Medical literature is important to doctors and patients -- for it serves as a guide to the best treatments available.
To discover that some of the articles on which treatments are based may be signed by doctors but actually written by others is disturbing.
The New York Times reports that ghost writers paid by a pharmaceutical company, Wyeth, of Madison, New Jersey, played an important role in generating 26 scientific papers supporting the use of hormone replacement therapy in women. The articles, the Times said, ''emphasized the benefits and de-emphasized the risks of taking hormones to protect against maladies like aging skin, heart disease and dementia.''
Dr. Jerome Kassirer, formed editor in chief of the New England Journal of Medicine, told me the practice of using ghost writers is ''outrageous.'' He said it ''undermines the credibility of physicians.''
The articles did not admit that Wyeth paid for the work. A Wyeth spokesman said the articles were scientifically accurate and that pharmaceutical companies routinely hired medical writing companies to assist authors in drafting manuscripts.
But Kassirer vehemently denounced the practice. ''It corrupts the data base of medicine. An article written by a company paid to produce a certain result can't be trusted.'' He referred to the fact that Wyeth had paid $25,000 to Design Write for writing an article which carried the name of a professor of obstetrics and gynecology as author. The professor praised the article as ''excellent.'' She was glad to lend her name to it.
The professor insisted that ''this is my work, this is what I believe, this is reflective of my view.''
The ghost writing practice seems to be widespread. Yet an assistant professor at the Mt. Sinai School of Medicine here, Dr. Joseph S. Ross, commented: ''It's almost like steroids and baseball. You don't know who was using and who wasn't. You don't know which articles are tainted and which aren't.''
A spokesman for Wyeth said the articles on hormone therapy were scientifically sound and subjected to rigorous review by outside experts on behalf of the medical journals that published them. The company says it has a policy now of requiring that contributions by medical writers be acknowledged in an article.
That's an improvement. But, as Kassirer says, the underlying problem involved in all this is trust. If trust is undermined, then the very relationship between doctors and patients is threatened.
There's nothing illegal about what's happening here. But there's the aroma of unethical behavior by both drug companies and doctors. The public deserves better.
