Ethical issues in direct-to-consumer healthcare: A scoping review

Area of Science:

• Health Ethics
• Healthcare Policy
• Consumer Health

Background:

• Direct-to-consumer (DTC) healthcare models are expanding rapidly.
• Ethical scholarship on DTC healthcare has been fragmented across medical specialties.
• A comprehensive overview of ethical challenges in DTC healthcare is lacking.

Purpose of the Study:

• To conduct a scoping review of ethical issues in the academic literature concerning DTC healthcare products and services.
• To identify and categorize ethical concerns across diverse DTC healthcare domains.
• To synthesize findings to inform future policy and interdisciplinary dialogue.

Main Methods:

• Systematic literature search on PubMed and Google Scholar (2011-2021).
• Inclusion of 86 publications discussing ethical issues in DTC healthcare.
• Coding of publications for ethical issues, DTC product/service type, study type, year, and geography.

Main Results:

• DTC healthcare products/services span neurotechnology, testing, in-person services, digital health, telemedicine, and physical interventions.
• Key ethical arguments favoring DTC healthcare include improved access, autonomy, and convenience.
• Major ethical concerns involve insufficient regulation, questionable efficacy/quality, safety, misleading advertising, and privacy.

Conclusions:

• Cross-cutting ethical issues in DTC healthcare necessitate a unified approach.
• Addressing challenges requires enhanced interdisciplinary communication and collaboration.
• Policy development must consider the multifaceted ethical landscape of DTC healthcare.