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How might we consider the ethical and legal dimensions of medical writing?



Hi class,

In response to my chapter (see link to reading below) on how technical (and, by extension, medical) communicators can work in an ethical manner, try to relate some aspect of the reading (cases, notions of ethics, guiding questions) to either the type of medical writing you are studying for assignment one (perhaps even in relation to a professional code of ethics) or the type of writing you expect to do as a professional. Remember that you can link us to info, pose questions, and a number of other things in your post.


Dr. Scott




  1. sarahmhudak says:

    Regulatory writing is definitely an area where ethics must be strictly maintained, not only for the success and trustworthiness of the medical writer and the profession, but in order to keep the potential users of the products safe. If a writer chooses to fabricate facts, or use language that could conceal potential negative side effects or outcomes of a drug or device in order to further their career and protect the company they are working for, then users will face these effects head on and without warning. Working in the healthcare field, even though the writing career dances around the edge, still plays a vital role in that area’s progression. Unethical choices can, overtime, lead to faults in healthcare.

    In Dr. Scott’s article, he creates a scenario about Angela Williams and her team having to deal with an unethical situation with BioInfo and Vaccitech’s new vaccine, FluEase. The vaccine has issues, but the companies want to hide them. If Williams was to comply, the users who were not in the clinical study’s age group would suffer.

    I wholeheartedly believe that unethical decisions, especially in the healthcare field, should be discouraged and avoided for the sake of the consumers and the reputations of the providers. However, choosing to or choosing not to go along with unethical decisions can be lose-lose situation. Williams could have chosen ethics over her career and protected future consumers from using FluEase wrongly, but that choice could negatively affect her future work, unless BioInfo and Vaccitech’s lies were discovered. My question is, would you take the career hit to save consumers? My answer, which is hopefully the same for those in this profession, would be to choose the ethical path and hope for the best in future writing endeavors.

  2. apectol91 says:

    I agree with Sarah, unethical situations should be avoided at all costs, especially when dealing with medical/health care products which could impose severely negative effects on their consumers. However, I would like to point out my use of the word should. Yes, we SHOULD avoid unethical situations, as if to merely suggest and not demand that avoidance. Ethics, or rather a lack there of, is a prevalent issue in any type of career or business. In fact, my mom wrote her master’s degree thesis on the prevalence of unethical behavior within the work place (ITT in her case). It seems as though many people are blinded by the light of success and will easily look the other way when ethics are at question if it means they will see some type of gain or benefit in their favor. This could apply not just to an individual but a company as a whole, as portrayed in Dr. Scott’s scenario about BioInfo and Vaccitech.

    I would also like to point out Dr. Scott’s statement that “ethical principles come from various sphere’s of influence.” I feel this is a powerful statement because it draws the question of who’s influence is the right influence? In reality, no two people have the same views and beliefs on everything. For this reason, I feel that in some situations deciding what is ethically right can be a lose-lose situation as Sarah pointed out. No matter what decision one is to make, it seems inevitable that someone won’t agree with that decision.

  3. hgmohan says:

    When I read about how the fictional company wanted to stretch the truth about their product, it got me thinking: how many real companies do the exact same thing? I’m sure we all want to believe that all health writers uphold their ethics, but let’s face it, some will put their finances first. The first thing that comes to mind are those infomercials you see on TV about the fastest way to build muscle with the least amount of effort, or the latest “diet”. They’ll say something scientific enough to sound remotely plausible, but at the end of the day, we know it’s not true. But what if another company, who was making something more important, did the same thing? Take the example in the reading: would it be just as unethical to blow the whistle on the company for trying to make their product better than it sounded? I would think not—after all, if the advertisement isn’t backed up by data, the companies are knowingly putting lives in danger for financial reasons. However, this doesn’t usually happen. This article by Forbes shows some examples of how drugs can be expressed in the media (http://www.forbes.com/2010/02/02/drug-advertising-lipitor-lifestyle-health-pharmaceuticals-safety.html). To summarize, the company was advertising their eyelash-thickening drug without warning people of the side-effects, which included bacterial infections and blindness. Unfortunately, as it was pointed out above, when money and success is involved, people are more likely to simply look the other way.

