During the past decade, the pharmaceutical publications trade has campaigned to persuade medicine, journals, ethicists, and the media that it is opposed to ghostwriting. Yet industry practices have changed little, and commercial drafting of clinical trial reports, consensus statements, and reviews that are authored by recruited academics remains routine. Here, I show that industry’s opposition is based on a redefinition of the term ghostwriting that obscures the continued, widespread use of the practice as originally defined in medical journal literature. I also argue that the ghostwriting debate has deflected attention from the broader set of strategies through which marketing influences medical publications. The use of writers, regardless of whether they are called ghosts, is just one of several options for building commercial perspectives into academic literature, then spinning their attribution to strengthen credibility.
Rebranding of ghostwriting
Outside medicine, a ghostwriter is “a person whose job it is to write material for someone else who is the named author.”
Drug companies and their agencies use writers to develop articles for academic authors, and in the 1990s and early 2000s this was commonly understood as ghostwriting, both by journal editors and the pharmaceutical publications trade. But today, the trade promotes an alternative definition, whereby writers are not classified as ghosts if they are named in a footnote.
The International Society for Medical Publication Professionals, a trade association, states: “Ghostwriters are individuals who contribute substantially to a medical publication but do not appear on the byline and are not acknowledged for their contribution.”
The Global Alliance of Publication Professionals, a trade advocacy unit, states: “A ghostwriter is someone who writes a paper, but whose name does not appear on the paper.”
Simply by acknowledging writers for editorial or writing “assistance”—a practice always widespread—commercially written literature is by these definitions freed from the egregious ghostwriting label. Consider, for instance, two commercially drafted studies of paroxetine, both criticised for using ghostwriting to produce allegedly biased content. One, study 352, mentions no writer but the other, the notorious study 329, discloses at the end of a tract of small print that “Editorial assistance was provided by Sally K Laden, MS.”
By the traditional definition, both articles are ghostwritten, but according to the trade definitions quoted above, Study 329 is not, even though the medical writer’s credit is inconspicuous. (Más)
- -Ghostwriting remains widespread in industry financed medical journal literature, although redefinition means it is not always labelled as such
- -The drug industry’s use of medical writers is only one of various means through which scholarly literature may be influenced for marketing purposes
- -ICMJE rules should be modified to ensure that industry medical writers are credited with coauthorship and to ensure that industry instigated literature is better attributed and labelled
- -The standard definition of ghostwriting should be reasserted within medicine, and industry’s promotional activities within publication ethics subjected to ethical study