Ethical issues in healthcare marketing**

Ethical issues in healthcare marketing

1. Ethical Issues in
healthcare marketing
Dr. EsraaMohammed Soltan
Lecturer of Nursing Administration-Suez Canal University
Diploma of Health Professions Education (DHPE)

2. Outline:
•Introduction
•Definition of ethics
•Definition of ethical issue
•Definition of ethical principle
•Definition of biomedical ethics
•Definition of healthcare marketing

3. Outline (cont.):
•Fundamentalethicalprinciples
•Bio-medicalethicsinthemarketingofhospitalservices
•Ethicallyproblematicpracticesusedinhealthcaremarketing
•Principlesofhealthcaremarketing
•Summary

4. Introduction:
Healthcaremarketingisanespeciallysensitivetopic
inrelationtoethicalconcerns.Potentialclientsof
healthservices,particularlyindividualssuffering
fromseriousconditions,belongtoacategory
vulnerabletoemotionalmanipulationandareeasily
influencedbyexaggeratedpromises.

5. Definition of ethics:
It is called moral philosophy, the discipline concerned
with what is morally good and bad, right and wrong.

6. Definition of ethical issue:
Ethicalissuesoccurwhenagivendecision,scenario
oractivitycreatesaconflictwithasociety'smoral
principles.

7. Definition of ethical principle:
Anethicalprincipleisasortof“ruleofthumb”on
howoneshouldorshouldn’tbehave.It’slikea
generalrulethatdefinesgoodorbadbehavior.

8. Definition of biomedical ethics:
Biomedicalethicsisshortenedto"bioethics."
Bioethicsisthesetofmoralprinciplesandvalues(the
ethicspan)neededtorespect,protect,andenhance
life(thebiopart).

9. Definition of healthcare marketing:
Itistheuseofmarketingstrategiesforthepurposes
ofprotectingandimprovingapopulation'shealthby
promotinghealthinformationandtreatmentoptions.

10. Fundamental ethical principles:
Respectingpatientautonomy
Supportingandfacilitatingself-determinationinhealthcaredecisionmaking
Beneficence
Upholdingpatients’bestinterestsandprotectingfromharm
Non-maleficence
Noactiontobetakenthatmaycauseharmtothepatient
Justice
Treatingeverypatientequallywithoutanybiasofeconomicstatusorcastetc

11. Autonomy:
•Thisprincipleisconsideredmostimportantinhealthcaredecision
making
•Dueimportanceisaccordedtopatients’rights,self-governance,and
individualchoice
•Autonomytopatientsincludedeterminationofhealthcaregoals,power
todeterminewhatcanbedoneandcannotbedoneonpatients’body
•Onlywhenapatientisincapableofmakingdecisiononhisown,the
decisionmaybetakenbyanotherpersoncloselyrelatedtothepatientor
bythedoctorwhennoneisavailable

12. Autonomy (cont.):
•Importanceisgiventopatient’sdesireandwishes,and
personalvalues
•Thisisbasedafterprovidingallrelatedinformationtothe
patienttoenablehim/heraninformeddecision
•Patient’sdecisionshouldbeentirelyvoluntaryandwithout
anydirectorindirectcoercion
•Patienthasarighttodignity,confidentialityandprivacy

13. Beneficence:
•Thisprincipleisbasedonthehealthcareproviders’obligationto
providebestcareasperthejudgementofacompetenthealthcare
provider
•Costandbenefitsneedtobebalanced
•Benefitsmayinclude:
•Prolonginglife,restoringfunction,relievingpainandsuffering
•Thisprincipleisuppermostinthemindsofthecaregiverswhile
decidingondeliveringhealthcare

14. Beneficence (cont.):
•Assessingpatient’sgoodisnoteasy
•Thisisnotonlybasedonscientificgroundbutalsoonpatient’s
expectations,goals,andvalues
•Thisaspectisrecognisedmoreandmorebythecaregivers
•Traditionallydoctorshavebeenpaternalisticintheirbehaviourtothe
patient
•Patient’sanddoctors’choicemaydiffer
•Doctors’increasinglyarerespectingpatient’schoicesafterallprosand
conshavebeenexplainedtothepatient