  4. kprashad says:

    We have always lived in a world where people have lied and cheated their way in order to further themselves at the cost of others. But that shouldn’t be how everyone acts in his or her career. Writers should always try to work in an ethical manner and not sacrifice their honest writing just to further themselves in their lives. If lies are passed out as the truth, then there would be some dire consequences that would happen to those that trust them. Not only lying, but medical writers should not try to play with their words to tell pass of a message when there is something else wrong. They should face these problems and try to work them out without having to sacrifice others.

    So people have always tried to lie to protect something, whether it be their career or the organization they work for. But lying as a medical writer can have terrible effects. For the writing I am doing, a person in Public Health Communications has to report on different medical terms in ways that others can understand them better. But if the writer lies about what causes a certain cure just to rake in more money and/or help the product seem more appealing, then that can affect the community and cause problems for others. The article mentions something similar to this where
    Angela Williams has to lie for BioInfo and Vaccitech in order for their vaccine to seem more appealing and have an even greater opportunity to make them money. However, Angela first thought through the entire scenario and considered the life cycle of her texts and her more specific obligations and consequences to her primary audiences of physicians, distributors, and the client’s sales force. She also thought through the financial issues that her clients would possibly face in the future. In the end, she decided that she was an employee and had an obligation to protect the organization she was working for. Even though we sometimes do have to keep our mouths shut since even being ethical could end in a losing situation. But at the same time, there are a lot of liars in the field, and being honest is something we should try to do more of.

  5. pmgomezg says:

    Ethics and the decision making process that goes along with it are an integral part of not only technical writing or health writing but also with almost any other kind of profession, especially those professions that communicate information to others.

    I feel like ethics in the health profession are more easily obscured than in other professions because of the importance and far-reaching effects incorporated in it. As a result it becomes even harder to distinguish what is the ethical thing to do in a certain situation. In the bioinfo and MegaPharm example provided in the reading, there are a variety of competing interests and influences that must be taken into account, like the interests of the users, clients, and other possible audiences.

    I would assume that in medical health journalism the same kind of interests apply though not as rigorously since there is no competing interest of a capitalistic entity (like a pharmaceutical company). However, a code of ethics much like the code that Sarah mentioned for regulatory writing must be in place also. Medical journalists have to take into account the confidentiality of the information they gather and also make sure that the information they gather is accurate and from a valid source so as to avoid misrepresenting information towards their audiences.

    In regards to Sarah’s question about taking a career hit to protect consumers, I agree that taking the high road seems like the best option, but this would be in a strictly black and white ethical situation. What if, you have an entire family dependent on your future career (a spouse and young children)? Would the ethical thing be to protect the consumers or protect your family?

    In raising this point I hope to show that in many cases its extremely difficult to decide whats right. Throughout the ages many philosophers have come up with ethical systems that seem like the way to go, however, it still hasn’t been decided which system is the best. If you’re looking at it through a utilitarian standpoint you can very well say that taking the career hit is the most ethical thing to do because it creates the most happiness for the greatest number of people. However, if you look at it through an ethic of care, it appears that the more ethical thing to do would be to protect your family. Of course legal matters must also be taken into account.

  6. kgardner1130 says:

    Harry raises an interesting point when he talks about the various commercials on TV that all claim to be the latest and greatest miracle drug. While taking nutrition class, we learned about how food labels can make misleading claims by leaving out certain words. For example, if a food item is “fat free”, it does not necessarily contain no fat as one would assume. This statement simply means that the product contains less than 0.5 g of fat per serving, so the company can round down and claim it is fat free. Learning about this got me to thinking about how many other claims are made with food, medicine, and vitamins that are not entirely true. Clearly this marketing is not entirely ethical, but it is effectively used by many companies.
    When reading the sections and responses about ethical situations in research, it made me think about a meeting I had at work today. I was asked to sit in on a technical update in which one of the research groups from the lab gave an update on their current research via PowerPoint. Toward the end of the presentation, there was a slide with several graphs representing data. After the group presented the slide, they moved to the next slide which was the same except it included the error bars. It turned out the error was quite significant but the researchers did not want to present this and taint their research. Of course, the slides were questioned by everyone at the meeting but it made me think about how often this must happen. When there is so much on the line with research such as money, advancement, and reputation, it can be tempting to skew results and exaggerate data. Even though some people may stand to gain from such unethical practices, as the text points out, it is important to think of the downstream effects of unethical research and reporting and how it can impact the lives of other companies and consumers.

