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    The Ongoing Conversation with Don Kemper

    It strikes me as somewhat ironic to be arguing with Don Kemper, a man I've known for a number of years since our introduction by a mutual acquaintence. We're not friends, but rather professional colleagues whose paths cross every now and again. We respect each other's work and I don't believe there are any egos or personalities involved.

    Selection of TRUSTe

    TRUSTe's inability to perform the function they claim to offer has been widely known and documented. But Don said that after talking with the organization's CEO, he felt confident in their ability to pull it off:

    TRUSTe was selected, in part, because I felt that they would carry the value of the seal program far beyond the 20 websites of Hi-Ethics. Clearly we expect that hundreds, if not thousands, of sites will apply for the seal and verification program over the next few years.

    But even the ideal of some sort of "seal" program as being a solution is contradicted by known research. Specifically, the California Healthcare Foundation, in conjunction with another online health organization -- the Internet Healthcare Coalition, released a report in February 2000. It showed that common seals available on the Web today (such as the TRUSTe or HON code seals) have no impact on a consumer's level of trust or confidence in a site.

    Perhaps TRUSTe can be trusted to do better with a health seal, though. How can we measure TRUSTe's effectiveness with an industry-specific seal? Well, perhaps we should look at other industry-specific seals TRUSTe has developed. TRUSTe has tried to branch out into only one other area -- child privacy. I went to a couple of large, popular kid sites looking for this seal and couldn't find it on any of them (including Disney!). So much for other efforts. Do we have any reason to believe TRUSTe will be any more helpful in promoting a Hi-Ethics health seal? Past history isn't hopeful.

    The fact is that most e-commerce sites don't sport a TRUSTe logo and most e-health sites won't either. TRUSTe charges a minimum of $300/year for the pleasure of displaying their logo, which is not a fee that most health Web sites will be willing to put up. You certainly won't see government sites like the NIH or NIMH sporting such a logo, nor will you see the vast majority of non-profit, personal, or academic sites. Only those sites that have the most to lose financially (e.g., commercial health sites) are behind such a program and will be the buyers of the seal.

    What's the Question?

    The question that remains unanswered is why is there even a Hi-Ethics organization to begin with? What goals could such an organization pursue that would be incongruent with a better balance in the group's representation?? After all, if commercial interests are incongruent with consumers' interests, it is highly unlikely the commercial interests will survive very long in a free market. They have to have similar missions or vision, or the consumers won't stick around very long.

    There's a streak of heavy-handed paternalism in all of this talk of a seal program and the need to give consumers more information about the ulterior motives of a commercial Web site. I'm all for disclosure of one's business and advertising practices or agreements where such a thing is not crystal clear. For instance, health marketing or advertising masquerading as unbiased content... Or, worse yet, health content masquerading as unbiased when it is very much biased, but the biases are subtle and aren't easily understood. That is where such a code should address -- subtle biases in what is or isn't discussed in health content presented, because of financial interests.

    That is the question that is still begging an answer, and the reason I left They couldn't or wouldn't separate out these subtle biases in the mental health content they were publishing because it might jeopardize a lucrative contract. (It appears that since my departure, the contract was renegotiated in some manner, but the questionable content remains, unedited, with all its biases intact.)

    But beyond these subtle differences that the Hi-Ethics code doesn't address (and, to be fair, would be difficult to codify without causing an extreme burden on member sites), will any of this help consumers make better-informed choices about their healthcare? I doubt it. With 100,000+ health Web sites in existence today, putting a seal on 20 or 200 still isn't going to touch most people who search for health information online. It's a drop in the bucket.

    Should you not do something if its impact is going to be negligible? No, I'm not saying that. I guess I would feel better about it if something had come from the partnership between the three leading health organizations online and it had been pushed by all three. I would also feel better about the seal if it could be opened to all (e.g., different "levels" of the seal depending on the nature of the site), allowing even consumers to afford putting it on their site.

    The Rest...

    Back to Don's reply...

    While verification has lagged behind, the work of HiEthics has done much good in getting member websites to abandon unethical practices in anticipation of the seal program. I have no doubt that gaps remain for advocates to point out at every site. However, I know that consumers are getting the benefit of the changes every day. (I recognize that your perspective is more demanding and less forgiving--and that's OK. Both perspectives are needed)

    Well, needed only because you can't be paternalistic on one hand claiming consumers need this sort of protection from commercial health Web sites, and then don't followup on getting one's own members to adhere to principles they've all agreed upon. You'll notice I keep harping on the time issue, well, mainly because Hi-Ethics has been so boastful about its achievement and we live in an Internet economy. Hundreds of businesses have come and gone since Hi-Ethics original announcement, and millions of new Americans have come online to research health information. Seems like if an effort was going to be successful, the sooner the better.

    Hi-Ethics appears to be on track to get something done in this area, at least being able to police its own members.

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Last reviewed: By John M. Grohol, Psy.D. on 30 Apr 2016
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