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| Ethics and Medical Marketing | ||
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Introduction: I wrote the following research paper in 1996 for a Marketing class. The paper is dated, but the issues it addresses continue to grow. The relationships between politics, pharmaceutical lobbyists, the news media (who treat allopathic medical studies and "discoveries" as if they were real news, even going so far as to have regular "medical" segments) the doctors themselves and the mafia-like organizations to which they belong. This paper does not address the obvious, which is the existence of alternative treatments of all kinds that generally perform better than any expensive allopathic "technological advancements." I wrote this paper with a Christian Conservative mainstream audience in mind - namely, my professor at a conservative Christian College, which I'm proud to say is my Alama Mater - Judson College. Back in the 1980s I became very interested in socialized health care. I studied the British model at every academic opportunity. I cannot tell you how horrified I am at the looming prospect of Obamacare. I can only hope that there are plenty of other people like me who are morally opposed to Big Pharma and to allopathy, in general. I have some theories about the sadistic perversions of this lot of professionals that I don't dare share with anyone buy my closest confidants. But, their record is clear for anyone who has the intestinal fortitude to look at their twisted history. Currently, we are seeing the out-of-control, unethical marketing of the dangerous Gardasil vaccine purported to protect very young girls and women from HPV (easily curable with herbs or radionics), which the medical community claims is the cause of cervical cancer. What they don't say is that cervical cancer is considered a "rare" diseases. They also fail to mention safer, saner and far more reasonable cures that have existed for milennia in the so-called alternative medial world. Gardasil is painful and has dangerous side-effects. People I know who have foolishly taken this vaccine or given it to their children are now afraid because the people who received the vaccine are now very sick. The same company is now trying to market their poison to boys. And, they have succeeded in forcing it upon some of the most vulnerable among us, immigrant women. A search on the internet on the "Dangers of Gardasil" will turn up many results. The research connecting HPV to Cancer is very weak to non-existent. For more information, please see my article: Eliminate HPV The dangers of vaccines have been gaining more attention as more and more children are diagnosed with autism and/or experience seizures after receiving vaccines. But, adversaries of big pharma have to speak carefully. The belief in the value and efficacy of vaccines is like a religion to many and it has to be handled delicately. Jenny McCarthy has been an advocate for healing children from vaccine trauma. I have seen her in television interviews and one outstanding feature of her appearances is how she delicately approaches the subject of vaccine dangers, saying that she is in opposition to schedules, numbers of vaccines and the age at which children are supposed to receive them. She is careful never to say that she is against vaccines. Such a statement tends to create a fearful, irrational, reactionary response in most people that would negate her message. She has written a book entitled, "Mother Warriors: A Nation of Parents Healing Autism Against All Odds," which is about treating vaccine damage. The truth is that there has never been any proof of the efficacy of vaccines; while there is plenty of evidence of the trauma, disease and death that they cause. But, this is information that most of the public is not ready to hear, even if it could save lives. An age old story is the medicalization of women, the treatment of womanhood itself as a disease, which is the foundation for modern medicine. Pregnancy and childbirth, in particular, have been targets for the allopaths and a battleground of abuses of both women and infants. This has been taken to an extreme turn in recent decades as we are seeing further evidence of in the news this week: Another Franken-litter, the world's second set of octuplets, were born to a woman through in vitro fertilization. Of course, there are possible life-long health complications and other dangers associated with this "miracle." Not to mention that anyone who wants to give birth to eight children at once probably needs to have her head examined, in the first place. Another sector of the economy has found the marketing of medical technologies to be quite a boon: Attorneys! Turn on day-time television and you will see ads asking you if you or anyone you know has been damaged by taking some prescription medicine or other. Apparently, this is an easy snare for some people