Share this article on:

You Will Be Caught

Shafer, Steven L. MD

doi: 10.1213/ANE.0b013e3182095c73
Editorials: Editorials

From the Editor-in-Chief, Anesthesia & Analgesia, Department of Anesthesiology, Columbia University, New York, New York.

The author declares no conflicts of interest.

Address correspondence and reprint requests to Steven L. Shafer, MD, Department of Anesthesiology, Columbia University, 630 West 168th St., P&S Box 46, New York, NY 10032. Address e-mail to

Accepted November 29, 2010

The Oxford English Dictionary defines plagiarism as “the practice of taking someone else's work or ideas and passing them off as one's own.”1 Plagiarism represents the most common form of misconduct occurring in Anesthesia & Analgesia. Plagiarism can be roughly divided into 5 different groups: intellectual theft, intellectual sloth, plagiarism for scientific English, technical plagiarism, and self-plagiarism.

Intellectual theft is the misrepresentation by an author that words and ideas previously published by another author represent the plagiarist's own scholarship. Intellectual theft is the form of plagiarism most closely associated with the definition in the Oxford English Dictionary. Intellectual theft may involve copying an insightful analysis from another paper, using an unusual and clever metaphor developed by another author, or copying large blocks of text to steal the scholarship of the original author. It is always without attribution, ensuring that the credit for the scholarship accrues to the plagiarist. I recall a reviewer's sardonic comment: “I thought the discussion was particularly well written. It was taken verbatim from one of my own papers.” That is reminiscent of George Bernard Shaw's comment, “I often quote myself. It adds spice to the conversation.”2

Intellectual theft is the most serious form of plagiarism. When I identify intellectual theft during peer review, I send a letter of concern to the author's institution and institute sanctions. Papers that contain plagiarism for intellectual theft must be retracted. Fortunately, intellectual theft is uncommon.

Intellectual sloth is the use of the words of another author simply to avoid the effort of writing new text. For example, there are many ways to describe a nerve block. Authors should use their own words when they describe a nerve block, or properly quote and attribute the description written by another author (e.g., As described in Wikipedia[footnote to Wikipedia page]:verbatim text describing nerve block”). However, it is surprisingly common for authors to simply cut and paste from an existing source, such as Wikipedia. This isn't intellectual theft, because the text that is copied is generic, and “is free content that anyone can edit or distribute.”* However, the author is simply too lazy to write the text in his or her own words, cannot be bothered to properly attribute the source, and instead chooses to paste in text found online. When plagiarism from intellectual sloth is identified during peer review, I typically either reject the paper or, depending on the circumstances, instruct the authors that the plagiarized text must be rewritten for the manuscript to be considered. The boundary between sloth and theft is not always clear, and each case is considered on its own merits. Plagiarism for intellectual sloth discovered after publication may require a retraction, a correction, or a letter of apology from the authors.

Plagiarism for scientific English is the most common type of plagiarism in submissions to Anesthesia & Analgesia. Authors uncomfortable with scientific English often turn to the Internet to see how other authors have expressed the same idea. Two retractions in the December issue of Anesthesia & Analgesia are examples of plagiarism by authors uncomfortable with scientific English.3,4 In both cases, the authors copied verbatim text from other articles to express themselves in proper English. In both cases, when the authors were asked to explain the plagiarism in the manuscript, they replied in broken English that they used the verbatim text to help express their ideas in proper English. I believe them, and believe they intended no harm.

In some cases of plagiarism for scientific English, nearly every sentence in the manuscript has been pasted from a published source. This is sometimes referred to as patchwork plagiarism. Typically, there is no single block of text from one source, and thus the paper is not plagiarized in the typical sense of the term. However, the authors have constructed a paper in proper scientific English by assembling a hodgepodge of sentences and sentence fragments from dozens of published articles or web sites, mutatis mutandis. This is particularly common in papers from non-English–speaking countries, and has been a source of concern to Chinese journals.5 Although I do not consider this plagiarism, I worry that the research may be inaccurately described by the collage of cut and pasted text.

