Inappropriate Authorship

Inappropriate Authorship in Nursing Journals

Maureen Shawn Kennedy

nurse author & Editor, 2015, 25(4), 2

Most nursing journals note that they ascribe to criteria for authorship according to the guidelines of the International Committee of Medical Journal Editors (ICMJE) or Committee on Publication Ethics (COPE), however it seems clear that many authors don’t follow suit. We experienced several instances whereby the corresponding authors of manuscripts submitted to the American Journal of Nursing (AJN) were unable to answer questions about content. We realized that despite our author forms asking what each author contributed to the paper, it was clear that many individuals listed as authors didn’t qualify. We also had situations where we found individuals were not named—on one paper, none of the named authors claimed writing the first draft!

Conversations with editors of other nursing journals confirmed many experiences with inappropriate authorship, either ghost authorship (not listing individuals who made substantial contribution in writing or revising a paper as authors) or honorary or “guest” authors (listing individuals who had little hand in writing or revising a paper as authors). While there had not been any research examining authorship practices among nursing journals, there has been such research among medical journals. Flanagin and colleagues (1998) found that among six peer-reviewed high impact factor medical journals, 19% had honorary authors and 11% had ghost authors. A follow-up ten years later (Wislar et al., 2011) showed similar albeit a bit better results:  17.6% honorary authors and 7.9% ghost authors.  We decided to examine authorship practices among nursing journals, nursing editors’ awareness of instances of inappropriate authorship and see how the results compared with those of medical journals.

The Study

After gaining IRB approval from the University of Pennsylvania and University of Technology, Sydney,  we reviewed original research, QI reports, and review articles having

List of Journals Used in the Study
List of Journals Used in the Study

multiple authors and published in 10 nursing journals between 2010 and 2012. The journals were a mix of specialty and non-specialty journals; all had impact factors and all noted that they followed the ICMJE or COPE guidelines. (See list in the figure at left.)

We contacted corresponding authors (1,356 in all) and invited them to complete an online survey (adapted from the survey used by Wislar and colleagues) about the participation of their co-authors on their papers and whether it met criteria for authorship according to the ICMJE guidelines:

Authorship credit should be based on: 1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; 2) drafting the article or revising it critically for important intellectual content; and 3) final approval of the version to be published. Participation solely in the collection of data does not justify authorship. (ICMJE, 1985, p. 722)

We also invited the 203 members on the listserv of the International Academy of Nursing Editors (INANE) to complete an online survey about their awareness of inappropriate authorship in their own or other nursing journals.

Quantitative Results

In the author survey, we received 556 responses from the corresponding authors – a 41% response rate; after removing incomplete surveys, there were 422 usable surveys: 304 from research articles, 96 review articles and 22 QI reports.

There were 42% of articles listing honorary authors and 27.6% with ghost authors. We found no differences related to journals, type of journals (specialty versus broad-based), or publishers.  In comparison with the results from the two medical journal surveys, nursing publications fared far worse in ethical authorship practices.

From the INANE listserv survey, we received 60 usable responses, a response rate of 29.5%. (Note: not all on the listserv are editors, so the actual response rate from editors may be higher.)  Briefly, 22 editors (36.7%) reported honorary authorship and 13 (21.7%) reported instances of ghost authorship among articles submitted for publication.

Qualitative Results from the Author Survey

We invited respondents to add any comments about authorship or the survey and received 72 responses that were grouped into five themes: “lack of awareness around rules for authorship; acknowledged need for debate, discussion, and promotion of ethical practice; knowingly tolerating, and sometimes deliberately promoting, transgressions in practice; power relations and expectations; and avoiding scrutiny.” (Kennedy et al., p. 419)

Why This Matters

Appropriate attribution of authorship should matter to everyone. Making a claim to be an author in the absence of any real contribution to the creation of an article is intellectually dishonest and unethical. Sadly, it is a common practice in nursing, as our study shows that well over one-third of articles examined have individuals named as authors who had had little to do with “authoring” the paper. Often, these individuals are in positions senior to the author, as faculty chairs or managers, and insist that they be included. Similarly, ghost authorship is a problem, with over one-quarter of articles having writers who were not listed as authors. The lack of transparency allows for the possibility of bias and conflicts of interest if there are hidden authors. When one considers that promotions and grant funding are often tied to one’s publications, it means that individuals claiming inappropriate authorship may enjoy career advancement at the expense of colleagues who act ethically.

By standing firm on this issue, editors can support authors who are under pressure from senior colleagues to act unethically. We urge editors to enforce the application of ICMJE criteria and insist that those named as authors deserve the title and all those who had a hand in writing are named.

Note: This article is a summary of Kennedy, Barnsteiner, & Daly (2014).


  1. Flanagin, A., Carey, L. A., Fontanarosa, P. B., Phillips, S. G., Pace, B. P., Lundberg, G. D., & Rennie, D. (1998). Prevalence of articles with honorary authors and ghost authors in peer-reviewed medical journals. JAMA: The Journal of the American Medical Association280(3), 222–224. Retrieved from
  2. Kennedy, M. S., Barnsteiner, J., & Daly, J. (2014). Honorary and ghost authorship in nursing publications. Journal of Nursing Scholarship: An Official Publication of Sigma Theta Tau International Honor Society of Nursing / Sigma Theta Tau46(6), 416–422.
  3. International Committee of Medical Journal Editors (ICJME). (2015). Recommendations: Defining the role of authors and contributors. Retrieved October 2, 2015, from
  4. Wislar, J. S., Flanagin, A., Fontanarosa, P. B., & DeAngelis, C. D. (2011). Honorary and ghost authorship in high impact biomedical journals: a cross sectional survey. BMJ , 343, 1–7.

about the author

Maureen “Shawn” Kennedy, MA, RN, FAAN has been the editor-in-chief of the American Journal of Nursing since 2010; she has served in a variety of other positions at the journal starting in 1996. Shawn was a visiting nurse scholar at the WHO Office of Nursing and Midwifery in 2008; in 2009 she was inducted into the Hunter College Hall of Fame and named a Fellow in the American Academy of Nursing in 2014.

NAE 2015 25 4 2 Kennedy

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Journal Complication Copyright 2015: John Wiley and Sons Ltd