The article published by Çokuğraş et al¹ reported the results of bronchial biopsies performed in 10 children with moderate asthma. The study showed thickening and “hyalinisation” of the basement membrane in nine of the patients as well as the presence of “overactive fibroblasts, degranulating mast cells, and lymphocyte infiltration in the submucosa”. The authors concluded that these changes were similar to the bronchial inflammation seen in adults with asthma. Importantly, however, eosinophils were seen in only one biopsy specimen. Data such as these are not commonly available from children with asthma, partly because of the practice of performing bronchoscopies in children under general anaesthesia.

This article has prompted Dr Bush and colleagues to write berating Thorax for daring to publish such data which they contend were collected without regard for proper ethical standards. They quote from the guidelines for the ethical conduct of medical research involving children published by the Royal College of Paediatrics and Child Health (UK), stating that high risk procedures are not justified for research purposes alone. The authors have responded, saying that they believe they had taken appropriate precautions, informed the parents fully, and obtained appropriate consent. They went to some lengths to point out in their original paper the precautions they undertook to ensure the safety of the children.

That research, like all human behaviour, must follow appropriate ethical guidelines is a fundamental principle under which we all …