A UK GDC FTP case involving five dentists has highlighted an issue regarding audits and significant event analysis. Although Irish dentists may not be involved in audit, the principles discussed in this article are valid in any jurisdiction.

Dental Protection has occasionally come across requests for advice from members regarding whether or not an article or other piece of written work can be used as part of a post-graduate thesis or dissertation. Recent activity suggests that it is vitally important to understand what constitutes plagiarism and what steps are taken by universities and other organisations to detect it.

A recent UK General Dental Council (GDC) fitness to practise case saw five dentists found to be dishonest, and they were subsequently suspended from the dental register for varying periods of time, after sharing their own or copying another individual’s Significant Event Analysis Reports (SEAs). We also know of other dentists who are receiving letters from their health board asking questions about audit reports and SEAs which they submitted a number of years ago.

There is no doubt that plagiarism is considered to be a dishonest conduct.

What is plagiarism?

Plagiarism is defined by the online oxford dictionaries[i] as ‘the practice of taking someone else’s work or ideas and passing them off as one’s own.’ It is considered a very serious matter and further research[ii] reveals that ‘to plagiarise means:

• to steal and pass off (the ideas or words of another) as one’s own
• to use (another’s production) without crediting the source
• to commit literary theft
• to present as new and original an idea or product derived from an existing source

In other words, plagiarism is an act of fraud. It involves both stealing someone else’s work and lying about it afterward.

The University of Glasgow[iii] states: “The incorporation of material without formal and proper acknowledgment (even with no deliberate attempt to cheat) can constitute plagiarism. Work may be considered to be plagiarised if it consists of: a direct quotation; a close paraphrase; an unacknowledged summary of a source; direct copying or transcription”.

In academia, universities use anti-plagiarism software to check the students’ coursework to determine if the coursework truly belongs to them.   Academics regard plagiarism as dishonest and fraudulent and it can amount to career suicide. Although plagiarism is a clear danger to anyone’s reputation and regarded as dishonest, some dentists are failing to understand the seriousness of the issue – in the UK, for example, NHS Education for Scotland (NES) has recently made thorough checks on work submitted to fulfil the QI requirements of the Terms of Service for dentists working in the NHS. The same anti-plagiarism software that has been used by universities for some years has recently been used by NES to check the validity of QI project reports and SEAs being submitted via the NES online Portal.

Students and teachers

The most common form of plagiarism is using another’s words or work without appropriate referencing. However, what readers might not be aware of is that in the case of co-authored work, if one of the authors has plagiarised any of the chapters or sections, both authors of the document will be considered to have acted dishonestly and could be accused of plagiarism.

For academic staff trying to prevent plagiarism, there are a variety of resources now available online to check the content of submitted work, which means that the chances of being discovered, if tempted, are high.

In October 2016, the GDC produced two new guidance documents on this topic – one for student dental professionals[iv], which applies to all student dental care professionals and not just to dental students. The other guidance document produced[v] is aimed at all providers delivering training programmes which lead to registration with the GDC. This latter guidance provides help for academic institutions in running fitness to practice hearings against students, the most serious sanction following such a hearing being expulsion from the course, depending on the severity of the offence. Plagiarism is included in the list of issues which could indicate that a student’s fitness to practice may be impaired and such conduct may be considered as a threshold matter for implementation of an institution’s fitness to practice procedures.

Academic staff

For academic staff tempted to take short cuts, the message is: please don’t. Whilst there may be readily available guidance for students on the subject, regulations for academic staff apply on an institution by institution basis. The concept of peer review before submission of papers to journals is intended to highlight and prevent the problem, although this may not necessarily be completely effective.

The risks to academic staff tempted to take shortcuts are loss of professional credibility and indeed loss of employment.  Plagiarism is not a crime as we understand that word in common parlance. Instead it is a civil law matter. However, that does not prevent the UK medical and dental regulatory bodies from bringing charges of plagiarism or dishonesty against a clinician. Regulatory bodies in other jurisdictions, such as the Dental Council in Ireland, could do likewise.

Dentists, clinical audit, SAEs and dishonesty

In Scotland, dentists on a health board dental list have been required to do at least 15 hours of QI activity during each three-year period. Several Scottish dentists have recently contacted Dental Protection for advice in relation to concerns raised about the sharing of clinical audits and final audit reports with other clinicians.  In some cases, the sharing of the audits has resulted in other dentists claiming the audits as their own work. Such a situation can, as explained above, result in allegations of dishonest conduct against all parties.