  7. tamarabwi32 says:

    I think this particular reading not only touches upon the ethical dilemmas faced by medical writers but also the care we must take as medical readers when processing the constant stream of information and scientific advances that are presented to us. In other words, being able to identify the issues with a healthcare product in the same way that BioInfo did with FluEase. I often sat in on lunch and learn afternoons at the animal hospital where I shadowed and listened to big animal food and vaccine companies market their products to the hospital using all kinds of data and presentations (as well as buying the whole group lunch). What I always admired about the veterinarian I was observing was how she was never afraid to criticize or point out flaws within the presentation she was watching. However, even veterinarians are susceptible to marketing campaigns. Now that I work for a small business that sells various brands of dog food I also see the ethical questions behind big vet schools like UF marketing Hills brand food (Science Diet) when there may be other similar dog and cat foods on the market for a much more reasonable price. I also found out that raw food diets are not being recommended by the AVMA due to pathogenic reasons. This same business that I work for sells raw food as a line of dog food and I have heard claims to the opposite with regards to the risks involved in handling it and its effectiveness as a diet. Ultimately, it will be my responsibility as a vet to be able to interpret this information and pass on what I believe to be the best advice to my clients. I believe that being a good reader in the medical field highlights the need for good writers.

  8. erahmes says:

    In consumer and public health writing I feel like ethics is a huge issue. A lot of this writing is trying to appeal to the consumer and in some cases persuade the consumer and this can lead to stretching of the truth. This is scary because it’s so easy for companies to twist the words around or advertise in a misleading way and as consumers we have no idea. For example, MegaPharm wanting to advertise pictures of people who were not approved to use FluEase. I think even though companies should do the ethical thing, a lot of them don’t. They are more focused on success or money than doing the right thing. They are not willing to jeopardize their career to do the right thing, which is sad.

  9. ryanmarracino says:

    After reading through the chapter I wanted to focus in a little on some of the guiding questions and how they are similar and different from the ones that Ian and I brainstormed together for our project. One of the first questions that struck me as being different that we could possibly add to our project is “What do [the readers] have at stake, how do they stand to benefit or lose?“ It brings up the ethical point that in medical writing and especially in marketing one cannot simply think of themselves as the beneficiaries of the project, and that in this field there can be a lot at stake in certain situations and the obligations carried by medical writers are that the audience expects not only accurate information, but also have that information presented in a way that it cannot be harmful to the end user of the product or service being advertised. Another related question in the chapter is what obligations the writer has to their employer? If you are working for someone and their only interest is profit from a new product and they ask you to maybe omit some information that could potentially cause consumers to not choose the product, but this information is essential to warn the consumers of possible flaws, then what is the responsibility of the writer both legally and morally? Would one simply act like a pawn to keep their job, or refuse to write the piece all together? It is a very fine line, and the FDA and other regulatory agencies patrol this line, but there are many cases historically where dangerous products were released to consumers where they did not have the proper information to protect themselves.

  10. igoldfarb says:

    In Medical Marketing & Advertising, ethics is one of, if not the most important guideline that a practitioner must follow. Besides honesty, you MUST be a very ethical person and work in an ethical manner if you are marketing new medical products and/or new medications to doctors, hospitals and most importantly patients. Just like in the hypothetical situation in Dr. Scott’s chapter, the company had to decide what they thought was ethically right. I personally believe that patients should be able to access all of the information that has been published regarding a medication and that every company that does research on said medication should publish ALL of their results, even if they are negative or show fault in the new medicine. We all as patients have a right to be informed. A pharmaceutical company should care more about their buyers (the patients) than how much profit they make. And if they care more about how much profit they make then no doctors should prescribe their medications & no patients should take their medications. If a new medication is created and throughout the various drug trials the researchers find that the medication may lead to an increased risk of a heart attack, that needs to be published in the study. Those who work in medical marketing and advertising need to make sure that the people they are selling to are informed completely about the product they are buying. It is the marketers and advertisers duty as a professional in the health care field to put patient care above all else.

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