Self-regulation: Who needs it?

Health Affairs

Volumn 19, Issue 6, 2000, Pages 132-139

  Boulding, Mark E ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; BIOETHICS AND PROFESSIONAL ETHICS; HEALTH CARE COST; HEALTH CARE QUALITY; HUMAN; INTERNET; MEDICAL ETHICS; SOCIAL CONTROL; STANDARD; UNITED STATES;

BIOETHICS AND PROFESSIONAL ETHICS;

CODES OF ETHICS; ETHICS, PROFESSIONAL; HEALTH CARE SECTOR; HUMANS; INTERNET; QUALITY ASSURANCE, HEALTH CARE; SOCIAL CONTROL, FORMAL; UNITED STATES;

EID: 0034328469     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.6.132     Document Type: Article

References (35)

1. Hi-Ethics, Health Internet Ethics: Ethical Principles for Offering Internet Health Services to Consumers, 1 May 2000, (30 August 2000).
2. Ethics Summit Steering Group, Health Code of Ethics, Internet Healthcare Coalition, 2000, (30 August 2000).
3. C. Calacanis, "Launch of the eHealth Ethics Initiative: eHealth Code of Ethics," iHealthcare Weekly.com, 25 May 2000, (29 August 2000).
4. J. Schwartz, "Online Health Sites to Unveil Standards for Ethics, Privacy," Washington Post, 7 May 2000, A20; and J. Goldman and Z. Hudson, "Virtually Exposed: Privacy and E-Health," Health Affairs (Nov/Dec 2000): 140-148.
5. J. Schwartz, "Online Health Sites to Unveil Standards for Ethics, Privacy," Washington Post, 7 May 2000, A20; and J. Goldman and Z. Hudson, "Virtually Exposed: Privacy and E-Health," Health Affairs (Nov/Dec 2000): 140-148.
6. G. McGee, "Economics and Net Medical Ethics: Dr. Koop, Meet Dr. Napster," MSNBC.com, "Breaking Bioethics" column, 23 June 2000, (30 August 2000).
7. Schwartz, "Online Health Sites."
8. The HONcode is an early example of an ethics code that was created with a view to the international environment. Health on the Net Foundation, HON Code of Conduct for Medical and Health Web Sites, April 1997, (30 August 2000). The American Medical Association also has published guidelines for its affiliated Web sites. M. Winkler et al.. Guidelines for Medical and Health Information Sites on the Internet: Principles Governing AMA Web Sites, 17 March 2000, (30 August 2000).
9. The HONcode is an early example of an ethics code that was created with a view to the international environment. Health on the Net Foundation, HON Code of Conduct for Medical and Health Web Sites, April 1997, (30 August 2000). The American Medical Association also has published guidelines for its affiliated Web sites. M. Winkler et al.. Guidelines for Medical and Health Information Sites on the Internet: Principles Governing AMA Web Sites, 17 March 2000, (30 August 2000).
10. For example, see B. Kane and D. Sands, "Guidelines for the Clinical Use of Electronic Mail with Patients," Journal of the American Medical Informatics Association 5, no. 1 (1998): 104-111.
11. More information about the Good Housekeeping Institute and its seal program can be found on the Good Housekeeping magazine Web site, , or in any issue of the magazine.
12. The Good Housekeeping Web site states that "if a product bearing the Seal proves to be defective within two years of purchase, Good Housekeeping will replace the product or refund the purchase price." (30 August 2000).
13. Some major examples include the federal laws creating and empowering the Federal Trade Commission, the state laws enacting Article 2 of the Uniform Commercial Code, and the judicial development of the doctrine of strict products liability.
14. National Committee for Quality Assurance, The State of Managed Care Quality, 1999, (30 August 2000); and K. Davis and C. Schoen, "Assuring Quality, Information, and Choice in Managed Care," Inquiry 35, no. 2 (1998): 104-114.
15. National Committee for Quality Assurance, The State of Managed Care Quality, 1999, (30 August 2000); and K. Davis and C. Schoen, "Assuring Quality, Information, and Choice in Managed Care," Inquiry 35, no. 2 (1998): 104-114.
16. K. Sack, "Gore, Sensing Edge, Pushes Bush for More Specifics on Health Care," New York Times, 28 August 2000, A1.
