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Practical steps to eliminate ghostwriting

Posted by AdamJacobs on 10 Oct 2009 at 15:30 GMT

We agree wholeheartedly with the PLoS Medicine editors’ argument that more must be done to eliminate ghostwriting from medical literature. Professional medical writers have a perfectly legitimate role to play in assisting authors to communicate their research, but ghostwriting is unacceptable. Recent research by two of us [1] has shown that professional medical writers are more likely to be acknowledged for their contributions now than in the past, but there is no room for complacency and efforts to eradicate ghostwriting must continue.

We are working through our professional associations in Europe, North America and the Asia-Pacific region to reinforce the importance of high ethical standards. We have published guidelines on the proper role of professional medical writers in publications [2–4].

We are pleased that the PLoS Medicine editors acknowledge that journal editors also have an important part to play. However, we suspect that many journal editors do not have the time or resources to investigate whether ethical medical writing practices have been followed during the manuscript preparation process. That is why we designed a checklist, which was published in PLoS Medicine [5; reference 5 in the PLoS Medicine editorial], that requires authors (and medical writers) to provide editors, on request, with documentation to prove that ghostwriting did not occur. The burden of proof will rest with authors, not with editors, lawyers, or investigative journalists.

There was much talk and angst among editors at the recent International Congress on Peer Review and Biomedical Publication about what to do about ghostwriting. Editors can do something. Will PLoS Medicine editors take the lead among editors and require authors who have used any type of medical writing assistance to complete this checklist?

Adam Jacobs, Elizabeth Wager, Karen Woolley, Art Gertel, and Cindy Hamilton.

1. Jacobs A, Hamilton CW (2009). Decreased evidence of ghostwriting in a 2008 vs 2005 survey of medical writers. The Write Stuff (Journal of the European Medical Writers Association) 18(2):118–123. Available online at

2. Jacobs A, Wager E (2005). European Medical Writers Association (EMWA) guidelines on the role of medical writers in developing peer-reviewed publications. Curr Med Res Opin 21(2):317–321. Available online at

3. Hamilton CW, Royer MG. AMWA Position Statement on the Contributions of Medical Writers to Scientific Publications. AMWA Journal. 2003;18(1):13-15. Available online at

4. Norris R, Bowman A, Fagan JM, et al. International Society for Medical Publication Professionals (ISMPP) position statement: the role of the professional medical writer. Curr Med Res Opin. Aug 2007;23(8):1837-1840. Available online at http://www.ncbi.nlm.nih.g...

5. Gøtzsche PC, Kassirer JP, Woolley KL, Wager E, Jacobs A, et al. (2009) What should be done to tackle ghostwriting in the medical literature? PLoS Med 6(2): e1000023. doi:10.1371/journal.pmed.1000023.

Competing interests declared: We have published or presented papers on ethical medical writing practices, are active members of associations in Europe, North America, and the Asia Pacific region for professional medical writers, and provide professional medical writing services to authors from academic, biotechnology, medical device, or pharmaceutical organizations.