Competition of interest may exist at all levels in the medical publication process. Ensuring the integrity of scientific scholarship involves protecting editorial independence, promoting the use of scientific arbitration boards, promoting transparency throughout all stages of publication, and protecting the relationship between the publisher and its editors through an effective legal framework. It is incumbent upon the publisher, editors, authors, and readers to ensure that the highest standards of scientific scholarship are upheld. Doing so will help reduce fraud and misrepresentation in medical research and increase the trustworthiness of landmark findings in science.