Vioxx populi: when ghosts prescribe the credit

Merpel's latest book?

The idea of the ghost-writer was explained to the IPKat many years ago as a simple arrangement that was harmless, conferred benefit all round and even played its part in making the world rotate just a little more sweetly about its axis. What he was told was this: imagine a famous footballer who is not very literate or articulate [I think I can do that, says the IPKat].  A publisher thinks he can sell lots of copies of a book in which the footballer tells his life story, but the footballer isn't able to generate a publishable text. Along comes a literate, articulate but probably impecunious journalist. The publisher pays the journalist lots of money to interview the footballer and write the story; the publisher sells the book under the attribution line "by + 'name of footballer', and makes lots of money; the footballer then receives lots of money; the public read the book and enjoy it. They are not deceived because, having heard the football celebrity being interviewed on television and radio, they know that he "speaks with his feet" [this is a euphemism; some Mediterranean footballers speak with their hands too, but that's another matter] and that any sentence of more than six words has probably been outsourced.  The journalist -- whose contribution is all but invisible -- is in effect a "ghost". He gets a credit on the page no-one reads, along with the copyright notice, the rubric about not being able to store the book in a retrieval system or lend it to your grandmother and, of course, the ISBN. So everyone's happy. 

But now it seems that this happy business model is being put to ill use. According to a recent article in the Guardian, "Scientists credited on ghostwritten articles 'should be charged with fraud', legal experts are calling for severe sanctions against scientists who 'guest author' papers written by drugs companies [i.e. the scientists are the celebrities and the drug companies are the "ghosts"]. This piece, purportedly authored by Ian Sample and drawn to the Kats' attention by fellow blogger Howard Knopf, explains:

"Doctors and scientists who put their names to medical articles they have not written should be charged with professional misconduct and fraud, according to legal experts. The proposals aim to stamp out the shady business of "guest authorship", where research papers written by pharmaceutical companies or industry-sponsored medical writers are passed off as the work of influential, independent academics. In the worst cases, doctors receive payments or other incentives to endorse articles without being familiar with the studies or data the reports describe. Often, the articles are biased and do not carry the names of the real authors.

The medical profession has long been troubled [and remunerated, wonders Merpel?] by guest authorship and ghostwriting, but the issue has become harder to ignore in recent years as the extent to which drugs companies use the tactic as a marketing tool has become clear. Articles drafted by industry with minimal involvement from guest authors have been published in leading journals on hormone replacement therapy (HRT), Vioxx (an anti-inflammatory drug that was withdrawn amid safety fears), Neurontin (used in pain relief), antidepressants, and the combination diet drug, Fen-phen (also withdrawn for safety reasons).

While the practice is not currently considered to be illegal, it is widely regarded as unethical and potentially harmful to patients because it skews the information that appears in medical journals. [Merpel asks if it might have a beneficial side too: the consumer, taking a drug with a celebrity scientific endorsement, might rightly feel entitled to his placebo effect]

Writing in the peer-reviewed open-access journal, PLoS Medicine, Simon Stern and Trudo Lemmens, who are law professors at the University of Toronto, warn that measures brought in by publishers and professional bodies to curb guest authorship and ghostwriting have so far failed to tackle the problem. [This can be the case where the class of persons tackling the problem overlaps with the class of persons causing it] They call for more severe sanctions against those involved, even when the articles are scientifically accurate.

... "A guest author's claim for credit of an article written by someone else constitutes legal fraud, [unlike the case of the footballers, where no professional expertise is asserted and the assumption is made that the person claiming the credit is not generally the author] and may give rise to claims that could be pursued in a class action," the authors write. The same offence could also support claims of "fraud on court" when drugs companies rely on ghostwritten articles in court cases. Stern and Lemmens argue that pharmaceutical companies and the medical writers they sponsor may also incur liability for soliciting and facilitating fraud.

... Adriane Fugh-Berman, a doctor at Georgetown University Medical Centre in Washington DC, ... said the Canadian lawyers had put forward a "provocative proposal for a serious problem".

"Ghostwriting distorts the scientific literature on drugs and other therapies, and changes prescribing decisions in a way that may be harmful to patients. It is thus a threat to public health. Academic institutions give lip service to being against ghostwriting but no academic has been sanctioned. Fear of legal action really might deter the practice, which is euphemistically termed 'editorial assistance'," ...

Some journals, including PLoS Medicine, have called for bans on guest authors and warn that unacknowledged ghostwriting will be retracted if discovered after publication, with the academics being reported to their institutions ..."

The IPKat is pleased that this issue has been raised, not least because in his own professional life he has seen some genuine and talented writers 'displaced' by senior colleagues who have claimed authorship of work they did not write.   Merpel says, if I wrote a medical piece that turned out to be wrong, I think I'd feel quite comfortable if some medical bigwig who claimed authorship of it was the person who was made to look silly.

Ghost writers here
Ghost riders here