to fall into. Particularly since people still trust their doctors and expect that they will be informed of the side effects of the drugs they are prescribed. Not necessarily so! A personal example of this comes from a neighbor who went to her doctor feeling a little blue. He prescribed Paxil. Some time after that, when she stopped feeling blue, she realized that she couldn't stop taking it without bad side effects. It turns out that doctors all over the place were failing to tell their patients that Paxil is very addictive before prescribing it, although, they must have known this. For many people, hospitalization is required to get off the drug; withdrawal from it can produce similar effects to coming down off of heroin, Nice! These are only a few examples, of course. Here is my old paper - still relatively fresh! ...And, I hope, thought-provoking. Ethics and Marketing of Medical Technologies American companies that produce medical goods and services are constantly involved with developing new and more sophisticated ways to meet the consumer demands for more high-quality, life-extending, life-enhancing medical technology. Companies sponsor scientific research at universities in hopes that it will yield marketable new medical technology for them. Marketing medical technology is big business that provides huge monetary returns for the manufacturers. We will examine the ethics of how large companies go about the marketing of medical technology through the news media, to doctors, and the public's demand for such products, and the high cost of health care. Since World War II, there has been a flood of new technologies that has turned allopathic doctors from a body of care-givers into an industry of cold science and technology. It is generally agreed that medical innovations have increased the life span and there appears to be no boundaries to high-tech possibilities of increasing it far more. Scientific romanticists endeavor to harness the very life force and they sell their ideas to the public via news broadcasts, magazines, and slick television ads directed at both doctors and consumers. According to the April 6, 1991 issue of The Economist, in the early 1980s, Glaxo, "The world's second-biggest pharmaceuticals company, "became one of the first to advertise directly to patients on American television, in a campaign about ulcers that was seen by 12 million people and generated 581,000 visits to doctors. Ranitidine (branded as Zantac) is now the world’s top-selling drug, accounting for half of Glaxo’s $5.1 billion sales." A 1986 Fortune magazine article, "Healthcare is Good for Madison Avenue," discusses the growing advertising by hospitals, doctors and H.M.O.s. "Health care advertising on television for example increased (in 1985) by 40% last year, to $125.6 million. Industry experts (projected) health care advertising could reach $1.6 billion by 1990, equal to the current ad spending of the Big Three automakers." An advertisement in Advertising Age, urges, "Claim your share of this $2.4 billion medical market," refers only to the home health care market. In a 1986 article from Editor and Publisher, entitled, "A Multi-Million Dollar Opportunity," states, "the health care industry has money to spend and it will spend it in whatever medium accommodates its needs the best." In Minneapolis, "a hotbed of hospital competition and the starting place for much of what is now sweeping the country" the newspaper " advertising budgets totaled about $10 million and budget proposals for 1986 in the same area total about $15 million. That is an increase of 50% in one year." In this article, newspaper advertisers were urged to be aggressive in their competition with other media over health care marketing dollars. Science and technology have become almost synonymous terms in the modern English language. New scientific discoveries and new technology are treated as news items by largely medically sponsored media. A June 3, 1996 article, "Free the Media," in The Nation, states “the domination of our media by corporate profiteers is nothing new. The purveyors of "patent medicine" - mostly useless, often lethal - went unscathed by reporters through the twenties because that industry spent more than any other on print advertising. Little has changed since then. Dorothy Nelkin, in her work Selling Science: How the Press Covers Science and Technology, points out that science journalists broker technological issues for their readers and help mold public consciousness about science and technology. Nelkin characterizes the relationship between scientists and the media as a promotional model. (134) In Women as Wombs, Janice G. Raymonds discusses the fallacies in medical reporting about women's reroductive health, but what she says easily applies to all aspects of medical reporting. She points out that: Press coverage of new reproductive technologies initially uses a language of promise. In some articles, risk