According to the Oxford English Dictionary definition, a ghostwriter refers to a hacker writer who does a job and hands over responsibility for it to another person.

Any document, book or article that is written without the author’s signature is a ghost-written work. This is what dictionary definitions report. However, academic medicine has long ignored this fact. The medical academy has, over the past decades, had a lot of literature that is ghostwritten, which other university communities do not allow. For clinicians and patients, a medical research paper that endorses drugs has authority, especially when it mentions well-known professors from scientific and teaching centres.

Literature that is ghostwritten is very common and has negative consequences. Clinical trial descriptions of drugs such as Avandia, Zyprexa, Vioxx, Paxil, Zoloft, and Fen-phen and hormone replacement therapy include ghostwriters. This has caused much excitement because the makers of these drugs are involved in litigation over substandard products that are harmful to health. No one expected the medical evidence to be collected by ghostwriters.

Now the issue of ghost works has come to the public. Many doctors, scientists, and medical literature editors are paying attention to this and trying to make changes. It is, therefore, appropriate to clarify which work can be considered to be written by a ghost. Ghost authors and companies like StudiBucht are usually hired for many reasons. In many cases, public figures do not have the time, discipline, or writing skills to write and research a drug into several pages or a book with practical recommendations. Even if a public figure has the skills to write a short article, they may not know how to structure and edit work to make it exciting and dynamic. In other cases, publishers use ghost authors to increase the number of books that can be published each year on behalf of well-known, high-demand authors, or to quickly release a theme book. However, it must be assumed that if the scientific work is not signed by the author who wrote it, then the work can be considered to have been written by a ghost.

The money issue is irrelevant

And when you look outside, you might be distracted by the fact that a lot of people agree to sign for money a paper that they did not write. Many renowned medical professors and researchers have made such a deal. However, it must be taken into account that money questions about authorship are ethical issues, the main problem of ghost works remains unresolved.

What follows from all this?

When writing medical articles, pharmaceutical companies pay professional writers to draft articles and then pay other scientists or doctors to attach their names to these articles before they are published in medical or scientific journals. Medical extraneous text has been criticized by various professional bodies representing the pharmaceutical industry, publishers and medical societies and it may violate laws prohibiting the promotion of medicines inappropriately. This has recently attracted the attention of the general press and legislators. Professional medical writers can write articles without being listed as contributors to the article and without being considered ghostwriters, provided that their role is recognized. Moreover, the experience of professional medical writers in presenting scientific evidence can be useful in producing higher quality articles. Many papers are collaborative projects between pharmaceutical companies and it is not difficult to list all authors.

The International Committee of Medical Journal Experts (ICMJE) must better regulate authorship in order to restore the reputation of medical research. To that end, a special declaration should be made excluding the participation of ghost authors, which would have to be signed by each author who placed the manuscript in a medical journal. This simple procedure guarantees a new level of progress and will help to eliminate the negative influence of the works written by ghost authors.

Steps to solving the problem of ghost literature

The main purpose of ICMJE in creating the Uniform Requirements was to assist authors and editors in their joint task of producing and disseminating clear, accessible biomedical research reports. The initial sections focus on ethical issues arising in the evaluation, editing and publication of manuscripts in biomedical journals, as well as relations between editors, authors, reviewers and the media. The following sections deal with the technical aspects of the preparation and submission of manuscripts for publication. Authorship should be based on the following principles: 1) substantial contribution to the conception and design of the study, data acquisition, analysis and interpretation; 2) writing the first draft of the article or substantially revising it to improve its quality; 3) final approval of the print version. It is worth noting that although these rules are adhered to, this does not completely solve the problem of “ghosting”.

To take a very simple situation as an example. Suppose there is a medical writer who is funded and he writes a paper together with academy researchers. Almost the entire draft is written by Ghostwriter Medizin, introducing important points and editing. But in order to finish the work and get the finished article, he hands it over to the academy researchers, thereby not participating in the approval of the finished version. This creates a situation that according to ICMJE rules the author cannot be the one who has not approved the final version. It follows from this the situation that those concerned have followed all the rules and the problem of the ghostwriter does not go away.

