advertising ethical case study

Ethical Marketing: 6 Examples of Brands that had Controversial Marketing Campaigns

Here’s what NOT to do when it comes to practicing ethics when marketing. We’ve picked out 6 case studies that happened in Singapore that we can learn from. This is part 1 of a 2-part series on Ethical Marketing. To learn more about how you can be mindful about ethics when marketing, head over to part 2 here.

With COVID-19 sticking around for longer than we hoped, it’s likely that even more businesses will shift towards operating online . That translates to more digital content vying for our eyeballs. As a digital marketer, it’s crucial that your content grabs the attention of your target audience.

When businesses fail to keep ethics in check, it can make them stand out in the wrong way. In this world where “customer is king”, a misstep can be detrimental for their brand. Take for example the multiple sagas House of Seafood (Punggol) was embroiled in – the use of claw machines for customers to catch live crabs , the upselling of surgical masks during the height of the pandemic and more recently, taking their crabs for a walk . The restaurant has drawn flak from the public for throwing marketing stunts that are “in poor taste”. Consumers have taken to platforms such as Google Reviews, Facebook and TripAdvisor to voice their discontent, calling for petitions to revoke their license.

Unfortunately, it’s been rather common that businesses have gotten into trouble for unethical marketing. Let’s take a look at a few instances in Singapore where campaigns or companies faced criticism for unethical practices in sales and promotions.

1. Mediacorp Ad: Racial Insensitivity

The portrayal of blackface was popularised in the 19th century after the creation of a genre in entertainment: blackface minstrel shows. White performers darkened their skin with shoe polish, grease paint or burnt cork, and illustrated behaviour that perpetuated caricatures of African Americans. Humiliating and unjust stereotypes portrayed involved undesirable characteristics such as hypersexuality, criminality and laziness.

While it’s now deemed an intolerable act of discrimination in the United States, challenging the longstanding racism that’s plagued the country remains an uphill battle.

Though we don’t share the same racial history as the United States, the concept of blackface isn’t foreign to us here in Singapore. It just manifests in another form: brownface.

In 2019, brownface appeared in an advertisement, promoting e-payment as a convenient option for all. The banner featured an ethnically Chinese actor who darkened his skin to portray a Singaporean Indian man . The ad sparked public outcry for its racist undertones in the portrayal of Indians and Malays.

Like blackface, brownface is dehumanising and unethical because it uses someone’s skin tone as a costume. Whatever intentions the advertisers had is irrelevant, as the ad is fundamentally offensive. It effectively reduced the representation of an entire ethnic minority group to just their skin colour .

For the uninitiated, wearing brownface might be easily perceived as harmless fun that doesn’t warrant the huge reaction it got from the public. Even in their apology for this e-payment ad, the agency mentioned choosing this Chinese actor specifically as he could represent characters “in a light-hearted way”. In other words, though there was no joke behind the ad, having a comedic actor wear brownface gave viewers the idea that it was meant to be laughed at.

Unfair and inadequate race representation reflects poorly on a company, particularly in a country strongly advocating racial harmony like Singapore. It’s important to factor in an additional layer of sensitivity when working on marketing efforts to ensure that no particular group feels excluded or discriminated against .

2. Circles.Life Ad: Acts of Tokenism

Being ethical isn’t only about striking while the iron is hot. It should be something weaved into your company’s DNA, and reinforced consistently at every stage of the marketing process.

Tokenism is defined as the superficial practice of making a symbolic effort to do something, in order to give the impression that certain values are honoured by a company. In the context of marketing, it could look like exploiting the differences among people to highlight inclusivity and diversity, without actually committing to it.  

In early June 2021, Singapore’s fourth telco Circles.Life received a lot of heat when they released an ad stating they were “100% for the people”. It was reportedly a collective effort between “a Filipino, a Malay and a Chinese”.

View this post on Instagram A post shared by Circles.Life (@circleslifesg)

This post was the telco’s attempt at trendjacking after racial issues had become significantly more sensitive. Cases of blatant racism like that of Beow Tan’s harassment of minorities , and a racist male verbally abusing and kicking a lady had surfaced, making race the topic on everyone’s minds. In a bid to appear inclusive, the advertisement did the exact opposite , coming off as mere tokenism instead.

When Circles.Life overtly stated the post was done by individuals from different races, they wanted to highlight their ethical and racially diverse hiring practices. But it backfired, as that’s how hiring employees should be in the first place . Furthermore, some detractors also pointed out that the post highlighted social hierarchies in Singapore. In the post, minority groups were classified as the lower-ranked employees working under the majority racial group in Singapore. Releasing this ad to promote their “race-blind” hiring at such a time was inappropriate, and did not serve its purpose.

While Circles.Life did not have ill intentions, the ad was not well designed and offensive, especially in a multiracial country like ours.

3. “Fire Sales”: False Advertisements

You’ve probably seen signs promoting a “Closing Down Sale”, or others touting a “Fire Sale”. These posters have been used by three retail brands – ABC Bargain Centre, ValuDollar and ABC Express – to attract more people to patronize their stores.

The “Closing Down Sale” lasted almost two years . These claims were effective for sales, but they were inaccurate and unethical. Customers made purchases under the belief that the deals and discounts lasted only for a short while, when in actual fact, they were not. These promotion tactics have since been discontinued to stop misleading consumers.

Amidst the surge in popularity of e-commerce, there have been more unscrupulous sellers. A 2019 study conducted by consultancy Frontier Economics reported that two in three consumers fell prey to unfair business practices while shopping online .

These false claims consisted of the following:

• Discounts ( “Buy NOW and save UP TO 60%!” )
• Deals ( “Buy THREE for the price of TWO!” )
• Time-limited Offers ( “Quick, this deal is ENDING in 30 MINUTES!” )
• Stock Running Low ( “Grab the LAST ONE in stock NOW!” )

Promotions get a ton of attention, and it is how shady sellers earn their money. These deals rush consumers to make decisions on the fly, because their minds are focused on the fear of losing out.

“Last one? Faster buy faster buy”

“WAH DISCOUNT? Must buy!”

Unfortunately, these false deals are especially effective in a society such as Singapore, which embodies the kiasu mentality .

This is due to an idea called “loss aversion” , which states people would rather avoid making a loss than gain something .

In reality, these “opportunities” don’t exist.

The prices reflected in these “discounts” and “deals”? They were the original prices sellers looked at, marked to profit without drawing suspicion.

“Time-based offers”? “Last in stock”? Many will notice they go on indefinitely. Any customer visiting the page, earlier or later, will see these phrases remain unchanged.

By marketing your products with these unethical tactics, you are not being fair to your customers. This is because they’ll be making decisions based on false information, and are being misled. Marketing your products with honesty matters if you want to build long-term relationships with your customers. What keeps them coming back ultimately, is being able to count on a company to have the best interests for their customers beyond mere profits.

4. Subway’s Meat Stack Sub: Hypocrisy

Ideally, there shouldn’t be discrepancies between advertised details and what a customer receives. I’m a big foodie, and I love an occasional trip to Subway. Getting a wide variety of ingredients and flavours in one edible submarine is all I ask for.

In September 2020, there was a new Sub – the “Meat Stack Sub” . In their slew of marketing campaigns, both online and offline , Subway stated it involved more meat and less advertising.

Yet, I saw these ads in many places around Singapore. Subway Singapore had also hired not one , but two well-known locals to promote the new Sub.

There was a contradiction : the ads about the Sub were made to look low in effort and cost, but there was so much ongoing promotion for it.

This campaign also gave the impression that the money saved on ads allowed the Sub to have a lot more meat in it. Because of that, people would think the sandwich is value for money. Yet, the Meat Stack was the most expensive option on the menu .

In my personal encounter with it, there wasn’t a significant increase in meat included either. It was clear that the advertisement had been exaggerated. This is a situation where the campaign had overstated things, and results turned out to be underwhelming. Subway had promoted one thing and produced another. The onus of accurate representations is on the company to deliver what was marketed. Though the ad was playful, it set unrealistic expectations on the experience of the product . In misleading the consumers, they alienated loyal consumers who answered the call to their ads for a Meat Stack.

5. Singapore Telcos: Smearing Competitors

Standing out in an increasingly crowded and competitive market is what makes or breaks businesses. However, it’s unethical to resort to underhand means to edge out competitors. The Singapore major Telco players in 2014 – SingTel, StarHub and M1 – were embroiled in a dispute over social media smears against SingTel’s competitors.

To promote a new mobile plan, SingTel employed social media agency Gushcloud to launch a campaign. Gushcloud had then incentivised social media influencers to make complaints on telco competitors StarHub and M1. SingTel engaged in what is called a “smear campaign” , defined as the deliberate attempt to undermine the credibility and reputation of its competitors by spreading false and disparaging comments.

SingTel's chief executive later made a public apology to StarHub and M1, both of which agreed not to pursue the matter. SingTel had also terminated their partnership with Gushcloud, with the latter taking full responsibility for the campaign.

Smear campaigns are unclassy and they often bite back at those who launch the campaign. In an ironic twist, during that period, SingTel’s own users flooded their social media page with immense dissatisfaction over SingTel’s services. The lesson here? You don’t have to love your competitors, but there are better ways to explore how you can beat the competition fairly, by focusing on improving within. When you highlight the positives and focus on delivering stellar customer service, the excellence of your product or service speaks for itself.

6. Beauty Salons: Aggressive Selling

In the past, my mother used to patronise this one hair salon near our house. I remember she always came back complaining.

They would sound something like this:

“Aiya, go cut hair only they want me to sign package again”

“This package haven’t end, they tell me buy another already”

The staff at the hair salon were often hard-selling packages to its customers. Some were nice, while others were more aggressive. But they all pressed customers just as much. I thought that it was just at this particular salon. Apparently, this was commonplace in the beauty industry.

Many hair salons and beauty parlours often adopt an aggressive approach to increase a customer’s lifetime value and engagement with their business.

The Consumers Association of Singapore (CASE) has mentioned that the beauty industry is often one of the “top” industries with complaints. In fact, in 2020, three beauty salons admitted to these unfair practices against customers . This was after many complaints were lodged for close to two years. Beyond pressuring customers to buy more treatments, some were charged additional costs. The salons had also charged consumers for even more packages without consent.

A fundamental rule that contributes to a strong, lasting business is to build rapport with your customers. Hard selling is unethical as it puts a high amount of pressure on customers; as if you’re shoving products down their throats. Psychologically, this puts customers on guard as they feel like their decisions are being dictated for them. They’re then more compelled to shut off and reject your pitch.

Doing Your Part as an Ethical Digital Marketer

While browsing through the case studies above, it’s easy to think: “Well duh, of course that’s unethical. Who in their right mind would approve these marketing efforts?” If it was that straightforward to determine the dichotomy between what’s ethical and what’s not, we wouldn’t be witnesses to these instances in marketing campaigns time and time again.

Some of the examples mentioned above are large corporations that have layers of personnel who gave their collective approval. You too, as digital marketers, are just as susceptible to making mistakes like these. The trick is acknowledging that it’s possible for you to make such mistakes and constantly checking yourself – be it adopting a customer’s perspective or taking a step back to evaluate a situation from the bigger picture of values and ethics.

How well you do depends on your marketing efforts, but it’s also based on how consumers receive it . If a particular marketing tactic doesn’t sit well with you, listen to that voice inside you and have a second take.

This is part 1 of a 2-part series on Ethical Marketing. To learn more about how you can be mindful about ethics when marketing, head over to part 2 here .

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Case Studies

More than 70 cases pair ethics concepts with real world situations. From journalism, performing arts, and scientific research to sports, law, and business, these case studies explore current and historic ethical dilemmas, their motivating biases, and their consequences. Each case includes discussion questions, related videos, and a bibliography.

A Million Little Pieces

James Frey’s popular memoir stirred controversy and media attention after it was revealed to contain numerous exaggerations and fabrications.

Abramoff: Lobbying Congress

Super-lobbyist Abramoff was caught in a scheme to lobby against his own clients. Was a corrupt individual or a corrupt system – or both – to blame?

Apple Suppliers & Labor Practices

Is tech company Apple, Inc. ethically obligated to oversee the questionable working conditions of other companies further down their supply chain?

Approaching the Presidency: Roosevelt & Taft

Some presidents view their responsibilities in strictly legal terms, others according to duty. Roosevelt and Taft took two extreme approaches.

Appropriating “Hope”

Fairey’s portrait of Barack Obama raised debate over the extent to which an artist can use and modify another’s artistic work, yet still call it one’s own.

Arctic Offshore Drilling

Competing groups frame the debate over oil drilling off Alaska’s coast in varying ways depending on their environmental and economic interests.

Banning Burkas: Freedom or Discrimination?

The French law banning women from wearing burkas in public sparked debate about discrimination and freedom of religion.

Birthing Vaccine Skepticism

Wakefield published an article riddled with inaccuracies and conflicts of interest that created significant vaccine hesitancy regarding the MMR vaccine.