is warned about, but mostly in a futuristic or abstract sense with rare reference to the historical context of past technologies gone wrong. Reproductive genetic engineering news is often covered as a series of dramatic events with the stress on technological miracle, magic, and mystique. Today, reproductive genetic engineering has become a national symbol of progress, co parable to the space program of the 1960s and 1970s. Also, according to Raymonds, "newspapers continued to report exaggerated figures" regarding the success rates of in vitro fertilization, even after the Federal Trade Commission had faulted In Vitro Fertilization America [a reproductive clinic] for advertisements and brochures that misled clients about their chances of taking home a baby. Genetic engineering is the best example of medical technology oversold to the American public via the news media. A September 27, 1982 article in Advertising Age entitled, "Full of Promise - But All in the Future," chronicles the rise and fall of genetic engineering as the source of marketable new medical technology. Scientists talked about curing genetic diseases through genetic manipulation. The hype came to us through the nightly news broadcast and newspapers. Scores of small companies sprang up, mostly on the coasts, near the great research universities - Harvard, Stanford and others - that pioneered the research. In just a couple of years, more than a half billion venture dollars poured into the fledgling industry. The biotechnical rush peaked most dramatically in late 1980, when Genentech, South San Francisco, Cal., one of the biggest genetic engineering companies, made its first public stock offering at $35 a share. Twenty minutes later, Genentech was selling at $89 a share. But hopes were so high that a shakeout was inevitable. Peter Pond senior vice-president of Smith Barney, Harris Upham & Co., who has followed the new biotechnology said, "They were looking at one to two years and now they are finding it’s five to ten." Now, in 1996, genetic engineering is still not what scientists, medical manufacturers and the media have promised. Still exaggerated claims about medical discoveries abound on television and in newspapers. Such an example of such promise turned to disappointment is exemplified in an article in the May 1996 issue of BioScience asks, "Has Gene Therapy Been Oversold?" A molecular geneticist at the University of Pittsburgh School of Medicine, Paul D. Robbins is quoted as saying: Many of the researchers doing gene therapy research with National Institutes of Health money actually are involved with biotech companies, and trials that they are running using NIH money would help boost the stock or raise venture capital for their biotech companies. I think the take-home message was that the field of gene therapy may have moved a little bit too quickly into the clinic without having the pre-clinical data to support those protocols. I think the hype was a little bit too much. Expectations among non-scientists were a little bit too high. Other examples of failed medical technology marketed with over-enthusiasm to the public via the media are breast implants, artificial hearts, Depo-Provera, the Dalkon Shield, estrogen therapy and more. The list of scientific technology marketing failures continues to grow. Science and technology have a strong relationship to the media. "The media need a steady, reliable flow of the raw material of news. In turn, the scientists need the media and go to great lengths to get their own version of their particular technological story out to the public." The strength of medical marketers "overpowers any competition for media access from critics or dissenters, providing the media with facilities in which to gather; they give journalists advance copies of speeches and forthcoming reports; they schedule press conferences at hours well-geared to news deadlines; they write press releases in usable language and they carefully organize their press conferences and 'photo opportunity' sessions." (Raymonds 125) It is readily apparent that the television and newspaper media, which are heavily sponsored by the medical industry, may not be inclined to report negatively about research funded by their supporters. Is it possible that some companies may be involved in skewing information about the effectiveness of their products to doctors and the public? An article form the 1986 Economist poses the question, "Might such heavy investment in development and marketing [of medical technology] istort expectations?" Some people believe that the large amount of money involved could cause the "scientific judgement: f a company to become "clouded." An example of such distortion of facts is given. Glaxo was accused of "confusing doctors in its promotion of Salmeterol, an anti-asthma drug that was launched in Britain [in November 1990] through claims about its potency." The September, 1985 issue of