August 2020

Preamble

This Code of Ethics supports the mission of the Orthopaedic Research Society (ORS), which is to advance musculoskeletal research worldwide. ORS can meet this mission only if it is viewed by the scientific and medical communities and by the general public as an unbiased organization whose activities are managed with utmost integrity. The ORS encourages members to participate actively in other professional societies and to develop mutually supportive collegial relationships with industry. However, certain activities may give the appearance of a conflict/duality of interest.

To ensure that such a reputation is maintained, this code provide guidelines to be followed by the members of the ORS, by the leadership of ORS, and by the editors of the Journal of Orthopaedic Research, JOR Spine, in conducting activities that support the Society’s scientific and educational mission.

The Code of Ethics of the ORS applies to the entire membership of the Society and is enforceable solely by the Society, for which membership means any Society member in any class of membership.

Ethical conduct extends beyond what is covered by this code, which consists primarily of enforceable rules about conflicts of interest. Ethics is not just about enforceable rules, but also about ideals and aspirational goals. An aspirational professional recognizes the importance of the moral relationships within her/his clinical and research work. Members of the ORS, as an integral part of the musculoskeletal community, should aspire to think and act ethically. Goals to consider both personally and professionally include:

  • demonstrating integrity;
  • respecting ORS members’ rights, dignity, cultures, and identities;
  • striving for professional and scholarly competence in research;
  • disclosing information in publications, podium presentations, and posters necessary to satisfy peer review, experimental reproduction of the study, and the ability to build upon another’s work;
  • promoting the sustainability of the ORS through participation and leadership in the Society; and,
  • engaging in good citizenship activities, including:
    • regular attendance at ORS meetings,
    • participation in peer-review of submitted abstracts and manuscripts,
    • collaborative research and professional activities,
    • scientific cordiality when interacting with fellow members of the ORS;

and sharing of data, reagents, and experimental techniques.

ORS leaders are expected to act in the interests of the Society and not for personal or third-party gain, promotion of commercial interests, or financial enrichment. This policy identifies and facilitates the resolution of conflict/dualities of interest. ORS leaders should engage in activities that are free from real or apparent conflicts/dualities of interest and from commercial or external influence or bias. Under this Policy, ORS leaders are discouraged from: (1) using their positions and status to promote commercial interests; (2) from participating in decisions and activities where an outside interest affects the leader’s loyalty to the Society; and 3) where a leader’s action could affect the value of a commercial enterprise in which the leader has a financial interest.

In particular, these ethics policy and guidelines define for the ORS Officers, Board of Directors, committee chairs and members, Editors and Associate Editors of ORS publications, the Publications Oversight Committee and Editorial Board of the Journal of Orthopaedic Research, section members, and representatives of ORS to other societies:

  1. what constitutes a conflict/duality/duality of interest; and
  2. how to resolve or manage a conflict/duality or duality of interest with respect to other professional societies, journals, industrial and pharmaceutical concerns and external entities.

Definition of Terms

Conflict/Duality of Interest; Apparent Conflict/Duality of Interest

A conflict/duality of interest is defined as a situation in which an individual decision-maker has any impediment to being impartial and loyal, such as: (1) a personal, professional, business, or volunteer position, responsibility, or interest; or 2) a conflicting duty to another entity where the individual’s allegiance may be split between the Society and the other entity. An apparent conflict/duality is defined as a situation or relationship that may cause an observer to question whether an impediment to impartiality exists.

Conflict/Duality Resolution

For all Officers and Committee Chairs, and all members of the Board of Directors, committees, sections, editors and associate editors, and other ORS leadership positions, in the event of any actual or apparent conflict/duality of interest related to service on behalf of the ORS, the individual must:

  1. publicly disclose (or have previously disclosed) the conflict/duality before the related discussion takes place
  2. Recuse him/herself from at least part of the discussion, when their insights on the topic may be influenced by the outside relationship
  3. Recuse him/herself from voting on the related matter, when their decision making may be influenced by the outside relationship

The Policy’s Intent and Limitations

It is the intention of the Society that actual and apparent conflicts and duality of interest and commercial bias be avoided when any leaders of the Society act, speak, represent, and participate in decision-making and policy generation on behalf of the ORS.

