The primary objective of this inquiry was to explore the nexus between authorship attribution in medical literature and accountability for scientific impropriety while assessing the influence of authorial multiplicity on the severity of sanctions imposed. Probit regression models were employed to scrutinize the impact of authorship on assuming accountability for scientific misconduct, and unordered multinomial logistic regression models were used to examine the influence of authorship and the number of bylines on the severity of punitive measures. First authors and corresponding authors were significantly more likely to be liable for scientific misconduct than other authors and were more likely to be penalized particularly severely. Furthermore, a negative correlation was observed between the number of authors' affiliations and the severity of punitive measures. Authorship exerts a pronounced influence on the attribution of accountability in scientific research misconduct, particularly evident in the heightened risk of severe penalties confronting first and corresponding authors owing to their principal roles. Hence, scientific research institutions and journals must delineate authorship specifications meticulously, ascertain authors' contributions judiciously, bolster initiatives aimed at fostering scientific research integrity, and uphold an environment conducive for robust scientific inquiry.