In recent years, there has been an “epidemic of doubt” and skepticism about the integrity of the process by which new medical and scientific findings are published. Progress in ophthalmology, or any medical specialty, comes from the reporting of important new investigations and clinical findings. The process of authorship, submission to a journal, peer review, acceptance, and publication are the fundamental steps for the introduction of new knowledge into our practices. Public health and patient care are affected by what is published in the medical literature; the introduction of new drugs, technology, and techniques may save lives, preserve vision, and ameliorate suffering. Because of its importance, the integrity of this process receives intense scrutiny by the medical profession, the media, and the public. In this environment, the necessity of having systematic and rigorous ethical standards is an increasing obligation for medical editors, for authors, and for the physicians and scientists who read the medical journals.