Ghost-Writing Is Wrong
The arguments are strong and straight-forward.
First of all, and most importantly, it is harmful to the public health. Although relatively little is known about the details of corporate ghostwriting, the glimpses that we get of it through anonymous surveys and lawsuits suggest that the reason pharmaceutical companies go through the trouble and expense of shaping medical opinion about the safety and efficacy of their products is that it is highly profitable. Marketing campaigns seek to influence the prescribing practices of doctors. Ghostwritten articles may mislead doctors about the actual risks and benefits associated with medical treatments. Medical misinformation of this sort has the risk of harming a large number of people. The potential for harm is amplified by the fact that ghostwritten articles usually bear the name of a highly respected researcher who appears to have no financial stake in the issue at hand.Furthermore, Moffatt and Elliott argue that ghost-writing undermines science.
Second, ghostwritten journal articles always contain undisclosed conflicts of interest. The failure to disclose conflicts occurs on many levels. The "named author" fails to disclose that he or she has received payment for agreeing to publish the paper under his or her name. The MECC fails to disclose that it has received a substantial amount of money to prepare the article and find a 'named author.' And the sponsoring company fails to disclose that it has a direct financial stake in the drug or product in question.
Ghostwritten articles are useful as marketing tools precisely because they appear to come from a disinterested source. In fact, the entire program of ghostwriting is designed to give articles written by people with a direct financial interest in promoting a product the appearance of disinterestedness.
The harm done by ghostwriting is compounded by the fact that the system of scientific communication is a key aspect of scientific objectivity. One approach to scientific objectivity holds that science is objective because of its procedures. According to this view, the foundation of scientific objectivity rests in the way scientists communicate and contest results. Helen Longino (2001) argues that scientific communities are objective insofar as their communication procedures are open and contestable. But ghostwritten papers conceal the interests of authors and sponsors in a way that makes it difficult to assess and contest the scientific data, which undermines the objectivity of science itself.
Ghost-writing appears to be yet another of the common practices in the contemporary health care arena that ought to create outrage, but have attracted little notice, yet another example of the anechoic effect.
Honest medical scientists ought to be outraged that their field has been contaminated by ghost-written articles meant to sell products. Physicians ought to be even more outraged that the clinical data on which they ought to be basing decisions for individual patients has been likewise contaminated.
WHAT IS TO BE DONE? - Moffatt and Elliott do make some recommendations:
First, universities need to treat the practice of signing on to ghostwritten journal articles as a case of academic misconduct. They need to institute rules to prevent faculty members from lending their names to papers they did not write, and when they discover cases where faculty members have engaged in the practice, they need to have mechanisms in place to sanction them.
Second, lawyers should start naming ghostwriters and sham authors as defendants in litigation against the pharmaceutical industry. As things stand now, only pharmaceutical companies are financially punished for fraud, and since their pockets are so deep, the threat of litigation is not sufficient to deter them from commissioning ghosted articles. But the threat of litigation would probably deter those with more limited financial resources. Litigation could serve as a dramatic way of making ghostwriters, sham authors, and medical communications companies directly culpable for 