Advertising and Marketing: A Practical Organizational Ethics Response

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Advertising and MarketingA Practical
Organizational Ethics Response

• Philip Boyle, Ph.D.
• Vice President,
• Mission Ethics
• www.CHE.ORG/ETHICS

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Etiquette

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  the red mood button on the lower left of screen

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• Advertising is constantly bombarded by criticism.
  Accused of encouraging materialism and
  consumption, causing us to purchase unneeded
  items, stereotyping, taking advantage of children
  and vulnerable, manipulating our behavior, and
  generally contributing to the downfall of the
  social system. Vance Packards The Hidden
  Persuaders

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Goals for todays class

• What are the rules that you ought to use in
  evaluating advertising and marketing
• Explore how different moral theory analyze
  advertising and marketing and business
  communications
• Investigate whether advertising and marketing in
  health care is more problematic
• Identify practical means and organizational
  ethics committee could respond.
• Develop rules for engagement at your site

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Questions

• Is there something inherently wronging in
  advertising or is it just some kinds of methods
  of advertising?
• Is there something inherently unethical about
  advertising in health care?
• And developing products to meet needs
• How can advertising be helpful or unhelpful in
  the mission of the organization?
• What is the best organizational response? Policy?
  Audits? Statements?

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Definitions and distinctions

• Advertising
• Marketingcomplex of commercial communications to
  create a favorable opinion and business
  communication
• Kinds
• Commercial ads
• Public service ads
• Political ads

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Cases

• Lasik eye surgery
• Sex for Life ads
• Direct to consumer ads
• Vioox Ad that tell you it can save your lifeand
  take out your liver
• Lamisil for the dematafite toes
• Viagra and blindness
• Web ads
• Unwarranted claims of surgery success
• Denigrating the gold standard from peer-reviewed
  journals
• Undocument claims of length of stay
• Atypical patient testimony
• Exaggeration fo physicians experience or
  credentials
• Propecia ad, bariatric surgery, tummy tucks
• Spending Medicare money on public service
  announcements
• Hospitals touting they are listed as one of the
  best hospitals based on the survey of the local
  patients
• Use of health data in Ads

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Practical options

• CEO, at prodding of Chief Ethics Officer,
  requests a review or development policy from
  Business Communications
• Board requests report special taskforce to review
  whether image and advertising fits mission
• Organizational ethics mechanisms adopts issue as
  priority education issue.

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Mission and the Bottom Line. From
Organizational Ethics in Health Care.

• The marketing director for PHC has developed and
  implemented a marketing plan that includes public
  advertising. This advertising is a mix of public
  service informational announcements as well as
  explicit advertising for PHC. At the end of the
  year, Medicaid sends PHC a form that allows it to
  bill Medicaid for certain public service
  informational announcements that so not include
  solicitations to contact PHC (such as a toll-free
  number for additional information).
• The marketing director decides not to file for
  these reimbursements for five reasons. First,
  complying with the restrictions on content is
  difficult and some what controversial. The
  regulations are complex, and any enforcement
  effort against an inappropriate claim is treated
  as an action for fraud. Second the amount of
  money at stake is relatively small, amounting to
  no more than 80,000. Third, the public health
  announcements benefit the entire organization
  because they help build public recognition of PHC
  within the community it serves. (They were in
  fact produced without considering whether
  Medicaid would pay for them.) Fourth, these
  announcements are consistent with the mission of
  PHC to provide public health care through
  information. Finally, the marketing director
  believes that it would be unethical to seek
  reimbursement because she believes that Medicaid
  funds, which are limited, are intended to meet
  the clinical needs of Medicaid patients and
  should not be diverted to general activities
  supporting the institutions.
• What would you do? Do you agree or disagree?

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Legal arguments

• Commercial speech is protected under 1st
  amendment
• Central Hudson Gas and Electric v Public Service
  Commission
• Commercial speech can be regulated if
• It is misleading or concerns an illegal product
• There is a substantial government interest
• The regulation directly advances govt interest
• Regulation is narrowly tailored

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Moral Arguments

• Puffery and embellishmentwhats wrong with it?
• mere exaggerations or hyperbole
• The best and the greatest as sales talknot
  regulated
• Everyone knows Wonder Bread or Greatest show on
  Earth is not greatest
• Form of opinion statement
• Coercion?
• Purchase unneeded item?
• Dealing with a vulnerable population
• Is where it advertised make a difference? Does
  the format make a moral difference?
• It is a matter of lying?
• Selling focuses on the need of the seller not the
  buyer?
• Goal of the adPublic health or something else?

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Moral Arguments

• Teleological Perspective focus on the
  consequences of behavior
• They focus on some utilitygreatest good for
  greatest number
• Does the advertising campaign bring about good
  for the corporation and its publics?
• Who benefits and who suffers as a result of the
  ad campaign?
• What information is most useful to society as
  part of an advertisement?