Blurred Lines of Copyright

Marvin Gaye’s Estate won a lawsuit against Robin Thicke and Pharrell Williams for the hit song “Blurred Lines,” which had a similar feel to one of his songs.

Bullfighting: Art or Not?

Bullfighting has been a prominent cultural and artistic event for centuries, but in recent decades it has faced increasing criticism for animal rights’ abuse.

Buying Green: Consumer Behavior

Do purchasing green products, such as organic foods and electric cars, give consumers the moral license to indulge in unethical behavior?

Cadavers in Car Safety Research

Engineers at Heidelberg University insist that the use of human cadavers in car safety research is ethical because their research can save lives.

Cardinals’ Computer Hacking

St. Louis Cardinals scouting director Chris Correa hacked into the Houston Astros’ webmail system, leading to legal repercussions and a lifetime ban from MLB.

Cheating: Atlanta’s School Scandal

Teachers and administrators at Parks Middle School adjust struggling students’ test scores in an effort to save their school from closure.

Cheating: Sign-Stealing in MLB

The Houston Astros’ sign-stealing scheme rocked the baseball world, leading to a game-changing MLB investigation and fallout.

Cheating: UNC’s Academic Fraud

UNC’s academic fraud scandal uncovered an 18-year scheme of unchecked coursework and fraudulent classes that enabled student-athletes to play sports.

Cheney v. U.S. District Court

A controversial case focuses on Justice Scalia’s personal friendship with Vice President Cheney and the possible conflict of interest it poses to the case.

Christina Fallin: “Appropriate Culturation?”

After Fallin posted a picture of herself wearing a Plain’s headdress on social media, uproar emerged over cultural appropriation and Fallin’s intentions.

Climate Change & the Paris Deal

While climate change poses many abstract problems, the actions (or inactions) of today’s populations will have tangible effects on future generations.

Cover-Up on Campus

While the Baylor University football team was winning on the field, university officials failed to take action when allegations of sexual assault by student athletes emerged.

Covering Female Athletes

Sports Illustrated stirs controversy when their cover photo of an Olympic skier seems to focus more on her physical appearance than her athletic abilities.

Covering Yourself? Journalists and the Bowl Championship

Can news outlets covering the Bowl Championship Series fairly report sports news if their own polls were used to create the news?

Cyber Harassment

After a student defames a middle school teacher on social media, the teacher confronts the student in class and posts a video of the confrontation online.

Defending Freedom of Tweets?

Running back Rashard Mendenhall receives backlash from fans after criticizing the celebration of the assassination of Osama Bin Laden in a tweet.

Dennis Kozlowski: Living Large

Dennis Kozlowski was an effective leader for Tyco in his first few years as CEO, but eventually faced criminal charges over his use of company assets.

Digital Downloads

File-sharing program Napster sparked debate over the legal and ethical dimensions of downloading unauthorized copies of copyrighted music.

Dr. V’s Magical Putter

Journalist Caleb Hannan outed Dr. V as a trans woman, sparking debate over the ethics of Hannan’s reporting, as well its role in Dr. V’s suicide.

East Germany’s Doping Machine

From 1968 to the late 1980s, East Germany (GDR) doped some 9,000 athletes to gain success in international athletic competitions despite being aware of the unfortunate side effects.

Ebola & American Intervention

Did the dispatch of U.S. military units to Liberia to aid in humanitarian relief during the Ebola epidemic help or hinder the process?

Edward Snowden: Traitor or Hero?

Was Edward Snowden’s release of confidential government documents ethically justifiable?

Ethical Pitfalls in Action

Why do good people do bad things? Behavioral ethics is the science of moral decision-making, which explores why and how people make the ethical (and unethical) decisions that they do.

Ethical Use of Home DNA Testing

The rising popularity of at-home DNA testing kits raises questions about privacy and consumer rights.

Flying the Confederate Flag

A heated debate ensues over whether or not the Confederate flag should be removed from the South Carolina State House grounds.

Freedom of Speech on Campus

In the wake of racially motivated offenses, student protests sparked debate over the roles of free speech, deliberation, and tolerance on campus.

Freedom vs. Duty in Clinical Social Work

What should social workers do when their personal values come in conflict with the clients they are meant to serve?

Full Disclosure: Manipulating Donors

When an intern witnesses a donor making a large gift to a non-profit organization under misleading circumstances, she struggles with what to do.

Gaming the System: The VA Scandal

The Veterans Administration’s incentives were meant to spur more efficient and productive healthcare, but not all administrators complied as intended.

German Police Battalion 101

During the Holocaust, ordinary Germans became willing killers even though they could have opted out from murdering their Jewish neighbors.

Head Injuries & American Football

Many studies have linked traumatic brain injuries and related conditions to American football, creating controversy around the safety of the sport.

Head Injuries & the NFL

American football is a rough and dangerous game and its impact on the players’ brain health has sparked a hotly contested debate.

Healthcare Obligations: Personal vs. Institutional

A medical doctor must make a difficult decision when informing patients of the effectiveness of flu shots while upholding institutional recommendations.

High Stakes Testing

In the wake of the No Child Left Behind Act, parents, teachers, and school administrators take different positions on how to assess student achievement.

In-FUR-mercials: Advertising & Adoption

When the Lied Animal Shelter faces a spike in animal intake, an advertising agency uses its moral imagination to increase pet adoptions.

Krogh & the Watergate Scandal

Egil Krogh was a young lawyer working for the Nixon Administration whose ethics faded from view when asked to play a part in the Watergate break-in.

Limbaugh on Drug Addiction

Radio talk show host Rush Limbaugh argued that drug abuse was a choice, not a disease. He later became addicted to painkillers.

U.S. Olympic swimmer Ryan Lochte’s “over-exaggeration” of an incident at the 2016 Rio Olympics led to very real consequences.

Meet Me at Starbucks

Two black men were arrested after an employee called the police on them, prompting Starbucks to implement “racial-bias” training across all its stores.

Myanmar Amber

Buying amber could potentially fund an ethnic civil war, but refraining allows collectors to acquire important specimens that could be used for research.

Negotiating Bankruptcy

Bankruptcy lawyer Gellene successfully represented a mining company during a major reorganization, but failed to disclose potential conflicts of interest.

Pao & Gender Bias

Ellen Pao stirred debate in the venture capital and tech industries when she filed a lawsuit against her employer on grounds of gender discrimination.

Pardoning Nixon

One month after Richard Nixon resigned from the presidency, Gerald Ford made the controversial decision to issue Nixon a full pardon.

Patient Autonomy & Informed Consent

Nursing staff and family members struggle with informed consent when taking care of a patient who has been deemed legally incompetent.

Prenatal Diagnosis & Parental Choice

Debate has emerged over the ethics of prenatal diagnosis and reproductive freedom in instances where testing has revealed genetic abnormalities.

Reporting on Robin Williams

After Robin Williams took his own life, news media covered the story in great detail, leading many to argue that such reporting violated the family’s privacy.

Responding to Child Migration

An influx of children migrants posed logistical and ethical dilemmas for U.S. authorities while intensifying ongoing debate about immigration.

Retracting Research: The Case of Chandok v. Klessig

A researcher makes the difficult decision to retract a published, peer-reviewed article after the original research results cannot be reproduced.

Sacking Social Media in College Sports

In the wake of questionable social media use by college athletes, the head coach at University of South Carolina bans his players from using Twitter.

Selling Enron

Following the deregulation of electricity markets in California, private energy company Enron profited greatly, but at a dire cost.

Snyder v. Phelps

Freedom of speech was put on trial in a case involving the Westboro Baptist Church and their protesting at the funeral of U.S. Marine Matthew Snyder.

Something Fishy at the Paralympics

Rampant cheating has plagued the Paralympics over the years, compromising the credibility and sportsmanship of Paralympian athletes.

Sports Blogs: The Wild West of Sports Journalism?

Deadspin pays an anonymous source for information related to NFL star Brett Favre, sparking debate over the ethics of “checkbook journalism.”

Stangl & the Holocaust

Franz Stangl was the most effective Nazi administrator in Poland, killing nearly one million Jews at Treblinka, but he claimed he was simply following orders.

Teaching Blackface: A Lesson on Stereotypes

A teacher was put on leave for showing a blackface video during a lesson on racial segregation, sparking discussion over how to teach about stereotypes.

The Astros’ Sign-Stealing Scandal

The Houston Astros rode a wave of success, culminating in a World Series win, but it all came crashing down when their sign-stealing scheme was revealed.

The Central Park Five

Despite the indisputable and overwhelming evidence of the innocence of the Central Park Five, some involved in the case refuse to believe it.

The CIA Leak

Legal and political fallout follows from the leak of classified information that led to the identification of CIA agent Valerie Plame.

The Collapse of Barings Bank

When faced with growing losses, investment banker Nick Leeson took big risks in an attempt to get out from under the losses. He lost.

The Costco Model

How can companies promote positive treatment of employees and benefit from leading with the best practices? Costco offers a model.

The FBI & Apple Security vs. Privacy

How can tech companies and government organizations strike a balance between maintaining national security and protecting user privacy?

The Miss Saigon Controversy

When a white actor was cast for the half-French, half-Vietnamese character in the Broadway production of Miss Saigon , debate ensued.

The Sandusky Scandal

Following the conviction of assistant coach Jerry Sandusky for sexual abuse, debate continues on how much university officials and head coach Joe Paterno knew of the crimes.

The Varsity Blues Scandal

A college admissions prep advisor told wealthy parents that while there were front doors into universities and back doors, he had created a side door that was worth exploring.

Providing radiation therapy to cancer patients, Therac-25 had malfunctions that resulted in 6 deaths. Who is accountable when technology causes harm?

Welfare Reform

The Welfare Reform Act changed how welfare operated, intensifying debate over the government’s role in supporting the poor through direct aid.

Wells Fargo and Moral Emotions

In a settlement with regulators, Wells Fargo Bank admitted that it had created as many as two million accounts for customers without their permission.

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7 Ethics in Advertising – It’s Importance and Effectiveness

Last updated on: May 15, 2024

In today’s consumer-driven world, advertising plays a significant role in shaping our perceptions, influencing our choices, and driving economic growth. However, with great power comes great responsibility. Ethical considerations in advertising have gained prominence as businesses strive to strike the right balance between persuasive marketing and responsible messaging. This article delves into the realm of ethics in advertising, exploring its importance, key principles, and real-world implications.

Table of Contents

What are Ethics in Advertising?

Ethics in advertising refer to the moral principles and standards that govern the conduct of advertisers and their communication with consumers. It involves ensuring that advertising messages are truthful, respectful, fair, and responsible, with a focus on protecting consumers’ interests and promoting societal well-being.

The Importance of Ethics in Advertising

Ethics in advertising hold immense significance for several reasons. Firstly, it fosters trust between advertisers and consumers. When advertisements are perceived as truthful, transparent, and respectful, consumers are more likely to develop positive attitudes towards brands and make informed purchasing decisions.

Secondly, ethical advertising contributes to the overall reputation of a company or industry. Advertisers who prioritize ethical practices not only attract loyal customers but also gain credibility and goodwill from the public. In contrast, unethical advertising can damage a brand’s image and lead to long-term negative consequences.

7 Key Ethics of Advertising Every Advertiser Should Know

Transparency and honesty in advertising.

Transparency and honesty are fundamental principles of ethical advertising. Advertisers should ensure that their claims are substantiated, avoiding false or misleading statements. Clear disclosures regarding product features, limitations, and potential risks must be provided to consumers. By maintaining transparency, advertisers establish credibility and build long-term relationships with their audience.

Avoiding Stereotypes and Offensive Content

Ethical advertising refrains from perpetuating stereotypes or using offensive content that may demean or marginalize individuals or communities. Advertisers should strive for inclusivity, embracing diversity in their campaigns and promoting positive social values. By avoiding stereotypes and offensive content, advertisers create an environment that celebrates and respects the diversity of their audience.

Respecting Consumer Privacy

Respecting consumer privacy is another vital aspect of ethical advertising. Advertisers must obtain consent when collecting personal information and ensure the secure handling of data. Transparency about data usage and providing opt-out mechanisms empower consumers to control their personal information, fostering trust and maintaining ethical standards.

Social Responsibility in Advertising

Ethical advertising encompasses social responsibility, where advertisers consider the broader impact of their messages on society. Advertisements should not encourage harmful behaviors, exploit vulnerabilities, or promote products that are detrimental to individuals or the environment. By embracing social responsibility, advertisers contribute positively to the well-being of communities and advocate for sustainable practices.

Balancing Creativity and Truthfulness

Ethical advertising strikes a delicate balance between creativity and truthfulness. While advertisements aim to capture attention and engage audiences, they should never sacrifice accuracy or misrepresent information. Advertisers can employ innovative and imaginative approaches while ensuring that the core message remains honest and authentic.

The Role of Regulatory Bodies

Regulatory bodies play a crucial role in upholding ethical standards in advertising. They establish guidelines and regulations that advertisers must adhere to, ensuring fairness, honesty, and transparency. These bodies monitor and investigate complaints, enforce penalties for violations, and protect consumers from misleading or deceptive advertising practices.