This policy does not govern ORS members in their roles as scientists, physicians, researchers, medical professionals, and administrators. Several professional societies, federal agencies, and other organizations have disseminated ethical guidelines available to ORS membership governing the conduct of research, the protection of human and animal subjects, and the care of patients.

ORS Process

These principles are formulated in concordance with the goals defined in the ORS Mission Statement and with the Bylaws of the ORS.

This policy is implemented through the completion and regular updating of conflict/duality of interest/disclosure forms by each individual who is elected or appointed to a leadership position in the ORS, including representing ORS or serving on an ORS committee. The conflict/duality of interest/disclosure forms shall be submitted to the Executive Director for distribution to the Board of Directors. The Executive Director will compile a list of disclosures, and the Ethics Committee and Executive Director will review the list against the Board Meeting agenda to determine possible conflicts/dualities. This list of disclosures with specific details omitted will be shared with the Board at the Board Meeting, and, upon request, with members of the Society.  The Executive Director is charged with collecting the forms and retaining them in the Society’s Business Office. As a general rule, the specific information contained therein should not be made public. Only the Secretary, who records the disclosures in the Board Meeting minutes, and when necessary the Ethics Committee, shall be privy to the declarations.

Any conflict/duality identified by the individual, the Executive Director, or the President shall be resolved or a plan of management be developed prior to discussion and determination of any such topic or issue.

The ORS encourages the involvement of industry representatives and members with ties to industry in its governance activities. However, certain volunteer leadership positions require decisions about the allocation of ORS time, priorities, and resources that can affect the interests of industries in the musculoskeletal field. These decisions include confidential information about corporate fundraising, program topics and speaker selection, emerging technologies, and long-term budgeting. Given the potential conflict between these interests, it is important that the Society ensures the declaration of conflicts of interests, and that upon any perception of conflict of interest the industry member declare such conflict and/or remove her/himself from all related discussions and from the decision-making process.

  1. Officers of the ORS

Officers of the ORS include the President, the First and Second Vice Presidents, the Secretary, and the Treasurer. Consistent with their duties, their decisions and actions during their tenures must be guided by the best interests and mission of the Society. As Officers, these individuals should engage in activities that are free from conflicts/dualities of interest and from commercial or external influence or bias. To these ends, the Officers are expected to follow this Policy.

  1. Individuals who are Officers in the ORS and are officers or nominees for office in other societies should consult with the Ethics Committee to determine whether concomitant service to both organizations would constitute or appear to constitute a conflict/duality of interest for ORS.
  2. Officers of the ORS should not serve as course directors, moderators, chairs, or speakers for commercially-supported symposia or CME activities that are held in conjunction with, but outside, the official program of the Annual Meeting of the ORS.
  3. During their tenures, the Officers of the ORS should consult with others, including the Ethics Committee, on the significance of actual or apparent conflicts/dualities or biases arising from work with corporate entities in relation to their primary roles as the senior leadership of the Society.
  4. The Officers of the ORS should not identify themselves as such when they are primarily representing their university, laboratory, research group, other affiliation, or self to the media, press, Congress/other legislative bodies or NIH/other funding agencies.
  5. Officers are required to maintain the confidentiality of information limited to the ORS Board of Directors, its committees, sections, and staff.
  1. In view of the policy-making and fiscal decisions rendered by ORS Officers, they must review the agendas of meetings in advance so that they can fully declare and disclose verbally any actual or apparent conflict/duality of interest related to issues that come before the Board of Directors. After disclosure and as directed, Officers shall recuse themselves from discussions in person and in conference calls and from voting on any such issues. In addition, after disclosure and as directed, Officers shall recuse themselves from discussion and voting on of issues that occur spontaneously (e.g., as new business) for which they have any actual or apparent conflict/duality of interest. Officers are expected to self-identify these issues and to comply with direction from the Board.
  1. No member of the Presidential line shall write a letter of support, recommendation, or endorsement of any candidate for the annual election. A letter of this nature from the Presidential Line could be construed as undue influence.
  1. The Officers are also charged with following the guidelines provided for Board members in Section III.
  1. Board of Directors of the ORS

