Ethical Guidelines

Introduction

The World Organization of Family Doctors (Wonca) has developed a set of principles and guidelines to govern the development and posting of website content, the acquisition and posting of online advertising and sponsorship, the rights to privacy and confidentiality of site visitors and patients, and the establishment of effective and secure e-commerce. This document is based on wide consultation and the published documents of other similar organizations. Some of these are included as appendices. (Policies and Guidelines for the COLA Website, Guidelines for AMA Web Sites, ACP-ASIM Policy, ACCME Accreditation Policies on Advertising and Commercial Support (95-B-02), and the Health on the Net Foundation (HON) Code of Conduct for Medical and Health Websites.

This Wonca document follows the convention of other published guidelines by separating executive principles - 'Policy' - from operational 'Guidelines'.

General

The Wonca website shall be relevant, accurate, informative, and useful to visitors. It shall conform to the highest ethical principles for healthcare organizations.

The Wonca website will be attractive to visitors and constructed to provide ease of navigation and clarity in presentation of materials. It will be designed to protect the privacy of individuals and the confidentiality of information provided by visitors.

These ethical policies and guidelines shall also apply to other electronic formats e.g. CD ROMs etc.

The Wonca website shall have an editorial board which shall include two members of the Wonca Executive, the Wonca CEO, and appointed members with expertise in IT, business, and legal affairs. The public should also be represented.

Content of Material

Policy

The content of educational materials placed on the Wonca website (i.e. text, graphics, tables, equations, audio, and video) will be of high quality, developed by individuals knowledgeable of the subject, and, when appropriate, will be reviewed by independent experts for accuracy and reliability.

Non-educational materials posted to the Wonca website must conform to the Policies, and Guidelines for the Wonca website and the policies, guidelines and procedures established by the Wonca editorial board.

Guidelines

Content experts may be drawn from government, academic, private, and commercial institutions, and may be individuals or Wonca employees knowledgeable of the subject area. The member organizations of Wonca, the World Health Organization and its non-governmental organizations in collaborative relations would also be important sources of expertise.

Content experts should be identified with the materials they have created (individual byline or list of authors, institution or agency, affiliation, commercial provider / producer, etc.) Affiliations and relevant financial disclosures for authors and content producers should be clearly indicated.

Details of the authors of the scientific and clinical content should be given with their affiliations, credentials, sources of funding and competing interests. References and sources for all content and information should be provided.

Content should be written in language complexity appropriate to the target audience for which it is intended.

Reference material used in the development of content should be cited in appropriate fashion.

Clinical editorial content should be reviewed by content experts not involved in creation of the content, and the content should be revised appropriately.

The Webmaster email address should be clearly displayed throughout the site. A list of persons responsible for content quality (independent experts, editorial board, etc.) should be available on the site.

Dates of posting, revision, and updating should be indicated on the site. Procedures for updating and removing time sensitive materials should be developed and implemented.

Site visitor responses may be invited but in this instance the Webmaster may reject material considered to be unsuitable.

Advertising Policy

Wonca shall adhere to the highest ethical standards of advertising and will apply these standards to determine the eligibility of products and services for advertising on the Wonca website.

Under no circumstance will the acceptance of an advertisement by Wonca be considered a guarantee or an endorsement of the products or services being advertised, or of the company that manufactures or distributes these products or services.

Editorial decisions and content on the website shall not be influenced by advertising, promotions, advertising representatives, or companies manufacturing or distributing advertised products or services.

Wonca, in its sole discretion, retains the right to decline any advertisement, or to cancel or remove advertising previously accepted for its website.

Wonca recognizes that while some types of advertising attempts to change physician's behavior, other advertising is directed towards the physician as a consumer, rather than as a professional.

Guidelines

Digital website advertising may be placed on the Wonca website. Advertising should be relevant to the publics served by Wonca and in keeping with Wonca's image as a world organization of family doctors.

Wonca will not accept advertisements that are deceptive, offensive, misrepresentative, not factual, or not in good taste. Wonca will not accept advertisements for tobacco, alcohol, or firearms, or any advertisement that conveys ethnic, religious, gender or age bias, prejudice or slurs. Price comparison advertising will normally be regarded as inappropriate.

Advertisements are accepted for publication entirely on the representation that the agency and/or advertiser are authorized to publish the contents. It is the advertiser's responsibility to comply with all applicable laws and regulations, including those related to pharmaceutical advertising to physicians and consumers.

Advertising and sponsorship associated with CME materials should conform to the policies and guidelines of relevant national accrediting bodies around the world. For global application Wonca accepts the policies and guidelines published by the Accreditation Council for Continuing Medical Education (USA), which are attached as Appendix 1. Wonca will strive to avoid conflicts with the advertising policies of its member organizations.

Advertisers will agree to indemnify, defend, and hold harmless Wonca for any claims or actions based on or arising out of any matter of any kind contained in such advertising, or the unauthorized use of any person's name or photograph, or any sketch, map, words, labels, trademarks, copyrighted matter, or libelous statement, in connection with advertising purchased according to Wonca's rate card terms.

An index of website advertisers shall be available through a 'table of contents' screen. Wonca will entertain and may publish as appropriate criticism of advertisements and advertising policy.

All advertisements are subject to review and approval by Wonca's chief executive officer. The CEO reserves the right to reject, cancel, or remove any advertisement or insertion order at any time and for any reason. Wonca will provide prompt notice of such rejection, cancellation, or removal to the advertiser, and the reasons for the action.

Digital advertisements must be readily distinguishable from editorial content. If the distinction is unclear, the word 'advertisement' should be added. 'Advertorial' will be rejected. Advertisements shall not appear within the text of original or review articles on clinical and scientific subjects.

