A medical writer's perspective on ghostwriting

Montreal-based medical writer Kate Johnson has weighed in on her blog about the ongoing ghostwriting scandal, saying a distinction needs to be made between anonymous writers hired by drug companies, and those hired by the researchers themselves.

It's a fair point, and Johnson goes to lengths to explain how academic journal articles can have several authors, named and unnamed.

Obviously, if four names appear on a paper, it is unlikely that all four people sat down and typed individual sections. As a medical editor I strongly discourage this degree of “co-operation” because of the disjointed and chaotic results. But it is when an additional, unnamed person is responsible for the writing, that the notion of ghostwriting takes shape.

The ghostwriting scandal revealed in August by the New York Times hinges on this type of ghostwriting, but here a further distinction should be made regarding the definition of ghostwriting.

Although the JAMA study does not make this distinction, the Times focuses on ghostwriters who were hired by drug companies to spin the science in favor of their products. This is clearly a corruption of science and an indisputable attempt to mislead doctors and the public.

Few medical academics could see anything except extreme dishonesty in this practice.

The only point I might quibble with Johnson is on her use of the word "obviously" at the beginning of the excerpt. I am not sure this is obvious to most people, but I could be wrong.

She is right, though, that there is a difference between ghostwriters paid by a drug company and those paid by a researcher -- especially since the drug companies have made clear in their internal documents (made public in court cases) that paying ghostwriters is part of their drug marketing strategy. One would expect that ghostwriters hired by the researchers themsleves would be more attuned to the researchers' findings than to the marketing needs of Big Pharma.

Johnson has pointed out before that many top researchers, for all their brilliance and innovation, are not the best writers -- so turn to people like her for help. As a reporter who has had to sift through many scientific reports, I appreciate that contribution.

But I would also like to know that such a contribution has been made. From a reporter's point of view, there's no such thing as too much information when it comes to such things. It also erodes a researcher's credibility if, and when, it is revealed that a ghostwriter has been used and not acknowledged.

Perhaps researchers, when considering how much (if any) credit to give to ghostwriters should ask themselves one simple question: would I accept such behaviour from one of my students?

Comments

[Adam]

Some interesting thoughts there, but I feel you've missed a couple of important points.

First, the word "ghostwriter" often causes confusion, and I fear it's done so again. A ghostwriter is, by definition, unacknowledged. If a professional medical writer helps a researcher write a paper and is appropriately acknowledged for doing so, that is not ghostwriting.

Pretty much everyone agrees that ghostwriting is bad. Most of the attention has been on industry-sponsored ghostwriters, but you are quite right that the same considerations apply to writers hired directly by researchers.

Most commentators agree that appropriately acknowledged assistance from professional medical writers is acceptable, and many would also say desirable.

But, as I also wrote on Kate Johnson's blog, it's also important to realise that medical writers hired by pharmaceutical companies aren't necessarily mere tools of the evil marketing department. Granted, some drug companies have done some egregiously bad things with ghostwriters and publications, but there's no reason to think that that's typical behaviour by drug companies. There are plenty of medical writers who work for the pharmaceutical industry, probably the vast majority, who do so in an entirely ethical manner.

My own research (http://dianthus.co.uk/ghostwriting-survey) has shown that medical writers who work for pharmaceutical companies are less likely to have their contributions unacknowledged (ie be ghostwriters) than those working elsewhere.