The Impact of Unethical Advertising

Unethical advertising can have far-reaching consequences. It erodes consumer trust, damages brand reputation, and undermines the integrity of the entire advertising industry. Moreover, misleading or manipulative advertisements can harm individuals by promoting unrealistic expectations, fostering insecurities, or exploiting vulnerabilities. Society as a whole suffers when unethical advertising practices prevail.

Case Studies: Ethical Advertising Campaigns

Numerous examples showcase the power of ethical advertising campaigns. The Dove “Real Beauty” campaign challenged traditional beauty standards, promoting self-acceptance and diversity. Patagonia’s “Don’t Buy This Jacket” campaign encouraged conscious consumption by urging consumers to consider the environmental impact of their purchases. These campaigns not only achieved commercial success but also made a positive impact on societal perceptions and behaviors.

Ethical Advertising: Challenges and Opportunities

Ethical advertising faces various challenges in today’s complex landscape. Advertisers must navigate the digital realm, where issues like ad fraud, data privacy, and invasive targeting pose ethical dilemmas. Additionally, the pressure to maximize profits and compete for consumers’ attention can tempt advertisers to employ questionable tactics. However, these challenges also present opportunities for advertisers to differentiate themselves by prioritizing ethics and establishing meaningful connections with their audience.

Educating Consumers about Ethical Advertising

Educating consumers about ethical advertising is vital for fostering a more discerning and informed audience. By increasing awareness about deceptive practices, promoting media literacy, and encouraging critical thinking, consumers can make more conscious choices and hold advertisers accountable for their ethical conduct. Collaboration between industry stakeholders, educational institutions, and advocacy groups can help empower consumers with the knowledge they need.

Measuring the Effectiveness of Ethical Advertising

Measuring the effectiveness of ethical advertising involves assessing its impact on consumer behavior, brand perception, and social attitudes. Metrics such as consumer trust, brand loyalty, purchase intent, and societal response can provide insights into the success of ethical advertising campaigns. By analyzing data and feedback, advertisers can refine their strategies and demonstrate the tangible benefits of ethical practices.

Ethical Advertising in the Digital Age

The digital age has revolutionized advertising, presenting both opportunities and challenges for ethical practices. Advertisers must navigate issues such as ad transparency, data privacy, and algorithmic bias. It is crucial to embrace responsible data collection, provide meaningful user experiences, and ensure that algorithms are unbiased and transparent. Adapting ethical principles to the digital landscape is essential for maintaining trust and relevance in the evolving advertising ecosystem.

In conclusion, ethics in advertising play a vital role in shaping the advertising landscape and maintaining a healthy relationship between advertisers and consumers. By adhering to ethical principles, advertisers can build trust, promote transparency, and foster positive societal values. The importance of honesty, transparency, respect, and social responsibility cannot be overstated in the world of advertising.

Ethical advertising not only benefits consumers by providing them with accurate information and empowering them to make informed decisions, but it also benefits advertisers themselves. Advertisers who prioritize ethics can establish a positive brand image, gain customer loyalty, and contribute to the overall reputation of their industry.

However, ethical advertising does face challenges in the digital age, such as data privacy concerns, algorithmic bias, and the need to adapt to evolving technologies. Advertisers must stay vigilant, embrace responsible practices, and adapt ethical principles to the digital landscape.

Educating consumers about ethical advertising is equally important. By raising awareness and promoting media literacy, consumers can become more discerning and make choices aligned with their values. Collaboration between industry stakeholders, educational institutions, and advocacy groups is key to empowering consumers with the knowledge they need.

Measuring the effectiveness of ethical advertising is crucial to demonstrate its impact and refine strategies. Metrics such as consumer trust, brand loyalty, and societal response provide valuable insights into the success of ethical advertising campaigns.

Ultimately, ethics in advertising contribute to a healthier and more sustainable advertising industry. By striking the right balance between persuasion and responsibility, advertisers can build lasting relationships, foster positive change, and create a trustworthy advertising environment.

FAQs Related to Ethics in Advertising

1. can ethics in advertising really make a difference.

Absolutely. Ethics in advertising have the power to shape consumer perceptions, build trust, and foster positive societal change. By adhering to ethical principles, advertisers can create meaningful connections with their audience and contribute to a healthier advertising industry.

2. How can consumers support ethical advertising?

Consumers can support ethical advertising by being aware of deceptive practices, promoting media literacy, and making conscious choices. By supporting brands that prioritize ethical advertising, consumers can influence the industry and encourage responsible practices.

3. What are the consequences of unethical advertising?

Unethical advertising can erode consumer trust, damage brand reputation, and harm individuals by promoting unrealistic expectations or exploiting vulnerabilities. It also undermines the integrity of the advertising industry as a whole.

4. How can regulatory bodies contribute to ethical advertising?

Regulatory bodies play a crucial role in upholding ethical standards in advertising. They establish guidelines, investigate complaints, and enforce penalties for violations, ensuring fairness, honesty, and transparency in advertising practices.

5. What role does social responsibility play in ethical advertising?

Social responsibility is a key aspect of ethical advertising. Advertisers should consider the broader impact of their messages on society, avoid promoting harmful behaviors, and advocate for sustainability and positive social values.

6. How important is ethics in advertising?

Ethics in advertising play a crucial role as they ensure transparency, trust, and credibility in the industry. Adhering to ethical principles helps build positive brand image, fosters long-term customer relationships, and avoids potential legal issues. Ultimately, ethics in advertising are vital for sustaining a reputable and responsible business.

7. What is the ethical side of advertising?

The ethical side of advertising involves promoting products or services while adhering to moral standards and societal norms. It emphasizes honesty, fairness, and respect for consumers’ rights. Ethical advertising avoids deceptive tactics, respects privacy, and provides accurate information, giving consumers the freedom to make informed choices.

8. What is an example of ethics in advertising?

An example of ethics in advertising is ensuring truthfulness in claims. When an advertisement accurately represents a product or service, it maintains ethical standards. For instance, a cosmetics company promoting the anti-aging effects of its product must provide reliable scientific evidence to support their claims. By doing so, they uphold ethical practices and avoid misleading consumers.

9. How do I know if an advertisement is ethical?

To determine if an advertisement is ethical, consider a few factors. First, check for transparency and honesty in the claims made. Look for evidence supporting the advertised benefits or features. Additionally, assess whether the advertisement respects consumers’ privacy and doesn’t engage in intrusive or manipulative tactics. Pay attention to any potential conflicts of interest, such as undisclosed sponsorships. By evaluating these aspects, you can gauge the ethical integrity of an advertisement.

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One reply to “7 ethics in advertising – it’s importance and effectiveness”.

Refreshing read! It’s inspiring to see the center of attention on moral marketing practices. Integrity in reality units manufacturers aside in the modern-day market.

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6 Ethics in Advertising

To begin our lesson on advertising ethics, let’s talk about weasels.

Study the following presentation slides by using the forward button or clicking on sections of the control bar.

Weasel words are a prime example of advertising hype. View the brief video “Ad Hype: True or False?” from the Federal Trade Commission.

AN UNDERAGE AUDIENCE

An interesting case study for advertising law and ethics involves Juul, a company that makes electronic cigarettes. In 2020, the Massachusetts attorney general’s office filed a lawsuit alleging that the company had bought online advertisements on websites for Nickelodeon, Cartoon Network and Seventeen magazine. This lawsuit came amid other accusations that the company targeted underage customers beginning around 2015. Read this NBC news article published shortly after the Massachusetts lawsuit was filed:

• Juul bought ad space on kids’ websites, including Cartoon Network, lawsuit alleges – NBC News

As an addendum to this case study, in 2022 Juul settled a multistate youth vaping inquiry for $438.5 million.

WHO BENEFITS?

As you can see from the examples and videos thus far in the lesson, a multitude of ethical concerns are connected to advertising.

Advertisements can persuade consumers to change attitudes and/or purchase products. An ethical, well-planned ad should benefit some members of an audience. Sometimes, however, the lure of financial gain or improved reputation can lead advertisers to unethical strategies.

The following video, created by Professor Mark Grabowski of Adelphi University in New York, provides an overview of ethical issues in advertising. Grabowski suggests that as an advertising professional, “You’re responsible not just for what you sell, but how you sell it.”

In the conclusion, Grabowski argues that “it’s largely up to advertisers themselves to ensure ethically responsible practices in their profession.”

To help you understand problematic, irresponsible advertising, you can study the following list of examples published in 2020 by USA Today.

• Misleading marketing: Cheerios, 5-Hour Energy drink among products tagged with outrageous claims – USA Today

PROFESSIONAL PRINCIPLES AND PRACTICES

Although some media professionals prefer to keep advertising in a separate category from journalism, the first principle of the Institute for Advertising Ethics says, “Advertising, public relations, marketing communications, news, and editorial all share a common objective of truth and high ethical standards in serving the public.” Read the ethical guidance on the institute’s website:

• Principles and Practices – Institute for Advertising Ethics

The introduction stresses that “all forms of communications, including advertising, should always do what is right for consumers, which in turn is right for business as well.”

As a quick summary, the Institute for Advertising Ethics suggests that advertising professionals should follow these general guidelines:

• Distinguish advertising from news content.
• Disclose payment or receipt of free products that would affect endorsements (from celebrities and social media influencers, for example).
• Treat consumers fairly based on the target audience for the ad and the nature of the product or service being advertised.
• Protect consumers’ privacy and be transparent when asking consumers to share personal information.

If you are considering a career in advertising, you can read a more complete version with abundant commentary .

Deceptive use of the word free often surfaces in disputes about advertising ethics.

For example, in 2022 the Associated Press reported that TurboTax would pay $141 million to U.S. customers “who were deceived by misleading promises of free tax-filing services.” An investigation suggested that through its ad slogan for “Free, Free, Free,” TurboTax was “using deceptive tactics to steer low-income tax filers away from the federally supported free services for which they qualified — and toward its own commercial products, instead.”

• Intuit to pay $141M settlement over ‘free’ TurboTax ads – Associated Press

TurboTax’s settlement tab in Arkansas was $1 million to be split among approximately 35,000 Arkansans.

CLOSER TO HOME (if you live in Arkansas)

Ideally, online reviews should be written by real consumers and provide authentic opinions about products and services they have purchased. However, some business owners, PR workers and others can’t resist the temptation to game the system unethically. While this may seem relatively harmless at first glance, consider how fake reviews devalue a system that many online viewers rely on to make spending decisions. Fake reviews are essentially advertisements masquerading as consumer opinions.

As an extreme example, you can read this story about a University of Central Arkansas business instructor who offered extra credit to students who wrote fake reviews. The article is from the student-run independent newspaper.

• UCA professor offers bonus points for fake reviews – UCAnews.live

SOCIAL MEDIA INFLUENCERS

Transparency has become a recurring ethical concern for social media influencing. Ethical standards for social influencers are still evolving among conscientious media professionals. They key ingredient is transparency. If an influencer is paid for a post, that needs to be clear to the audience.

As an example from 2022, several prominent social media influencers were part of a social media campaign financed by the Chinese Consulate in New York, although the influencers’ followers weren’t aware of that.

• China used TV, TikTok stars in discreet Olympics campaign – Associated Press

The article includes this:

Instagram requires that influencers tag the sponsor, and both TikTok and Instagram require their users to register the posts as a paid partnership with the company. Most influencers, however, flout those rules — leaving social media users in the dark about who is paying for the posts they see in their feeds.

Another ethical concern is that social media influencers sometimes accept money for products or services they know nothing about. Perhaps the most prominent case involved the overhyped Fyre Festival in 2017. Models and influencers, such as Bella Hadid and Kendall Jenner, promoted the festival through social media, blindly trusting that the event was legitimate. As it turned out, the Fyre Festival was a scam, and its organizer was sent to jail for fraud.

• Has Fyre Festival burned influencers? – BBC

Ultimately, the Fyre Festival became the subject of two interesting documentary films but did not lead to clearer ethical or legal standards for social media influencing.

And we’ll close with a quick influencer example from January 2023. The example involves TikTok, mascara and deceptive eyelashes in an influencer’s post. The Rolling Stone magazine headline below emphasizes a connection to concepts in this chapter.

• TikTok’s eyelash controversy is really about truth in advertising – Rolling Stone

Perhaps this is the moral of the story: Even though influencers (and those who employ and manage them) are not news journalists, they should still maintain ethical standards for truth and transparency.

CLOSING REVIEW

Write about it.

Answer each of the following numbered items with approximately five sentences for each response. When possible, strengthen your responses with brief supporting content from this chapter.

1. You studied weasel words in advertising. Now find an example of an advertisement that you think incorporates weasel words in delivering its message. If possible, include an image or provide a link to the the ad design or video with your response. Explain how the ad deceives consumers by giving a vague promise or making a claim that is difficult to measure.

2. If you were an executive, would you be in favor of your company incorporating social media influencers into its advertising campaigns? If so, for what types of products do you think it would be useful and appropriate? Conversely, for what types of products do you think it would be inappropriate? Based on IAE guidelines and content from this chapter (such as the Fyre Festival example), what ethical concerns would you have with using a social media influencer, and how could you alleviate those concerns in the planning and decision-making process?

