Ethics in Action Ethics In Authorship: Should I Be Listed as an Author on This Paper?

Ethics In Authorship: Should I Be Listed as an Author on This Paper?

By Jeremy Simon, MD, PhD

The Case

One of the senior faculty in your department elicits input from you and two other residents on a manuscript. He provides each of you with a specific part of the manuscript to work on, with the requirement that you write no more than 300 words each. After the manuscript is completed, your faculty member has written a 5,000-word article. He tells you and your classmates that because you contributed a minimal amount to the article, under ICJME guidance, you will not be listed as authors. He will mention your names in the acknowledgments. You speak with your fellow residents and are upset; you were specifically asked to limit the size of your contribution, which your faculty member now tells you is not significant enough to merit authorship. Your faculty member is already a tenured professor; the three of you were interested in having an article for your CV to help start an academic career. Is what your faculty member did ethical?

Authorship of articles in academic medicine has undergone a slow evolution. Frequently, department chairs or other senior faculty members would be routinely listed as authors on papers, regardless of their degree of involvement. On other papers, multiple faculty members would be listed, to be able to credit them with authorship, even if their contributions were minimal as well. This gamesmanship with assigning authors to academic papers took on an additional unsavory dimension when it became public that pharmaceutical companies would assign a well-known physician author to a scientific paper that was ghostwritten by a technical writer to bring more attention to the article.

The International Committee of Medical Journal Editors (ICJME) released guidelines that specifically define the criteria that should be

“By disrupting a longstanding practice through which many physicians over the years may have manipulated to burnish their CVs and achieve academic promotions, the use of the ICJME guidelines has been an ethical boon to publishing.”

used to determine authorship, require manuscripts to define each author’s role in the performance of the study or preparation of the manuscript, the appropriate number of authors that should be listed, and acknowledgement of any financial or other conflicts of interest. The role of these guidelines is to make the publication more transparent, by helping to demonstrate that the authors listed did contribute meaningfully to the paper and to make clear any potential conflicts that could cast doubt on the impartiality of the results being reported.

The ICJME authorship criteria do not specify any rigid values that are required for authorship. They do, however, give guidance as to what should be done to qualify as an author: • Contribute to the intellectual content of the work through concept and study design, data acquisition, and/or data analysis • Draft, critically review, or revise the manuscript • Approve the final version of the manuscript for submission

There is no question that the ICJME guidelines do not create any ethical conflict in publication; to the contrary, the guidelines have been widely adopted and are a demonstration of the rigor and selectivity of the journal. By disrupting a longstanding practice through which many physicians over the years may have manipulated to burnish their CVs and achieve academic promotions, the use of the ICJME guidelines has been an ethical boon to publishing.

What the faculty member did to the residents is a different matter altogether. While the resident’s contributions did not meet ICJME guidelines for inclusion as authors, by limiting their contributions, it seems that the faculty member ensured a priori that the residents could not possibly qualify for authorship. In the news industry, there was once a well-known practice known as “bigfooting” in which a lesser-known journalist would break and write a story and then be forced by the editors to turn the information over to a more famous journalist to present the story, often without crediting the lessfamous journalist who did all the legwork. Attaching a marquee name to the story was done to elicit more readership or viewership. Similarly, academic bigfooting involves listing a senior, well-known figure as a lead author to increase likelihood of publication and citation.

Is this ethical? There are several issues. First, the senior faculty member obviously knew that the limitations he put the residents under in terms of length of their submissions would likely preclude them from meeting authorship criteria. Therefore, he needed to be clear with the residents ahead of time that this would be a project that may get them academic writing practice but would not result in authorship credit. By not explaining this ahead of time, he created misunderstanding and hard feelings. At least some of the residents may have inquired about writing a longer piece to earn authorship credit. The faculty member should also have included mentoring in this assignment. Lastly, the faculty member should ensure that he attributes in the final work any direct quotes he uses from the resident’s contributions.

Academic authorship has become more rigorous, with fair assignment of authorship becoming a much higher priority than it has been historically. However, there are still potential pitfalls, particularly involving senior faculty members with junior members or residents, and care must be taken to avoid an ethical misstep.

ABOUT THE AUTHOR

Dr. Simon is a professor of emergency medicine at the Columbia University Medical Center, in addition to serving as faculty associate at the Columbia Center for Clinical Medical Ethics. Dr. Simon is also a senior research associate for the department of philosophy at the University of Johannesburg.