Iowa's Sen. Charles Grassley released a new report on medical ghostwriting, one more indication of the ethical lapses and the marketing of medicine which he has been doggedly investigating. Grassley has asked researchers, clinicians, universities, and federal agencies along with the pharmaceutical industry to explain their practices and relationships that have not been less than transparent. This report is the newest example showing how ghostwritten articles touting research findings, and appearing in prominent medical journals, have become a tool to promote a drug. The end result has created cynicism about a profession that clings to self-policing despite ethical breaches riddled with conflicts-of-interest.

One example of the clever ways to avoid disclosing that something was ghost written, in a process involving many players, is described this way in the senator's report:

"[P]harmaceutical companies usually pay the medical education, communications, or marketing companies or the medical writers for drafting the manuscript instead of the authors listed in the publication, so these payments do not appear in financial disclosure forms submitted by university faculty."

Grassley's Investigations have shown Individuals have chosen not to disclose, and universities and government agencies have failed to demand full disclosure along with regulatory compliance. Investigative journalism and public shaming have led to subsequent federal interest and congressional hearings about the entire industry and its relationship to medical leadership.

In the open marketplace, ghost writing is one of the practices sitting on an ethical frontier. Companies with the Madison Avenue names of DesignWrite (actually located in Princeton), or the confident sounding Scientific Therapeutics Information, Inc., have become the conduit. Last year, the Institute of Medicine (IOM) lambasted how drug companies marketed medicine in a widely hailed report, "Conflict of Interest in Medical Research, Education, and Practice"

The release of a report about ghostwriting comes on the heels of the reform efforts. The University of Michigan boldly announced it will take no money from pharma for any part of its medical activities, while there is new scrutiny to NIMH practices and policies, and on the morning of a day-long conference at George Washington University, "Prescription for Conflict."

Download Ghostwriting in Medical Literature.