Improving Authorship Accountability: Ethical Considerations in Manuscript Preparation

Authors, reviewers, and editors all have a stake in ethical issues related to preparing a manuscript for publication. Authors have multiple responsibilities including reporting the source of information, avoiding conflict of interest, and assuring accuracy of data being reported. Reviewers have responsibilities for checking accuracy of manuscript content, maintaining confidentiality of the content being reviewed, and avoiding conflict of interest in the review process. Finally, editors must confront ethical issues that include plagiarism, falsified data, misconduct, publication bias, and overall quality and integrity of their journals' content. This paper focuses on the ethical issue of authorship accountability in preparing manuscripts for publication. Reports of plagiarism as well as falsification and fabrication of data have concerned scientists, editors, and publishers for many years. The increasing numbers of publications with multiple authors also have contributed to the need for establishing clearly outlined requirements for publishing. In 1978 a group of medical journal editors met to discuss concerns of multiple authorship and scientific misconduct. This prestigious group, sometimes referred to as the Vancouver Group, organized a committee called the International Committee for Medical Journal Editors (ICMJE). In 1985 they published their first statement addressing standards for authorship. In its fifth revision since that time, the Uniform Requirements for Manuscripts Submitted to Biomedical Journals has been adopted by hundreds of scientific journals throughout the world (Jones, 4; ICMJE, 2001). These standards, which can be found at www.icmje.org, include requirements for authorship accountability. Multiple authorship has increased significantly since the early 1900's when one or two authors on a manuscript was most common. Since then the number of authors listed on a manuscript has continued to multiply. Research and manuscript preparation are both time-consuming projects whereby dividing the workload among various investigators and staff helps to alleviate some of the pressures. Although an increased number of authors can hinder communication and accountability, authors who follow the steps below can improve their accountability for manuscript content. Many editors and publishers now require authors to sign a paper stating they contributed to the manuscript and have agreed to publish the paper. The group should decide who will be the first author and the order of the remaining authors' names. Being first author carries a special significance to readers, department heads, and tenure-track faculty. She or he also assumes a great deal of responsibility. The first author coordinates, leads, and is ultimately responsible for keeping all authors on a timetable for completing the writing. It is often the first author who edits the manuscript for a smooth flow among sections written by different authors. The first author is responsible for the overall integrity of the work, although with research two individuals may be needed to assume the oversight of integrity. Journal editors are becoming more aware of serious problems associated with reporting research. For example, Altman (1) commented that 81% of Phase 2 cancer trials did not report the statistical design. And, serious statistical errors were found in 40% of articles reviewed in one journal. With this information being reported, authors are being held accountable to strengthen the science in their manuscripts. This takes teamwork from the Institutional Review Board (IRB) to the researchers, authors, peer reviewers, and editors. Having the first twoauthors assume responsibility for the integrity of research being reported is just one step towards an improvement in authorship accountability. An outline should be developed with assignments of responsibilities for the various sections of the paper. At this point each author has an assignment and can begin extracting or analyzing data or organizing articles for the literature review. Author guidelines for the target journal are distributed to each author, because each author must be accountable for her or his section and the overall paper. Although actual meetings may not be held during the writing process, communication should be ongoing via e-mail or phone. Communications that break down during the preparation of a manuscript often result in ethical problems. Editors usually communicate with the corresponding author only; thus, it is often difficult to ensure that communication among all authors has occurred. Although it is the authors' responsibility to communicate with each other, the editor can sometimes pick up on possible problems. Communication problems among multiple authors can result in ethical problems. I have had several instances that demonstrate this. A corresponding author had submitted a manuscript to a journal I edit prior to his completing a fellowship in the U.S., but during the review period he had returned to his home country. As I corresponded with him by e-mail during revisions, it occurred to me that he was not communicating with his co-authors. I asked him for comments from each author and he said he did not know how to contact them. He gave me permission to contact the authors and I sent the revised manuscript to them. Thus, all authors were accountable for the revision. In another case, one of the authors contacted me after the revised paper had been accepted. She had no communication with the corresponding author after the paper was submitted and had no idea that it had been reviewed or revised. It was obvious the two had become estranged some time during the manuscript preparation and submission. They lived in different cities and were definitely not communicating. I sent a copy of the final manuscript to the second author. She had corrections, which then had to be discussed with the first author and the publisher. Being accountable for the content of a manuscript also means the author needs to disclose any potential conflict of interest. Conflict of interest may develop in situations where financial interests may compromise the author's or investigator's professional judgment (ICMJE, 2001; Davidoff, 2; Rennie & Flanagin, 5; Flanagin, 2002; WAME, 2002). Author accountability has become a concern for editors as industry-sponsored research and publications have become more common. Pharmaceutical companies pay professionals who are well known in their field to be authors on manuscripts using data or information that has been funded by the company. These selected and paid authors often do not actually write the manuscript but are able to review the paper with some mild editing or suggestions. These papers are often written by ghost writers who are contracted by sponsors of the research. Several ethical concerns have been raised by this practice. Of greatest concern is the extent of control by the authors over content of the material being reported. The potential problem that arises in situations such as this is the amount of control an author has over the manuscript and the bias or undue influence that may exist. While disclosure has been a practice in manuscript submissions, most editors and publishers now require a statement identifying sponsorship of the manuscript and any potential conflict of interest that may bias the work (ICMJE, 2001; Davidoff, 2). Failure to disclose such information may result in questions about the scientific merit of the paper. Publishing the same or similar information in more than one journal also raises some ethical issues for authors and editors. ICMJE has taken the position that if an article is being republished, this must be done with full knowledge of the author and editor based on international copyright laws (ICMJE, 2001). Authors should always inform the editor in writing that a similar manuscript with the same data has been published in another journal and include the other manuscript's reference in the new submission. A copy of the previously published manuscript should be included with the submitted paper to allow the editor to decide how to handle the situation (ICMJE, 2001). In addition, reviewers should notify the editor if they suspect the manuscript they are reviewing is a duplicate of one already published that was not referenced or disclosed in the current manuscript. Authors have many ethical responsibilities that must be carefully considered when preparing manuscripts. Reviewers and editors can help improve authorship accountability by reviewing for ethical problems and developing author guidelines that provide information on the journal's policies and expectations. Linda Ohler, MSN, RN, CCTC, FAAN, Editor of Progress in Transplantation. You may contact the author at lindaohler@aol.com.

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