3. Pick ONE of the following options and respond by providing clear support from the Institute for Advertising Ethics (IAE) Principles and Practices:

Option A – Based on IAE guidelines , is it ever appropriate to use sex for attention-grabbing content in advertising if the product itself is not related to sex? In case you need a specific example, you can apply your response to this Carl’s Jr. ad that generated controversy when it aired during the 2015 Super Bowl. (Warning – some readers may be offended by the contents of the ad.)

Option B – You read a brief example involving Juul. Suppose you work for an ad agency tasked with developing a campaign for Juul. How would you follow IAE guidelines while still crafting a successful campaign for Juul? Is that possible?

Ethics in Journalism and Strategic Media Copyright © by Dave Bostwick is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License , except where otherwise noted.

Business Ethics: Marketing Ethics

• IIT Library Resources
• Web Resources
• Marketing Ethics

Case Studies

• Whistleblowing

A selection of case studies discussing marketing ethics.  The majority of these cases were developed for the APPE Ethics Bowl . 

• Roach Baiting A case study discussing an instance of guerrilla marketing tactics. Case study developed for the 2010 APPE Intercollegiate Ethics Bowl.
• Shock Marketing An instance of shock marketing used by a clothing company raises some controversy. Case study developed for the 2009 Regional APPE Intercollegiate Ethics Bowls.
• Prescription Drug Advertising Case looks at the ethics of direct-to-consumer advertising. Case from the 2008 Regional APPE Ethics Bowls.
• Redux Beverages Case of a beverage company naming an energy drink "Cocaine" to help boost sales. Case study developed for the 2008 Regional APPE Intercollegiate Ethics Bowls.

Marketing Codes of Ethics

Professional Codes of Ethics dealing with marketing practices.

• American Marketing Association Ethical Norms and Values for Marketers
• Better Business Bureau Code of Advertising Code of ethics developed by the Better Business Bureau, focusing on best practices for advertising for member businesses.
• Data Marketing and Analytics Guidelines for Ethical Business Practice.
• Direct Selling Association Code of Ethics
• Word of Mouth Marketing Association Code of Ethics and Standards of Conduct of WOMMA

Other Online Resources

• Ethics Resources -American Marketing Association A collection of online resources on legal and ethical issues in marketing compiled by the American Marketing Association for students and instructors.
• Corporate Responsibility Center of the Direct Marketing Association A collection of resources on corporate responsibility maintained by the Direct Marketing Association.

Rights of and Services for Consumers

• National Do Not Call Registry The National Do Not Call Registry allows consumers to register phone numbers in a national registry that puts them on a list of numbers that telemarketers are not allowed to contact.
• The CAN-SPAM Act A description written by the U.S. Federal Trade Commission that describes how businesses can comply with the CAN-SPAM Act that governs how businesses can use email for advertising purposes.
• Better Business Bureau Resources for Consumers compiled by the Better Business Bureau, including the ability to file a complaint against a business.

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• Next: Case Studies >>
• Last Updated: Dec 5, 2023 1:47 PM
• URL: https://guides.library.iit.edu/businessethics

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Home > Ethics > Ethics Case Studies

Ethics Ethics Case Studies

The SPJ Code of Ethics is voluntarily embraced by thousands of journalists, regardless of place or platform, and is widely used in newsrooms and classrooms as a guide for ethical behavior. The code is intended not as a set of "rules" but as a resource for ethical decision-making. It is not — nor can it be under the First Amendment — legally enforceable. For an expanded explanation, please follow this link .

For journalism instructors and others interested in presenting ethical dilemmas for debate and discussion, SPJ has a useful resource. We've been collecting a number of case studies for use in workshops. The Ethics AdviceLine operated by the Chicago Headline Club and Loyola University also has provided a number of examples. There seems to be no shortage of ethical issues in journalism these days. Please feel free to use these examples in your classes, speeches, columns, workshops or other modes of communication.

Kobe Bryant’s Past: A Tweet Too Soon? On January 26, 2020, Kobe Bryant died at the age of 41 in a helicopter crash in the Los Angeles area. While the majority of social media praised Bryant after his death, within a few hours after the story broke, Felicia Sonmez, a reporter for The Washington Post , tweeted a link to an article from 2003 about the allegations of sexual assault against Bryant. The question: Is there a limit to truth-telling? How long (if at all) should a journalist wait after a person’s death before resurfacing sensitive information about their past?

A controversial apology After photographs of a speech and protests at Northwestern University appeared on the university's newspaper's website, some of the participants contacted the newspaper to complain. It became a “firestorm,” — first from students who felt victimized, and then, after the newspaper apologized, from journalists and others who accused the newspaper of apologizing for simply doing its job. The question: Is an apology the appropriate response? Is there something else the student journalists should have done?

Using the ‘Holocaust’ Metaphor People for the Ethical Treatment of Animals, or PETA, is a nonprofit animal rights organization known for its controversial approach to communications and public relations. In 2003, PETA launched a new campaign, named “Holocaust on Your Plate,” that compares the slaughter of animals for human use to the murder of 6 million Jews in WWII. The question: Is “Holocaust on Your Plate” ethically wrong or a truthful comparison?

Aaargh! Pirates! (and the Press) As collections of songs, studio recordings from an upcoming album or merely unreleased demos, are leaked online, these outlets cover the leak with a breaking story or a blog post. But they don’t stop there. Rolling Stone and Billboard often also will include a link within the story to listen to the songs that were leaked. The question: If Billboard and Rolling Stone are essentially pointing readers in the right direction, to the leaked music, are they not aiding in helping the Internet community find the material and consume it?

Reigning on the Parade Frank Whelan, a features writer who also wrote a history column for the Allentown, Pennsylvania, Morning Call , took part in a gay rights parade in June 2006 and stirred up a classic ethical dilemma. The situation raises any number of questions about what is and isn’t a conflict of interest. The question: What should the “consequences” be for Frank Whelan?

Controversy over a Concert Three former members of the Eagles rock band came to Denver during the 2004 election campaign to raise money for a U.S. Senate candidate, Democrat Ken Salazar. John Temple, editor and publisher of the Rocky Mountain News, advised his reporters not to go to the fundraising concerts. The question: Is it fair to ask newspaper staffers — or employees at other news media, for that matter — not to attend events that may have a political purpose? Are the rules different for different jobs at the news outlet?

Deep Throat, and His Motive The Watergate story is considered perhaps American journalism’s defining accomplishment. Two intrepid young reporters for The Washington Post , carefully verifying and expanding upon information given to them by sources they went to great lengths to protect, revealed brutally damaging information about one of the most powerful figures on Earth, the American president. The question: Is protecting a source more important than revealing all the relevant information about a news story?

When Sources Won’t Talk The SPJ Code of Ethics offers guidance on at least three aspects of this dilemma. “Test the accuracy of information from all sources and exercise care to avoid inadvertent error.” One source was not sufficient in revealing this information. The question: How could the editors maintain credibility and remain fair to both sides yet find solid sources for a news tip with inflammatory allegations?

A Suspect “Confession” John Mark Karr, 41, was arrested in mid-August in Bangkok, Thailand, at the request of Colorado and U.S. officials. During questioning, he confessed to the murder of JonBenet Ramsey. Karr was arrested after Michael Tracey, a journalism professor at the University of Colorado, alerted authorities to information he had drawn from e-mails Karr had sent him over the past four years. The question: Do you break a confidence with your source if you think it can solve a murder — or protect children half a world away?

Who’s the “Predator”? “To Catch a Predator,” the ratings-grabbing series on NBC’s Dateline, appeared to catch on with the public. But it also raised serious ethical questions for journalists. The question: If your newspaper or television station were approached by Perverted Justice to participate in a “sting” designed to identify real and potential perverts, should you go along, or say, “No thanks”? Was NBC reporting the news or creating it?

The Media’s Foul Ball The Chicago Cubs in 2003 were five outs from advancing to the World Series for the first time since 1945 when a 26-year-old fan tried to grab a foul ball, preventing outfielder Moises Alou from catching it. The hapless fan's identity was unknown. But he became recognizable through televised replays as the young baby-faced man in glasses, a Cubs baseball cap and earphones who bobbled the ball and was blamed for costing the Cubs a trip to the World Series. The question: Given the potential danger to the man, should he be identified by the media?

Publishing Drunk Drivers’ Photos When readers of The Anderson News picked up the Dec. 31, 1997, issue of the newspaper, stripped across the top of the front page was a New Year’s greeting and a warning. “HAVE A HAPPY NEW YEAR,” the banner read. “But please don’t drink and drive and risk having your picture published.” Readers were referred to the editorial page where White explained that starting in January 1998 the newspaper would publish photographs of all persons convicted of drunken driving in Anderson County. The question: Is this an appropriate policy for a newspaper?

Naming Victims of Sex Crimes On January 8, 2007, 13-year-old Ben Ownby disappeared while walking home from school in Beaufort, Missouri. A tip from a school friend led police on a frantic four-day search that ended unusually happily: the police discovered not only Ben, but another boy as well—15-year-old Shawn Hornbeck, who, four years earlier, had disappeared while riding his bike at the age of 11. Media scrutiny on Shawn’s years of captivity became intense. The question: Question: Should children who are thought to be the victims of sexual abuse ever be named in the media? What should be done about the continued use of names of kidnap victims who are later found to be sexual assault victims? Should use of their names be discontinued at that point?

A Self-Serving Leak San Francisco Chronicle reporters Mark Fainaru-Wada and Lance Williams were widely praised for their stories about sports figures involved with steroids. They turned their investigation into a very successful book, Game of Shadows . And they won the admiration of fellow journalists because they were willing to go to prison to protect the source who had leaked testimony to them from the grand jury investigating the BALCO sports-and-steroids. Their source, however, was not quite so noble. The question: Should the two reporters have continued to protect this key source even after he admitted to lying? Should they have promised confidentiality in the first place?

The Times and Jayson Blair Jayson Blair advanced quickly during his tenure at The New York Times , where he was hired as a full-time staff writer after his internship there and others at The Boston Globe and The Washington Post . Even accusations of inaccuracy and a series of corrections to his reports on Washington, D.C.-area sniper attacks did not stop Blair from moving on to national coverage of the war in Iraq. But when suspicions arose over his reports on military families, an internal review found that he was fabricating material and communicating with editors from his Brooklyn apartment — or within the Times building — rather than from outside New York. The question: How does the Times investigate problems and correct policies that allowed the Blair scandal to happen?

Cooperating with the Government It began on Jan. 18, 2005, and ended two weeks later after the longest prison standoff in recent U.S. history. The question: Should your media outlet go along with the state’s request not to release the information?

Offensive Images Caricatures of the Prophet Muhammad didn’t cause much of a stir when they were first published in September 2005. But when they were republished in early 2006, after Muslim leaders called attention to the 12 images, it set off rioting throughout the Islamic world. Embassies were burned; people were killed. After the rioting and killing started, it was difficult to ignore the cartoons. Question: Do we publish the cartoons or not?

The Sting Perverted-Justice.com is a Web site that can be very convenient for a reporter looking for a good story. But the tactic raises some ethical questions. The Web site scans Internet chat rooms looking for men who can be lured into sexually explicit conversations with invented underage correspondents. Perverted-Justice posts the men’s pictures on its Web site. Is it ethically defensible to employ such a sting tactic? Should you buy into the agenda of an advocacy group — even if it’s an agenda as worthy as this one?

A Media-Savvy Killer Since his first murder in 1974, the “BTK” killer — his own acronym, for “bind, torture, kill” — has sent the Wichita Eagle four letters and one poem. How should a newspaper, or other media outlet, handle communications from someone who says he’s guilty of multiple sensational crimes? And how much should it cooperate with law enforcement authorities?

A Congressman’s Past The (Portland) Oregonian learned that a Democratic member of the U.S. Congress, up for re-election to his fourth term, had been accused by an ex-girlfriend of a sexual assault some 28 years previously. But criminal charges never were filed, and neither the congressman, David Wu, nor his accuser wanted to discuss the case now, only weeks before the 2004 election. Question: Should The Oregonian publish this story?

Using this Process to Craft a Policy It used to be that a reporter would absolutely NEVER let a source check out a story before it appeared. But there has been growing acceptance of the idea that it’s more important to be accurate than to be independent. Do we let sources see what we’re planning to write? And if we do, when?

SPJ News –  SPJ calls for action by journalists against gag rules after key legal win –  SPJ Foundation awards over $45,000 in grants to seven initiatives and journalism programs –  SPJ announces 2023 Mark of Excellence National Winners

6. Marketing Ethics: Selling Controversial Products

Source: Frank Gruber, (CC BY-NC-NDS, 2.0, 2008) Figure 6.1 Advertisers are continually exploring new media for advertising as they seek to break through the promotional clutter of modern life to attract the attention of consumers. Here, the Budweiser beer logo is imprinted on the top of a house adjacent to the Wrigley Field baseball park in Chicago, Illinois.

