To explore how a “harm chain” analysis could identify and address stakeholders' concerns about direct‐to‐consumer advertising of prescription medicines (DTCA).
The paper analyses the development of stakeholder theory before exploring and discussing the tension between normative and instrumental logic. The authors adopt a utilitarian perspective, which they use to identify the range of stakeholders involved with or affected by DTCA.
A “harm chain” analysis identifies common concerns held by stakeholders; these include disquiet over the quality of information provided via DTCA and possible derogation of doctors' role as prescribers. The paper outlines prescriptive advertising guidelines that could address these issues, but notes that failure to achieve a satisfactory reduction in harm potential may result in a ban on DTCA.
Although a utilitarian norm will not satisfy all stakeholders' interests, the authors believe that it will produce the greatest reduction in harm, as well as maximising the benefits that can result from DTCA. The conclusions imply the need for independent monitoring of DTCA's effects on stakeholder groups to ensure that regulations governing this advertising are broadly based.
The authors suggest changes to DTCA regulation, specifically the introduction of a “fair balance” criterion and a statement explicitly recognising doctors' role in determining appropriate treatments.
Although the debate over DTCA has been well documented, this paper represents the first attempt to use stakeholder theory to explore the ethical issues associated with this advertising. The analysis produces a decision‐making model that the authors recommend should guide future policy decisions.