The powers of the Board of Directors are to manage the property and affairs and determine the policies of the ORS. Board members are elected to represent all constituents of ORS membership and should strive during their tenure on the Board to further the mission and goals of the ORS without external influence and conflict/duality of interest.

To these ends, Board members are expected to follow this Policy.

  1. Individuals who are Board members in the ORS and are officers or nominees for office in other societies should consult with the Ethics Committee to determine whether concomitant service to both organizations would constitute or appear to constitute a conflict/duality of interest for ORS.
  2. Board members of the ORS, like all ORS Officers, Committee chairs and members, members of ORS sections, and staff, are required to maintain the confidentiality of information limited to the ORS Board of Directors, committees, sections, and staff.
  3. In view of the policy-making and fiscal decisions rendered by the Board, Board members must review the agendas of meetings in advance so that they can fully declare and disclose verbally any actual or apparent conflict/duality of interest related to issues that come before the Board. After disclosure and as directed, Board members shall recuse themselves from discussions in person and in conference calls and from voting on any such issues. In addition, after disclosure and as directed, Board members shall recuse themselves from discussion and voting on issues that occur spontaneously (e.g., as new business) for which they have any actual or apparent conflict/duality of interest. Board members are expected to self-identify these issues and to comply with direction from the Board.
  4. During their tenures, the Board members of the ORS should consult with others, including the Ethics Committee, on the significance of actual or apparent conflicts/dualities or biases arising from work with corporate entities in relation to their primary roles as the senior leadership.
  1. No member of the ORS Board of Directors shall serve in a role where they may have a perceived conflict of interest or undue influence which includes, but not limited to; serving as a Section Chair or Officer, Editor, Co-Editor, or Associate Editor, meeting chair or program chair of an ORS related meeting or event.
  1. All members of the ORS Board of Directors should abstain from voting when they have a conflict of interest.   Board members are discouraged from abstaining from voting for any other reason other than what is stated above.  A verbal explanation of the reason for abstaining from voting will need to be disclosed to the Board verbally.

III. Nominees for Office or Board Membership

  1. Members of ORS should assure the Nominating Committee that they can act on behalf of the ORS, free from bias or unresolvable conflict/duality of interest, prior to accepting nominations for and election to Officer or Board member status in the ORS. They must disclose all actual or apparent conflict/duality of interest in their submitted ballot material for publication in the ORS ballot. In addition, nominees must disclose any additional relationships or conflicts/dualities of interest that arise between ballot preparation and voting and during service.
  1. Chairs and Members of Committees, Editorial Board(s), and Sections

The committees, sections, and editorial boards of the ORS and its publications carry out the work of the Society on behalf of the membership. The distinct functions of the committees, sections, and editorial boards are intended to address the broad mission of the ORS: to promote excellence in research and education, to integrate basic and clinical science in the field of musculoskeletal research, and to facilitate the translation of research into clinical practice for the betterment of human health.