17. The N'CQA, for its part, is calling for increased participation by hospitals and fee-for-service providers in its self-regulatory system. NCQA, The State of Managed Care Quality.
18. Association of the British Pharmaceutical Industry, The Prescription Medicines Code of Practice Authority, 24 January 2000, (30 August 2000).
19. H. Simmonds, The Internet and the Code of Practice for the Pharmaceutical Industry, 1997, (30 August 2000).
20. More information about the MCA and its interaction with the PMCPA is available at , "Post-Licensing" (30 August 2000).
21. See, for example, the European Union's Directive 95/46/EC on "the protection of individuals with regard to the processing of personal data and on the free movement of such data."
22. J. Schwartz, "ETC Seeks Online Privacy Laws; Agency Says Internet Industry's Self-Regulation Falls Short," Washington Post, 23 May 2000, E5.
23. K. Perine, "FTC Backs Its Online Privacy Report," The Standard, 25 May 2000, (30 August 2000).
24. Based on the author's personal knowledge after attending the event.
25. Federal Trade Commission, Online Profiling A Report to Congress, Port 2, "Recommendations," July 2000, (30 August 2000).
26. Federal Trade Commission, Online Profiling A Report to Congress, Port 2, "Recommendations," July 2000, (30 August 2000).
27. See GcoCities, Inc., Docket no. C-3849,1999 FTC LEXIS 17 (FTC, 5 February 1999). The GeoCities case was the first of several cases where the FTC successfully obtained consent decrees against Web sites that did not follow their own privacy policies.
28. Health Care Financing Administration, "Security and Electronic Signature Standards," 63 Federal Register 43242 (12 August 1998). By contrast, the much-criticized proposed HIPAA regulations on confidentiality of identifiable health information take a more directive approach. See Department of Health and Human Services, "Standards for Privacy of Individually Identifiable Health Information," 64 Federal Register 59918 (3 November 1999).
29. Health Care Financing Administration, "Security and Electronic Signature Standards," 63 Federal Register 43242 (12 August 1998). By contrast, the much-criticized proposed HIPAA regulations on confidentiality of identifiable health information take a more directive approach. See Department of Health and Human Services, "Standards for Privacy of Individually Identifiable Health Information," 64 Federal Register 59918 (3 November 1999).
30. A recent study of consumer opinion found that online health users trusted "portal" health care Web sites the least when it came to protecting their health information. Cyber Dialogue, Ethics Survey of Consumer Attitudes about Health Web Sites (Oakland: California HealthCare Foundation, 2000), 10
31. On ethical grounds, see J. Schwartz, "The Fox in 'Chick' Koop," Washington Post, 9 January 2000, Fl; on privacy grounds, see J. Schwartz, "Medical Web Sites Faulted on Privacy," Wasnington Post, 1 February 2000, E1. There are examples from other major newspapers and magazines, but these two articles capture the basic criticisms.
32. On ethical grounds, see J. Schwartz, "The Fox in 'Chick' Koop," Washington Post, 9 January 2000, Fl; on privacy grounds, see J. Schwartz, "Medical Web Sites Faulted on Privacy," Wasnington Post, 1 February 2000, E1. There are examples from other major newspapers and magazines, but these two articles capture the basic criticisms.
33. Of course, any self-regulatory system also may have the effect of advancing the economic interests of members through differentiation, which may raise anticompetitive concerns. See McGee, "Economics and Net Medical Ethics." However, this critique applies to both self-regulation and direct government regulation (for example, in the systems of mandatory regulation that apply to physicians or attorneys) and therefore should not serve as a criterion for choosing between the two.
34. See, for example, D. Wilkins, "Who Should Regulate Lawyers?" Harvard Law Review 105 (1992): 801.
35. J. Goldman, Z. Hudson, and R. Smith, Privacy: Report on the Privacy Policies and Practices of Web Sites (Oakland: California HealthCare Foundation, 2000).