Legal and Ethical Constraints on Marketing and Advertising

This chapter explores the ethics of marketing and advertising. As the most visible form of marketing, advertising is one of the principal motors of a capitalist economy and also one of the largest modern industries: The global advertising market was valued at $495 billion in 2013 (the United States was the largest national market at $152 billion). 1 Advertisements not only inform consumers of available products, services, promotions, and sales, they serve a vital business function by allowing brands to distinguish themselves from competitors, which rewards firms for improving the quality of their offerings. Advertising is a key ally for innovation, because advertising allows firms to create awareness and desire among consumers to buy new products. Despite these benefits, the advertising industry has long been suspected of using devious tactics. As a result, many consumers are highly skeptical and even disdainful of advertising in general.

Advertisers sometimes take the risk of shocking the public with their ads because they are seeking to break through the communications clutter of modern life. Today, the average American is exposed to a great number of advertising messages every day, with estimates running from several hundred to several thousand ads per day. 2 In order to attract the public’s attention, advertisers may resort to appeals and tactics of questionable taste. Little wonder that more than half of Americans believe that advertising today is out of control. Social critics point to advertising as one of the most objectionable aspects of our consumer economy. From the billboards that blot out the countryside along highways, to the television shows that are interrupted every few minutes by outlandish commercials, to the mailboxes and e-mail accounts that become cluttered with direct marketing, advertising methods are often criticized for being intrusive, offensive, silly, and even dishonest.

As a result of the perceived abuses of advertising, national governments all over the world have imposed laws and regulations on the advertising industry. Every country or region has its own area of sensitivity. In many Muslim nations, for example, there are prohibitions against advertisements that display nudity or offend traditional notions of decency. France and Germany prohibit comparative advertisements in which one brand claims to be superior to another.

The modern marketplace abounds with products that pose difficult challenges for regulators. Consider the example of tobacco and alcohol. These products can be harmful or dangerous, but many people nonetheless desire to consume them. Most Western countries have decided that it is counterproductive to outlaw the sale of tobacco and alcohol, as doing so may create a black market and stimulate organized crime. The official response of most governments has been to allow the sale of such products but to prohibit or strictly constrain their advertising. Other product categories that tend to be governed by specific advertising regulations include pharmaceuticals and financial products.

Many products have positive uses but can also be dangerous if misused, like automobiles, knives, razors, lighter fluid, pesticides, toys, athletic equipment, and so on. In such cases, the law usually prohibits advertising that encourages the consumer to use the product in a dangerous fashion. Another common type of marketing regulation is one that prohibits advertisements from making false, deceptive, or misleading claims. In most countries, such rules are enforced by the ministry for consumer affairs. In the United States, rules against deceptive advertisements are promulgated and enforced by the Federal Trade Commission (FTC).

There are certain product categories in which exaggerated claims are commonly made. For example, in the case of skin creams, cosmetics, perfumes, deodorants, toothpaste, mouthwash, and so on, advertisers typically claim (or suggest indirectly) that their products make the consumer more physically attractive, especially to the opposite sex. The problem is that some consumers may not be sophisticated enough to discern the difference between innocent puffery and claims of effectiveness. Thus, teenage boys have been known to douse themselves with Unilever’s Axe deodorant products in the hope that they will attract females as effectively as is suggested in Axe’s notoriously provocative advertising. Many advertisements for such products come so close to making deceptive appeals that they may trigger the FTC’s attention. As a result, advertisers have learned to be cautious in the precise wording of their claims. For example, advertisements for skin cream may permissibly suggest that the user’s skin will “look and feel better” after use of the product, but they cannot include text guaranteeing the disappearance of wrinkles.

In many countries, regulators are especially vigilant when it comes to advertising aimed at children, because it is felt that children are sometimes more susceptible to manipulation or suggestion and are less likely to understand the dangers associated with the use of an advertised product. In Greece, for example, toy advertisements are prohibited between the hours of 7 a.m. and 10 p.m. In Sweden and Norway, all advertising aimed at children is prohibited, and in France, a child may not appear as the spokesperson in a commercial. In Holland, advertisements for sweets must include a toothbrush at the bottom of the ad to remind children to brush their teeth after eating sweets.

In this chapter, we will begin with a review of the advertising industry’s “self-regulation” of objectionable or unethical advertising. Many advertisements and marketing tactics fall into a regulatory gray area, where the advertisement is technically legal but still manages to offend some of the population. A frequent cause of such offense is the advertiser’s quest to develop a humorous or surprising advertisement. For example, one Danish advertisement featured an image of the Pope wearing a particular brand of sneakers, which offended many Catholics. In Italy, the fashion company Benetton shocked the nation by using an advertisement in which a priest is seen kissing a nun. In cases like these, it is not possible to make the advertisements illegal, but advertising industry associations feel it is necessary nonetheless to police the market for objectionable advertisements.

Our chapter-ending case study will deal with the ethical dilemma faced by executives at an advertising consultancy that is considering accepting an account for a global brand that manufactures skin-whitening products. The CEO of our company will call upon us to consider and debate the pros and cons of developing a US advertising campaign for Fair and Lovely, an Indian brand. In the United States, this product is demanded primarily by immigrants from South Asian countries, a large and growing demographic.

Many people feel that advertisements for such products contain racist appeals, since they are implicitly based on promoting the superiority of white skin. Is it ethical to market and promote such a product? Why or why not? Let us first consider some background to allow us to answer these questions.

Principles of Marketing Ethics

As stated earlier, every country has a basic framework of advertising law. Many types of advertisement are simply prohibited by law. However, with respect to advertisements that are legal but morally questionable (or otherwise objectionable), the advertising sector polices itself by applying self-regulatory codes of marketing and advertising ethics. This means that the advertising industry sets up its own committees to police questionable advertisements. Virtually every country has at least one advertising industry trade association with a self-regulatory panel or committee that reviews consumer complaints. After examining the advertisement in question, the panel decides whether or not to ask the advertiser to remove the advertisement; although advertisers are not legally obliged to follow the decisions of such committees, they usually do.

The self-regulatory panels base their decisions on ethical principles contained in codes of advertising ethics. The most influential codes are those established by the International Chamber of Commerce (ICC); ICC Codes are followed by advertising bodies in over 30 countries. The ICC Codes are based on the core principles of legality, decency, honesty, and truthfulness in all marketing communications. The ICC further emphasizes that “all marketing communications should be prepared with a due sense of social and professional responsibility and should conform to the principles of fair competition, as generally accepted in business. No communication should be such as to impair public confidence in marketing.”

Self-regulatory codes are deliberately framed in general terms, because it can be very difficult to objectively define what kind of advertisement can be considered “decent.” It is assumed that standards of decency vary on a national or cultural basis, and in addition are likely to change over time. Thus, the ICC Code thus provides general guidelines: “Marketing communications should not contain statements or audio or visual treatments which offend standards of decency currently prevailing in the country and culture concerned.”

The ICC Code further stipulates the following: 3

• Marketing communications should be so framed as not to abuse the trust of consumers or exploit their lack of experience or knowledge. Relevant factors likely to affect consumers’ decisions should be communicated in such a way and at such a time that consumers can take them into account.
• Marketing communications should respect human dignity and should not incite or condone any form of discrimination, including that based upon race, national origin, religion, gender, age, disability, or sexual orientation.
• Marketing communications should not without justifiable reason play on fear or exploit misfortune or suffering.
• Marketing communications should not appear to condone or incite violent, unlawful, or antisocial behavior.
• Marketing communications should not play on superstition.

Examples of Objectionable Advertising

Discriminatory advertisements.

Source: Kim Bhasin and Patricia Laya, “26 Shockingly Offensive Vintage Ads,” Business Insider, June 14, 2011. Figure 6.2 This is a vintage Schlitz beer advertisement from 1951.

As we review the history of advertising, we will observe that certain ads and campaigns were previously considered acceptable, and even popular, but today would generally be regarded as objectionable (in clear violation of one or more of the principles outlined above). Such cases can help illustrate the ongoing evolution of community standards in marketing ethics.

Consider the vintage ad for Schlitz beer in Figure 6.2. A suit-clad husband is comforting his tearful wife, who has just burned the evening’s dinner. The advertising copy reads as follows: “Don’t worry, darling, you didn’t burn the beer.” This advertisement appears to be aimed at men and contains a mocking and patronizing reference to young housewives of the day. In its time, such an advertisement was probably considered by many to represent light-hearted humor, but today it would be considered offensive by many viewers. The unstated implication is that men are breadwinners while women are weepy and emotional homemakers. By contemporary standards, the Schlitz ad is overtly sexist.

While it might seem that such advertisements are relics of the past, controversial discriminatory appeals and references continue to appear in the media. As a further example, consider the advertisement for the Mountain Dew soft-drink in Figure 6.3: 4

Source: Christopher Heine, “Mountain Dew Pulls ‘Arguably Most Racist Commercial in History’,” Adweek (2013) Figure 6.3 Mountain Dew’s zany but ill-fated campaign featuring a Mountain Dew-crazed goat.

Mountain Dew had run a successful series of edgy commercials targeted at Internet viewers and users of social media (an increasingly popular tactic). Perhaps influenced by the remarkable success of insurance company GEICO’s advertising mascot (a green gecko with a cockney accent), Mountain Dew had created a series of ads featuring a goat with a crazed passion for the caffeine-laced green soda. For one of these commercials, Mountain Dew hired hip-hop artist Tyler the Creator to create and produce the advertisement. In the ad in question, the goat is driving a car and is pulled over and arrested by a policeman. In flashback, we see the goat attacking a woman to wrench away her bottle of Mountain Dew, leaving the woman bloodied and wounded. In the next scene, the woman tries to identify her assailant from a police line-up that features the goat and four black men. Drinking steadily from a bottle of Mountain Dew, the policeman prods the woman to make a choice. The goat responds to the situation by speaking in a parodic hip-hop style, employing slang phrases such as “do her up” and “ya better not snitch on a playa.” Meanwhile, the Dew-amped policeman urges the woman to “nail this little sucker” and suggests it is “the one with the doo-rag.”

In retrospect, one wonders how such an offensive advertisement could have been released by a subsidiary of one of the world’s largest marketing organizations (Mountain Dew is a PepsiCo subsidiary). There was a great deal of outrage voiced when the ad was posted on Mountain Dew’s music/arts website. One college professor labeled the commercial as “arguably the most racist commercial in history.” The ad was promptly pulled and PepsiCo accepted full responsibility and apologized. To no avail, PepsiCo had pointed out that Tyler was African-American and that the four black men featured in the lineup were actually his close friends. Apparently, the irony intended by Tyler was meant to mock racism and discriminatory police practices. However, as many other advertisers had learned before, humor is a two-edged sword in advertising. It can attract attention, but it can also be misunderstood and cause offense.

Encouraging Harmful or Dangerous Practices

The advertisement in Figure 6.4 illustrates two categories of advertising that merit special scrutiny: advertisements featuring children and advertisements encouraging misuse of a product. Would any parent think it appropriate to have his or her infant shave himself with a razor? Of course not, but clearly that was not the intent of the advertiser.

Source: Kim Bashin, “20 Creepy Ads Featuring Children,” Business Insider, Oct. 26, 2011. Figure 6.4 This is a vintage Gillette advertisement from 1905.

The ad is attempting to be humorous by employing an absurd image, a baby shaving itself. The ad is also trying to make the point that the new Gillette safety razor is so safe that even a baby could use it without harm. There also may have been an intention to create an association between the smoothness of a baby’s skin and the closeness of the shave provided by the razor. By today’s standards, however, the advertisement appears reckless. While it is not possible that a baby would be influenced by an advertisement, it is not inconceivable that a small child of five or six years of age might be encouraged by this advertisement to play with a razor: The baby seems to be having such fun, and the small child might have seen his or her father shaving. Regardless of the likelihood that the advertisement could cause harm, today’s advertisers have become increasingly wary of using advertising that features children engaged in dangerous activities.

Potentially Dangerous Products: Advertising Bans and Restrictions

As stated above, there are products that are sold legally but that are considered to have such a high potential for harm or abuse such that their advertising has been banned or regulated. Let us consider just two such product areas: cigarettes and alcoholic beverages.

Source: Cory Doctorow, “Particularly Despicable Cigarette Ad,”, Nov. 25, 2011. Figure 6.5This is a 1962 advertisement for the L&M cigarette brand featured in the edition of Popular Science magazine.

Concerned with medical research that revealed the health hazards of smoking, the US and European governments began to regulate tobacco advertising in the 1960s. The print ad in Figure 6.5, from 1962, features an idyllic family scene that suggests that a smoker gets “lots more” from a particular brand. The ad suggests that one acceptable way to enjoy the smoking experience is to smoke in the company of one’s spouse and children. In 1964, however, the US Surgeon General issued a formal report that concluded that smoking caused lung cancer and chronic bronchitis. This led to the government instituting a series of regulations aimed at the tobacco industry. The new laws required health warning labels on all cigarette packages and required that all cigarette companies file annual reports to the FTC. One goal of these regulations was to oblige the large tobacco companies to disclose their advertising expenditures and strategies, so that the government would be able to assess the link between tobacco advertising and smoking-related health risks.

