Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-22T23:50:46.258Z Has data issue: false hasContentIssue false
  • English
  • Français

Marketing the Research Missions of Academic Medical Centers: Why Messages Blurring Lines Between Clinical Care and Research Are Bad for both Business and Ethics

Published online by Cambridge University Press:  12 July 2019

MARK YARBOROUGH ,
TIMOTHY HOUK ,
SARAH TINKER PERRAULT ,
YAEL SCHENKER  and
RICHARD R. SHARP
Get access Rights & Permissions [Opens in a new window]

Abstract:

Academic Medical Centers (AMCs) offer patient care and perform research. Increasingly, AMCs advertise to the public in order to garner income that can support these dual missions. In what follows, we raise concerns about the ways that advertising blurs important distinctions between them. Such blurring is detrimental to AMC efforts to fulfill critically important ethical responsibilities pertaining both to science communication and clinical research, because marketing campaigns can employ hype that weakens research integrity and contributes to therapeutic misconception and misestimation, undermining the informed consent process that is essential to the ethical conduct of research. We offer ethical analysis of common advertising practices that justify these concerns. We also suggest the need for a deliberative body convened by the Association of American Medical Colleges and others to develop a set of voluntary guidelines that AMCs can use to avoid in the future, the problems found in many current AMC advertising practices.

Keywords

Academic Medical Centersadvertising practicesmarketingscience communicationclinical researchtherapeutic misconceptioninformed consent
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Issue 3 , July 2019 , pp. 468 - 475
Copyright
Copyright © Cambridge University Press 2019 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. About AAHC; available at http://www.aahcdc.org/About.aspx (last accessed 1 Feb 2017).

2. Finn, R. Hospital marketing practices: When is it appropriate to advertise new technology? Journal of the Nationall Cancer Institute 2001;93:6–7.CrossRefGoogle ScholarPubMed

3. Oxman, D. Hospital advertising. The Hospitalist 2007; Jan(1).Google Scholar

4. Graziano, L. Promoting promises and marketing miracles: An overview of hospital advertising. Ageless Arts: The Journal of the Southern Association for the History of Medicine and Science 2015:155–70.Google Scholar

5. Larson, RJ, Schwartz, LM, Woloshin, S, Welch, HG. Advertising by academic medical centers. Archives of Internal Medicine 2005;165:645–51.CrossRefGoogle ScholarPubMed

6. Singer, N. Cancer center ads use emotion more than fact. The New York Times 2009; 19 Dec 2009.Google Scholar

7. Caulfield, T, Sipp, D, Murry, CE, Daley, GQ, Kimmelman, J. SCIENTIFIC COMMUNITY. Confronting stem cell hype. Science 2016;352:776–7.CrossRefGoogle ScholarPubMed

8. Association of American Medical Colleges. Clinical Research: A Reaffirmation of Trust Between Medical Science and the Public. Proclamation and Pledge of Academic, Scientific, and Patient Health Organizations. Washington, DC: Association of American Medical Colleges 2000.

9. America’s Health Literacy: Why we need accessible health information; available at http://www.health.gov/communication/literacy/issuebrief/ (last accessed 2 Feb 2017)

10. Corrigan, O. Empty ethics: The problem with informed consent. Sociology of Health & Illness 2003;25:768–92.CrossRefGoogle ScholarPubMed

11. Recruiting study subjects–Information sheet guidance for institutional review boards and clinical investigators. 2010; available at http://www.fda.gov/RegulatoryInformation/Guidances/ucm126428.htm (last accessed 20 July 2012).

