Being the Ghost in the Machine: A Medical Ghostwriter's Personal View

PLoS 9.8.2011


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Introduction
Ethical concerns about medical ghostwriting have been directed primarily at “guest” authors and the pharmaceutical companies that pay them. One voice that is largely missing is that of the ghostwriters themselves who, after all, create the documents that are in the ethical and legal crosshairs. Without them, one could argue, there can be no fraud, because it is they who create the fraudulent product.

For almost 11 years, I worked as a medical writer, creating a variety of pieces including the occasional ghostwritten article. For the most part, I never saw the finished paper, nor did I care to. This article describes what I did, why I did it, why I stopped doing it, and what I think might be done about the problem of fraud in authorship.

How Industry Uses the ICMJE Guidelines to Manipulate Authorship—And How They Should Be Revised

PLoS 9. August 2011

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Summary Points
Academic authorship boosts the credibility of industry publications and masks their commercial function.
Alongside traditional “guest authorship” and ghostwriting, industry may simply exaggerate the contribution of named academic authors and downplay that of commercial writers, who are excluded from authorship but listed as contributors in the small print.
Rather than obstructing industry, the current International Committee of Medical Journal Editors (ICMJE) authorship guidelines provide a ready tool for misattributing authorship. Industry also relies on selective interpretations of key authorship concepts.
The ICMJE guidelines should be fundamentally revised and the concept of origination given comparable importance to authorship and contributorship.
Companies and writers who work on industry publications should be listed as byline authors.