Ghostwriting

According to the International Herald Tribune (IHT), the Journal of the American Medical Association (JAMA) has published an article about Merck’s practice of writing research studies and then asking doctors to slap their names on them. This practice has called into question Merck’s marketing of Vioxx, a profitable cardiovascular drug that was pulled off the shelves due to its link to heart attacks.

Merck acknowledged Tuesday that it sometimes hired outside medical writers to draft research reports before handing them over to the doctors whose names eventually appear on the publication. But the company disputed the article’s conclusion that the authors do little of the actual research or analysis.

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One paper involved a study of Vioxx as a possible deterrent to Alzheimer’s progression.

The draft of the paper, dated August 2003, identified the lead writer as "External author?" But when it was published in 2005 in the journal Neuropsychopharmacology, the lead author was listed as Dr. Leon Thal, a well-known Alzheimer’s researcher at the University of California, San Diego.

The second author listed on the published Alzheimer’s paper, whose name had not been on the draft, was Ferris, the New York University professor. Ferris, reached by telephone Tuesday, said he had played an active role in the research and he was substantially involved in helping shape the final draft.
"It’s simply false that we didn’t contribute to the final publication," Ferris said.

A third author, also not named on the initial draft, was Dr. Louis Kirby, currently the medical director for the company Provista Life Sciences. In an e-mail message on Tuesday, Kirby said that as a clinical investigator for the study he had enrolled more patients, 109, than any of the other researchers. He also said he made revisions to the final document.

"The fact that the draft was written by a Merck employee for later discussion by all the authors does not in and of itself constitute ghostwriting," Kirby’s e-mail message said.

Uh, yeah it does.

In my interview with Joe, he flat-out told me that they basically rewrote articles to the point where they were ghostwritten. He said that doctors submitted information but wrote it terribly. The job of the editors at the magazine was to rewrite it—substantially—so they made it sound and look good. The magazine was loath to criticize any products (especially if the owners advertised in the magazine), in fact, they would play up the benefits of products and try to minimize the risks. By the time the article was published, the original submission would be nearly unrecognizable. The piece would be so heavily edited with added information that editors were essentially writing a brand new piece and slapping a doctor’s name on it. Doctors, in fact, sometimes wouldn’t even know what they wrote until they read the article. That, to me, is a bit scary.

I was willing to do it because I really wanted a job and love heavy editing. However, after reading this, I’m glad I didn’t get the position. In retrospect, it seems rather unethical for me to “rewrite” an article for a doctor who doesn’t really know what I wrote until it gets published. As far as I know, doctors don’t really seem to have a problem with this. Perhaps the prestige of getting their name out there attached to a well-written article attracts them more than the idea of being heavily involved in the editorial process of their article being “recrafted.” Doctors always are “busy” and never seem to have “time” (something I learned from my previous job) so I think the last thing on their mind is whether their research has been significantly expanded to the point where it isn’t anything like the way they originally wrote it. Unless the information isn’t accurate. Then that’s when hell gets raised.

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