146 EDITORIAL Gift Authorship: An Unethical Practice in Medical Writing Ishtiaq Ahmed “I have often noticed that a bribe has that effect it changes a relation. The man who offers a bribe gives away a little of his own importance” (dGraham Greene). The Gift authorship is defined as “co-authorship awarded to a person who has not contributed 1 significantly to the study.” According to International Committee of Medical Journal Editors (ICJME), authorship criteria guidelines, an “author” is generally considered to be someone who has made a substantive intellectual contributions to a published study, including the conceptualization, acquisition, analysis of data, drafting of the manuscript and 2 approval of the manuscript to be published. But these guidelines are not accepted or followed by all journals universally. Instead of ICJME author ship criteria, some of the journals has started using contributor lists, showing contribution or role of each person in place of or in addition to traditional 3 lists of authors. Authorship is considered one of the most imperative aspect of the research which recognizes the research credit and is crucial for clinician because it is the primary criterion to judge their professional 4,5 progression and output. Secondly, the entire departmental or institutional efficiency is also 3,4 judged on their publication record. Due to this, the authorship list is a key information regarding their contribution in research performed and it is considered very important because incorrect information may award credit to undeserving person. Moreover, if a clinician or scientists are giving false information's about contribution in research project or publication than how one should expect him to be any more honest about his findings or results? The authorship assignment is a candid decision which is usually troubled by many issues in all research disciplines. During manuscript writing, the principal authors should decide that who will qualify as an author and who will be recognized as 3 collaborators. There are several possible reasons for this unethical or malpractice in assigning gift authorship. The two main conditions which affect the solvency of authorship list are award of "gift or honorary" authorship and "ghost" authors i.e. 3,6 exclusion from manuscript. In first case usually these are the personals included unfairly who are the respected authorities of the institution or belong to department or unit and their inclusion can give more credibility or weightage to the research even if they have no participation in the work. They usually appear unfairly as an author in all publications generated by their department or institution and get unjustified recognition and material benefit from this unethical assignment. The second type i.e. ghost authors who really participated but they were considered prudent to be excluded because they have obvious conflict of interest which could affect the intent and credibility 7 of the manuscript. We should view the publication delinquencies as a range of felonies like pressurizing on gift authorship (e.g. as a departmental head) or neglecting a justified junior researcher from authorship is only a one step away from misappropriating results of a subordinate researches and thus committing a crime equivalent to plagiarism. Moreover, inappropriate authorship practices like demand for gift author usually set a bad tradition which may likely to harm the associations between team fellows. The community of scholars suffers when a person is given credit for the work which is not his own, or he has no contribution or credit in shaping the ideas, outcomes, or the authorship is given to a person who was not involved integral ly in generation, description, implementation and description of the idea in research work. The reasons for this misconduct have been speculated as recognition need, promotion pressure, tenure issues, poor mentoring and Correspondence: Prof. Ishtiaq Ahmed Professor of Surgery Al Nafees Medical College Isra University, Islamabad E-mail: surgish2000@yahoo.com Received: August 04, 2020; Accepted: August 10, 2020 Department of Surgery Al Nafees Medical College Isra University, Islamabad 11 criteria. The problems regarding level of participation which merits authorship remains vague. The editors are usually unable to arbitrate over authorship disputes because it requires detailed and local knowledge of the institute where manuscript was produced. However, the institutions could play a better role in enforcing and setting up the authorship policies. Disputes could be minimized, if authorship criteria were mutually agreed in writing, between all participants' at the beginning of research project. To me the authorship in medical writing is very important ethical concern which should be emphasized to the researchers and especially postgraduates. In my view this culture of “Publish or Perish” is mainly responsible for increasing trend in unethical research, medical writing or practice of plagiarism. This also leads to ethical issue in authorship, like order, gift or ghost authorship issues. In my observation and as reported in literature too, the gift authorship practice prevalent widely and on increase in recent years. The ICMJE (International Committee of Medical Journal Editors) has given clear and specific guidelines regarding authorship criteria which are followed by majority of medical 12 journals. According to this, contributors who failed to meet ICJME criteria should be refrained from authorship but can be listed in acknowledgment section. Among different possible reasons to award gift authorship, the commonest may be that the junior investigators often feel pressure in assigning authorship to their senior co-workers or to the seniors who might have significant role in shaping their future