• Education Department, Hospital
• Ethical Review
• Ethics, Pharmacy
• PUBLIC HEALTH
• CLINICAL MEDICINE

Authorship attribution in scientific publications is increasingly significant, particularly in healthcare and hospital pharmacy. Authorship reflects the contributions of those involved in research, ensuring that scientific merit is recognised in a transparent and fair manner. However, unethical practices such as ghostwriting and guest or gift authorship compromise research transparency and integrity, undermining trust in published findings. Moreover, gender disparities affect the visibility and recognition of female researchers and healthcare professionals.

The term ‘author’ should denote an individual who provides substantial intellectual input to the creation of scientific work. Scientific authorship formally acknowledges those who have made significant contributions to the conception, execution, and publication of a study.1 In healthcare, including hospital pharmacy, pharmacological and clinical research is essential to improve patient care, making the correct attribution of authorship a crucial factor. The guidelines of the International Committee of Medical Journal Editors (ICMJE) establish strict criteria to define authorship eligibility.2 However, in many academic and hospital settings, these criteria are not always observed, leading to unethical practices that compromise the scientific process’s integrity.

Ghostwriting involves an external writer, often funded by a pharmaceutical company, drafting a scientific article that is subsequently published under the names of researchers or physicians who did not directly contribute to the writing.3 This practice is particularly concerning: high-cost drugs with complex safety profiles require rigorous, independent scientific evaluation. When ghostwritten publications favour specific therapies or products, results may be biased, potentially influencing therapeutic decisions inappropriately.4 For a hospital pharmacist, responsible for managing high-risk medications and optimising treatments for critical patients, ghostwriting poses a threat to therapeutic transparency and safety. Decisions on drug use should be based on solid, transparent evidence; however, data influenced by ghostwriting may introduce insufficiently validated therapies or downplay side effects.

Guest or gift authorship involves including individuals as authors of an article without having made a significant contribution to the research.5 In hospital practice, this phenomenon may occur when a department head, director, or chief is added as an author to increase the likelihood of publication or to give the article greater visibility. This practice is problematic, as it distorts fair credit attribution and creates a false perception of scientific authority. In a complex and critical environment such as a hospital, collaboration among multidisciplinary teams is essential. Each professional—be they physician, pharmacist, or researcher—contributes uniquely to patient care and research. Authorship attribution should reflect these contributions fairly and transparently. Adding names for ‘prestige’ compromises the authenticity of contributions and undermines the collaborative, meritocratic culture that should underpin scientific research.

Gender disparities are another critical issue in scientific authorship. Although women constitute a significant portion of the healthcare workforce, their representation as first or senior authors—key roles in scientific studies—remains disproportionately low compared with men.6 A 2013 study by Vincent Larivière showed that women are underrepresented as first authors in high-impact journal articles despite their substantial research contributions.6 It is essential that healthcare institutions promote an inclusive culture that equitably recognises women’s contributions. Creating environments that support women’s access to leadership roles in research and clinical practice is crucial to reducing disparities and improving the overall quality of healthcare research. Only through greater gender equity can comprehensive research and therapeutic approaches that truly reflect patients’ needs be achieved.

Unethical authorship practices significantly impact scientific transparency and can negatively influence clinical therapy choices. In hospital pharmacy, where therapeutic decisions must be based on robust evidence, the quality of scientific publications is essential. Additionally, gender disparities limit growth opportunities for qualified female professionals, hindering the full acknowledgement of their contributions.

Scientific journals should actively commit to ensuring and verifying the authenticity and accuracy of authorship attribution, preserving the integrity of published research and adequately recognising each researcher’s contribution. The European Journal of Hospital Pharmacy (EJHP) has strongly promoted the involvement of pharmacists in research and the dissemination of their findings through publication. Furthermore, EJHP condemns not only these unethical practices in scientific recognition, but also the predatory behaviours promoted by certain journals, which I had the opportunity to explore, describe, and share in this journal through the manuscript ‘The ugly phenomenon of predatory journals: what they are and how to avoid them’.7 None of the practices described are considered acceptable by EJHP.8 For further details and insights, readers and potential authors are encouraged to consult the ‘Authors’ section available on the journal’s website.9

In conclusion, healthcare institutions and scientific journals must encourage sound authorship practices. This ensures ethical and inclusive research that supports therapeutic decisions based on reliable data. For hospital pharmacists, maintaining a focus on scientific integrity is essential to ensure that each therapeutic decision is supported by transparent and independent evidence. Only in this way can we offer patients the best possible care, based on inclusive and rigorous science.