What to do if you suspect an ethical problem in a manuscript received?

The reviewer (or editor) communicates concern about a potential ethics issue in the manuscript (e.g., absence of ethics committee clearance, or concern about patient consent, patient protection, or animal experiments). Then:

• Thank the reviewer and inform him/her that you plan to investigate
• The author provides the relevant details. There can be two responses (1 and 2):

1. Satisfactory response

• Apologize and continue with the review process.

2. No response or unsatisfactory response

• Inform the author that the review process is suspended until the case has been resolved
• Communicate your concern to the author's facility or the person responsible for research standards at the facility. Two actions or solutions (a and b) follow from this:

a) The problem is satisfactorily resolved, then:

• Inform the reviewer of the results of the case.

b) No response or unsatisfactory response, then:

• Contact the center every 3-6 months to try to get them to bring their investigation to completion
• If the problem is satisfactorily resolved: Inform the reviewer of the results of the case
• If no response or unsatisfactory response: Refer the case to other competent authorities. Inform the reviewer of the results of the case