A publication should be retracted if it reports unethical research

On November 28, 2015, the scientific journal Respiration published the paper Autologous Peripheral Blood Mononuclear Cells as Treatment in Refractory Acute Respiratory Distress Syndrome (Respiration 2015; 90: 481-492). The principal author was Paolo Macchiarini, who at that time was employed at Karolinska Institutet. He was fired from the institute in March the following year after a series of gross errors were discovered in connection with his activities at Karolinska Institutet and the Karolinska University Hospital. (For details see KI website.)

After a thorough investigation of the Respiration paper, I decided in January this year that Macchiarini and three of his co-authors should be held guilty of scientific misconduct due to severe violations of ethical standards.

Following the decision, I wrote a letter to the Editor of Respiration and requested that the article be retracted.

Despite a number of notifications, the journal has failed to retract the article in question – an article that may negatively impact clinical practice and cause human suffering. This is why I now choose to publish parts of the dialogue that I have had with the Journal’s editor.

From Respiration (February 6th 2018):

”Dear Professor Ottersen,

We have received a request from the Karolinska Institutet to retract the above article. At the same time, we have been contacted by one of the authors asking us to delay our decision regarding this matter.

The Editors and the publishing house are both of the opinion that it is the journal’s duty  to the scientific community to provide a platform for discussions and a forum for debating. Furthermore, the background of the conflict between the two parties should be transparent to the readers to enable them to form their own opinion.

Therefore, we would like to ask all parties concerned to write a ‘Letter to the Editor’ pertaining to this conflict for simultaneous publication. The maximum length should be 4 manuscript pages with the possibility of supplementary online material. The article in question along with the Letters will be ‘Free Access’ with reciprocal links between the article and the Letters. Deadline for receipt of the Letters is the end of February 2018. Please submit to the Editorial Office as an email attachment.

We sincerely hope that both parties will take advantage of this offer to present their viewpoint.

With best regards,

Linda Haas

Editorial Office ‘Respiration’

My answer (February 23rd 2018):

Dear Editor

Thank you for your letter. We are not interested in engaging in a discussion about this matter. Our request for retraction is based on a formal decision by the Rector/Vice-Chancellor. We uphold our request and look forward to learn about your final decision.

In case you choose not to comply with our request we would like to know your arguments for this.

Best regards

Ole Petter Ottersen

From Respiration (March 10th 2018):

Dear Professor Ottersen, 

Thank you for your reply. 

We would to emphasise that we have taken your request for the retraction of this article very seriously, however, we found it only fair to all parties concerned to offer the option of publishing a letter on this matter in question. 

We believe, that based on the evidence available to the journal, we are not in a position to make a judgement on whether or not to retract this article. We have, therefore, decided to leave it up to our readers to build their own opinion on the matter and decide for themselves with regard to the validity of the conclusions. We do not want to patronize the readers of the journal ‘Respiration’.

Finally, we would like to ask you to reconsider your decision not to engage in any discussion. If you decision remains unchanged, we would like to ask for your consent to publish your retraction request in the journal ‘Respiration’.

Yours sincerely,

Professor Felix J.F. Herth


Thomas H. Nold

On behalf of S. Karger Publishers

My answer (April 4th 2018):

Dear Editor

Thank you for your mail.

We uphold our claim that the paper be retracted. We would like to be informed about the journal’s policy in such matters. This issue has a bearing on important ethical principles and we are surprised at your response to our request.

In our investigation we have solicited and received comments from all authors, and they have all been informed about our decision. Our decision is final and we see no reason why we should  engage in a further discussion in your journal.

Obviously you are free to publish our report if you so wish.


Ole Petter Ottersen

Surprised and disappointed

I am both surprised and disappointed with the journal’s response. This is an article based on  unethical research that has caused unnecessary suffering for a severely injured patient. The paper has to be withdrawn.

As I see it, editors of medical journals have a collective responsibility for the integrity of the published record. When notified of ethical breaches they have an imperative to act, and when faced with a formal decision on scientific misconduct they should ensure that the paper be retracted or removed. Failure to respond will undermine trust in medical publishing and in medical research at large.  In the case at hand the reader will not even find an expression of concern.

Those who follow my blog will know that earlier this spring we discussed how journals should handle papers that are published with fake identities and fake affiliations – as in the case of “Lars Andersson”. In this case, two out of three journals took responsibility and decided to retract the articles.

To me it is obvious that Respiration should do the same.



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