Oct;18(10):663-672 [PMID: 34079102]
  16. CA Cancer J Clin. 2024 May-Jun;74(3):229-263 [PMID: 38572751]
  17. Nature. 2023 Jan;613(7942):138-144 [PMID: 36600070]
  18. Soc Sci Med. 2019 Nov;240:112552 [PMID: 31561111]
  19. N Engl J Med. 2010 Aug 19;363(8):711-23 [PMID: 20525992]
  20. JAMA. 2018 Nov 20;320(19):2042-2043 [PMID: 30458490]
  21. Nat Rev Cancer. 2024 Aug;24(8):516-517 [PMID: 38755440]
  22. Nat Rev Cancer. 2016 Apr;16(4):201-18 [PMID: 27009393]
  23. BMJ. 2024 May 15;385:e077341 [PMID: 38749552]
  24. Nature. 2022 May;605(7908):119-125 [PMID: 35477758]
  25. Health Psychol. 2020 May;39(5):355-357 [PMID: 32202824]
  26. Surgery. 2020 Sep;168(3):440-447 [PMID: 32641278]
  27. Int J Cancer. 2024 Jun 1;154(11):1890-1899 [PMID: 38323453]
  28. J Natl Cancer Inst. 1980 Nov;65(5):1055-61 [PMID: 6933238]
  29. Cell Physiol Biochem. 2016;38(5):1663-80 [PMID: 27160408]
  30. Life Sci Alliance. 2022 Jan 12;5(4): [PMID: 35022248]
  31. CA Cancer J Clin. 2022 Jan;72(1):7-33 [PMID: 35020204]
  32. Proc Natl Acad Sci U S A. 2003 Apr 1;100(7):3983-8 [PMID: 12629218]
  33. Nucleic Acids Res. 2023 Sep 8;51(16):8309-8321 [PMID: 37528048]
  34. Cancer Res. 2003 Sep 15;63(18):5821-8 [PMID: 14522905]
  35. Clin Trials. 2023 Oct;20(5):457-462 [PMID: 37264897]
  36. Cancer Med. 2024 Oct;13(20):e70318 [PMID: 39440551]
  37. Int J Epidemiol. 2022 Feb 18;51(1):324-333 [PMID: 34223891]
  38. Science. 2007 Dec 14;318(5857):1722; author reply 1722 [PMID: 18079385]
  39. N Engl J Med. 2002 Aug 22;347(8):567-75 [PMID: 12192016]
  40. JAMA Oncol. 2023 Apr 1;9(4):465-472 [PMID: 36821107]
  41. J Cogn Neurosci. 2005 May;17(5):800-10 [PMID: 15904546]
  42. J Natl Cancer Inst. 2011 Jan 19;103(2):117-28 [PMID: 21228314]
  43. Nature. 2021 Sep;597(7874):9 [PMID: 34465904]
  44. Nat Med. 1997 Jul;3(7):730-7 [PMID: 9212098]
  45. Science. 2007 Jul 20;317(5836):337 [PMID: 17641192]
  46. Semin Neurol. 2018 Apr;38(2):176-181 [PMID: 29791943]
  47. BMC Med. 2024 Oct 15;22(1):469 [PMID: 39407233]
  48. Dig Surg. 2012;29(1):6-17 [PMID: 22441614]
  49. Nature. 2023 Nov;623(7987):466-467 [PMID: 37949983]
  50. JAMA Netw Open. 2024 Sep 3;7(9):e2431427 [PMID: 39226054]
  51. Nat Aging. 2024 Nov;4(11):1635-1642 [PMID: 39375565]
  52. mBio. 2016 Jun 07;7(3): [PMID: 27273827]
  53. Sci Adv. 2021 May 21;7(21): [PMID: 34020944]
  54. J Safety Res. 2003;34(5):533-8 [PMID: 14733987]
  55. Cancer Epidemiol Biomarkers Prev. 2020 Jul;29(7):1304-1312 [PMID: 32522832]
  56. Nature. 2004 Nov 18;432(7015):396-401 [PMID: 15549107]
  57. Science. 2018 Apr 13;360(6385):162-163 [PMID: 29650665]
  58. Science. 2016 May 6;352(6286):663-4 [PMID: 27151854]
  59. J Med Ethics. 2022 Jul;48(7):479-484 [PMID: 33990431]
  60. Nature. 2021 Mar;591(7851):516-519 [PMID: 33758408]
  61. Science. 2018 Jul 6;361(6397):16-20 [PMID: 29976808]
  62. Cancer Invest. 2014 Dec;32(10):497-506 [PMID: 25250506]
  63. Proc Natl Acad Sci U S A. 2022 May 24;119(21):e2118301119 [PMID: 35580183]
  64. Nat Rev Clin Oncol. 2022 Oct;19(10):656-673 [PMID: 36068272]
  65. PLoS One. 2018 Aug 29;13(8):e0203117 [PMID: 30157262]
  66. EMBO J. 2024 Oct;43(20):4786-4804 [PMID: 39210146]
  67. J Clin Oncol. 2016 Mar 20;34(9):927-35 [PMID: 26786933]
  68. CA Cancer J Clin. 2024 Jan-Feb;74(1):12-49 [PMID: 38230766]
  69. Ann Surg Oncol. 2020 May;27(5):1580-1588 [PMID: 31792717]
  70. J Cancer Res Ther. 2024 Apr 1;20(2):592-598 [PMID: 38687929]
  71. Proc Natl Acad Sci U S A. 2021 Mar 2;118(9): [PMID: 33622786]
  72. Cancer. 2013 Mar 15;119(6):1140-8 [PMID: 23065954]
  73. JAMA Oncol. 2024 Jul 1;10(7):887-895 [PMID: 38753341]
  74. Plant Physiol. 1995 Dec;109(4):1131-1132 [PMID: 12228658]
  75. Nature. 2012 Sep 6;489(7414):57-74 [PMID: 22955616]
  76. Int J Cancer. 2018 Dec 1;143(11):2758-2766 [PMID: 30095162]
  77. JAMA Intern Med. 2015 Dec;175(12):1992-4 [PMID: 26502403]
  78. Mhealth. 2016 Feb 02;2:3 [PMID: 28293581]
  79. Cell Physiol Biochem. 2023 Dec 27;57(6):512-537 [PMID: 38149603]
  80. PLoS One. 2022 Feb 2;17(2):e0263185 [PMID: 35108316]
  81. Presse Med (1893). 1954 May 5;62(33):709-12 [PMID: 13177441]
  82. Nature. 1994 Feb 17;367(6464):645-8 [PMID: 7509044]
  83. Lancet. 2016 Aug 13;388(10045):684-95 [PMID: 27236345]
  84. BMJ. 2024 Aug 7;386:q1706 [PMID: 39111803]
  85. Clin Cancer Res. 2013 Aug 15;19(16):4297-304 [PMID: 23719260]
  86. Proc Natl Acad Sci U S A. 2003 Dec 9;100(25):15178-83 [PMID: 14645703]
  87. Nat Rev Gastroenterol Hepatol. 2024 Feb;21(2):125-133 [PMID: 37794234]
  88. CA Cancer J Clin. 2023 Jan;73(1):17-48 [PMID: 36633525]
  89. Ann Oncol. 2013 Dec;24(12):3056-60 [PMID: 24121120]
  90. Nature. 2024 Oct 3;: [PMID: 39363027]
  91. Clin Cancer Res. 2013 Jun 1;19(11):2804-9 [PMID: 23553847]
  92. Nature. 2023 Apr;616(7957):419-420 [PMID: 37019961]
  93. Psychol Bull. 2004 Sep;130(5):711-47 [PMID: 15367078]
  94. Z Krebsforsch. 1948;56(1):36-79 [PMID: 18886098]
  95. N Engl J Med. 2012 Sep 27;367(13):1187-97 [PMID: 22894553]
  96. Prev Med. 2005 May;40(5):535-41 [PMID: 15749135]
  97. J Clin Epidemiol. 2024 Aug;172:111397 [PMID: 38815634]
  98. Eur J Epidemiol. 2023 Sep;38(9):933-937 [PMID: 37530938]
  99. J Cell Biochem. 2021 Jul;122(7):694-695 [PMID: 33559144]
  100. Mol Cells. 2008 Nov 30;26(5):514-6 [PMID: 18711315]
  101. Clin Cancer Res. 2013 Aug 15;19(16):4305-8 [PMID: 23833307]
  102. J Cancer. 2014 Jan 01;5(1):3-24 [PMID: 24396494]
  103. Nature. 2020 Oct;586(7829):358-360 [PMID: 33041342]
  104. Int J Cancer. 2021 Aug 1;149(3):492-493 [PMID: 33905542]
  105. Science. 2022 Apr 8;376(6589):eabg5601 [PMID: 35389777]
  106. J Natl Cancer Inst. 2008 Jun 18;100(12):888-97 [PMID: 18544740]
  107. J Natl Cancer Inst. 2020 Nov 1;112(11):1105-1117 [PMID: 32016323]
  108. Nature. 2024 Feb;626(7997):17-18 [PMID: 38243120]
  109. J Inherit Metab Dis. 2022 May;45(3):517-528 [PMID: 35066899]
  110. J Natl Cancer Inst. 1983 Jun;70(6):1011-4 [PMID: 6574268]
  111. N Engl J Med. 2012 Jun 14;366(24):2284-93 [PMID: 22591257]
  112. J Am Coll Surg. 2020 Apr;230(4):689-698 [PMID: 32014570]
  113. Ann Gastroenterol Surg. 2019 Jan 14;3(1):50-56 [PMID: 30697610]
  114. BMJ. 2017 Oct 4;359:j4530 [PMID: 28978555]
  115. BMJ. 2022 Mar 2;376:o498 [PMID: 35236744]

