Ethical and Legal Issues in Medical Writing

While the concept of medical writing is an admirable one, it also imposes certain responsibilities on medical writers. In our modern age of technological advances, the written word can be rapidly digitized and transmitted worldwide. Published articles carry the weight of authority, particularly when published in scholarly journals. Unfortunately, there is always the danger of misinformation which, once published, is not easily retracted or corrected.

Other ethical problems can also arise, such as plagiarism and simultaneous submission. These problems cannot usually be detected by the editor or editorial staff. It is the responsibility of the medical writer to be familiar with the ethics of medical writing and to adhere to certain rules. Following are some of these basic rules of ethics in writing.

Simultaneous Submission

A writer should not simultaneously submit the same article (or similar articles) to more than one publication. This practice most often occurs with students or unpublished authors. Perhaps they believe that submitting the same paper to various publications will increase the probability of publication. Editors of different publications, however, do not generally compare articles received. This raises the real possibility of actual publication of the same article by two or more journals. This creates an awkward and embarrassing situation for all publications concerned. Many publications, such as this one, require that the author submit a signed statement declaring that the piece has not been submitted elsewhere.

The appropriate course for an author to follow is to initially submit the paper to the most desired publication. The author must then await word of either acceptance or rejection. If the author has not received notice within a reasonable period of time, he or she should contact the editor to determine the status of the submitted piece. If no notice is forthcoming, the author should then state that the paper has been withdrawn and that it will be submitted elsewhere.

Plagiarism

Plagiarism is the theft of intellectual property. In its most blatant form, the actual words of another author are copied verbatim without any form of permission or credit. This practice subjects the plagiarizer to civil and criminal penalties. Such penalties are generally not applied unless the plagiarizer has profited financially by his or her actions. More likely, the author caught plagiarizing is subject to academic sanction and professional disrepute.

A more insidious ethical problem is stealing ideas or paraphrasing another’s work. This is a form of intellectual laziness that denies credit to the original author. The simple remedy is to give credit where credit is due. The footnote is the ideal mode of crediting a different author (or authors) for an original idea or research. If the idea is more generalized, a listing in the bibliography is appropriate.

Fair Use

The present copyright laws (17 U.S.C. 107, 1988 ed. and Supp. IV) allow “fair use” of a published work as long as credit is given. Following is the provision of the Copyright Act called “Limitations on exclusive rights: Fair use”:

• Notwithstanding the provisions of sections 106 and 106A, the fair use of a copyrighted work, including such use by reproduction in copies or phonorecords or by any other means specified by that section, for purposes such as criticism, comment, news reporting, teaching (including multiple copies for classroom use), scholarship, or research, is not an infringement of copyright. In determining whether the use made of a work in any particular case is a fair use, the factors to be considered shall include: (1) the purpose and character of the use, including whether such use is of a commercial nature or is for nonprofit educational purposes; (2) the nature of the copyrighted work; (3) the amount and substantiality of the portion used in relation to the copyrighted work as a whole; and (4) the effect of the use upon the potential market for or value of the copyrighted work. The fact that a work is unpublished shall not itself bar a finding of fair use if such finding is made upon consideration of all of the above factors.

If the need arises to use more than this amount or to use a graph, table, photograph, or illustration, permission should be sought from the copyright holder. The copyright holder may be the author(s) or the publisher of the journal or book. Such permissions are routinely granted, although a modest fee is occasionally charged.

Duty to Disclose

Since much research is underwritten by pharmaceutical and podiatric companies, authors have a duty to disclose the identity of any entity sponsoring the research. While such sponsorship does not invalidate scientifically based research, it is only fair that the reader be made aware of such sponsorship. If the author is a principal, a paid employee, or an independent contractor of either the sponsoring entity or any company related to the subject matter of the article, the publication needs to be informed.

Intellectual Honesty

Ethical writing requires the author to give a balanced presentation of the subject matter. This means that in addition to presenting theory, data, and conclusions, the author must cite previously published contradicting research. This open disclosure invites the reader to compare and contrast opposing views and draw appropriate conclusions.

An author has the additional responsibility of informing the publication of any new studies published in the interim between the time the paper is submitted and the time it is actually published. Most publications have a lag time of several months to a year or more until publication.

Summary

The medical community invests great confidence in published articles and research. It is incumbent on authors to be aware of the ethical responsibilities inherent in medical writing.