J Thorac Cardiovasc Surg 2002;123:839-841
© 2002 The American Association for Thoracic Surgery
Controversies in cardiothoracic surgery: Is it ethical to advertise surgical results to increase referrals?
Martin F. McKneally, MD, PhD
From the Department of Surgery and Joint Centre for Bioethics, University of Toronto, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada.
Received for publication Oct 24, 2001. Accepted for publication Oct 25, 2001.
Address for reprints: Martin F. McKneally, MD, 77 Forest Grove Dr, Toronto, Ontario, Canada M2K 1Z4 (E-mail: martin.mckneally@utoronto.ca).
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Introduction
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Should our profession accept medical advertising as ethically appropriate? This issue was vigorously debated at the May 2001 Annual Meeting of The American Association for Thoracic Surgery (AATS) in San Diego.
Pro: Delos Cosgrove, from The Cleveland Clinic, gave a historical overview of the evolution of the relationship between advertising and medicine in the United States. Medical advertising was viewed as unethical in the United States until 1975, when the Federal Trade Commission ruled that the American Medical Association's ban on advertising was a restraint of trade, violating a fundamental principle of American capitalism. After a 7-year battle, the Supreme Court narrowly upheld the decision of the lower courts that the ban violated federal law. The AMA acquiesced, lifting all restrictions except those that protect patients from deceptive advertising. Cosgrove effectively proved that the law in the United States was on his side.
Turning to policy, he cited statements of the American Hospital Association: "Healthcare advertising should be truthful, fair, accurate, complete and sensitive to the health care needs of the public. False or misleading statements, or statements that might lead the uninformed to draw false conclusions ... are unacceptable and unethical"; the American College of Physicians: "Advertising by physicians is unethical when it contains statements that are unsubstantiated, false, deceptive, or misleading, including misleading by omitting necessary information"; and the American College of Surgeons: "Communications to the public must not convey false, untrue, deceptive, or misleading information through statements, testimonials, photographs, graphics, or other means." Cosgrove concluded that our medical organizations prohibit deception but clearly endorse the right to advertise.
He presented empiric evidence of approval within the profession. Expenditures for medical advertising are increasing at a rate of 50% per year. By very conservative estimates, hospitals were responsible for spending $167 million on advertising in 2000 and physicians . . . [Full Text of this Article]
Copyright © 2002 by The American Association for Thoracic Surgery.