Technical plagiarism is the use of verbatim text not identified as verbatim, but referenced to the original source. Because the plagiarized text referenced the source, this is not an attempt to steal the ideas or concepts of another author. The offense is a technical one: the author has not structured the text so that the original author receives credit for the words. In a recent instance, an author used an apt metaphor about consciousness copied from an article by Alkire et al.6 in Science. As expressed in the submission to Anesthesia & Analgesia: “any conscious experience, even one of pure darkness, must be extraordinarily informative.6” The author isn't attempting to steal Professor Alkire's insight, because he referenced Professor Alkire's article. However, technically, this is plagiarism. The author hasn't given Professor Alkire credit for the actual words. The proper way to express this would be: As Professor Alkire noted, “any conscious experience, even one of pure darkness, must be extraordinarily informative.”6 Because the author wishes to use the particularly elegant insight of Professor Alkire, he must give proper credit to Professor Alkire to avoid technical plagiarism. Technical plagiarism represents an error in manuscript preparation, not an intent to steal. If technical plagiarism is found in a manuscript, we may issue an errata, or request that the author submit a letter of apology.

Self-plagiarism occurs when an author uses his or her verbatim words from a previous manuscript in a new submission. Self-plagiarism is an oxymoron, because the term implies that an author has stolen from himself, a seeming impossibility.7 It is unrealistic to expect an author working in a field to generate a novel description of a concept or technique every time he or she chooses to write about it. Indeed, abandoning a perfectly accurate description to avoid “self-plagiarism” runs a risk of corrupting a previously accurate description.

How much of an author's own text can be recycled in a new manuscript? Samuelson reports that “some people use the 30% rule (i.e., a rule of thumb that if one reuses no more than 30% of one's prose in an article, that's OK). This strikes me as a gray zone, and I would certainly not recommend any greater use than this, and very likely would recommend less unless one has sought permission for the reuse.”2 Kravitz and Feldman8 observed, “In our informal poll, many experts … are fine with around 10% recycling of verbiage, some even arguing for the benefits of repeating complex methods verbatim. A few suggested limits of 15–20%, but none countenanced more than 30%.” I encourage those interested in the subject to read the posting by Jef Akst for The Scientist, and multiple thoughtful comments that follow her post.a

Anesthesia & Analgesia explicitly accepts self-plagiarism in the Methods section of a manuscript, but discourages it elsewhere. We recently retracted a paper involving self-plagiarism.9 Although “self-plagiarism” was mentioned in the request for retraction,10 the self-plagiarism alone might not have required retraction. In this case, the manuscript was also retracted11 because the authors did not inform the Journal of a very similar paper undergoing peer review in Anesthesiology.12 Because the paper had been accepted on a presumption of novelty, when we realized it contained almost no new information, the paper was retracted.

I am loathe to deprive authors the right to use their own words. Although we discourage author's use of their previously published verbatim text except in the methods section of a manuscript, only egregious cases of “self plagiarism” require a response from Anesthesia & Analgesia. The extreme case, duplicate publication, is very different. Duplicate publication is the dishonest representation of the novelty of the submission. Duplicate submission is a serious form of author misconduct and always requires a retraction.

Anesthesia & Analgesia has taken a very firm line on plagiarism, resulting in several recent retractions. This is heartbreaking for everyone, including me. My goal is to nurture and support scholars, particularly those in the developing world. However, a nonretracted manuscript containing plagiarized text represents a “normalization of deviance.”13 It is often a copyright violation. Retractions can be devastating for authors, who may be unaware that the submitted manuscript contains plagiarized text if the manuscript was written by coauthors who did not understand the rules regarding plagiarism.

Now for the good news: we can prevent this!

Anesthesia & Analgesia screens every submitted manuscript for plagiarism. The program I use, CrossCheck, is incredibly thorough. CrossCheck screens manuscripts against nearly all published journals, as well as against a huge variety of Internet sources. CrossCheck has identified plagiarized text from obscure medical journals, on-line CME courses, and unpublished (but on-line) PhD dissertations.

I have screened every submitted manuscript for many months. Approximately 1 of every 10 submissions has had unacceptable amounts of text taken verbatim and without attribution from another source. I have seen examples of each type of plagiarism described above, the most common being plagiarism for scientific English. I try to avoid being too judgmental about plagiarism for scientific English, recognizing that it must be a nightmare for authors to publish in a language they do not speak. How would I respond if my promotion depended on publication of my papers in Mandarin? In most cases, I issue an initial decision letter to the author requesting that the author rewrite the verbatim text.

One hundred percent screening for plagiarism is a service to our authors. If this is successful, no author will ever again face having a paper retracted from Anesthesia & Analgesia for plagiarism.