It is important to understand that any allegation that a dental registrant has acted in a way that would be considered to be misleading or dishonest is taken very seriously by the GDC in the UK. The recent UK case of Ivey v Genting Casinos (UK) Ltd[vi] changed the legal test for dishonesty that is applicable before the regulators in that jurisdiction. In that case, the UK Supreme Court confirmed that the previously used two-stage ‘Ghosh’[vii] test was no longer applicable. The Ghosh test had both an objective and a subjective part to the two-stage test, which the courts and regulators used when considering whether conduct was dishonest. The Ivey case arguably makes it easier for dishonesty to be established as ‘it will no longer be necessary to prove that a professional subjectively understood that he or she was acting dishonestly.’[viii] Although the Ivey case has not been formally adopted in Ireland, it has been considered in cases before Irish regulators. However, there are no formal judgements as yet, clarifying the position. Other Irish regulatory cases[ix] deal more with dishonesty at sanction stage.

Regulatory bodies – GMC and GDC

In 2008, a well-known UK psychiatrist admitted inadvertent plagiarism in a hearing before the GMC, resulting in a three-month suspension and his resignation as an NHS consultant. The individual[x] concerned apparently explained at the time that a ‘copy and paste error’ meant that references had not been included in his work. That is how easily plagiarism can happen.

All students and members of the UK dental team are aware of the GDC’s Standards for the Dental Team[xi]. Principal nine sets out the guiding principle that would cover an allegation of plagiarism, particularly the requirement that registrants should “Ensure that your conduct, both at work and in your personal life, justifies patients’ trust in you and the public’s trust in the dental profession.” In Ireland, there areseveral principles of theCode of Practice: Professional Behaviour and Ethical Conduct that would be breached in the event of unethical conduct such plagiarism or dishonesty.

Summary

Plagiarism poses a great risk to a clinician’s career and professional reputation. It is essential to make sure that all work submitted, whatever the type and in whatever capacity, is your own and properly referenced. Not even one sentence should be copied from another person’s work without the required references. In sharing your work with others, you are taking a risk that some of your exact wording will be used, which also carries the risk of an allegation of dishonest conduct.

“Regard your good name as the richest jewel you can possibly be possessed of – for credit is like fire; when once you have kindled it you may easily preserve it, but if you once extinguish it, you will find it an arduous task to rekindle it again. The way to a good reputation is to endeavour to be what you desire to appear.”
― Socrates[xii]

Helen Kaney BDS LLB Dip LP MBA FFGDP (UK) FFFLM
Lead Dento-legal Consultant and Head of Dental Services, Scotland, Dental Protection

Helen spent many years in general dental practice before training as a solicitor and working for law firms that acted for commercial insurers and the UK indemnity organisations, acting for both doctors and dentists in various matters including clinical negligence claims and regulatory matters. She also worked as a dentolegal adviser for a commercial insurer which provided claims-made insurance for clinicians. Helen has worked for Dental Protection for the last 10 years where she is a Lead Dento-legal Consultant and Head of Dental Services, Scotland.

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[i] https://en.oxforddictionaries.com/definition/plagiarism Accessed 15 August 2019

[ii] http://www.plagiarism.org/article/what-is-plagiarism Accessed 15 August 2019

[iii] https://www.gla.ac.uk/myglasgow/leads/students/plagiarism/ Accessed 15 August 2019

[iv] General Dental Council Student professionalism and fitness to practise – what you need to know, October 2016 Available at: https://www.gdc-uk.org/docs/default-source/guidance-for-students/student-professionalism-and-fitness-to-practise-an-introduction-for-students.pdf

[v] General Dental Council Student professionalism and fitness to practise Guidance for training providers, October 2016 Available at:

[vi] [2017] UKSC 67

[vii] R v Ghosh [1982] QB 1053

[viii] https://www.clydeco.com/insight/article/ivey-v-genting-casinos-a-new-test-for-dishonesty-among-professionals Accessed 15 August 2019

[ix] Law Society –v- Enright [2016] IEHC 151 and Carroll v. the Law Society of Ireland [2005] IEHC 199

[x] http://www.telegraph.co.uk/men/thinking-man/raj-persauds-wilderness-years–ive-spent-a-lot-of-time-thinking/ Accessed 15 August 2019

[xi] Standards for the Dental Team, www.gdc-uk.org, Effective from 30 September 2013

[xii] Available at: https://www.goodreads.com/quotes/365753-regard-your-good-name-as-the-richest-jewel-you-can Accessed 15 August 2019

Tags: Dental Protection, Helen Kaney, legal, socrates