Word Cloud

Created with Highcharts 10.0.0cancerhealthcarescienceintegrityquantityfocusqualityshiftmediamarketingstrongaccountabilityBackground:Tremendousachievementspast200yearsenhancedlifeexpectancyparalleldogmahumanisticliberaleducationAdvancementsincludedvaccinestreatingcauseseghepatitisC-inducedliverhumanpapillomavirus-inducedcervicalalongimprovedsurvivalchildrencontrastdevelopmentsfrequentlytouted"discoveries""breakthroughs"headlinesdemonstratedephemeralrathergamechangersrealityincidencesincreasingrelapsemortalityrateschangedsubstantiallyexperiencingtodaysimilarchallengesso-calledHumboldtreformtrendtowardsmanagerialismhealthcareendangersMethods:Duecomplexityin-depthcontemplationreviewcontainsfoundationsactionsinformationregardingexampletechnologypublishingpredatorypublishersfollowedpsychologicsociologicaspectsinfluenceperceptionResults:complexparadoxicaltransformationoccurredhumanismreplacedrevenuetogether"citationsilence"ignoringoriginalfindingsincreasedcorruptionmisconductexplainserodedConclusion:CountriessocietiesemphasisAwarenesssituationmayrepresentfirststeptowardrenewedErosionHealthcareScientificIntegrity:GrowingConcern

Similar Articles

Cited By

No available data.