For the majority of academic medical centers that lack a policy (New York University, Brown University and Baylor College of Medicine, to name a few) Lacasse and Leo outlined basic steps toward developing, implementing and enforcing one in their article. "The main goal of the proposal was to reduce the prevalence of ghostwriting," Lacasse explains. "Why would it stop if there weren't some repercussions?"
Lacasse and Leo suggest that a strict ban be enacted by the deans of academic medical centers following a period of amnesty spanning the remaining months of the 2009–10 academic year, after which any scientist who violates the ban should be deemed guilty of academic misconduct. Lacasse and Leo even recommend that scientists who have participated in ghostwriting in the past should confess, and that their ghostwritten papers be reevaluated and even retracted if appropriate. It is unclear what incentives would exist for scientists to come clean. "We're arguing for a change in culture where it's a very negative thing to have been involved in ghostwriting," Lacasse says.
And whereas their proposal for the ban starts with the deans, Lacasse and Leo say they would love to see a task force within the National Institutes of Health (NIH), the world's largest biomedical research funder, according to a 2008 article published in BMC Genomics. "Many people who've participated in ghostwriting are recipients of NIH grants," Leo says.
While NIH policy does not use the term "ghostwriting," federal regulations on research misconduct such as plagiarism and fabrication could be applicable to ghostwriting, according to an NIH spokesperson.
In a recent interview on C–SPAN's "Newsmakers" program, NIH Director Francis Collins announced that the agency would issue a "proposed rule" early this year that will require pharmaceutical companies to publicly disclose financial relationships with NIH-funded scientists. "I was shocked by that revelation—that people would allow their names to be used on articles they did not write, that were written for them, particularly by companies that have something to gain by the way the data is presented…. If we want to have the integrity of science preserved, that's not the way to do it," Collins said in the December 21 interview.
NIH is currently drafting a Notice of Proposed Rulemaking, which could introduce revisions and enhancements to the current regulations, according to a spokesperson. The notice will be posted for public comment as NIH develops the final rule, which is anticipated in summer or fall of 2010.
Lacasse and Leo plan to follow up on their proposal at the beginning of the 2010 academic year, and hope to see evidence of a culture change. Lacasse says most nonmedical academics are astonished that ghostwriting occurs. "Try explaining to a history prof that on the other side of campus a prof is getting credit for work he didn't do!"