A medical journal editor's role in exposing an unethical research study.

The involvement of Dr. Richard Mattingly, Editor of Obstetrics & Gynecology between 1972 and 1985, in the publication of an article on carcinoma in situ (CIS) of the cervix, facilitated exposure of an unethical study into the natural history of CIS of the cervix (now termed cervical intraepithelial neoplasia 3) by Dr. Herbert Green. The object of Dr. Green's study was to verify his premise that CIS was not a precursor of invasive cancer, and he published his "atypical viewpoint" that CIS was a benign disorder in international medical journals and the lay press. Alarmed by the number of women developing cancer and frustrated by the failure of the hospital authorities to deal with the problem, Dr. Bill McIndoe began presenting his interpretation of Dr. Green's study at international scientific meetings. Dr. Mattingly was aware of both Dr. Green's previous publications and the difficulties facing Dr. McIndoe, and he encouraged Dr. McIndoe to publish his data in Obstetrics & Gynecology. The correspondence between Dr. Mattingly, a senior U.S. academic and journal editor wishing to publish important scientific data, and Dr. McIndoe, an unknown antipodean clinician intent on revealing an unethical experiment, provides important lessons for all who practice medicine, in particular those in positions of responsibility.