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Ethical and Legal Considerations

Annette Flanagin

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Subscriber: null; date: 19 January 2020


Advertisements appear in print and online journals, email alerts, other online information products and services, and other types of media (such as podcasts and blogs). For biomedical publications, advertisements typically include the following:

  • Advertisements that promote professional or trade-related products (primarily pharmaceuticals and medical equipment in biomedical publications), services, educational opportunities or products, or announcements (see also 5.12.3, Advertorials). These are typically called display advertisements in print; online, they may include banners, pop-up windows, or text-based ads (such as in email alerts or other online communications of information) (see also 5.12.6, Advertising and Sponsorship in Online Publications).

  • Display advertisements that promote products and services not specifically related to a profession or trade (such as an ad for an automobile or an airline in a medical journal).

  • Classified or recruitment advertisements (listings of employment opportunities, educational courses, workshops, announcements, or other services).

In most cases, advertisers pay to place advertisements for their products and services in publications. Those advertisements for which a publisher does not typically charge a fee include public service announcements, ads for nonprofit organizations or charities, and “house ads,” which promote a product or service provided by the owner of the publication.

Important considerations for editors and publishers are whether paid advertisements and sponsorship invite potential infringements on editorial independence and whether they represent important revenue opportunities for journals in increasingly competitive markets.7,8 The keys to maintaining editorial integrity are to achieve a balance between these seemingly opposing forces, to maintain a recognizable separation between the functions and decisions of editorial and advertising departments, and to have consistent and publicly available policies on advertising and sponsorship.2,9

Although the primary function of most journals is to educate and inform in a neutral manner and that of advertisements is to educate and inform in a promotional manner, advertisers and editors share a common goal—to influence the behavior of readers.10 Obvious differences between editorial text and advertising copy exist. In biomedical publication, editorial material typically comprises text composed in a consistent scholarly format with data-based tables and figures, whereas advertisements typically contain bold, colorful statements and eye-catching graphics. Scholarly editorial material is generally intended to be objective, whereas advertisements are generally intended to be preferential, selective, and persuasive. Problems arise when the means to achieve the common goal—of influencing behavior—fall outside expected norms or violate specific regulations and standards.

In many countries, advertisers must meet specific criteria established by national regulatory agencies. For example, drug ads are required to follow the regulations of the Food and Drug Administration in the United States,11 the Association of the British Pharmaceutical Industry in the United Kingdom,12 and the Pharmaceutical Advertising Advisory Board in Canada.13 The International Federation of Pharmaceutical Manufacturers Associations has regularly updated guidelines for pharmaceutical marketing practices that may be helpful for countries without well-defined regulations.14 However, each of these regulatory agencies has been criticized for not enforcing its regulations.15,16

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