Medical ghostwriting and ‘Guest Authorship’: twins separated at birth?

vancouver purpleParticipants at this month’s International Congress on Peer Review and Biomedical Publication in Vancouver heard an interesting medical journal survey report on ghostwriting vs. ‘guest authorship’ that has me scratching my head in confusion. Presented by the Journal of the American Medical Association, the report confirmed that the prevalence of both ‘honorary’ and ‘ghost authors’ in medical journal articles is “still a concern”. 

Here’s a dose of reality for JAMA editors: it’s not just a “concern”.  It’s global fraud being perpetrated upon the innocent patients of the world thanks in part to the lax (some more cynical than I might say ‘non-existent’) controls in place in many medical journal editors’ offices. For example:

  • only four of the journals surveyed ask and then publish information on who the actual article authors are (Annals of Internal Medicine, JAMA, Lancet,and PLoS Medicine)
  • New England Journal of Medicine claims that the journal “asks about author contributions but doesn’t publish them.” (Earth to NEJM: this is the same as not asking).
  • Nature Medicine has “no instructions to authors about disclosing author contributions.”

This sounds like a de facto stamp of approval for the common practice of ghostwriting and ‘guest writing’. But by now, you may be asking the question: “Carolyn, what is the difference between ‘guest writing’ and ‘ghostwriting’ in research published in medical journals”?  The answer, my fellow Nags, is:  not much.  But here’s JAMA’s official definition: 

“In their earlier survey, published in JAMA in 1998, the authors spell out their definition of honorary author in depth, pointing out that an ‘honorary’ or ‘guest’ author is often something ‘bestowed as a tribute to a department chair or to the person who acquired funding for the study.’ By contrast, a ‘ghost’ author refers to someone who is not named as an author, despite having made substantial contributions to the research or writing of the article.”

Am I missing something here, or is this definition basically saying that when you see a person’s name above a medical journal article, it is essentially meaningless?

Bestowing a “tribute” like false authorship to a department chair is like university students fraudulently putting their own names on purchased internet essays.  The similarity: neither actually wrote them. The difference: the students are punished for their fraud.  Department chairs are honoured for it.

More to the point, academics get to add one more title to the all-important list of published papers on their CVs, without all that bother of actually doing the work. How is this fraud any more palatable than medical ghostwriting, in which the actual drug company-paid author’s name is missing from the article credits entirely?

Back in Vancouver, many members of the audience, justifiably outraged, called for a naming and shaming of physicians and academics who sign on with Big Pharma’s medical ghostwriters.

And JAMA presenters offered this laughably simplistic explanation about their survey findings that ghostwriting appears to have slightly declined while guest authorship has not.

“It’s unclear. Our assumption is that there is more awareness among authors and journals [about the stigma of ghost authorship] and more awareness among those who participate in ghostwriting and fund it.”  

“Awareness”?  I guess that high-profile court cases like the 8,400 lawsuits facing Wyeth Pharmaceutical and its 26 ghostwritten journal articles will do a lot to raise “awareness” in drug companies who fund fraudulent medical ghostwriting.

Learn more about the survey reported in Vancouver.

See also:

11 thoughts on “Medical ghostwriting and ‘Guest Authorship’: twins separated at birth?

  1. Excellent information, well put. I have just subscribed to your site – always something thought-provoking going on here!

  2. This practice of guest authorship is rampant and, oddly enough, is considered perfectly acceptable in the academic community where I work as a research assistant. Profs would be quite offended if anybody opposed their ‘guest authorship’ status, and really – who would do such a thing to these senior faculty who already consider themselves to be gods? They just need to sit back and watch their ‘tribute’ publication list grow, even for projects they may be utterly unaware of, or worse, those that arrive from drug company writers.

    Medical school administrators will NEVER touch this subject, as faculty with hefty publication lists are good for business, and they are used to turning a blind eye if it will attract grants and donors. Thank you for helping to inform the public about this widespread practice – that’s the only place where change will start to happen whether these old profs approve or not.

  3. As a senior academic, I believe it’s unfair to tar all medical faculty with the same brush through the implication that all guest authors are somehow lying cheats, as you have done here. There are many times when it’s appropriate that scientific papers acknowledge the contributions of senior physicians. There are many other valuable contributions other than sitting down and drafting a paper – without which academic research might not be possible.

  4. This shows a remarkable arrogance on the part of ‘guest author’ academics who don’t ‘get it’. Self-absorbed situational ethics at work.

  5. Good example of how you can take something that sounds innocuous and benign – “guest author” – to hide something blatantly fraudulent. The ivory tower set somehow believe they are not like the rest of us when it comes to doing the right thing. Love your website – I’m a new subscriber.

  6. Can hardly believe this is going on under the noses of those we are trusting to safeguard our health. And what’s being done to stop them?

  7. Medical ghostwriting – are you kidding me? Why is this still going on when it sounds like EVERYBODY who could stop it knows all about it?

  8. I thought this was common knowledge!

    When I was in grad school, it was just the way things were done. All of us accepted that we grad students did the actual work, which may or may not have even been reviewed by our advisors, who then were listed as lead authors for journal publication purposes. Hell, we were just glad to have our names anywhere on a publication at that time.

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