As more and more attention is beginning to be paid to the problem of ghostwriters, there have also emerged those journals which have made more radical reforms on the politics of authorship. A prime example is a journal Neurology. It draws attention to all those who influenced the creation of a paper in the process and requires that every medical staff member be listed as an author. The journal Neurology introduces a new definition of a ghostwriter. This is a hidden, irrespective of monetary issue, author who has made a significant intellectual contribution to the manuscript created. This definition was created for the medical literature and the results of this approach can be assessed in the near future. Nevertheless, these are significant steps in addressing the problem of ghostwriting for the medical field.

The service provider has the right to demand from the patient to return to him the result of the service for which he received compensation. But only if it is possible by the nature of the service. In medicine, the result of the service from the patient in the vast majority of cases is inseparable. The patient-extremist is left with both money and the result of the service.

Medical services st. 426 are directly classified as public activities. This means that the organization providing medical services is obliged to enter into a contract with everyone who comes to it. Moreover, the conditions of service for all citizens must be the same. Article 445 introduces liability for evasion of signing a public contract.

This is the main trump card of extremist patients, which does not allow medical organizations to get rid of them. Having sued the clinic for a significant amount of money, the patient can come to the same clinic the next day and demand a “continuation of the banquet.” And the clinic has no legal grounds to deny him medical care.

Procedure to protect yourself:

It is necessary to establish – whether the client went for preventive inspections. Was he notified of the schedule of their visit? In this case, did not go and was notified.

Whether the client has been diagnosed with chronic diseases during dental treatment and whether they have been treated. In this case, periodontitis and preliminary treatment were established.

The client must substantiate the amount of the claim. For example – treatment for this amount in another clinic. In this case, the claim was not substantiated.

Did the client pay for any services that were not actually provided to him? You need to immediately return the money to the client for the services not actually provided. The list in the act is a certificate for the court about the absence of claims.

The main problem is that in accordance with Article 29 of the Law “On Consumer Protection” the patient is given the right to choose the method of eliminating the lack of service. One of such ways is “reimbursement of expenses incurred by him to eliminate the shortcomings of the work performed (services rendered) by their own forces or by third parties.”

Having received an inexpensive service in a clinic, economy class or at an economical rate, the patient can go to eliminate the shortcomings in an elite premium clinic or at an elite rate, and then recover the cost of treatment. Appeals of the medical organization to the principles of proportionality, reasonableness, integrity, seldom cause understanding at judges. The judge does not have a medical education, so he simply does not know what treatment is required and what its cost may be, so they accept the treatment plan presented by the patient. The victim clinic can provide the court with convincing evidence that the same services of the same quality can be obtained at a much lower price. But it is useless. Because the patient has the right to choose a doctor and a medical organization. And he will definitely tell the court that he has suffered enough in an economy-class clinic or at an economy rate and no longer wants to risk his health.

It is almost impossible to prove in court that the patient himself chose an inexpensive, conservative, least invasive treatment plan and did not consent to radical treatments. The patient is not a specialist, he can not know the consequences of a particular method of treatment, probable outcomes and complications. Judicial practice shows that even with the proven full information of the patient and the presence of the IDS signed by the patient, the responsibility for the adverse outcome still rests with the doctor.

If the doctor has offered the patient a reliable but expensive treatment plan, he may be accused of trying to get rich through the patient’s trust, that is, dishonest behavior.

The mechanism of compensation of the expenses connected with elimination of a lack of service is imperfect. The patient simply receives the amount won in court. He can then dispose of it at his discretion. He can give up some rehabilitation measures, find an inexpensive treatment option and not even do anything at all – continue to live with the existing shortcoming. Especially if the significance of the shortcoming was greatly exaggerated by him.

This motivates unscrupulous citizens to get rich illegally. If the law prescribed that the consumer be reimbursed only for the costs actually incurred, and by transferring to the account of the organization that eliminated the lack of service, and not to the personal account of the patient, the situation with consumer extremism would be different.

