The Ethics of External Peer Review

Abstract

External peer review can be a useful part of a quality improvement program. However, it can also be used for political and punitive purposes. The distinction between potentially useful and damaging review is largely an issue of the ethics of how it is done. The ethics of external peer review lie not only in the process itself, but also in the role of the pathologists performing the review. While there are many ethical issues involved in external peer review, the most important may be a dedication to due process, allowing the pathologist under review to respond to allegations, and an insistence on complete information prior to drawing conclusions. Well established criteria for external peer review may provide protection both for the pathologist under review against allegations of negligence or incompetence, but also for the reviewers against accusations of bad faith.