By Stacey Kusterbeck
Direct-to-consumer (DTC) healthcare products and services continue to evolve, with a diverse range of offerings on the market. “However, we noticed that DTC healthcare had never really been viewed as a unified field, or a single phenomenon,” says Ashwini Nagappan, MBE, a PhD candidate at UCLA Fielding School of Public Health. Rather, it seemed that different DTC offerings were considered in isolation from an ethical standpoint. Authors disregarded that there might be potential overlaps in their benefits and challenges, says Nagappan.
Nagappan and colleagues decided to conduct a literature review on the ethical issues of DTC healthcare. The researchers reviewed 86 articles published from 2011 and 2021 on ethical issues involving DTC healthcare products and services.1
The publications cited these ethical arguments in favor of DTC healthcare: improved access (both financial and geographic), increased autonomy, and enhanced convenience. Most publications cited insufficient regulation as an ethical concern. “This calls for some careful attention to address existing regulatory gaps and loopholes,” according to Nagappan. Publications cited these ethical concerns about DTC healthcare: questionable quality, safety and physical harms, misleading advertisements, and privacy.
“Many ethical issues were shared across various DTC products and services, highlighting the value of viewing DTC healthcare as a broad social phenomenon,” notes Nagappan.
Clinicians might need to familiarize themselves with DTC options to field questions from patients who might be interested in these offerings, suggest the authors. “For clinicians who work for DTC companies, they might need to address ethical dilemmas related to conflicts of interest, the suitability of providing specific services or products DTC, and the capability to meet the standard of care within a DTC context,” offers Nagappan.
- Nagappan A, Kalokairinou L, Wexler A. Ethical issues in direct-to-consumer healthcare: A scoping review. PLOS Digit Health 2024;3:e0000452.
