Sunday, August 23, 2009

Medical Ghostwriting: Spooks in the Ivory Tower


We have spent many dinner discussions with our kids discussing plagiarism. This infraction was verboten even when I was student back when, according to our kids, ‘I used to take the dinosaur out for a walk’. While I don’t think the offense is more serious today, it is much more prevalent. Educators report that there is an epidemic of it in our schools and universities. Perhaps, the practice even crosses national boundaries, which might mean that we are in the midst of a plagiarism pandemic. Unlike ‘swine flu’, there’s no vaccine available for this disease.

Of course, the offense is so much easier to commit today, with expansive information on any imaginable subject available with a keystroke. I’m sure I could cut & paste a 10 page term paper on nearly any topic during half-time of a televised football game.

Some of these rule-bending kids grow up to be adults who still misunderstand the importance of owning work that appears under their name. Joe Biden, historians Doris Kearns Goodwin and Stephen Ambrose and the infamous former New York Times reporter Jayson Blair are well known examples of folks who ‘borrowed’ without permission or attribution.

Regrettably, doctors are not immune to the affliction. I’m not referring to community physicians who do honest work each day seeing their patients. The sickness seems to have a predilection for a minority of academic physicians in our nation’s most prestigious medical schools. These are our leaders who are charged to serve as models of integrity and personal rectitude. They lecture widely about emerging medical developments. They meet with legislators to educate lawmakers and to influence health care policy. They are the prime authors of medical journal articles that are read by physicians like me who aim to stay current in our professional fields.

We now learn that scores of published journal articles over past years weren’t written by the stated authors. These articles were ghostwritten by writers hired by drug companies who prepared slanted drafts that favored their pharmaceutical employers’ interests. Disclosure to the readers of this improper practice was absent or too dilute to matter. How did these purported authors justify this misconduct? Weren’t their ethical compasses spinning wildly?

In response, medical schools, universities, medical editors and drug companies are establishing new policies to reclaim their ethical credentials. This is a limp PR response to a pattern of unethical activity that should never have occurred. Academicians and all parties involved shouldn’t need to consult a 3-ringed binder to determine if presenting a paid writer’s article as someone else’s work is proper. They should already know right from wrong, like the rest of us do. Rules, regulations and laws are more necessary for enforcing infractions than for teaching ethical behavior. Most of us don’t have to consult law books to determine if embezzlement or theft is acceptable.

If an academic physician happens to be reading this post, and is unsure if he should sign off on the drug company’s journal article on his desk, consult my kids first for some plagiarism pointers. True, they’ve never published anything, but I would trust their advice on this issue. Why? Their work is always their own.

On Halloween, many of us used to dress up as ghosts as we prowled our neighborhoods in search of treats. Now, we have ghosts masquerading as doctors. This time, we’re the ones who have been tricked.

Ghost image from http://www.kidsturncentral.com

6 comments:

Anonymous said...

I've heard that medical articles have been written on behalf of drug companies, but did not realize that they were signed by prestigious physicians for the sake of having authoritive authors. Unbelievable.

If you have a chance, could you please post links to articles on this subject.

I hope that the medical community will give the culprits a good slap on the wrist. If that does not happen, it will be an open invitation for continuing ethics abuses. We need more whistle blowers!

Alex J.

Michael Kirsch, M.D. said...

Alex,

Here are 2 links for your interest.

http://www.nytimes.com/2009/08/19/health/research/19ethics.html

http://www.nytimes.com/2009/08/05/health/research/05ghost.html?_r=1&ref=research

Anonymous said...

Thank you for writing and posting what you do. It's good to hear from a doctor's perspective about the problems patients have obtaining proper medical care.

I've had problems finding decent physicians and found your posts quite useful in understanding what the problems are. I've also found another blog from the patient's perspective that might compliment your views, though it looks like they've had a much worse time than me with doctor's: http://enoughdangit.blogspot.com/

Perhaps you can collaborate to make some changes on a much larger scale.

Thank you again for your posts.

Jessica

Anonymous said...

Gee, do you suppose this plagiarism plague got bumped up a notch by mommy or daddy "helping" a little too much with the kiddies homework? I'm old enough to have been in the generation prior to the new thinking, where mommy and daddy were too busy doing their own work and I was on my own with the school work.

barb

katejohnsonmednews said...

Dr. Kirsch,
You make some very valid points. When industry and researchers get too close it erodes our trust in what they say. But, unfortunately, industry has something to offer that researchers desperately need - writers! I am a medical journalist and writer - not connected to industry. I do some writing for researchers and I wrote about it in an op-ed piece in the Montreal Gazette ( http://bit.ly/WW9vk ), as well as on my blog . Would love to know what you think. You can also find me on Twitter http://twitter.com/kjohnsonmed

Michael Kirsch, M.D. said...

Here's the latest on ghostwriting. Enjoy! http://nyti.ms/cXUCuR

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