Digital advertisements must appear as fixed banners. Any advertisements with scrolling, "pop-up", animation or audio features should not be used on Wonca websites.

Digital advertisements may not be juxtaposed with, appear in line with, or appear adjacent to editorial content on the same topic, or be linked with editorial content on the same topic.

Digital advertisements that are fixed in relation to the viewer's screen should be placed to ensure that juxtaposition would not occur as screen content changes.

Digital banner advertisements should be limited to one advertisement per screen view.

Advertisements and promotional icons may not appear on the home page of the Wonca website, except that Wonca may acknowledge sponsorship or financial support of the website with a statement of such sponsorship. This statement may be associated with the sponsor's icon, which may or may not have a link to the sponsor's website.

Variables used to determine relevance ranking in search facilities should be posted. Advertisers may not influence the manner in which search results are displayed.

Advertisements may link off-site to a commercial website, provided that the viewer is clearly informed with a buffer page that to proceed by clicking would mean the viewer would leave the Wonca website.

Wonca reserves the right to not link to or to remove links to other websites.

Wonca shall control access to its website both directly or via another website; return to the Wonca website from another shall be via the 'Back' icon rather than via a 'Wonca website' or a 'Return to Wonca website' icon on the other website

Methods of corporate funding should be described in the website's information about advertising or the digital rate card.

Sponsorship Policy

Wonca will retain sole ownership of its website.

Sponsored content on the Wonca website will be accompanied by acknowledgement of the sponsor in a highly visible fashion so that visitors are aware that Wonca has accepted commercial support for the product or service.

Wonca's operational policies and procedures will conform to the policies and procedures of national accrediting bodies such as ACCME. Single sponsored areas will comply with the rules for supplements established by the International Committee of Medical Journal Editors. (See appendix).

Guidelines

Wonca may seek sponsorships, grants and financial assistance to support its website and its education initiatives. Wonca will seek sponsorship from multiple donors and will try to avoid single sponsorships.

All financial or material support for website content and other types of online products (such as distance learning websites, online databases, or material on CD-ROM) will be acknowledged and clearly indicated on the home page, or on the home page of the product supported by the donor.

Acknowledgement of support may appear on the home page, on the running foot of all pages, on any packaging and collateral material included (e.g. CD-ROM jewel case and companion print insert), and on any materials used to publicize the online product. Content accessed through the site that does not reside on the site (e.g. abstracts or articles from another site) will not include sponsorship information.

These acknowledgements will not make any claim for any supporting company products. The final wording and positioning of the acknowledgement will be determined by Wonca. The wording will be similar to "Produced by Wonca with support from [Company]…".

The home page acknowledgement of digital products may be linked to an onsite "About [Company]" page. The running foot acknowledgement will not be linked to any other materials.

Other acknowledgements and disclosures may be required, as deemed necessary by Wonca.

Privacy and Confidentiality Policy

Wonca will protect the privacy of, and will not release personal information provided by individual visitors to the Wonca website without their permission.

Guidelines

A link to the privacy policy of the Wonca website should be provided o the homepage or the site navigational bar and should be easily accessible to the user.

Wonca's Webmaster will ensure that the technology and access used by third parties, such as links and advertisements, adheres to the Wonca privacy policies, and does not permit unauthorized access to site visitor data.

Wonca will not collect, and will not allow third parties to collect, personal health information from site visitors.

Wonca may collect, retain, and use the name, e-mail address, or any other non medical personal information provided it is volunteered by the visitor after the visitor is informed about the potential use of such information. Names and e-mail addresses of site visitors should not be provided, released, or sold to a third party without the site visitor's express permission.

Wonca may collect, retain, and use non-identifiable website visitor data to help shape and direct the creation and maintenance of content and to determine the type of advertisement to be seen by site visitors.

The process of opting into any functionality that includes collection of personal information should include an explicit notice that personal information will be saved, with explanation of how the information will be used and by whom.

Wonca may use e-mail addresses voluntarily provided by site visitors to notify them about updates, products, services, activities, or upcoming events. Site visitors who do not wish to receive such notifications via e-mail should be able to opt out of receiving such information at any time.

Market research conducted by Wonca or its agents to enhance the site should be clearly identified as such.

E-Commerce Policy

Wonca will ensure that users and purchasers of information, products, and services on the Wonca website will have access to secure, efficient transactions for on-line and remote customer fulfillment.

E-commerce transactions will adhere to Wonca's Privacy and Confidentiality Policies.

Guidelines

A link or reference to the Wonca website's policies on privacy should be clearly visible.

The security software and encryption protocol used on the site for financial transactions should be described.

Users should be able to opt in or opt out of functions that track personal information at any time.

A link or reference to customer service contact information (email, telephone, fax, mail), including hours of operation and time zone, should be clearly visible.

The terms of use for e-commerce should require a deliberate selection (accept/not accept)

Users should be able to review transaction information prior to execution (information, products, and services listed; prices; totals; shipping and handling expenses).

As a courtesy, following execution of the transaction, users should be provided, on a page or by email, purchase information (see item 6 above) as well as shipping tracking number, if appropriate.

Users will be notified on-screen when entering or leaving a secure site and will have the option to proceed or remain on the current site.

If a user's browser does not support a secure connection, the user will be so informed and given the option to either terminate or complete the transaction.

Response times for feedback and fulfillment should be clearly stated.

Non-Wonca products and services sold through the Wonca website will not be endorsed or co-branded by Wonca. Any product promotions must adhere to Wonca's policies on Advertising and Sponsorship.