Academic publication is enriched by contributions from patients who bring their lived experience to the task of authoring or co-authoring. Some public co-authors wish to remain anonymous, as their story is sensitive, blows the whistle on corrupt or illegal activity or carries stigma. Others may be planning to move into a new phase of life and want their old life to be forgotten. A third group of authors may wish to protect their family’s privacy. In some jurisdictions, authors may endanger their own lives by reporting findings that are deeply unpopular with research participants, politicians or the public. Yet more live within traditional cultures where their background, gender or ethnicity would lead to their material being discounted, or where one’s complete given name represents a major disclosure that is reserved for family and close friends. For these, and perhaps other reasons too, authors may wish to conceal their identity.
As long as such authors can be contacted via the corresponding author, it should be OK for them to use an incomplete name, initials or a pen name to protect their privacy. In this way, the scientific publication meets expectations of integrity and transparency, while the author retains the degree of privacy they want.
There is an adjacent practice by which individual identities are submerged in a group, and both groups of academics and groups of experts by experience have adopted this practice. The principle is the same – that authors must be contactable and accountable. The issues set out here apply to all authors of academic papers, but may be more salient for consumer authors, as such experts by experience have joined the writing team precisely because of their personal experience. As more and more research is co-produced, editors will receive a corresponding increase in the number of manuscripts from writing teams which include authors who wish to conceal their identity.
The issue is not confined to publishing. We know of a recent research funding application in which the team wanted to include a forensic patient as a co-applicant. For reasons of personal safety, the person was unwilling to have their full name published by the funding body. Unfortunately, recent guidance from NIHR INVOLVE on engaging public co-applicants strays into this topic with an unwarranted prohibition, as the following paragraphs show:
“Publishing guidelines for journals do not allow submissions that include anonymous contributors or pseudonyms.”Public Co-Applicants in Research – guidance on roles and responsibilities (January 2019, NHS R&D Forum, the Health Research Authority and INVOLVE
I think that the idea is of using initials, an incomplete name or pseudonymn with contact via the corresponding author is sound, but the case is strengthened by pointing to a range of articles that have already been published in prestigious peer-reviewed journals. Then, armed with these examples, it is possible to seek:
- support from individual editors
- amendment where necessary of the guidelines for authors published by specific journals
- support from editors groups, such as the International Committee of Medical Journal Editors (ICJME)
- an update of the GPP3 Good Publishing Guidelines.
So please can you help me find examples? Search results are being added to the free guidance document How to involve the public as co-authors. This webpage will be updated as new ideas emerge about how to find the examples we need.
In summary, this is a search for people who:
- are recognised as full authors at the start of the paper, not those who appear in the acknowledgements at the foot of the publication.
- are experts by experience (sometimes called ‘consumers’) who are using initials, partial names or pseudonyms, so their identity is never revealed anywhere in the paper.
- are recognised as individual authors rather than subsumed into a group.
- can be contacted via the corresponding author.
Working on the project
This project has been uploaded to TaskExchange, an online resource run by the Cochrane Collaboration. Two members of TaskExchange have kindly volunteered to help so far – Hariklia Nguyen and one other. Some possible approaches are set out below.
#1: Scan lists of references
PubMed and similar places may be searched, perhaps with the help of a guide. For example, Taboada et al guide us through the zbMATH database and note that the creator of Student’s t test used a pseudonym in publishing this widely-used statistical tool (‘Student’ was the pen name of William Sealy Gosset, adopted because the Guinness brewery as his employer had banned staff from publishing). Others have explored the topic of anonymity too, including Bohannon, Prakash and Wendl and noted, amongst many other things, that the selection of a pseudonym conceals some aspects of the author while expressing others. Commentators such as Rao and Guenther have shown how any attempt to achieve anonymity is pretty comprehensively doomed in the age of the internet, while Dobreski and Kwaśnik show how library cataloguing systems are changing to reveal more about authors. Meanwhile, Finn observed that pen names can be misused to make false claims, so using a pseudonym must not be a vehicle for presenting hoax data, as Bohannon, Lindsay, Pluckrose and Boghossian have graphically illustrated.
It may be possible to spot authors using initials only, but not those who add fictitious initials, such as the K adopted by the author Joanne Rowling. Incomplete names will be more difficult to detect, as some forenames are also used as surnames, and cultural and language differences mean that recognising incomplete names outside one’s own culture is hard. Pseudonyms will be impossible to detect unless people use the direct ‘Anonymous’ or a flamboyantly humorous name to signal that this is a pseudonym, such as ‘Sally Popkorn‘. But who would know that F.D.C. Willard, the co-author working with physicist and mathematician Jack H. Hetherington, was his cat? Such examples bring the use of pseudonyms into disrepute and may in the end deny publication to legitimate authors.
A brief look at PubMed suggests that authors calling themselves ‘Patient’ may be using their real surname. Meanwhile, catologuing systems used to be unreliable, so author data were sometimes corrupted and in this context, ‘anonymous’ means that the archivists no longer have the information.
The British Medical Journal has a strategy to promote contributions from consumers, so we might hope that they have some examples. The journal is prestigious with an impact factor of 23. The new journal Research Involvement and Engagement is specifically aimed at consumer perspectives, so it would be fascinating to discover whether it contains any examples. The NIHR Involve evidence library contains an archive of papers about consumer involvement, so it would be good to see if any of these authors use pseudonyms.
#2: Find authors who publish under a group name
A second strategy may be to seek out papers where a group of public co-authors have submerged their individual identities into a group name which appears as a single author. Good search terms might be ‘Group’ or ‘Forum’. Whilst this is not the central goal of this project, it may (i) show that there are indeed examples of this practice; and (ii) create the opportunity to email the corresponding author and ask if individual group members have co-authored papers in their own right. Such individuals might then be willing to let us know of any papers that are published using initials, incomplete names or pseudonyms.