I urge all authors, regardless of country, native language, institution, academic rank, or their position in the list of authors, to do their part and screen every submission for plagiarism. When plagiarism is found, all authors are held accountable. As reviewed in this issue of the Journal, there are numerous web sites providing reasonably high quality plagiarism detection at no cost.14 There is no “down side” to screening manuscripts using these programs. Identification of plagiarism before submission may save the author, the coauthors, his or her institution, and even his or her country the embarrassment of having the plagiarism identified after publication and the article retracted.

We live in the era of the Internet and Google. Medical journals are digitizing their archives and posting them online, where they are indexed by Google, Yahoo, Bing, and other search engines. Programs such as Deja Vub troll through the medical literature looking for duplicate publications. Even cases of plagiarism decades old may be caught in this digital age. Additionally, the Internet brings contemporary articles to tens of thousands of new readers. Duplicate text will eventually be identified, because the plagiarism sits, forever visible to the world, awaiting detection.

I urge authors to do their part: screen every manuscript for plagiarism. I urge senior faculty to do their part and insist that every manuscript from their research group be screened for plagiarism. No longer can a prominent investigator deny accountability for plagiarism because a junior coauthor copied text without his or her knowledge. The software to detect plagiarism is freely available and easy to use. There is no excuse for failing to teach junior authors the importance of checking for plagiarism or not checking your own submissions. I urge departments chairs to do their part and require authors in their department to screen every manuscript for plagiarism prior to submission. I urge institutions to do their part and require 100% screening of manuscripts from their institution for plagiarism prior to submission. I will do my part, and screen every submission for plagiarism. Working together, we can prevent another case of plagiarism from ever being published in Anesthesia & Analgesia.

The “take home” message for every author is that we are doing our best to prevent you from publishing plagiarized text in Anesthesia & Analgesia. We are counting on you to join this effort by screening your own papers. However, if we both fail, and plagiarism appears in the journal, you will be caught.

Don't plagiarize.

*, last accessed January 10, 2011
Cited Here...

a Akst J. When Is Self-Plagiarism OK? Available at: Accessed January 10, 2011.
Cited Here...

b Deja Vu: A Database of Highly Similar Citations. Available at: Accessed January 10, 2011.
Cited Here...

Back to Top | Article Outline


1. Oxford Dictionary of the English Language. 2nd ed, revised.Oxford, UK: Oxford University Press, 2005
2. Samuelson P. Self-plagiarism or fair use. Commun ACM 1994;37:21–5
3. Bhatnagar S, Shafer SL. Request for retraction. Anesth Analg 2010;111:1560
4. Shafer SL. Notice of retraction. Anesth Analg 2010;111:1561
5. Zhang Y. Chinese journal finds 31% of submissions plagiarized. Nature 2010;467:153
6. Alkire MT, Hudetz AG, Tononi G. Consciousness and anesthesia. Science 2008;322:876–80
7. Bird SJ. Self-plagiarism and dual and redundant publications: what is the problem? Sci Eng Ethics 2002;8:543–4
8. Kravitz RI, Feldman MD. From the editors' desk: self-plagiarism and other editorial crimes and misdemeanors. J Gen Intern Med 2010, DOI: 10.1007/s11606-010-1562-z, published online November 9, 2010
9. Neligan PJ, Malhotra G, Fraser M, Williams N, Greenblatt EP, Cereda M, Ochroch EA. Retraction: noninvasive ventilation immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesth Analg 2010;111:519
10. Neligan P, Williams N, Greenblatt E, Cereda M, Ochroch EA. Retraction letter for Neligan P, Malhotra G, Fraser MW, Williams N, Greenblatt EP, Cereda M, Ochroch EA. Noninvasive ventilation immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesth Analg 2010;110:1360–5; Anesth Analg 2010;111:576
11. Neligan PJ, Malhotra G, Fraser M, Williams N, Greenblatt EP, Cereda M, Ochroch EA. Noninvasive ventilation immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesth Analg 2010;110:1360–5
12. Neligan PJ, Malhotra G, Fraser M, Williams N, Greenblatt EP, Cereda M, Ochroch EA. Continuous positive airway pressure via the Boussignac system immediately after extubation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparoscopic bariatric surgery. Anesthesiology 2009;110:878–84
13. Prielipp RC, Magro M, Morell RC, Brull SJ. The normalization of deviance: do we (un)knowingly accept doing the wrong thing? Anesth Analg 2010;110:1499–502
14. Ochroch EA. Review of plagiarism detection freeware. Anesth Analg 2011;112:742–3
© 2011 International Anesthesia Research Society