Madison Avenue, ran an article called, "Bloody Good Advertising Most Americans Never See," depicting the artsy, high-tech advertisements that at that time, only appeared in medical journals. An advertisement in the September 27 issues of Advertising Age for Healthcare Network warns medical companies, "One word from a doctor, nurse or pharmacist can counteract $10 million in OTC advertising." Are the manufacturers satisfying consumer need or are they creating a market? The Economist, April 6, 1991 says: The industry stands accused of conducting promotional drives disguised as education al and fact-finding campaigns; of offering doctors, not pens and notepads but hard cash; of distorting data to suit its promotional needs; of blurring side-effects; and of bad-mouthing rival products and unnecessarily alarming doctors and their patients. What about post-marketing? The same article in The Economist says: Almost immediately after a drug has been launched, Glaxo and others establish small studies ostensibly to monitor the performance of their drugs in a normal population, rather than the one carefully selected from clinical trials. The idea is to spot any new adverse effects. But because doctors are paid for the exercise, it may be regarded as a covert form of promotion, particularly as recruited patients often stick to the drugs after the study is complete. The September 20, 1990 issue of a medical magazine Hospitals tells us more about the spreading concern over the ethics of medical marketing in an article entitled, "New Guidelines Tackle Ethics in Advertising.: Newly revised guidelines on health care facility advertising were released in fall, 1990 by the American Society for Health Care Marketing and Public Relations. According to Bill Stiles of the Hamilton Medical Center, the new guidelines, which have been expanded to cover all health care providers, focus on defining ethical and unethical advertising behavior. The guidelines address the ethical issues of unnecessary care, sensationalistic advertising targeted at AIDS or cancer patients, comparative advertising, and bait-and-switch advertising. (Johnsson) Without public demand, products such as those provided by the medial industry would not exist. What creates the demand for better and higher quality health care: Americans love youthfulness, active living and the prospect of a longer life span. Most people believe that medical technology has delivered this in the past and there is a general belief that science can do this in the future. "The healthcare industry in the United States is highly profitable, feeding effectively upon public desire and demand, and in turn helping to stimulate that desire and demand.: (Callahan 80-81) What about the controversial high costs of healthcare in our capitalist system? Greater demand leads to higher costs as newer products are introduced to the market and old technologies are updated. Industry alone cannot be blamed for the current state of affairs of healthcare marketing. The industry is "giving the public what it demands, and what it demands is better health, a process that feeds upon itsel." (Ibid.) Furthermore, "Technological innovations that really reduce costs, simultaneously and by definition reduce sales and income as well." (Evans 453) If the American public demands newer and better technology, the free market system is the one that can best provide the supply of technology, however, dangerous and misleading claims, manipulated information and advertisements passed off to the public in the guise of news reports must be quelled in the name of ethics. The manner in which medical technology is marketed needs to be examined, revised and closely monitored. Meanwhile, the consumer must beware. Works Cited Callahan, Daniel. What Kind of Life, The Limits of Medical Progress. New York, New York: Simon & Schuster, 1990. Consoli, John. "A Multi-million Dollar Opportunity." Editor & Publisher, 1 February 1986, P. 15. Economist, The. Vol. 319, 6 April 1991. "The Ethics of Marketing Drugs: The World According to Ernest." P. 72. Evans, Robert G. "Illusions of Necessity: Evading Responsibility for Choice in Health Care." Journal of Health Politics, Policy and Law, 10 (Fall 1986), Pp. 439-467. Hart, Stephen. "Has Gene Therapy Been Oversold?" BioScience. Vol. 46, No. 6, May 1996, P. 319. Johnsson, Julie. "New Guidelines Tackle Ethics in Advertising." Hospitals. Vol. 64, 20 September 1990, P. 65. Madison Avenue. Vol. 27, September 1985. Bloody Good Advertising Most Americans Never See." P. 113-116. Miller, Mark Crispin. "Free the Media." The Nation, 3 June 1996, P. 10. Nash, Ed. "Full of Promise - But All in the Future." Advertising Age. Vol. 53, 27 September 1982, P. M-7. Nelking, Dorothy. Selling Science: How the Press Covers Science and Technology. New York: W. H. Freeman, 1987. Tracy, Elanor-Johnson. "Health Care is Good for Madison Avenue." Fortune, 4 August 1986, P. 145+. |
 Angela Kaelin |