With regard to the recent New York Times article about ghost writing for the pharmaceutical industry, I have been laying low and just seeing what happens. I worked for a Medical Communications company for 4 years as a Medical Writer. It is really incumbent upon the American Medical Writers Association (AMWA, http://www.amwa.org) to be the voice of medical writers, and indeed, the current Chair of AMWA responded to this article and it was published in the Times.

I really believe that while there may be some funny business going on from time to time, most medical writers and pharma companies, along with the doctors that the companies “recruit” as the authors are on the up and up. The doctors who were asked to be authors on the papers I worked on were always primary investigators in the clinical trial that was to be published, and were recruited at the initial stages of publication development. In every case that I came across, the author contributed significantly to the paper, even if they didn’t write every word. I never witnessed any case of an author being on the paper without providing comments on the drafts. It is true that the medical writers write drafts, but they are always circulated for comments, which are always incorporated. The meat of the papers, the Materials and Methods and Results sections, are technical, and there’s no reason why a professional medical writer shouldn’t put that together for busy physicians. I don’t see anything wrong with that. The authors always had the final say on the content of the paper and are often required by the journals to sign their names to a statement that the work is original and that they contributed to it significantly.

The real ethical issues that have arisen from the whole medical writing industry, in my opinion, are all grey areas with blurry lines. What bothered me about medical writing for the pharma industry was the vague sense of playing games with subtle language and presenting things a certain way, mostly in the Discussion section (and to some extent the Introduction section) of the paper. The publications I worked on were scientifically solid, and most scientists know to concentrate mostly on the quality of the data presented and don’t pay too much mind to the Discussion section, where most of the “creativity” comes in. It really is time for psychologists to weigh in on how the subtleties of marketing messages in publications written in conjunction with medical writers are perceived and absorbed, and particularly how that advertising affects the prescribing practices of “target audience” physicians. As with most technology today, the development of strong, clear, legally enforceable guidelines lags behind the complex issues that influence the way they manifest themselves in our society.