Ethical Guidelines for Direct-To-Consumer Promotion of Transcranial Magnetic Stimulation

Medical providers started to consider Transcranial Magnetic Stimulation (TMS) for the noninvasive treatment of different psychiatric and neurology disorders as this technique become more popular in recent years. Many medical providers are trying to reach patients using direct-to-consumer (DTC) promotion of approved and off-label indications. Most of the time, these ads exaggerate benefits, create unrealistic expectations, and often exaggerate benefits. The procedure is expensive, and many insurance companies do not reimburse it; some patients may not have access to it. The study examines the ethical issues related to DTC promotion of TMS. It proposes clear ethical guidelines for transparency, equity, informed consent, data privacy, and regulation. These measures aim to encourage responsible marketing practices while ensuring the welfare of patients is protected.

The best practice guide does not include patient autonomy and transparency in DTC advertising for TMS. Examining specialist publications, regulations, and ethical considerations ensures the structuring of ethical guidelines and the responsible promotion of DTC's medical marketing.

A comprehensive literature review was conducted in the PubMed, PsycINFO, BMC, and Google Scholar databases from their inception to 2025 using keywords related to TMS, regulatory compliance, DTC, marketing ethics, and patient impact. Studies that contained information regarding misinformation risks, patients' decision making, ethical guidelines in medical advertising, and DTC promotion were analyzed.

The analysis of these studies identified key ethical concerns that include insufficient regulatory oversight, misleading claims that exaggerate benefits and downplay risks, privacy risks in targeted advertising, lack of standardized informed consent procedures, and limited access due to high treatment costs. Our study proposes ethical guidelines based on the ethical concerns identified that medical providers can use to ensure that patients have equitable access, transparency, and regulatory accountability.

Implementing our guidelines will ensure that patients receive unbiased information, high-quality care, and equitable access, reinforcing TMS's ethical foundation in clinical practice.