12. Appelbaum, PS, Roth, LH, Lidz, C. The therapeutic misconception: Informed consent in psychiatric research. International Journal of Law and Psychiatry 1982;5:319–29.CrossRefGoogle ScholarPubMed

13. Kimmelman, J. The therapeutic misconception at 25: Treatment, research, and confusion. Hastings Center Report 2007;37:36–42.CrossRefGoogle ScholarPubMed

14. Horng, S, Grady, C. Misunderstanding in clinical research: distinguishing therapeutic misconception, therapeutic misestimation, and therapeutic optimism. IRB: Ethics & Human Research 2003;25:11–6.CrossRefGoogle ScholarPubMed

15. Zivotofsky, AZ, Zivotofsky, NT. Capitalism works for health care too. American Journal of Bioethics 2014;14:56–8.CrossRefGoogle ScholarPubMed

16. See note 4, Graziano 2015.

17. Nelson, WA, Campfield, J. The ethics of hospital marketing. Marketing efforts are necessary but should be ethical and appropriate. Healthcare Executive 2008;23:44–5.Google ScholarPubMed

18. See note 4, Graziano 2015.

19. See note 3, Oxman 2007.

20. See note 15, Zivotofsky, Zivotofsky 2014.

21. Charuvastra, A, Marder, SR. Unconscious emotional reasoning and the therapeutic misconception. Journal of Medical Ethics 2008;34:193–7.CrossRefGoogle ScholarPubMed

22. Wright, JR, Whelan, TJ, Schiff, S, et al. Why cancer patients enter randomized clinical trials: exploring the factors that influence their decision. Journal of Clinical Oncology 2004;22:4312–8.CrossRefGoogle ScholarPubMed

23. Tversky, A, Kahneman, D. Rational choice and the framing of decisions. Journal of Business 1986:S251–S78.CrossRefGoogle Scholar

24. Halpern, SD, Loewenstein, G, Volpp, KG, et al. Default options in advance directives influence how patients set goals for end-of-life care. Health Affairs (Millwood) 2013;32:408–17.CrossRefGoogle ScholarPubMed

25. Ubel, PA, Comerford, DA, Johnson, E. Healthcare.gov 3.0--behavioral economics and insurance exchanges. New England Journal of Medicine 2015;372:695–8.CrossRefGoogle ScholarPubMed

26. See note 7, Caulfield et al. 2016.

27. Kimmelman, J, London, AJ. Predicting harms and benefits in translational trials: ethics, evidence, and uncertainty. PLOS Medicine 2011;8:e1001010.CrossRefGoogle ScholarPubMed

28. Pentz, RD, White, M, Harvey, RD, et al. Therapeutic misconception, misestimation, and optimism in participants enrolled in phase 1 trials. Cancer 2012;118:4571–8.CrossRefGoogle ScholarPubMed

29. See note 11, FDA 2010.

30. ISSCR. Guidelines for stem cell science and clinical translation 2016; available at http://www.isscr.org/docs/default-source/all-isscr-guidelines/guidelines-2016/isscr-guidelines-for-stem-cell-research-and-clinical-translation.pdf?sfvrsn=4 (last accessed 22 Jan 2018).

31. Presidential Commission for the Study of Bioethical Issues. Introducing New Primer Series: Spotting and Responding to Hype. 2016; available at https://bioethicsarchive.georgetown.edu/pcsbi/blog/2016/08/03/introducing-new-primer-series-spotting-and-responding-to-hype/index.html (last accessed January 22, 2018).

32. Egener, BE, Mason, DJ, McDonald, WJ, et al. The charter on professionalism for health care organizations. Academic Medicine 2017; 8:1091–9.CrossRefGoogle Scholar

33. See note 5, Larson et al. 2005.

34. See note 17, Nelson, Campfield 2008.

35. Vater, LB, Donohue, JM, Arnold, R, White, DB, Chu, E, Schenker, Y. What are cancer centers advertising to the public?: A content analysis. Annals Internal Medicine 2014;160:813–20.CrossRefGoogle ScholarPubMed

36. Schwartz, LM, Woloshin, S. The case for letting information speak for itself. Effective Clinical Practice 2001;4:76–9.Google Scholar

37. See note 3, Oxman 2007.

38. Schenker, Y, Arnold, RM, London, AJ. The ethics of advertising for health care services. American Journal of Bioethics 2014;14:34–43.CrossRefGoogle ScholarPubMed