Throughout the late 1960s, the US government accumulated and analyzed data on the marketing and advertising practices of the large cigarette companies and finally concluded that tobacco advertising encouraged smoking. As a result, the Public Health Cigarette Smoking Act was passed and signed into law in 1970. This act banned all cigarette advertising on television and radio advertising in the United States. At the time the prohibition went into effect, tobacco companies were spending eighty percent of their advertising budgets on television advertising, so the impact of the law was significant.

Subsequently, the United States enacted further restrictions on cigarette advertising. In 1999, billboard advertising of tobacco products was banned. In 2010, tobacco companies were prohibited from sponsoring athletic, musical, or artistic events, and from featuring their logos on apparel. However, the government has stopped short of banning print advertising. These governmental efforts have been matched by a certain level of self-regulation on the part of tobacco companies. For example, after a public outcry over its use of a cartoonish camel to sell cigarettes (it was feared that such advertising would be appealing to children and teenagers), Camel Cigarettes voluntarily stopped advertising in magazines in 2007. However, in 2013 Camel resumed its practice of advertising in magazines.

Alcohol has been classified by the International Agency on Research for Cancer (IARC) as a Group 1 carcinogen, meaning that the circumstances in which humans are exposed to alcohol are sufficient to create a risk of cancer. According to the World Health Organization (WHO), alcohol causes approximately 1.8 million deaths per year. In the United States alone, approximately 10,000 deaths per year are the result of automobile accidents caused by drunk driving. Despite these sobering statistics, the US government has taken a very different approach to alcohol advertising as compared with tobacco advertising. In essence, the FTC has primarily asked the alcohol industry to self-regulate.

Given that advertising is known to be an effective means of increasing sales and market share, why would alcoholic beverage companies agree to abide by self-regulation? Here, the example of advertising bans on tobacco products is instructive. Other industries whose products are seen as controversial have been influenced by the threat of an advertising ban similar to that placed on tobacco products. Consequently, trade associations for such industries have sought to maintain an open dialogue with legislators in the hope of appeasing them with effective self-regulation, so as not to be faced with a total ban. In the United States, the self-regulatory focus has been to minimize the exposure of underage drinkers to the advertising of alcoholic beverages. Currently, the alcoholic beverage industry has agreed to restrict advertising in print, TV, and radio to those venues where studies show that more than 70% of viewers will be of drinking age (i.e., older than 21). Further, the industry has agreed to support a public campaign against underage drinking and to include warnings about drinking responsibly in all advertising. The FTC has urged industry to apply the 70% rule to sponsorship of musical and sporting events as well but no agreement has been reached.

Even with these self-regulatory measures in place, there remains a good deal of concern among watchdog groups about the appeal of TV advertising to young people, who are considered more likely to abuse alcohol than older viewers. Moreover, the alcohol industry continues to employ advertising appeals based on the implicit sexual allure of drinking in bars or at parties. This approach is disturbing to industry critics who see the glamorizing and sexualizing of alcohol consumption as another way of attracting young people to alcohol products. As with cigarettes, the implicit threat is that if the industry can get young people “hooked” early in life, then they will become lifelong consumers of a product with known health risks. Youths who begin drinking at age 15 are four times more likely to become alcoholics than those who begin drinking at age 21. 5

Case Study: The Marketing of Skin-Whitening Creams

Americans—in particular, white Americans—spend hours in tanning salons going to great efforts (and sometimes even incurring great pain and health risks) to make their skin darker. In other parts of the world, such as the Caribbean, Africa, East Asia, and the Indian sub-continent, people go to much expense to lighten their skin. They do so through the purchase and application of skin-whitening or skin-lightening creams that purport to make dark skin lighter. (Whether or not they actually work is controversial.) In many of these regions, lighter skin is more highly regarded socially. Arguably, this phenomenon is a sad by-product of colonialism, in that it is based on a positive association with the skin color of Caucasians. The flip-side is that, in the United States and Europe, darker skin is often considered attractive and exotic.

Fair and Lovely is an Indian brand of skin-whitening products manufactured and marketed by Hindustan Lever Ltd. (HLL). Fair and Lovely is the top-selling skin-whitening brand in India, followed closely by Fairever which is made by CavinKare. HLL advertising touts Fair and Lovely as a “miracle worker” and claims that it is “proven to deliver one to three shades of change.” As a result of competition from Fairever , HLL stepped up its marketing efforts in recent years, which led to a great deal of controversy. One of the controversial HLL ad campaigns was based on the theme “The fairer girl gets the boy.”

In one of the typical television commercials used in this campaign, a poor father is lamenting the fact that he does not have a son who can work and help support the family. His daughter, who has dark skin, looks on and clearly feels a sense of guilt. When she seeks employment, she is rebuffed because of her dark skin. Her unhappy lot is magically transformed with the use of Fair and Lovely skin-whitening cream. Suddenly, she not only appears to have much lighter skin, but the other characters in the commercial perceive her as much more beautiful. She dons a miniskirt and finds employment as a flight attendant, receiving the romantic attention of a fair-skinned Westerner. Among the many improbable benefits associated with use of Fair and Lovely , it seems, are a wardrobe change, secure employment, and a foreign boyfriend. The newly confident young woman is now a success and can take her proud father out for a lavish dinner.

The popularity of Fair and Lovely , as well as other skin-whitening creams, is tied to Indian cultural traditions. Lighter skin has been associated with a higher caste and therefore greater social status. Most of the famous female stars in India’s popular Bollywood movie industry are light-skinned. Do the Fair and Lovely products—or those of competitors—really make someone’s skin lighter? Or is this idea just an illusion perpetuated by effective advertising? In its official documentation regarding Fair and Lovely, HLL only states that the cream contains vitamins essential to skin care and UV blocking agents (as in sunscreens). In other words, rather than actually turning the skin lighter, Fair and Lovely may only work by keeping skin from getting darker, something likely to happen in sun-drenched areas of India. Critics claim that at best such products temporarily bleach skin lighter.

Not everyone in India is comfortable with the promotion of skin-whitening creams. A number of groups have come out against HLL and Fair and Lovely, charging the company with deceptive advertising and the promotion of discrimination and sexism. Many critics point out that the celebration of lighter skin is implicitly a rejection of darker skin. Thus, the Women of Worth Foundation launched a campaign called “Dark is Beautiful” to protest skin-whitening products.

Indian fashion writer Rumnique Nannar observed the following:

I’ve heard the stray dig “for a Punjabi, you’re quite dark” or jokingly mentioned, “are you sure you haven’t been adopted from Kerala?” or even the infamous, “wow, you are, like, so exotic”—all standard fare for me as the darker blip in family photos. Having your identity reduced to skin tone can be crushing, particularly when it doesn’t fit with the more fair ideal admired by most cultures. In India, ads by Emami and Fair and Lovely often seemed laughable and pompous to me, with grandfathers sanctioning the use of skin lightening creams to ensure the success and subsequent beauty of their dusky daughters. 6

Nannar points out that to be identified or even judged according to one’s skin color is demeaning and diminishes a woman’s self-esteem and creates a sense of insecurity.

Topic for Debate: Should an American Advertising Agency Represent Fair and Lovely?

In this fictional case, a small but highly successful new advertising agency based in New York City, Enviralism, Inc., has become known for its ability to craft effective social media campaigns targeting the so-called millennial generation (young people born between the early 1980s and early 2000s). Enviralism has become successful especially with rapidly growing high-tech, fashion, and communications groups. This small agency is known for its cutting-edge creativity.

The CEO of Enviralism, Ralph Rodriguez, has been approached by Unilever, one of the world’s largest consumer goods conglomerates, with a US advertising budget in the tens of millions, to craft a strategy for marketing Fair and Lovely products to South Asian and East Asian immigrants and their first-generation children. Unilever is aware of the controversies surrounding Fair and Lovely products, but is also aware that there is a significant US market for skin-whitening products. As a result, Unilever would like to tap into Enviralism’s knack for thinking up unusual, outside-the-box marketing strategies. In its initial discussions, Unilever has talked about starting with an annual $2 million budget, which might be doubled or tripled in subsequent years. This would instantly make Unilever the largest client at Enviralism, which is still a very small boutique agency with only 18 employees.

However, when Rodriguez discusses the opportunity with his Creative Director, Elaine Williams, she demurs: “That’s a straight-up racist product, Ralph. We can’t go there, no matter how much money it makes us.”

Ralph, who has just invested $200,000 in renovating a Williamsburg loft into beautiful new offices for Enviralism (complete with state-of-the-art computer and graphics equipment), is not so sure.

He counters, “What about Coppertone? What about Hawaiian Tropic? Those products make people’s skin darker, supposedly, but nobody complains. What about Afro Sheen and other hair-straighteners for the black community? Nobody says those are racist. This is a $500 million market in India alone, not to mention a standard skin-care product category in Japan, China, Indonesia, and Thailand—we’re talking about a market with well over two and a half billion people!”

Ralph can see that Elaine is not convinced, so he schedules a board meeting where his top executives will argue the case, pro and con, for accepting the Unilever account. You will be assigned to one of those teams. Should Enviralism agree to craft advertising campaigns for the Fair and Lovely product line?

Affirmative

Enviralism should agree to represent Fair and Lovely in the United States.

Possible Arguments

• We have a responsibility to customers to provide them with the products they desire; we should not demean our customers by treating them like children.
• Fair and Lovely is not dangerous and may provide psychological benefits to customers, like other cosmetics products.
• Fair and Lovely’s skin enrichment, sun blocking, and moisturizing features are beneficial.

Enviralism should refuse to represent Fair and Lovely.

• Fair and Lovely is an ineffective product and its related advertising claims are therefore deceptive.
• Fair and Lovely promotes and sustains social, racial, and ethnic stereotypes and prejudices.
• Marketing Fair and Lovely would be socially irresponsible.

6.1 “Whiter-Skin Ad Campaign Spurs Debate Among Thais”

Chomchuen, Warangkana. “Whiter-Skin Ad Campaign Spurs Debate Among Thais.” Wall Street Journal . October 25, 2013. http://online.wsj.com/news/articles/SB10001424052702304799404579157422770231930 .

6.2 “Skin Whitener Advertisements Labeled Racist”

Sidner, Sara. “Skin Whitener Advertisements Labeled Racist.” CNN . September 9, 2009. http://edition.cnn.com/2009/WORLD/asiapcf/09/09/india.skin/#cnnSTCText

6.3 The Dark Side of Skin-Whitening Cream

Hundal, Sunny. “The Dark Side of Skin-Whitening Cream: The Dangerous Fashion for Skin-Whitening across Asia Perpetuates Racism and Should be Stigmatized as Such.” The Guardian. April 1, 2010. http://www.theguardian.com/commentisfree/2010/apr/01/skin-whitening-death-thailand/print .

Synthesis Questions

• Is there anything wrong in marketing cosmetics products with the suggestion that they make the buyer more beautiful, even if this is unrealistic in many cases?
• Should skin-whitening products be legal? Why or why not?
• Does modern society have too much advertising? How could we control it? Can you suggest any specific mechanisms or regulations that should be implemented?

1. “Magna Global 2013 Advertising Market Forecast,” Magna Global, accessed October 23, 2012, http://news.magnaglobal.com/magna-global/press-releases/advertising-growth-2013.print .

2. For example, the article “Anywhere the Eye Can See, It’s Likely to See an Ad,” (New York Times, January 15, 2007), quotes figures ranging from 2,000 to 5,000 per day. Advertising industry sources argue that the number is much smaller, commonly around 300 per day.

3. “ICC Code of Consolidated Advertising and Marketing Practice,” International Chamber of Commerce (2011), accessed December 2, 2014, http://codescentre.com/about-you/marketer-view.aspx .

4.The commercial can be viewed on YouTube via the following link: http://www.youtube.com/watch?feature=player_embedded&v=MdFRWf-CNC8

5. AAFP, “Alcohol Advertising and Youth” (Position Paper), American Academy of Family Physicians, accessed October 25, 2013, http://www.aafp.org/about/policies/all/alcohol-advertising.html.

6. Rumnique Nannar, “Is Dark Beautiful? The Fairness Debate Opens Wide in India,” Huffington Post, August 26, 2013, http://www.huffingtonpost.ca/jugni-style/is-dark-beautiful-the-fai_b_3793257.html .

• Good Corporation, Bad Corporation: Corporate Social Responsibility in the Global Economy. Authored by : Elizabeth Pulos and Guillermo C. Jimenez. Located at : https://textbooks.opensuny.org/good-corporation-bad-corporation/ . Project : Open SUNY Textbooks. License : CC BY-NC-SA: Attribution-NonCommercial-ShareAlike

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Case Study Research Method in Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul Mcleod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).

The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.

The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.

There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.

 Famous Case Studies

• Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
• Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
• Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
• Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
• Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.