15. Non-maleficence:
•Themaximof“First,donoharm”isthebasisofthisprinciple
•Purposely,noharmisinflicteduponpatients
•Butitisnoteasytodeterminewhichproceduremaycauseharm,
thoughtheharmisnotintended
•Medicalprocessesalwaysarenottotallyharmless
•Atthetimeofchoosingatreatment,theconsiderationisthatit
shouldalwaysdomorebenefittothepatientthanithasthe
potentialtocauseharm

16. Justice:
•Justiceorequitydefineswhateachpersoninsocietyis
entitledtoasamemberofthesociety
•Treatmentshouldbebasedonclinicalconsiderationandnot
oncast,religion,economicstatus

17. Bio-medical ethics in marketing of
hospital services:
OriginallyAmericanMedicalAssociation(AMA)prohibitedadvertisingby
physiciansforattractingpatients
•Traditionally,physiciansandmedicalsocietiesdidnotsupport
advertisingbyphysicians
•Theirviewswerethatadvertisingcommercializedthepracticeof
medicine
•Thispracticedidnotrespectthedignityoftheprofession
•Physicianswereexpectedtogetreferralsfromotherphysiciansandfrom
satisfiedpatients
•Theywereexpectedtoachievethisbyprovidinggoodcaretotheir
patients

18. Bio-medical ethics in marketing of
hospital services (cont.):
•InUSA,theFederalTradeCommission(FTC)determined
thatthemedicalprofessioncouldadvertisetoattractpatients
•TheFTCheldthattheprohibitionofadvertisingby
physiciansimposedbytheAMA’scodeofethicswasan
unlawfulrestraintofcompetition
•In1982,theUSSupremeCourtdecidedinfavourofthe
FTC

19. Bio-medical ethics in marketing of
hospital services (cont.):
•AsperFTC,allbusinessesandprofessionalshavetheright
toinformthepublicabouttheservicestheyprovide
•Consumersalsohaveinformedchoicesbasedontruthful
advertisement
•TheEthicalCommitteeoftheAmericanCollegeof
ObstetriciansandGynaecologistsexaminedwhetheran
advertisementoritsmethodisethicalornot

20. Ethical committee of the American college of
Obstetricians and Gynaecologists
recommendations:
•Itisethicalforphysicianstomarkettheirpractice
•Advertisementsmustbetruthfulandnotdeceptiveor
misleading
•Advertisementsmustnotconveydiscriminatoryattitudes
•Advertisingthatseekstodenigratethecompetenceofother
individualprofessionalsorgrouppracticesisalways
unethical
•Allpaidadvertisingmustbeidentifiedassuch

21. Ethical Committee of the American College
of Obstetricians and Gynaecologists
recommendations (cont.):
•Physiciansshouldconsiderboththeintentanditseffecton
thepublic’sviewoftheprofession
•Apaidadvertisementpromotingtheactivitiesofaphysician
orpracticemustbeclearlyidentifiedasadvertising
•Itisnotethicaltocompensatethecommunicationmediato
compensateinanywayforpublicityinanewsitem
•Advertisersshouldbecarefulnottoimplyspecialtytraining
whensuchhasnotbeenundertaken

22. Bio-medicalethicsinmarketingofhospital
services–medicalcouncilofIndia
regulations:
•MCIintheirCodeofEthicslaiddownthefollowingguideline:
•Physicianscandisplayonlytheauthorizedsuffixtotheirnames
•Advertising
•Solicitingofpatientsbyphysiciansororganizationisunethical
•Aphysicianshallnotmakeuseofhim/herasasubjectofanyformor
mannerofadvertisingtoinviteattentiontohimorher
•Self-aggrandisementinadvertisementsisunethical
•Shallnotrenderhis/hernametobeusedforendorsinganyproduct

23. MCI –Ethics Regulation:
•Amedicalpractitionerispermittedtomakeaformal
announcementinpressregardingthefollowing:
•Onstartingpractice
•Onchangeoftypeofpractice
•Onchangingaddress
•Ontemporaryabsencefromduty
•Onresumptionofanotherpractice
•Onsucceedingtoanotherpractice
•Publicdeclarationofchanges

