The youngest patient was two years old when she died three months after Professor Paolo Macchiarini’s experimental surgery to replace her trachea. Since then, Macchiarini has been accused of scientific malpractice. An external investigation found that he reported in a paper that ethics approval had been obtained when it had not, misrepresented patients’ outcomes in several papers, and other issues rated as malpractice.
The vice-chancellor at the Karolinska Institute, where Macchiarini worked, decided that Macchiarini acted “without due care”, but that his behaviour “does not qualify as scientific misconduct”.
That might have been the end of the matter but for the work of journalists. Vanity Fair reported Macchiarini’s plans to marry the producer of a TV documentary about his work in a ceremony officiated by Pope Francis at the Pope’s summer residence with guests including Vladimir Putin and Barack Obama. In reality, the Pope plans took him to South America instead of the wedding of the already-married surgeon. Macchiarini’s CV was only slightly less fanciful. Sveriges Television alleged that some Russian patients Macchiarini operated onwere not ill enough to warrant such a risky procedure.
The misconduct investigation into Macchiarini’s work was subsequently reopened: he was fired (and is under investigation for manslaughter by Swedish prosecutors); and the vice-chancellor resigned, as did several eminent scientists, including Nobel-prize judges.
Macchiarini’s work hastened the deaths of several patients, yet until pressurised by the media, the Karolinska Institute was prepared to overlook misconduct. There is no scientific misconduct so severe that distinguished scientists might not seek to ignore it. How can we ensure that university investigations into research misconduct (or indeed other types of misconduct) are thorough and fair, and as importantly, seen to be thorough and fair? Quis custodiet ipsos custodes?