Here’s a fascinating peek into the shadowy world of medical ghostwriting by an 11-year veteran of the practice. Linda Logdberg, writing in the current edition of the open-access medical journal PLoS, discusses how the increasingly troubling aspects of her job pushed her to quit:
..the ethical issues began to tap me on the shoulder: perhaps the most memorable example of this was a contraceptive product that caused severe, unpredictable vaginal bleeding in some women. My job was to draft a monograph that would profile the product’s benefits, one of which, according to the client, was that although the bleeding could be severe, it was at least something that women could anticipate. In other words—the bad news is that a meteorite will strike you, but the good news is—a meteorite will strike you!
This kind of doublespeak became more and more troubling, and my career came to an end over a job involving revising a manuscript supporting the use of a drug for attention deficit-hyperactivity disorder (ADHD), with a duration of action that fell between that of shorter- and longer-acting formulations. However, I have two children with ADHD, and I failed to see the benefit of a drug that would wear off right at suppertime, rather than a few hours before or a few hours after. Suppertime is a time in ADHD households when tempers and homework arguments are often at their worst. So I questioned the account executive at the large agency that had hired me. In particular, I wanted to ask the physician author their view of the drug’s benefits. Attempts to discuss my misgivings with the meded contact met with the curt admonition to “just write it.” But perhaps because this particular disorder was so close to home, I was unwilling to turn this ugly duckling of a “me-too” drug into a marketable swan.
She ultimately decided to “burn…[her] medical writing bridges” and talk to reporters at The New York Times, who were working on an investigative article about pharmaceutical companies marketing to doctors. Shortly after The Times piece was published in November, 2002, Logdberg writes:
I received a polite letter from an executive of the meded company asking for all the materials back and reminding me of my confidentiality agreement. I also received a direct threat of legal retaliation in a phone call from my former contact at that agency.