The Updated World Association of Medical Editors (WAME) Recommendations on Chatbots and Generative AI in Relation to Scholarly Publications and International Committee of Medical Journal Editors (ICMJE) Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals (May 2023)
Authors: Lapeña José Florencio 
Published: June 2023

On January 20, 2023, the World Association of Medical Editors published a policy statement on Chatbots, ChatGPT, and Scholarly Manuscripts: WAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications.1 There were four recommendations, namely: 1. Chatbots cannot be authors; 2. Authors should be transparent when chatbots are used and provide information about how they were used; 3. Authors are responsible for the work performed by a chatbot in their paper (including the accuracy of what is presented, and the absence of plagiarism) and for appropriate attribution of all sources (including for material produced by the chatbot); and 4. Editors need appropriate tools to help them detect content generated or altered by AI and these tools must be available regardless of their ability to pay.1 This statement was spurred in part by some journals beginning to publish papers in which chatbots such as ChatGPT were listed as co-authors.2
First, only humans can be authors. Chatbots cannot be authors because they cannot meet authorship requirements “as they cannot understand the role of authors or take responsibility for the paper.”1 In particular, they cannot meet the third and fourth ICMJE criteria for authorship, namely “Final approval of the version to be published” and “Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.”1,3 Moreover, “a chatbot cannot understand a conflict of interest statement, or have the legal standing to sign (such a) statement,” nor can they “hold copyright.”1 Because authors submitting a manuscript must ensure that all those named as authors meet ICMJE authorship criteria, chatbots clearly should not be included as authors.1
Second, authors should acknowledge the sources of their materials. When chatbots are used, authors “should declare this fact and provide full technical specifications of the chatbot used (name, version, model, source) and method of application in the paper they are submitting (query structure, syntax),” “consistent with the ICMJE recommendation of acknowledging writing assistance.”1,4
Third, authors must take public responsibility for their work; “Human authors of articles written with the help of a chatbot are responsible for the contributions made by chatbots, including their accuracy,” and “must be able to assert that there is no plagiarism in their paper, including in text produced by the chatbot.”1Consequently, authors must “ensure … appropriate attribution of all quoted material, including full citations,” “seek and cite the sources that support,” as well as oppose (since chatbots can be designed to omit counterviews), the chatbot’s statements.1
Fourth, to facilitate all this, medical journal editors (who “use manuscript evaluation approaches from the 20th century”) “need appropriate (digital) tools … that will help them evaluate … 21st century … content (generated or altered by AI) efficiently and accurately.”1