The integrity of the published record of scientific research depends not only on the validity of the science but also on honesty in authorship. Editors and readers need to be confident that authors have undertaken the work described and have ensured that the manuscript accurately reflects their work, irrespective of whether they took the lead in writing or sought assistance from a medical writer. The scientific record is distorted if the primary purpose of an article is to persuade readers in favor of a special interest, rather than to inform and educate, and this purpose is concealed.
Ghost authorship exists when someone has made substantial contributions to writing a manuscript and this role is not mentioned in the manuscript itself. WAME considers ghost authorship dishonest and unacceptable. Ghost authors generally work on behalf of companies, or agents acting for those companies, with a commercial interest in the topic, and this compounds the problem. For example, a writer employed by a commercial company may prepare an article, then invite an expert in the field to submit the work, perhaps with minor revisions, under his or her own name. The submitting author may be paid, directly or indirectly, for this service. In other circumstances, investigators may pay a professional writer to help them prepare their article but not mention this assistance, gaining credit for writing they have not done. Although editors seek to avoid publication of ghost written articles, these articles are often very difficult to detect.
Submitting authors bear primary responsibility for naming all contributors to manuscripts and describing their contributions. Ghost authorship would be avoided if corresponding authors listed everyone else who participated in the work, including those who contributed only to the writing, along with their individual contributions and institutional affiliations, stated explicitly how the work was paid for, and fully disclosed any further potential competing interests.
However, responsibility for ghost written manuscripts goes beyond individual authors. Other parties, including companies—such as marketing, communications, and medical education companies who are paid to assist pharmaceutical and medical device companies in disseminating favorable messages about their products—may initiate the sequence of events for which the author is the final and most easily identified participant. These other participants are also responsible for ghost-written manuscripts and addressing their roles should be part of the solution.
To prevent some instances of ghost authorship, editors should make clear in their journal's information for authors that medical writers can be legitimate contributors and that their roles and affiliations should be described in the manuscript. When editors detect ghost written manuscripts, their actions should involve both the submitting authors and commercial participants if they are involved. Several actions are possible: 1) publish a notice that a manuscript has been ghost written, along with the names of the responsible companies and the submitting author; 2) alert the authors' academic institutions, identifying the commercial companies; 3) provide specific names if contacted by the popular media or government organizations; and 4) share their experiences on the WAME Listserve and within other forums. Together, these actions would increase transparency and public accountability for ghost writing and its manipulation of the scientific record for monetary gain and deter others from this practice.