Poster - #UCLAFSPH-22 - Keywords: direct-to-consumer ethics review

Direct-to-Consumer Healthcare: A Scoping Review of Ethical Issues, Challenges, and Recommendations

Ashwini Nagappan (1,2), Louiza Kalokairinou (2), & Anna Wexler (2)
(1) Department of Health Policy & Management, Fielding School of Public Health, UCLA (2) Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania

ABSTRACT:
In recent years, an increasing number of health products and services are being offered on a direct-to- consumer (DTC) basis, including telehealth, neurostimulation devices, wearable heart-rhythm monitors, and mental health apps. While ethical and policy concerns have been raised about various DTC health products and services, discussions have mostly been domain-specific, such as publications regarding DTC telemedicine, neurotechnologies, and laboratory testing. The present study aimed to provide a cross-cutting analysis that would capture the range of ethical issues being raised across medical specialties. In particular, we sought to characterize the types of DTC products and services examined by scholars, the concordant ethical issues, the critiques of regulation, and the recommendations made to stakeholders. As our findings indicate, there is significant overlap regarding the ethical issues identified across multiple medical specialties, highlighting the importance of understanding DTC healthcare as a broad social phenomenon. The major cross- cutting issues were efficacy and quality concerns, as well as safety and harms and insufficient regulation of products. As the market for DTC healthcare products and services continues to grow, regulators and healthcare providers may benefit from understanding how parallel medical specialties have navigated the concomitant ethical and policy challenges.