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Deontological Perspective based on rules or
universalizability

• Is the advertising truthful?
• Does any group suffer life-threatening or
  dignity-debasing consequences as a result of the
  ad campaign?
• Does the product being advertised add genuine
  value?
• Are the rights of individuals being protected by
  the ad campaign?
• What duties to consumers and publics are being
  served in the ads?

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Virtue Perspective

• Based on view that human communities require
  certain virtues or skills including honesty
  truthfulness, compassion, loyalty, and justice
• What kind of life/society is being promoted in
  the ads?
• Are the values being advertised the ones to which
  the organization subscribes?
• Does the advertising agency understand the
  central values of the hospital and why it holds
  them?

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Natural law perspective

• Values/goods to be positively promoted and
  protected from being acted against
• What goods will be promoted by advertising?
• A tool to inform people about the availability of
  rationally desirable new products
• A tool for sustaining honest and ethically
  responsible competition
• A tool to positively influence the media
• A tool to communicate a message of a religious
  naturemessages of faith, compassion,
• A tool in politics to create a democratic
  conversation

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Natural law perspective

• What goods will be risked by advertising?
• A tool to misrepresent and withhold relevant
  facts to make choices
• Brand ads promote similar products but to choose
  on loyalty (not rational)
• A tool for consumerism geared towards having
  not being better off.
• Worse when they harm poorAvon Products in Amazon
• Seeking wants that are artificial created
• A tool directed to meet the needs of those who
  can afford products and
• Avoid those who cannot
• A tool for stereotyping/discrimination by placing
  other at a disadvantage
• A tool that can promote values such as envy,
  status seeking, and lust (ant-religious)
• A tool to undercut democratic participation by
  limiting voice to wealthy

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Possible questions for an audit

• Does embellishment occur in this ad/campaign?
• Does the ad accurately portray the situation in
  the hospital?
• Are there portions of the ad that may not be able
  to be substantiated?
• Is the message appropriate for the media to be
  used to convey it?
• Are there certain media/programs with which the
  hospital may not want to be associated?
• Are there consumer groups that may not understand
  the ad and its message?

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Policy considerations

• Your ads should not be misleading to patients.
• Your ads should not lead patients to demand
  services they do not reasonably need.
• All your advertising claims should be based on
  facts.
• Your ad should present a fair and honest account
  of the service advertised.
• Hospitals are held to a higher standard in
  advertising than would generally
• be applied to other commercial enterprises.

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SAMPLE POLICY

• All internal and external marketing
  communications are guided by the following
  principles
• ? fairness, honesty and accuracy
• ? respect for the individual
• ? sensitivity to the emotional, spiritual and
  physical needs of the people we serve
• ? determination to express the unique character
  of St. Elsewhere as a Catholic institution
• ? commitment to deliver all that we promise
• Whats missing from the policies?

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Advertising Guidelines of the Council of Medical
Specialty Societies

• TRUTH Advertising shall tell the truth, and
  shall reveal significant facts, the omission of
  which would mislead the public.
• SUBSTANTIATION Advertising claims shall be
  substantiated by evidence in possession of the
  advertiser and advertising agency, prior to
  making such claims.
• COMPARISONS Advertising shall refrain from
  making false, misleading, or unsubstantiated
  statements or claims about a competitor or his
  products or services.
• BAIT ADVERTISING Advertising shall not offer
  products or services for sale unless such offer
  constitutes a bona fide effort to sell the
  advertised products or services and is not a
  device to switch consumers to other goods or
  services, usually higher priced.

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• GUARANTEES AND WARRANTIES Advertising of
  guarantees and warranties shall be explicit, with
  sufficient information to apprise consumers of
  their principal terms and limitations or, when
  space or time restrictions preclude such
  disclosures, the advertisement should clearly
  reveal where the full text of the guarantee or
  warranty can be examined before purchase.
• PRICE CLAIMS Advertising shall avoid price
  claims which age false or misleading, or savings
  claims which do not offer provable savings.
• TESTIMONIALS Advertising containing testimonials
  shall be limited to those of competent witnesses
  who are reflecting a real and honest opinion or
  experience.
• TASTE AND DECENCY Advertising shall be free of
  statements, illustrations or implications which
  are offensive to good taste or public decency.

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• We, the members of the American Association of
  Advertising Agencies, in addition to supporting
  and obeying the laws and legal regulations
  pertaining to advertising, undertake to extend
  and broaden the application of high ethical
  standards. Specifically, we will not knowingly
  create advertising that contains
• False or misleading statements or exaggerations,
  visual or verbal
• Testimonials that do not reflect the real opinion
  of the individual(s) involved
• Price claims that are misleading
• Claims insufficiently supported or that distort
  the true meaning or practicable application of
  statements made by professional or scientific
  authority
• Statements, suggestions, or pictures offensive to
  public decency or minority segments of the
  populations.
• We recognize that there are areas that are
  subject to honestly different interpretations and
  judgment. Nevertheless, we agree not to
  recommend to an advertiser, and to discourage the
  use of, advertising that is in poor or
  questionable taste or that is deliberately
  irritating through aural or visual content or
  presentation.

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• Website http//advertising.utexas.edu/research/la
  w/catholic.html

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