Intended for healthcare professionals


Health websites in US propose new ethics code

BMJ 2000; 320 doi: (Published 20 May 2000) Cite this as: BMJ 2000;320:1359
  1. Fred Charatan
  1. Florida

    A group of 20 leading health internet services have joined together to produce a 14 point set of ethical principles designed to ensure reliable health information and services to as many as 11.5 million consumers.

    The consortium, Hi-Ethics for Health Internet Ethics, said on 8 May: “Because Hi-Ethics organisations represent a significant portion of the internet health space, they are able to make a swift and direct positive impact on the consumer's internet health experience.”, the website set up by the former US surgeon general, C Everett Koop, which has been criticised for mixing information with advertising (BMJ 1999;319:727), claimed credit for the effort.

    “By virtue of the vast recognition of the brand and our leadership position in the ‘e-health’ space, our company has always been a lightning rod for change and has a responsibility to lead in the area of ethical and responsible business practice,” said Dennis Upah, the chief operating officer for

    “It is vital to the future of the entire industry to arrive at tough standards regarding privacy and visible distinctions between editorial content and advertising,” he added.

    Major components of the Hi-Ethics principles include clear identification of advertisements and disclosure of paid sponsorships; giving consumers information about, and control over, how their personal data are used; and ensuring that health advice on the internet is accurate and up to date.

    The principles also emphasise that for consumers a link from one site to another does not imply any endorsement of the linked site.

    The consortium expects compliant companies to tag their websites with a Hi-Ethics motto or logo, as a sort of seal of approval. In addition, a full list of participating companies can be found on the consortium's website (

    Hi-Ethics stressed that the adoption of self regulation does not mean that the consortium is against government regulation of health information on the internet. For example, through a federal and state campaign known as Operation Cure All, the US Federal Trade Commission has been cracking down on companies that use the internet to peddle fraudulent products and offer dubious health advice.

    The National Consumers League, a non-profit consumers organisation has set up Internet Fraud Watch to help consumers protect themselves on-line.

    Although the Hi-Ethics principles would not currently be enforceable by law, theFederal Trade Commission can take action against a company that fails to operate by standards that it has declared it follows.

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