#3: Select stigmatised groups
A third strategy may be to target highly sensitive topics and look for papers that report the consumer’s point of view. These would be areas most likely to utilise initials, incomplete names or pseudonyms. Researchers in these fields might be among those most likely to support the goal of this investigation – to create ways for the author’s voice to be heard whilst respecting their wish for confidentiality. So research on stigmatised behaviours, such as the views of those who commit violence or members of stigmatised minorities might yield examples. This may be as varied as the subjective experiences of people convicted of crimes against children, survivors of domestic violence or people engaged in lifestyles that are condemned in certain societies, whether that means abortion practice in the USA or anti-gay sentiment in Russia. We could try guessing which topics might be fruitful.
It appears that the range of ideas regarded as sensitive may be larger than initially thought, and a whole new academic journal is being produced for people wishing to write under a pseudonym – see here.
#4: Ask people who research journalism practices
A search within the academic disciplines that investigate librarianship, publishing, journalism and bibliometrics using terms such as ‘pseudonyms’ ‘anonymisation’, ‘noms de plume’ or ‘consumer authors’ may locate people interested in our question. These experts in trends in academic publishing may have additional ideas.
For example, Hays has studied small circulation journals, known as zines, to uncover attitudes about the use of pseudonyms, and the findings may point to views that might be found amongst academic authors too.
Many famous people choose a pseudonym, stage name or pen name, including Woody Allen, John le Carre, John Denver, Whoopi Goldberg, Ben Kingsley, Spike Lee, Demi Moore, George Orwell, Meg Ryan, Dr Seuss, Patience Strong, Ice T and Mark Twain. Some authors, having achieved fame with their own name, go on to write more under a pseudonym, not to dodge the critical gaze of the publisher (as with anonymised peer review in academia), but for a more substantial motive. Agatha Christie, Benjamin Franklin, J.K Rowling, C.S. Lewis and many others ask for their work to be judged by the public on its merit, rather than by reference to their reputation. As Vainio writes, ‘anonymity should help all parties to focus on what has been said instead of who has said it.’
Academic editors may consider if they take a different position to their sister journalists who do offer the option of anonymity under specific circumstances and support its uptake:
Identify sources clearly. The public is entitled to as much information as possible to judge the reliability and motivations of sources. Consider sources’ motives before promising anonymity. Reserve anonymity for sources who may face danger, retribution, or other harm, and have information that cannot be obtained elsewhere. Explain why anonymity was granted.Society for Professional Journalists Code of Ethics, 2014
There is some academic discussion of anonymisation for research respondents, such as in the work by Barratt & Lenton, Lahman et al, Berkhout and Petrova et al. A poignant example is the work by Grinyer that describes bereaved parents using real names to honour the memory of the child they had lost, while other parents with a child who had survived cancer chose a pseudonym to protect their family’s privacy. Moreover, the impact of concealing or disclosing one’s own name may change over time, as personal, professional and political circumstances change, and there is no effective way to retrieve information after it has entered the public domain.
In Mukungu‘s work with Namibian women who campaign for the ending of violence against women and girls, the risks of harm that were associated with research publication paled into insignificance in contrast with the personal cost of standing up for justice in their own community. Some of her respondents had spent a lifetime bravely identifying with their message, and so would not hide behind a pseudonym but instead insisted on their own names being used. Disclosure can empower, just as confidentiality can injure.
However, the use of one’s own name cannot be equated with a desire for a better world. Blee illustrated in her study of racist groups where some members wished to forego anonymity and use their real names to promote their racist agenda. So it is clear that the decision to use one’s given name or a pseudonym is complex, individual and unpredictable.
The issues that arise for research respondents may also apply to the authors themselves when they are employing autoethnographic and other reflective approaches in which the author’s own experience is included and acknowledged. One might also ponder why conventional research ethics asserts that those who provide research evidence should usually be anonymised while those who process and report it may not.
Finally, researchers that adopt a pseudonym would do well to heed the warning by Scheper-Hughes that the mask of anonymity can permit the author to become lazy and self-interested, rather than disciplined, moderate and accountable. This stance is challenged by Vainio, who argues for explicit and careful anonymisation as a mechanism for gaining vital distance between the lives of respondents and the data that they dispassionately analyse.
#5: Look for book chapters
Whilst our ideal target is papers in high impact academic journals, examples from edited academic textbooks may also be of interest.
For example, Dening T (ed) Oxford Textbook of Old Age Psychiatry, 2nd edition (2013). Oxford: Oxford University Press. This book includes:
- chapter 30 about living with about dementia which was written by a couple using their own name
- chapter 41 about the experience of depression written by an author using a pseudonym
- chapter 47 which is about long-term illness co-authored by a named academic and an expert by experience who chooses to remain anonymous.
One might persistently use Twitter and other online platforms to circulate our inquiry and see what comes back.
#7: Target GPP4
There will shortly be a consultation about the current Good Publishing Practice guidelines (GPP3), in order to produce an updated version that will be known as GPP4. Our question might be of interest to the people involved in producing GPP4 – the International Society for Medical Publication Professionals, who can be contacted here.
Here’s what the International Committee of Medical Journal Editors said in response to an inquiry:
In rare circumstances, editors allow for anonymous publication, for example when identification of the author(s) might lead to a breach in patient confidentiality or other harm to a patient. Authors must nonetheless meet the criteria we have established for authorship. The specific situation would need to be discussed with the editor of the journal who would need to decide if the present circumstances warrant author anonymity in light of the challenges it poses to accountability.International Committee of Medical Journal Editors
#8: Consider other uses of anonymisation
Anonymisation is used to protect some people brought before the courts and family members in significant case reviews, such as this one.