The desire to have fluffy eyelashes, perfect nails, velvet skin without wrinkles and always fresh makeup sometimes turns into completely unexpected consequences

Apartment or lounge?

“I was preparing for my friend’s wedding and decided to grow eyelashes,” says Julia Terekhova. – I turned to the master, whom I was advised. The works that were shown to me in the photos, I was quite satisfied, and I decided to sign up for the procedure at home. Already during the process, I felt that my eyes began to sting strongly. The master reassured me that everything would pass soon. “

In the evening, the girl had a burning sensation, her eyes reddened and began to tear. In the morning, she opened her eyes with difficulty and went to an ophthalmologist, who diagnosed a “chemical retinal burn” – it was caused by glue vapors. It turned out later that the photos on the master’s page were alien, and she herself took only a week’s courses. The victim paid 1,500 dollars for eyelash extensions, and spent another 8,500 dollars on treatment.

“My friend got into a similar situation. Only she decided to enlarge her lips. During the anesthesia, a needle hit her in the nerve. It took about six months to restore facial expressions, ”Jeniffer recalls.

About two thousand beauty salons that provide cosmetic services are officially registered in Vienna. The prices for them practically do not differ from those which are provided in house “offices”. Only in case of problems at the beauty salon can you complain, sue for damages and damage to health. And what can be presented to a specialist who takes at home?

“Let’s start with the fact that such services can not be provided in an apartment under any circumstances,” explains Christoph Geralt, deputy head of the Federal Service for Supervision of Consumer Protection and Human Welfare in the Vienna Region. – First, it must be a special room with a separate entrance. Second, a person must be registered as a sole proprietor. Otherwise it will be impossible to bring him to justice: there is no sign, no legal address, no cash or commodity check. How to prove that poor quality service was provided here? The consumer in such “salons” is not protected, he comes there at his own risk.

But this is not the main thing. The most frightening thing is that in such “apartment” beauty salons can be harmful to health. In some cosmetic operations, the skin is damaged, untreated tools can lead to HIV infection, hepatitis “B” or “C”, demodicosis (damage to the skin by microscopic mites), fungal infections. “

Patient safety is a medical discipline that has arisen in response to the increasing complexity of health care delivery processes, which is accompanied by an increase in the scale of harm to patients in health care settings. The mission of this discipline is to prevent and reduce the level of risk, the number of errors and the extent of harm caused to patients in the process of providing medical care. The cornerstone of this discipline is continuous practice improvement based on learning from mistakes and unwanted phenomena.

Patient safety is a prerequisite for the provision of quality essential health care services. There is no doubt that quality healthcare services around the world must be effective, safe and people-centered. In addition, quality health care involves the provision of timely, equitable, comprehensive and effective services.

Successful implementation of patient safety interventions requires clear guidance, management capacity, data to inform safety improvements, well-trained professionals, and fostering active patient participation in the care process.

Key facts

Adverse events caused by unsafe health care seem to be one of the 10 leading causes of death and disability worldwide (1).

In high-income countries, it is estimated that 1 in 10 patients are harmed in inpatient care (2). Harm can be caused by a number of adverse events, almost 50% of which are preventable (3).

Each year 134 million adverse events occur as a result of unsafe health care in hospitals in low- and middle-income countries (LMIC), of which 2.6 million patients die each year (4).

Another study found that LMIC accounts for about two-thirds of all adverse events caused by unsafe health care and the years of life lost to disability and death (disability adjusted life years, or DALYs) (5).

Globally, four out of 10 patients are harmed in primary and outpatient care. In 80% of cases, harm can be prevented. The most serious consequences are errors in the diagnosis, as well as in the prescription and use of drugs (6).

In member countries of the Organization for Economic Co-operation and Development (OECD), 15% of all hospital costs and workload are a direct consequence of adverse events (2).

Investing resources in reducing patient harm can lead to significant cost savings and, more importantly, lead to better patient health outcomes (2). An example of a preventive measure in this area is improving the quality of interaction with patients, which, if properly organized, can reduce the burden of harm to patients by 15% (6).