career. Secondly, the junior academics are of impression that addition of senior colleagues as co-author will enhance the chances of publication. Moreover, senior researchers sometime may assign gift authorship to give an impression of collaboration or good working relations or as a compensation for nepotisms. Regardless of justification, this unethical practice of assigning gift authorship is deplorable for academic publications. The authorship should not be assigned or presumed as a veracious just on the basis of status or on association with researches or without a substantial contribution to the research project. In my view, this behavior from senior colleagues shows a sense of superiority and the believe that the rules merely don't apply to oneself, presumably because 8 financial conflict of interest. Among different reasons why this gift authorship is regarded unethical are firstly, a not genuinely earned authorship may signify the gifted author's expertise falsely. Secondly, gifted author is supposed as being more professional and skilled as compared to his peers. Thirdly, this unethical contribution, gives biased professional advantage to this person over his associates. Finally, a fabricated competency level is to be perceived about this individual and may be expected to achieve goals or tasks which may be 9 outside his competencies and expertise. Why we should be worried about proper authorship nomination? It is argued that authorship abuse is a victimless crime having no impact on scientific growth or reliability of medical literature. Authorship of a scientific paper matters a lot because the whole research and publication process relies on trust. The anecdotal evidence shows that the person who flouts authorship conventions can also pledge other types of publication or research related misconduct and this authorship abuse is not a victimless 4 corruption. In academic institutes, the promotion, job contract and remuneration are mainly influenced by the publications volume especially in the peer reviewed journals. The competences and expertise of the faculty is usually presumed on the basis high volume of publications. Awarding honorary authorship to a published work is a misconduct which is dishonest and threatens the foundational assumptions on which a community of scholars 2 operates. In literature review, a self-administered, web-based published survey shows that among staggering total of 50%, the 39% of manuscripts has honorary, 9% has 10 ghost and 2% are having both types of authorship. Bates and colleagues compared the authorship criteria and disclosure of contributions from author contribution forms of three medical journals and analyzed according to authorship criteria of ICMJE and observed that honorary authors varied in different journal, reaching up to 60% in the Annals of 9 Internal Medicine to a low of 4% in JAMA. Malički and colleagues studied that how authors describe their contribution to the paper submitted to the journal with reference to ICJME authorship criteria and reported that only 15.6% has correctly or clearly declared their contribution according to ICMJE 147 JIIMC 2020 Vol. 15, No.3 medical journal. BMC Med Res Methodol. 2012 12:189. Doi: 10.1186/1471-2288-12-189. 6. Jones JW, McCullough LB, Richman BW. The ethics of bylines: would the real authors please stand up? J Vasc Surg 2005; 42:816-818. 7. Reyes H B. Ethical problems in scientific publications. Rev. Medium Chile. 2018;146(3): http://dx.doi.org/10.4067/ s0034-98872018000300373 8. Broome ME. The 'truth, the whole truth and nothing but the truth. . .' Nurs Outlook 2008; 56:281-282. 9. Zaki SA. Gift author ship a cause of concern. Lung India. 2011; 28(3):232-233. 10. Mowatt G, Shirran L, Grimshaw JM, Rennie D, Flanagin A, Yank V, et al. Prevalence of honorary and ghost authorship in Cochrane reviews. JAMA 2002; 287:2769-2771. 11. Malički M, Jerončić A, Marušić M, Malički MA. Why do you think you should be the author on this manuscript? Analysis of open-ended responses of authors in a general medical journal. BMC Med Res Methodol 2012, 12:189. Doi: http://www.biomedcentral.com/1471-2288/12/189. 12. Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publication.2011. Website [http://www.icmje.org ] Accessed on 2020 Apr, 3. 13. Matías-Guiu J, García-Ramos R. Author and authorship in medical journals. Neurologia. 2009; 24(1):1-6. 14. Bates T, Anic A, Marusic M, Marusic A. Authorship criteria and disclosure of contributions: comparison of 3 general medical journals with different author contribution forms. JAMA 2004; 292:86-8. REFERENCES 1. Jones JW, McCullough LB. Is a gift authorship really a grift authorship? J Vasc Surg 2015; 61:1092-1093. http://dx.doi.org/10.1016/j.jvs.2015.02.006. 2. Authorship guidelines. International Committee of Medical Journal Editors. 2019. Website: [www.icmje.com]. Accessed on March 5, 2020. 3. Wager E. Recognition, reward and responsibility: Why the authorship of scientific papers matters. Maturitas. 2009;(62):109–112 4. Sharma BB, Singh V. Ethics in writing: Learning to stay away from plagiarism and scientific misconduct. Lung India. 2011; 28:148–150. 5. Malički M, Ana Jerončić A, Marušić M, Marušić A. Why do you think you should be the author on this manuscript? Analysis of open-ended responses of authors in a general one is exclusive and merits special treatment. Claiming off concepts and experiences as one's own, when they are not, and declining to recognize, in acknowledge or authorship or how others shape one's work and ideas is just simply deceitful and “alarming. In conclusion, gift authorship practice should be strongly discouraged and condemned in medical writing. The authorship credit and order should be based on the relative scholarly abilities and professional contributions of the collaborators. JIIMC 2020 Vol. 15, No.3 148