  1. Chairs and members of committees, sections, and editorial boards must assure that they act in these roles in a manner free from commercial bias and that they resolve or have an approved management plan for any conflict or duality of interest or disclose them and then recuse themselves from related deliberations and voting.
  2. In calling meetings or conference calls to order, committee chairs and section leaders must regularly request disclosure from members regarding any items on the agenda of the meeting or conference call for which they have an actual or apparent conflict or duality of interest. Members shall recuse themselves from voting on and discussing such issues. In addition, chairs and members of committees, sections, and editorial boards shall recuse themselves from voting on, and from discussion of, issues that occur spontaneously (e.g., as new business) for which they have any actual or apparent conflict/duality of interest.
  3. Program Committee chairs must assure that all CME educational activities are planned free of conflict/duality or duality of interest and commercial bias or influence.
  4. Editorial Board members must strive to ensure that the Journal of Orthopaedic Research and JOR Spine are free from commercial influence and unresolved conflict/duality of interests and that it reflects high-quality, peer-reviewed science and a balanced view of therapeutics available to treat human diseases.
  5. Nominations for awards and/or service as Officers or on the Board of Directors or committees must be reviewed free from personal and external bias and conflict/duality or the appearance of a conflict/duality of interest. To that end, all committee members should disclose to the respective Committee or the Board potential duality or conflict/duality of interest, which includes proposing an individual for nomination, providing a letter of recommendation, and/or having a close professional or personal relationship with the nominee. The member with a conflict/duality or the appearance of a conflict/duality of interest should recuse herself/himself from discussions regarding the nominated individual as well as from the vote involving that award or office. A member of either the Awards and Recognition or Nominating Committee should not serve if she/he is being nominated for an award or office, or Board or committee service, respectively.
  6. Chairs and members of committees, sections, and editorial boards should maintain the confidentiality of information limited to the chairs, committees, editorial boards, sections, and staff.
  1. Nominees for Committee Chairs and Members of Editorial Board(s), and Sections
  1. All members of the ORS should ensure the Nominating Committee and the Board of Directors that they can act on behalf of ORS, free from bias or any unresolved or unresolvable conflicts/dualities of interest, prior to accepting nominations for service as chairs or members of committees, sections, and/or editorial board members and associate editors of the Journal of Orthopaedic Research or JOR Spine. All actual or apparent conflicts/dualities of interest must be disclosed prior to accepting service as a chair or member of a committee, section, or editorial board, or as an associate editor.
  1. Representatives of the ORS to Other Organizations, Government Agencies, and Commercial Entities
  1. Representatives of the ORS to other organizations and entities should ensure that they present the mission and policies of the Society in a balanced manner, free from conflict or duality of interest and commercial influence.
  2. Representatives of the ORS should maintain the confidentiality of information limited to ORS, its Board of Directors, Officers, committees, sections, and staff.

VII. Nominees for Representatives of the ORS to Other Organizations, Government Agencies, and Commercial Entities

  1. All members of the ORS should assure the Board of Directors that they can act on behalf of the ORS, free from bias or unresolvable conflict/duality of interest, prior to accepting nominations to serve as representatives of ORS to other organizations or groups.

