Abstract
Fraud is often coupled with misconduct and the two are certainly related; fraud by definition is misconduct, but not all misconduct is fraud. Fraud always contains intent whilst misconduct covers a wide range of activities, from carelessness, right through to deliberate deception. It is vitally important that fraud and misconduct, once suspected, are reported and fully investigated. But unless everyone involved in research at any level accepts the possibility that fraud exists, there will still be research fraud, and patients will continue to be abused and put at risk.