Clinical Case Studies

• Studying the effectiveness of psychotherapy approaches with an individual patient
• Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
• Neuropsychological cases investigating brain injuries or disorders

Child Psychology Case Studies

• Studying psychological development from birth through adolescence
• Cases of learning disabilities, autism spectrum disorders, ADHD
• Effects of trauma, abuse, deprivation on development

Types of Case Studies

• Explanatory case studies : Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
• Exploratory case studies : Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
• Descriptive case studies : Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
• Multiple-case studies : Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
• Intrinsic : Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
• Collective : Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.

Where Do You Find Data for a Case Study?

There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence. Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.

1. Primary sources

• Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
• Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
• Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.

2. Secondary sources

• News/Media – News coverage of events related to the case study.
• Academic articles – Journal articles, dissertations etc. that discuss the case.
• Government reports – Official data and records related to the case context.
• Books/films – Books, documentaries or films discussing the case.

3. Archival records

Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.

Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.

4. Organizational records

Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.

Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.

However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.

• Organizational/industrial psychology research : Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
• Clinical psychology : Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
• School psychology : Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.

How do I Write a Case Study in Psychology?

Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes. Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.

1. Introduction

• Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
• Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.

2. Case Presentation

• Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
• Include client demographics like age and gender, information about social relationships, and mental health history.
• Describe all physical, emotional, and/or sensory symptoms reported by the client.
• Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
• Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
• Clearly state the working diagnosis or clinical impression before transitioning to management.

3. Management and Outcome

• Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
• Present the results of the intervention,including any quantitative or qualitative data collected.
• For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.

4. Discussion

• Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
• Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
• Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
• Offer clinical implications, and suggest future research directions.

5. Additional Items

• Thank specific assistants for writing support only. No patient acknowledgments.
• References should directly support any key claims or quotes included.
• Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists ).

Limitations

• Lacking scientific rigor and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feelings may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e., descriptive) data , a lot depends on the psychologist’s interpretation of the information she has acquired.

This means that there is a lot of scope for Anna O , and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.

For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans ).

This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.

Breuer, J., & Freud, S. (1895).  Studies on hysteria . Standard Edition 2: London.

Curtiss, S. (1981). Genie: The case of a modern wild child .

Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine , 151(3), 298-304

Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306

Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE , 10: 151-318.

Harlow J. M. (1848). Passage of an iron rod through the head.  Boston Medical and Surgical Journal, 39 , 389–393.

Harlow, J. M. (1868).  Recovery from the Passage of an Iron Bar through the Head .  Publications of the Massachusetts Medical Society. 2  (3), 327-347.

Money, J., & Ehrhardt, A. A. (1972).  Man & Woman, Boy & Girl : The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Further Information

• Case Study Approach
• Case Study Method
• Enhancing the Quality of Case Studies in Health Services Research
• “We do things together” A case study of “couplehood” in dementia
• Using mixed methods for evaluating an integrative approach to cancer care: a case study

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• Patient safety culture and medication safety in European intensive care units: a focus group study
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• http://orcid.org/0000-0003-3841-0534 Raisa Laaksonen 1 ,
• http://orcid.org/0000-0003-2270-4722 Andrea Rahel Burch 2 ,
• http://orcid.org/0000-0002-3018-3843 Jana Lass 3 ,
• http://orcid.org/0000-0002-0695-7052 Suzanne McCarthy 4 ,
• http://orcid.org/0000-0002-5798-6240 Moninne Howlett 5 , 6 ,
• http://orcid.org/0000-0001-6637-7028 Virginia Silvari 4 , 7
• 1 Department of Pharmacology and Pharmacotherapy, Faculty of Pharmacy , University of Helsinki , Helsinki , Finland
• 2 Hospital Pharmacy , University Hospital Zürich , Zürich , Switzerland
• 3 Institute of Pharmacy , University of Tartu , Tartu , Estonia
• 4 School of Pharmacy , University College Cork , Cork , Ireland
• 5 Pharmacy Department , Children's Health Ireland , Dublin , Ireland
• 6 School of Pharmacy and Biomolecular Sciences , Royal College of Surgeons in Ireland , Dublin , Ireland
• 7 Pharmacy Department , Cork University Hospital , Cork , Ireland
• Correspondence to Dr Raisa Laaksonen, Department of Pharmacology and Pharmacotherapy, University of Helsinki, Helsinki, Finland; raisa.laaksonen{at}helsinki.fi

Background Patients in intensive care units (ICUs) are susceptible to medication errors (MEs) for many reasons, including the complexity and intensity of care. Little is known about patient safety culture, its relationship to medication safety, and ME prevention strategies used in ICUs. This study explored the attitudes of healthcare professionals (HCPs) working in ICUs or within medication safety towards patient safety culture, medication safety, and factors influencing implementation of ME prevention strategies in ICUs across Europe.

Methods This qualitative study employed focus group discussions; ethical approval was obtained. Invitations to participate were distributed to HCPs working in ICUs or as medication safety officers across Europe. In May 2022, online focus group discussions were conducted. Discussions were transcribed verbatim and analysed. The framework analysis employed was inductive, systematic and transparent, and completed through a collaborative and iterative process.

Results Three nurses and 11 pharmacists, from seven different countries, participated in three focus group discussions. There was a sense of improvement in blame culture leading to more open culture, although it was not the case for all participants. Blame culture, when present, was thought to be prevalent among more senior ICU staff and hospital managers. Facilitators for improving medication safety included communicating with HCPs and providing feedback on MEs and ME prevention strategies, interprofessional working without hierarchies, and having a ‘good’ culture and environment. Barriers included lack of engagement of HCPs and their attitudes towards medication safety, and an existing blame culture. Participants reported 25 different ME prevention strategies in use including: assessing knowledge; teaching and training; auditing practice; incident reporting; and involvement of pharmacists.

Conclusions This study examined the attitudes of HCPs on patient safety culture and medication safety in the ICU setting in Europe and gained their insight into facilitators and barriers to the implementation of ME prevention strategies to improve medication safety.

• CRITICAL CARE
• MEDICAL ERRORS
• Clinical Governance
• Risk Management
• Quality of Health Care

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/ejhpharm-2024-004212

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Patients admitted to intensive care units (ICUs) are more susceptible to medication errors (MEs). Little is known about how patient safety culture relates to medication safety, and which ME prevention strategies are currently in use, or planned, in ICUs across Europe.

WHAT THIS STUDY ADDS

This study provides the perspectives of nurses and pharmacists working in various areas of ICU patient management across Europe on patient safety culture and medication safety, and indicates barriers and facilitators for the implementation of ME prevention strategies to improve medication safety in European ICUs.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

The findings of this study inform healthcare professionals who have influence to improve medication safety in their ICUs, on how perceived patient safety culture may influence medication safety, and which factors influence the implementation of medication prevention strategies in ICUs.

Introduction

Medications errors (MEs) are a significant cause of harm in healthcare, resulting in increased morbidity and mortality. 1 A positive patient safety culture and ME prevention strategies or medication safety initiatives have been shown to improve patient safety. 2 3

Critically ill patients admitted to intensive care units (ICUs) are vulnerable to MEs due to underlying comorbidities, organ dysfunction, limited physiological reserve, complexity of care and polypharmacy, and the inability of sedated or intubated patients to recognise or communicate on any MEs. 4–7 Furthermore, different patient, medication and environment related risk factors contribute to MEs in ICU patients. 5 8 9

Several strategies have been identified to decrease MEs, including computerised prescriber order entry (CPOE), clinical decision support systems (CDSS), bar-code medication administration (BCMA) technology, smart infusion pumps, clinical pharmacists’ contribution to patient care in ICUs, medication reconciliation, medication use education, and communication during transfer of care. 10

A positive patient safety culture, the shared beliefs, values, attitudes, and behaviours regarding safety within an organisation, have been associated with a lower rate of MEs 11 ; patient safety culture may also influence implementation of ME prevention strategies. 12 Little is known about patient safety culture as experienced by healthcare professionals (HCPs) working in various areas of ICU patient management, and their perceptions of factors influencing implementation of ME prevention strategies in European ICUs.

The aim of this study was to explore the perceptions and experiences of HCPs, working in ICUs or within medication safety, of patient safety culture, advancement of medication safety, and implementation of ME prevention strategies in ICUs in Europe.

Study design

Online focus group discussions were conducted with HCPs working within ICUs, or medication safety, in Europe. Qualitative research and focus group discussions provide an interpretation of experiences and perceptions of individuals and groups in certain contexts. 13 Participants in focus group discussions influence each other; the data are a product of everyone’s contribution. 14 15

Research team and reflexivity

The research team consisted of six pharmacists: three working in ICUs of university hospitals (AB, JL, MH); one a medication safety pharmacist (VS); and two medication safety researchers (RL, SMcC). RL and SMcC have extensive experience in conducting qualitative research, and research in medication safety. This research forms part of a wider project commissioned by the European Association of Hospital Pharmacists (EAHP); a special interest group (SIG) was convened to explore the topic of MEs in the ICU setting. 16 17

The team positions our research within a social constructionist paradigm which emphasises the role of social interactions in shaping knowledge and meaning. This guided our discussions and decisions regarding methodology and the choice of focus groups for data collection, our analysis of the data using an inductive approach, and interpretation of findings through reflection and questioning our understanding, assumption, and biases as researchers and as HCPs. 13 This approach of continually scrutinising our positions, or reflexivity, enhanced the depth and authenticity of our findings. Reflexivity has been defined as ‘a set of continuous, collaborative, and multifaceted practices through which researchers self-consciously critique, appraise, and evaluate how their subjectivity and context influence the research process’. 18

Participant recruitment

Participants were recruited using purposive sampling with the assistance of the EAHP and the SIG through relevant national and European professional networks, using emails, newsletters, and social media advertisements sent to the members of these organisations. Participant information contained an explanation of the study, how the data would be used, and who was organising the study. HCPs working in ICUs, or as medication safety experts, within Europe, were eligible to participate, provided they were suitably fluent in English. Participation based on informed consent was voluntary and confidential.

Four potential dates for the focus group discussions were agreed; the participants confirmed their availability by email. To accommodate online facilitation and participation, a maximum of eight participants were to be recruited to each focus group. It was considered that it would be possible to reach thematic saturation with a total of 15–20 participants, 19 that is, no new experiences or perceptions emerge from the data during the last focus group discussion.

Focus group topic guide

To ensure credibility of the research, 13 literature on patient safety culture and ME prevention strategies was utilised by the research team 17 to develop a topic guide (Appendix 1). A collaborative and iterative process was subsequently used to produce the final topic guide. This involved a discussion with the wider SIG, which, being comprised of HCPs working in ICUs and within medication safety, was representative of the target study population. As the focus group discussions were in English, the topic guide was sent to participants in advance.

Conducting the focus group discussions

Three 90 min focus group discussions were conducted in May 2022, using an online facility, Zoom. Demographic data were collected.

The facilitator (RL) introduced the topics and encouraged everyone to contribute, such as drawing quiet participants to the discussion and asking dominant participants to give room to others. The focus group discussions were run in a structured way to ensure the objectives were met. An assistant facilitator (MH, SMcC or VS) undertook field notes and supported the facilitator. The participants were told that the researchers are pharmacists with experience in research, medication safety and intensive care. A record-keeper (GML or SK) took notes to support the transcription. The discussions were audiorecorded.

Handling and storing the focus group discussion data

The discussions and the participants were given individual codes; data were pseudonymised. After verbatim transcription, audiorecordings were deleted. As another layer of ensuring the trustworthiness of the research, the participants were offered the opportunity to verify the accuracy and completeness of the transcripts of their focus group discussion. All data will be securely stored for 24 months after publication, after which they will be destroyed.

Analysis and reporting of the focus group discussion data

The transcribed discussions were entered onto an Atlas.ti (version 9) database for storage, coding, and retrieval. A framework approach 19 was used; the analysis was inductive, systematic, iterative, and transparent. The main researcher (RL) identified recurring themes that were used as the codes of the framework. As part of rigorous analysis, other researchers (AB, JL, SMcC and VS) checked and confirmed the coding and the trustworthiness of the interpretations. 13 Participant quotes were selectively chosen for inclusion based on their relevance to the identified themes and their capacity to illustrate key points. Frequencies have been used to demonstrate the density of discussion of barriers and facilitators to medication safety and ME prevention strategies identified by the participants in the focus group discussions. 20

This qualitative study is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) 15 and was part of a larger programme of work to develop medication safety recommendations for European ICUs. 16

Twenty-one HCPs expressed interest in participating, of whom 13 participated in one of three focus group discussions ( table 1 ). One further participant (a pharmacist), who was unable to contribute to their nominated group due to technical issues, provided written responses; these are included in the reported results. All findings are reported as the findings of the focus group discussions 1-4.

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Characteristics of the focus group discussion participants (n=14)

Patient safety culture

The participants (n=14) discussed their perceptions of the patient safety culture prevalent in their ICU or hospital setting. While one participant reported that open patient safety culture had existed in both hospitals where they had worked, and another reported that blame culture prevailed in that whole country, most perceived that both blame and open culture co-existed in the hospitals and ICUs where they worked. One reported that open patient safety culture had prevailed in the ICU in the past, but this had turned into blame culture after departure of a supportive senior member of staff. However, others mostly perceived that patient safety culture had improved over the years, was currently improving or was actively being improved.

