I found this picture interesting.
Take a look at look at the two images from your seat. Note which face is angry, and which is calm (Mr Left or Mr Right). Now get up and move back at least 10 feet.
I had the same feeling when speaking about ghostwriting and scientific misconduct at recent meetings of the International Society of Medical Publication Professionals (ISMPP). Different people, apparently looking at the same world, do not see the same thing.
Although "ghostwriters" are ostensibly the key enemy, I had a different view after these meetings. Most honestly believe that what they do is important and good. Most are very nice people, well intended, and with genuine concerns about integrity. Most are shocked when shown examples of what has happened - and the consequences.
This is in contrast to academic medical leadership who have acquiesced with deception, and have passed their sense of integrity to the next generation. Medical writers do facilitate deception, but are not generally responsible for it. Some ghostwriters have however been participants in outright scientific fraud.
There are problems with overemphasising only one facet of a very large problem, and pretending that it is the whole problem.
Work of Phillippe G. Schyns and Aude Oliva at MIT