Publication Ethics Insight | Who Really “Owns” a Manuscript? (ICMJE Perspective)

In scientific publishing, authorship is often seen as a title something reserved for investigators or key opinion leaders.

But here’s a question worth asking:
:backhand_index_pointing_right: Is authorship about designation… or contribution?

According to the ICMJE Recommendations, authorship is not about your job title it’s about your intellectual ownership of the work.

This challenges a long-standing misconception:

Medical writers should not be authors.

In reality, medical writers can and should be authors if they meet the required criteria.

:small_blue_diamond: Authorship is earned when all four criteria are met:
:check_mark: Significant intellectual contribution to the work
:check_mark: Drafting or critically revising the manuscript
:check_mark: Final approval of the version to be published
:check_mark: Accountability for the accuracy and integrity of the content

If even one of these is missing, authorship may not be appropriate.

But that doesn’t mean invisibility.

:small_blue_diamond: When medical writers contribute without meeting all criteria, transparent acknowledgment is essential
not just as a courtesy, but as an ethical responsibility.

Because failing to acknowledge contributions leads to a deeper issue:
:backhand_index_pointing_right: Ghostwriting one of the most serious ethical concerns in medical publishing


:light_bulb: A shift in perspective

Instead of asking:
:cross_mark: “Should medical writers be authors?”

We should be asking:
:white_check_mark: “Did they contribute intellectually and take responsibility for the work?”

Because ethical authorship is not about hierarchy
it’s about accountability, transparency, and trust.


:speech_balloon: Let’s discuss:
Do you think medical writers are still under-recognized in authorship decisions even when they meet the criteria?

MBH/AB

2 Likes

I completely agree that authorship should reflect intellectual contribution, not hierarchy.

What I don’t understand is how these “ghostwriter” positions are still openly available for candidates to apply, when transparency is supposed to be central to ethical publishing.

Well written!