VIII. Editor(s) and Associate Editors of the Journal of Orthopaedic Research, JOR Spine, and Other ORS Publications

  1. Editors and Associate Editors working on behalf of the ORS should uphold the highest principles of scientific objectivity in conducting the review and publication of submissions to the Journal of Orthopaedic Research, JOR Spine, and other ORS enduring materials.
  2. Reviewers and authors of editorials, invited reviews, commentaries, and other materials in the Journal of Orthopaedic Research, JOR Spine, and other ORS publications shall be, with the best possible effort, selected on the basis of scientific and clinical expertise, without external influence or commercial bias.
  3. Editors and Associate Editors of the Journal of Orthopaedic Research, JOR Spine or other ORS publications shall strive for objectivity in the review and decision-making process concerning submitted contributions. Their decisions shall be, with the best possible effort, free from commercial bias, external influence, and unresolved conflict/duality of interest. If an actual or apparent conflict or duality of interest exists, then an Editor and/or Associate Editor must disclose the conflict/duality and then excuse herself/himself from any decision-making regarding the specific submission. Responsibilities for such a submission will be delegated to other appropriately qualified members of the Editorial Board or another Associate Editor.
  4. Editors and Associate Editors shall work with the publisher of the Journal to ensure that full disclosure of industrial, pharmaceutical, and financial relationships involving authors will be obtained, as these relationships may have an impact on views derived by the readers of the published manuscript.
  5. Associate Editors must disclose if they are also serving as an Editor or Associate Editor for other journals in the field.
  1. Nominees for Editor(s) and Associate Editors of the Journal of Orthopaedic Research and Other ORS Publications
  1. All members of the ORS should assure the Board of Directors and the Publications Advisory Board that they can act on behalf of the ORS, free from bias or conflict/duality of interest, prior to accepting nominations for editorship and associate editorship of the Journal of Orthopaedic Research, JOR Spine, and other publications of the ORS.
  1. Nominating Committee
  2. No member of the Nominating Committee shall write a letter of support, recommendation, or endorsement of any candidate for the annual election. The Nominating Committee will be responsible for the endorsement of the entire slate presented to the membership for election.
  3. Ethics Committee
  1. To provide guidance for ethical issues of the ORS, a panel of individuals will serve in the capacity of an Ethics Committee to interpret the ethical requirements and standards of the Society. The Committee may on its own initiative, or upon request by any ORS Officer or member, review the conflict/duality of interest disclosures of any Board member, Officer, of Editor(s) of the Journal of Orthopaedic Research or JOR Spine. The Committee will assist in the review of ethical issues and questions raised by Officers, Board members, committees, the Editorial Board, sections, members, and staff. The Committee will assist in developing a conflict management plan, if one is needed. Additional experts can be appointed to serve on the Committee on an ad hoc basis, depending on the nature of the issue under consideration. This committee will further propose modifications to the Ethics Policy and Guidelines on an as-needed basis.
  2. The Committee will have four members.
  3. Nominees for vacancies on the Ethics Committee will be recommended by the Ethics Committee Chair and approved by the Board of Directors. The Ethics Committee may suggest ad hoc members to the Board for approval.

XII. Ethics Appeal Committee

A separate body, the Ethics Appeals Committee, and its members (no fewer than three people, however the Committee will consist of an odd-number of members to avoid a tie-vote) will be appointed by the Board of Directors on an as-needed basis. All appeals of any decisions of the Ethics Committee will be heard and voted upon by the Ethics Appeals Committee. The Ethics Appeals Committee’s decisions shall be final.

XII. Process Following Adoption of This Ethics Policy

  1. Officers, Members of the Board of Directors, Committee Chairs, and Editors in office at the time of adopting these guidelines or subsequent editions shall not be subject to retroactive application.
  2. The qualification for service for all future nominated Board members, Officers, and Editors proposed for the Ballot and committee and section chairs and members will be subject to these principles.
  3. To move toward compliance with the ethical guidelines and principles of the ORS, at the time of adoption, the extant Officers, Board members, and committee and section chairs must review their membership and ongoing activities for compliance with this code. They should inform the ORS President and Executive Director of any instances of noncompliance and discuss with the ORS President how these issues will be handled.
  4. To ensure that future activities of the ORS meet the standards of the Society, the ethical implications of forming new relationships, beginning new ventures, and/or committing funding or resources of the Society will be reviewed by the Board of Directors and other relevant committees, concomitant with the other aspects and implications of these ventures.

Background

ORS leadership expects that the ORS Code of Ethics will guide all ORS interactions with industry. These additional guiding principles further define the Society’s interaction with industry. Before introducing these principles, some definitions are useful:

  • “Supporter/Sponsor” refers to the organization, company, or government entity that provides financial support for an ORS endeavor through an educational or other grant mechanism.
  • “Advertiser” refers to an individual, company, or organization who/that pays a fee for advertising space in the Journal of Orthopaedic Research, JOR Spine, or other ORS publications. All advertisements are approved by the Editor(s) prior to acceptance.
  • “Renter/purchaser” refers to the individual or company who rents ORS exhibit booths, or purchases ORS publications, Journal of Orthopaedic Research subscriptions, advertisements, meeting bag inserts, and/or other products.
  • “Industry-Supported Symposium” refers to a session at any ORS Meeting that is financially supported by industry and organized by people other than the Society’s Program or Planning Committee. Industry-Supported Symposia will be identified as such in meeting materials and will not, at any time, be eligible for CME.

