Ghostwriting Raises Global Alarm and Undermines the Supreme Court!?

By Paul Thacker

The University of Toronto Law School and Joint Centre for Bioethics are hosting the first international seminar on ghost authorship in biomedical research this morning. Unfortunately, there is no webcast, but you catch the agenda here, and read some of the papers being discussed on this page.

I’m on the first panel to discuss the Senate Finance Committee’s ghostwriting report, which Senator Charles Grassley (R-IA) released last summer (full disclosure: while working as a staffer for Senator Grassley, I helped put this report together).

Before I begin, allow me to digress and discuss today’s New York Times front-page scoop about Justice Clarence Thomas being caught with a Supreme Court opinion ghostwritten for him by attorneys at Goldman Sachs. The case involves a lawsuit brought by shareholders against Goldman executives for hiding financial loss information in the months leading up to the 2008 stock market crash.

Kind of an amazing story. According to drafts and emails obtained by the Times, Goldman attorneys wrote “entire passages and tinkered with sentences in the opinion summary to slant language in favor of Goldman executives and against shareholders.”

Wow. Pretty stunning. Especially since it isn’t true.

I actually made this story up to illustrate a point. If a corporation in fact ghostwrote an opinion for a judge, you better believe it would be on the front page of every newspaper, and would be followed by a media firestorm of outrage. The story would churn for days in the press, with TV talking heads and bloggers exhaustively spinning the story to match their own preconceived biases of our legal system.

However, ghostwriting happens every day in academic medicine, where prominent physicians sign their names to papers that were written by companies paid by Big Pharma. And very few blink an eye.

The reason? Leaders in medicine have allowed this pathological behavior to become established in their profession. It is now considered “normal.” But it must end.

Why should we care about ghostwriting?

Not because we’re worried that Sarah Palin herself didn’t write Going Rogue.

According to data provided by the Congressional Budget Office to Senate staffers, healthcare programs now devour more of the federal budget than the Pentagon. Pharmaceuticals make up 15% of this healthcare spending, translating into about 2% of annual federal costs. With so many billions of dollars spilling out federal coffers, we must ensure this money is spent wisely and in the public interest.

To get an even bigger slice of healthcare dollars, corporations use ghostwritten articles to seed the literature with marketing “studies” that favor their products in spite of, and often contradicting, medical data. Often, this will merely hoodwink doctors into prescribing similar but more expensive drugs over cheaper generics. But in some instances, this can lead to disastrous and deadly results, such as when ghostwritten studies misled doctors into prescribing the epilepsy drug Neurontin for conditions such as bipolar disorder.

Physicians, government agencies such as the FDA, and policymakers behind Medicare and Medicaid all make decisions based on studies published in academic journals. So if we are going to control healthcare costs, protect our citizens from snake oil salesmen, and remain the leader in biomedical research, we need to make sure that scientific literature remains as pristine as possible.  

Paul Thacker is a POGO Investigator. Download the slides he prepared for the panel.