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ICO report calls for advertising restrictions

The paper, entitled Direct to Consumer Medical Advertising in Ireland – Informing and empowering patients, doctors and healthcare professionals, has been published by the Irish College of Ophthalmologists (ICO) in response to growing concerns relating to the marketing and advertising of elective procedures.

As first reported in the Medical Independent (MI) on 17 December, the ICO intends to lobby the HSE and Department of Health to ensure that standards for medical advertising are included in legislation.

The ICO has stated that regulations are required to provide a clear framework to ensure that people considering a procedure can make fully informed, unbiased decisions and under which, advertisers can be held to account if required.

The report highlights that regulation is necessary to reflect the changing market, particularly the significant growth in elective procedures and the increasing use of digital marketing.

Under the key recommendations contained in the report, the ICO is proposing to Government that provisions specific to the responsible advertising of medical and surgical procedures be included in the forthcoming Patient Safety (Licensing) Bill to ensure that all medical facilities offering such services be regulated in this regard.

ICO President and ophthalmic surgeon Mr William Power said: “While the ICO acknowledge the Medical Council of Ireland’s Guide to Professional Conduct and Ethics for Medical Practitioners contains certain provisions on providing information to the public, it must be stressed that currently in Ireland there is no formal regulation specific to the advertising and marketing of medical procedures. Due to the nature and sensitivities of medical advertising and the potential risk of a negative outcome for patients, it is the view of the ICO that existing controls including those set out in the Medical Council ethical guide and the ASAI voluntary code, are insufficient.”

He added, “The ICO welcomes the steps undertaken by the Government to focus on improved patient safety measures, including the forthcoming Health Information and Patient Safety Bill and the Patient Safety (Licensing) Bill and commends the decision to establish an independent National Patient Advocacy Service. It is the view of the ICO that the Patient Safety (Licensing) Bill should include regulations on responsible advertising and marketing standards applicable to healthcare facilities and clinics in order to ensure that standards are applied in a consistent and systemic way.”

The report is the latest initiative by the ICO to promote and safeguard the highest standards of patient safety, and follows the publication of Guidelines for Refractive Surgery in Ireland and Advertising and Marketing Guidelines by the College in 2015.

Mr Power said, “While advertising has a legitimate role in providing information, it can have an adverse impact, particularly if it trivialises the risks of procedures, targets vulnerable consumers, or misleads people by portraying an outcome that may not be attainable for all. No surgery is risk free and controls on advertising which indicates the contrary are required. All medical interventions imply risk and while those risks may be infrequent or rare, prospective patients must be fully informed.”

He said marketing and advertising for elective medical procedures has increased considerably in recent years but this should not be managed in the same way as advertising of other consumable goods or services. “The end products of the two are not comparable. Protection for prospective patients must be introduced,” Mr Power stressed.

The ICO report states that incentives such as ‘reductions for a friend’ and ‘special price for a limited time’ are contrary to the concept of informed consent, which is a legal requirement for any surgery or medical treatment. It highlights that, in other jurisdictions, these practices are seen as ‘incentivising’ the consumer and considered not to be in their best interests, and both the practice and the advertising of such offers have been banned.

The report considers whether advertising that only states the benefits of medical procedures is leading to raised and, at times, unrealistic expectations among the patient population, thus contributing to a more litigious environment.

Mr Power said: “The processes by which patient expectations are formed must be examined, in order to determine whether they are a contributing factor to the surge in medical malpractice legal cases in Ireland. The cost of claims to the State is considerable and the continued increases in professional indemnity costs for medical practitioners are unsustainable.”

The report concludes that tighter guidelines and formal legislation controlling direct-to-consumer medical advertising is required in order to safeguard and promote patient safety, and to enhance the consumer’s ability to make a fully informed decision before undertaking an elective procedure.

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