[Misconduct in clinical scientific investigations].

The most important ways of misconduct in clinical scientific research are falsifying results, plagiarize and over-interpretation. Motives are prestige, money, pressure of time and conflict of interests. The "publish or perish" phenomenon and the sometimes difficult attainable deadline play an important role. Furthermore, there is a "gray-zone" in which clinical scientific researchers are influenced by the pharmaceutical industry, leading to the writing of tendentious publications. Few data are available concerning the frequency of misconduct. In general, one may say that the phenomenon is underestimated. The number of professional organizations for the detection of misconduct and to start a balanced investigation procedure of this phenomenon is limited. An exception is "Office of Research Integrity" in the US that does pioneering work in the field. Some of the better journals in the profession are making serious efforts to detect misconduct (e.g. New England Journal of Medicine, British Medical Journal). To prevent misconduct the following measures can be considered: education concerning the topic in the faculties of medicine, biomedical sciences and pharmaceutics sciences; extension of the competences of the ethical committees; realistic financing of research and the establishing of a "clinical scientific fund", without any relation with the pharmaceutical industry, for the support of self-generated clinical project after 'peer review'. Finally, the questions can be raised if the Royal Academy of Medicine (Belgium) could not play a role in this important matter.