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AMA Issues Web Ethics Guidelines

March 22, 2000

NEW YORK (AP) _ The American Medical Association is updating its Internet guidelines to help consumers assess the reliability of what they read online.

As more patients turn to the Internet for medical information, the nation’s largest doctors’ organization hopes its new policy becomes a model for other sites.

The standards, published in today’s Journal of the American Medical Association, could reduce worries about misleading information and breaches of confidentiality.

``The guidelines stress disclosure, stress informed consent and stress privacy and confidentiality as absolute tenets that must be adhered to,″ said Robert Musacchio, the AMA’s senior vice president for publishing and business services.

Dr. Margaret Winker, who as deputy editor of the influential journal supervised the effort, said the medical group needed to raise standards because ``there’s a lot more potential for ethical lapses on medical sites than other parts of the Internet.″

The effort was prompted by the upcoming launch of a for-profit site, Medem, by the AMA and six other doctors’ groups. The site will offer health information and allow patients to correspond with doctors online.

Currently, AMA sites offer journal research articles and limited consumer information.

The new guidelines will apply to all of those sites. Authors of the guidelines believe private sites could adopt them as well, although the medical group has no plans to police or endorse other sites.

Through the Internet, consumers can research anything from allergies to weight management and obtain details about prevention, symptoms and treatment. But there is potential for incomplete, misleading or inaccurate information, particularly with sponsors involved.

And while many non-health sites routinely track how visitors spend their time online, doing so at health sites could violate privacy. For instance, employers or insurers could guess medical conditions by monitoring what diseases Web users research.

The AMA will require its sites to warn users and obtain their consent before collecting personal information. Those sites may collect group data without consent as long as individuals are not identified. They should, however, obtain permission before disclosing information to outsiders.

Deborah Pierce, an attorney with the Electronic Frontier Foundation in San Francisco, lauded the AMA guidelines, saying they surpass in detail and protection the policies at most other Web sites. But she said sites should get users’ consent in all cases.

The new AMA guidelines prohibit placing ads next to online articles on the same topic. They also call for sites to review articles for accuracy and to disclose outside affiliations _ for example, if an author has a stake in a company that makes a drug discussed.

Former Surgeon General C. Everett Koop, in particular, was criticized last year for failing to fully disclose the sponsors of his site, drkoop.com. For a time, Koop was entitled to a commission on products sold through his Web site.

And the AMA was severely criticized from within and without over a 1998 deal to endorse products of appliance maker Sunbeam Corp. The AMA eventually paid Sunbeam nearly $10 million after backing out of the deal.

Last month, a coalition that includes industry, academia and patients groups released a draft of an ethics code. A final version is expected in May.

Dr. Helga Rippen, chairwoman of the coalition, said she believes the AMA matches her group’s intent, though the AMA guidelines may be too detailed to be practical for every Web site.

The new guidelines also do not address the ethics of doctors who make diagnoses online and authorize prescriptions without ever seeing the patient. Some rogue Web sites also let computer users order drugs without a prescription.

Executives at other private health sites predicted that the AMA effort will prompt companies to re-evaluate their own policies and perhaps weed out questionable operations.

Sharon Allred, executive vice president of eMD.com, an Atlanta-based drug and health resource site, believes her policies already meet AMA standards. Yet given the AMA’s reputation, she said, ``it would not be wise ... to disregard it completely.″


On the Net: AMA site at http://www.ama-assn.org

Code of Ethics from Internet Healthcare Coalition, http://www.ihealthcoalition.org

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