24. MCI –Ethics Regulation:
•Unethicalactsalsoinclude:
•Printingofselfphotographoranysuchmaterialofpublicityintheletter
headoronsignboardoftheconsultingroomareregardedasself-
advertisementandunethicalconduct
•Publicationinlaypress
•Aphysicianshouldnotcontributetolaypressarticlesandgiveinterviews
regardingdiseasesandtreatment
•Thismayhavetheeffectofadvertisinghimselfofsolicitingpractice

25. MCI –Ethics Regulation:
•Aninstitutionrunbyaphysicianmaybeadvertisedinlay
press
•Theseadvertisementshouldcontainonlynameoftheinstitution,typeof
patientsadmitted,typeoftrainingandotherfacilitiesofferedandthefees
•Itisimpropertousealargesignboard
•Onthesignboardonlyhis/hername,universityqualification,nameof
specialty,registrationnumber
•Itisimpropertoaffixasign-boardonachemistsshoporinplaceswhere
he/shedoesnotresideorwork
•Aphysicianshallnotusetoutstoprocurepatients

26. Principles of healthcare marketing:
•Hyperbolicandambiguousphrasesmustbeavoided
•Avoidpromisingresultsthatcannotbeconsistentlyachieved.
•Usingunprovable,subjective,superlativeand
unsubstantiatedstatementsisnotacceptable("bestinthe
world","mosttrusted"etc.).
•Avoidpromotingahealthcareorganizationbyusinga
negativecampaignagainstotherhealthcareproviders(unfair
competition).

27. Principles of healthcare marketing
(cont.):
•Paidadvertisingshouldbeidentifiedassuch.
•Ahealthcareorganizationshouldbemindfulofallrelevant
marketingguidelinesandlaws,onalocal,nationaland
internationallevel.
•Marketingcommunicationcannotpresentinformationina
misleadingmannerordisplaydiscrimination.

28. Principles of healthcare marketing
(cont.):
•Ahealthadvertisershouldconsiderwhatmediaformisthe
mostethicallysuitableineveryindividualcase.
•Avoidhiringpaidactorswhowillfalselypresentthemselves
asmedicalprofessionals,ortoimplicitlyorexplicitlystate
incorrectcredentialsofaphysician(subspecialtytraining,
typeofmedicaldegreeetc.).

29. Principles of healthcare marketing
(cont.):
•Particularcautionisadvisedwhenadvertisingalternative,
experimentalorcontroversialmedicalservicesthatarenota
subjectofprofessionalconsensus.
•Whenitcomestospecialoffers(freeservices,discounts
etc.),itisdeceptivetoavoidmentioningany"hiddencosts".
•Healthcareadvertisersarestrictlyforbiddentodiscloseany
privatepatients'informationwithouttheirformalconsent.

30. Ethicallyproblematicpractices
usedinhealthcaremarketing:
•Fearmongering
•Presentingonlythepositivesidesofaprocedureor
medication(withoutmentioningrisksandside
effects)
•Alteringvideosandimagesdigitallyinadeceptive
manner("before&afterphotos")

31. Summary:
•Definition of ethics
•Definition of ethical issue
•Definition of ethical principle
•Definition of biomedical ethics
•Definition of healthcare marketing
•Fundamentalethicalprinciples
•Bio-medicalethicsinthemarketingofhospitalservices
•Ethicallyproblematicpracticesusedinhealthcaremarketing
•Principlesofhealthcaremarketing

32. References:
•Franklin,B.J.(2011).Biomedicalethicsforengineers:Ethicsand
decisionmakinginbiomedicalandbiosystemengineering.Biomedical
Instrumentation&Technology,43(3),196-196.
•Linton,A.D.(2015).Introductiontomedical-surgicalnursing.Elsevier
HealthSciences.
•Mantas,J.,Šendelj,R.,&Ognjanović,I.(Eds.).(2020).Health
InformationManagement:EmpoweringPublicHealth(Vol.274).IOS
Press.
•Maxwell,J.C.(2023).BigPicture.OswaalAspiretoInspireBook,2023,
138.

33. References:
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Purcarea,V.L.(2016).Ethicalissuesinadvertisingandpromotionof
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