Editorial: Ghosting medical science

Published in The Hindu on September 1, 2009

Medical ghostwriting, according to a researcher, “occurs when someone makes substantial contributions to a manuscript without attribution or disclosure. It is considered bad publication practice in the medical sciences, and some argue it is scientific misconduct.” An extreme case is what the U.S.-based Wyeth Pharmaceuticals did, according to a cache of 1500 documents that is now in the public realm. Wyeth hired professional ghostwriters to make a major contribution to the production of 26 papers that were published in 18 medical journals between 1998 and 2005. The papers showed in good light Prempro — the corporation’s blockbuster hormone therapy drug prescribed to menopausal women — in the face of mounting evidence of increased breast cancer risk from taking the drug. Even after this particular ghostwriting scandal was brought to light by a U.S. Senator, the documents would have remained out of reach but for the public-spirited intervention of PLoS Medicine, an open access journal, and The New York Times. The two acted as intervenors in the litigation brought against the drug company by thousands of affected women.

It is scandalous that ghostwritten papers that mimic well-researched science manage to get published in reputed medical journals. The effect is to mislead doctors by playing down the harmful effects of the drug and encouraging them to prescribe it to more patients. What is shocking is the willingness of researchers of repute to lend their names to the ghostwritten papers. Since the number of newly discovered molecules is very small, pharmaceutical companies sometimes feel obliged to make the most out of commercially available drugs. This is believed to be a major factor behind medical ghostwriting. One way to counter this is to punish the researchers who collude in such sharp practices. Unlike in the case of data manipulation and science fraud, universities have not shown much inclination to crack the whip against academics who lend their names to the ghostwritten papers. Where even the U.S. government failed, a group of medical journal editors succeeded in bringing about more transparency and accountability in the way clinical trials are conducted — by obliging drug companies to register trials prior to enrolling the first volunteer. They have also achieved a measure of success in obliging authors to disclose any conflict of interest. Conscientious journal editors and publishers have a big responsibility to ensure that unscrupulous sections of the pharmaceutical industry do not use their journals to mislead the scientific community and cause injury to the public.