We appreciate the comments of Drs Joob and Wiwanitkit with regard to our recent article. Most of their comments (eg, “translational plagiarism”) are on plagiarism and not self- plagiarism, but some are relevant to both. The authors of this letter are correct that the response to plagiarism or unacceptable duplication is quite variable and at times minimal. The medical and scientific community may need to address this issue and possibly create a set of rules for detection and response to these issues.

In the ancient Greek amphitheatre where the Olympic Games took place there were 2 series of sculptures with plaques. On one side of the entrance were statues with a plaque dedicated to individual winners of the games. On the other side, and in the same size and style, were sculptures with plaques with names of the contestants who were found to cheat, paid for by fines imposed upon the cheaters. It is possible that we need to adopt a similar approach in our professional environment.