General Guiding Principles

  1. The ORS may seek corporate support for educational initiatives that support the Society’s mission and goals, including the ORS Annual Meeting, grants and awards, professional development programs, scientific meetings, ORS publications, and the ORS websites and newsletters.
  1. Corporate support enables the Society to leverage its resources and increase its scientific offerings and impact.
  1. ORS meeting co-chairs and organizers, work to ensure that the ORS Annual Meeting Official Program, other ORS meeting programs, and all publications and other product content stemming from such meetings are free of undue influence by any party.
  1. ORS staff members may seek industry support for ORS programs and products in the form of educational and other grants according to relevant guidelines. These guidelines allow no industry influence over content.
  1. The ORS will not make exceptions to its policies for corporate supporters or other groups/individuals.
  1. The ORS acknowledges industry support through the common practices adopted by other nonprofit groups and government entities: signage and slides at meetings; in writing in its programs, advertisements, newsletters and on its website; and with plaques presented at an annual social event, or as in accordance with ACCME guidelines.

Principles Guiding Annual and Other Meetings

  1. The ORS is the sole sponsor of all its Official Program scientific sessions at its Annual Meeting, except joint symposia, which are organized with other groups. When ORS partners with another organization or government entity (e.g., in the case of a joint symposium at the ORS Annual Meeting or another meeting), the two (or more) entities co-plan the event and co-select the speakers and topics in accordance with the ORS Partnership Policy (addendum A).
  2. The ORS Annual Meeting Official Program may include Industry-Supported Symposia and Working Groups; however, as per ACCME guidelines, none are eligible for CME accreditation and will be disclosed to meeting attendees in the meeting materials. Other industry-supported programs, not included as part of the ORS Annual Meeting Official Program are considered an Ancillary Program. These sessions are held in conjunction with the ORS Annual Meeting, and can only be advertised using this language.
  3. All Industry-Supported and other Symposia, such as all Official Program sessions, must disclose in written materials all speaker conflicts and/or appearances of conflict, and must disseminate, collect, and provide evaluation forms or summary to the ORS Program Committee. The Committee will report complaints regarding undue corporate influence in its Official and/or Ancillary Program to the organizer(s), to the ORS Industry Engagement Committee, to the ORS Board of Directors, and to the Ethics Committee.
  4. Meetings to which the ORS sends representatives may result in the generation of written documents (e.g., consensus or position statements) as work product from the meeting. ORS members who are supported by the ORS to attend such meetings must disclose all conflicts and/or appearances of conflict and acknowledge the support of the ORS in the written materials.

The Journal of Orthopaedic Research and JOR Spine serve as a forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies. Besides the policies and guidelines pertaining to the Journal found elsewhere in this document, the Journal also addresses matters of conflicts of interest and financial disclosure as part of its manuscript submission, review, and publication processes as described at the Journal’s website. In addition, the Journal Editors from time to time present principles to which the Journal adheres through editorials published in the Journal. ORS members and authors submitting manuscripts for publication are encouraged to familiarize themselves with these principles:

  • Orthopaedic surgeons, scientists, and industry by J.A. Buckwalter and T.M. Wright. J Orthop Res. 2008 Mar;26(3):279.
  • Plagiarism by T.M. Wright, J.A. Buckwalter, and H.J. Donahue. J Orthop Res. 2010 Sep;28(9):1119.
  • Publishing the results of multiple experiments using the same methods and outcome measures by J.A. Buckwalter, T.M. Wright, H.J. Donahue and P.C. Amadio. J Orthop Res. 2011 Feb;29(2):155.
  • Scientific credibility requires complete presentation of methods by J.A. Buckwalter, T.M. Wright, C.B. Frank, R.B Martin, L.J. Sandell, S.B. Trippel. J Orthop Res. 1997 Mar;15(2):161.
  • Plagiarism: An assault on the integrity of scientific research by J.A. Buckwalter, T.M. Wright, L. Mogoanta, B. Alman. J Orthop Res. 2012 Dec;30(12):1867-8