‘I do think there is already an improvement [in patient safety culture], but there is quite a lot of things to do yet .’ Participant 1, focus group discussion 1

Influence of blame culture on patient and medication safety

The participants thought that if blame culture was prevalent in their working environment, this was more pronounced among more senior ICU staff and hospital managers. Blame culture was perceived to have a greater impact on more junior staff, especially if they were new; junior staff were more likely to be blamed, judged, or even punished for errors occurring. The fear of being blamed or punished may have prevented members of staff from admitting or reporting their own mistakes or near-misses, or those of others, or led to covering up mistakes as means of protection.

‘But often I get the sense that, yes, the younger newer staff are often, I suppose they are quick to be blamed and I think it’s very hard for them to raise their hand. So, I think it’s a very difficult position for those new staff coming in .’ Participant 4, focus group discussion 1 ‘The error reporting incidents are very low in [my country] because of the fear of punishment to be honest. […] There is no punishment, but anyway the healthcare personnel [have] [a] fear of it. […] The doctors and nurses, they have [a] fear of a potential error, so they don’t want to say it and they cover their errors .’ Participant 2, focus group discussion 2

Some participants reported that pharmacists, nurses, and doctors, especially in senior positions, could blame other members of staff for mistakes, rather than considering the circumstances leading to an incident. Others thought that pharmacists were seen as impartial and supportive, and that ICU staff might be willing to discuss medication-related issues with pharmacists, but not with their colleagues, for fear of being judged incompetent. Indeed, they described hierarchical structures in ICUs which may foster blame culture further.

‘It’s less problematic to share a question, let’s say, with a pharmacist than with a colleague or a nurse.’ Participant 3, focus group discussion 1

‘ When you are in a small group and maybe where the line manager isn’t there, there is a safety where you can talk openly and freely about an incident .’ Participant 4, focus group discussion 1

The participants perceived that in some ICUs, HCPs may believe that individual members of staff are responsible for committing an ME or a near-miss, whereas in others, HCPs think that the circumstances or the system may be defective, thus facilitating the occurrence of MEs.

Developing and improving an open patient and medication safety culture

The participants discussed the need to develop or improve the existing open culture and remove any remains of blame culture. This would allow staff to feel safe when reporting and discussing incidents or near-misses. Even changing the medication safety language could be beneficial.

‘We have a system of reporting our medication errors and we also report our near-misses, and we call them "good catches because if you change the language around this, people think it’s a good thing .’ Participant 5, focus group discussion 4

Creating such an open culture was thought to be dependent on everyone working within the ICU. An open culture could be achieved if there was an atmosphere that supported ‘good’ teamwork, where everyone has their role, and more experienced and junior members of staff work together and support each other.

To achieve an open patient safety culture, it was thought important that any fear of blame was removed to allow staff to communicate openly. Such a step was perceived to require moving towards system-based patient and medication safety thinking, where causes of incidents and near-misses are sought in the working processes and the environment.

‘I think that it’s very powerful like when a new nurse starts and they see that in the first couple of weeks of starting in the unit they are told “Oh, the risk meeting, it’s happening, we are all going to gather on the nurse station and talk about incidents”. And they see that somebody reported something, we talked about [it], we are seeing what we learnt about it, and nobody is being shot down or getting blamed .’ Participant 5, focus group discussion 4

Interprofessional collaboration and working together to achieve the best outcomes for the patient were perceived as important. In situations when "things had not gone well ", that is, there had been a medication-related incident, a member of staff would be offered support. This support could include a debriefing, opportunities to voice concerns, and feeling comfortable about discussing the incident. The debriefing could include thinking about the circumstances that had led to "not an ideal situation ", which was thought preferable to thinking that " things had gone wrong ". In addition to debriefings, it was perceived that safety briefings should be offered to all members of staff. The participants thought that when an open culture existed it would be possible, with the involvement of everyone, to identify the " root causes " of incidents within the system and learn from them to improve the medication processes and structures. In such an environment, staff would want to be involved in improving practice, looking actively for processes that are not working well and monitoring improvement.

‘[Recently,] a […] nurse […] was involved in an incident […] [and said] “Once I made the error, I want to be part of the solution.”[…] This is just such a really positive way of knowing that […] the support is there, certainly from a patient safety culture to assist with somebody going through a journey together and coming to a resolution .’ Participant 2, focus group discussion 4

Changes in the processes and structures were perceived to consistently require raising awareness among staff to maintain momentum of safety initiatives, and the support and allocated resources from the hospital management. National patient and medication safety initiatives were perceived as supportive for such changes. To further support the open culture, it was thought that communication and feedback on patient and medication safety improvements between the hospital management and staff should be improved. To foster an open culture and the development of patient and medication safety, it was perceived that being aware of relevant ME prevention strategies was crucial. Developing a good strategy for these improvements, such as implementing an electronic incident reporting system, whose reports would be reviewed independently by a clinical risk or safety team, was important.

Factors influencing the implementation of medication error prevention strategies

Barriers to medication safety.

Three themes of barriers to medication safety and the implementation of ME prevention strategies emerged from the discussions ( table 2 , the themes of barriers were ordered based on the work of Khatri et al 21 ). The participants mentioned most frequently a lack of HCP engagement and their attitudes towards medication safety (n=37).

Perceived barriers to implementing medication safety strategies in intensive care units (ICU) identified by nurses and pharmacists (n=14) working in ICUs and medication safety across Europe

‘It’s more difficult to change the system, to implement some strategies if the managers are not supporting you on your way to do this.’ Participant 2, focus group discussion 4

Facilitators for medication safety

Three themes of facilitators for medication safety and implementation of ME prevention strategies emerged from the discussions ( table 3 , the themes of facilitators were ordered based on the work of Khatri et al 21 ). The participants mentioned most frequently engaging HCPs in improving medication safety, providing feedback to them on MEs and ME prevention strategies, and communicating with other HCPs (n=31) as facilitators.

Perceived facilitators for implementing medication safety strategies in intensive care units (ICU) identified by nurses and pharmacists (n=14) working in ICUs and medication safety across Europe

‘A really important thing in terms of encouraging to report is that there is an outcome that there will be discussion and changes will happen and that there will be benefits to the reporting, that things will become safer and that there will be a benefit.’ Participant 5, focus group discussion 4 ‘Education of the staff is really important and to have these discussion meetings over these errors […] I am always thinking how these errors, proposals, how much staff is going to know about it, and how to give this information .’ Participant 2, focus group discussion 4

Medication error prevention strategies

The participants discussed ME prevention strategies that were in use, planned to be implemented in the next 5 years, not in use, perceived to be ineffective, or rejected in their ICUs.

Medication error prevention strategies in use and planned to be implemented

The participants reported 25 different ME prevention strategies in use and 11 planned for implementation in the next 5 years ( figure 1 ). They mentioned most frequently assessing knowledge and auditing practice and learning, teaching and training (n=34) as ME prevention strategies in use, and electronic prescribing (EP) and administration support (n=24) as strategies planned to be implemented.

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Frequency of medication error prevention strategies (in use or planned in the next 5 years) in intensive care units (ICUs) as mentioned in the focus group discussions by the nurses and pharmacists (n=14) working in ICUs and medication safety across Europe.

Medication error prevention strategies not in use, perceived to be ineffective or that have been rejected

The participants reported six different ME prevention strategies not in use, seven perceived to be ineffective, and six that had been rejected from implementation or use ( figure 2 ). They mentioned most frequently EP and administration support (n=7) as ME prevention strategies not in use, double-checking (n=10) as strategy perceived as ineffective, and EP and administration support (n=3) as rejected strategies.

Frequency of medication error prevention strategies (not in use, perceived as ineffective or rejected from implementation or use) in intensive care units (ICUs) as mentioned in the focus group discussions by the nurses and pharmacists (n=14) working in ICUs and medication safety across Europe.

This study explored the perceptions and experiences of nurses and pharmacists, working in ICUs or within medication safety, of patient safety culture, advancement of medication safety, and implementation of ME prevention strategies.

The participants perceived that, while patient safety culture is improving and open culture more evident, blame culture still existed in ICUs across Europe. In an environment where blame culture exists, mistakes go unnoticed or are unreported, questions are not asked, or issues about the safe use of medicines are not discussed, it is difficult to improve patient and medication safety. 21 The participants agreed that open culture is a prerequisite for identifying and reporting mistakes, identifying the root causes of incidents and, through this, being able to take measures to avoid future mistakes, improving medication safety at the system level.

Senior ICU staff and hospital management were seen by participants as influential in determining how patient safety culture was experienced in the ICU. Globally, low perceptions of the management 22–25 and teamwork climate 26 have been among the issues negatively affecting the patient safety climate. Without the support of senior staff and management for an open culture, blame culture may continue to influence the people working within the ICUs and the patients they care for. Indeed, low patient safety climate scores for punitive response to error and error reporting have suggested the existence of a blame culture. 27 In this study, hierarchies and a punitive environment were perceived as barriers to developing medication safety, whereas working interprofessionally without hierarchies in an open environment were thought to facilitate improving medication safety. Instead of improving patient safety culture at the system level, a lack of engagement in, and negative attitudes towards, medication safety were perceived as barriers to safe medication processes. When staff do not perceive a need to engage in medication safety, receiving feedback may be difficult and viewed as criticism. Such an attitude may consequently result in failing to fully use existing medication safety strategies, not implementing new ones, or not reporting MEs. In previous studies, a poor work environment, especially staffing, 28 tiredness at work 29 30 , and stress recognition have negatively influenced patient and medication safety. 25 30 In this study, a lack of skills and knowledge about medication safety, a lack of resources and funding, and time, staffing and workload were perceived as barriers to medication safety. Indeed, these all may lead to declining engagement in developing and improving patient or medication safety, and thus declining patient and medication safety.

Mirroring the barriers experienced to impede implementation of ME prevention strategies, facilitators such as a ‘good’ patient safety culture and environment, and working interprofessionally without hierarchies, including the patient and family, were perceived to exist. Moreover, further facilitators could be provided in the form of national and institutional structures such as national programmes, hospital management, as well as resources, that is, funding, human resources, and time and energy, some of which might be accessible if the management see medication safety as a priority and include it as a task or even a responsibility in job descriptions. Additionally, the implementation and use of ME prevention strategies, such as technology supporting correct prescribing and administration of medicines, and reporting MEs or near-misses, requires resources. There was a wide variation in the use of ME prevention strategies, suggesting some scope for learning from ‘best’ practices. 10 The focus group discussions were enriched as participants had experienced diverse levels of implementation of ME prevention strategies and so different views of perceived or experienced barriers and facilitators were discussed.

Strengths and limitations

The strengths of this study include the use of purposive sampling to recruit nurses and pharmacists from a range of European countries, representing Northern, Southern and Western European regions. 31 All worked in ICUs, within medication safety, or both, bringing diverse experiences and perceptions, which were both similar and different, and enriched the data and increased transferability to other European ICUs. Although 15–20 participants might be needed to reach thematic saturation, 19 no new experiences or perceptions emerged during the last focus group discussion. However, the findings are based on the perceptions and experiences of a small number of participants.

The use of online focus groups afforded us the advantage of flexibility and convenience, enabling participation of HCPs from across Europe. However, they do present certain limitations, particularly in terms of sensitivity to intragroup dynamics. The absence of face-to-face interaction in virtual settings may hinder the subtle non-verbal cues and interpersonal nuances that are crucial for understanding group dynamics in qualitative research. Additionally, factors such as internet connectivity or other technical issues (which occurred in this study and resulted in submission of a written response by one participant), varying levels of digital literacy among participants, and challenges in ensuring equal participation, may influence the quality of interaction and depth of insights gained during online focus groups.

As with any research, the resources for focus group discussions were limited; up to four focus group discussions could have been conducted within the time frame allocated for this part of the overall research package, informing development of recommendations for improving medication safety within intensive care settings in Europe. 17 A significant limitation of this study stems from challenges in recruiting medical practitioners, a key stakeholder group. It is important to interpret the study findings with the awareness that participants consisted of only two HCP categories, nurses, and pharmacists. While the study focused on capturing the perspectives of HCPs, recognising the significance of other stakeholders, such as hospital management, could offer additional insights and future work should involve participation of this cohort. There was also a lack of participation of HCPs from the Eastern European region 31 ; the requirement to be suitably fluent in English to participate may have influenced involvement, and so it should be recognised that the results of this study may not reflect practice in that region. As with any study, there may be some response bias such as individuals with greater interest or expertise being more likely to participate.

To our knowledge, this study is the first to examine the perceived attitudes of HCPs on patient safety culture and medication safety in the ICU setting in Europe. The results give an insight into their beliefs on facilitators and barriers to implementing ME prevention strategies to improve medication safety in European ICUs, and thus may guide HCPs when searching for, and prioritising, measures for enhancing medication safety in ICUs.

Ethics statements

Patient consent for publication.

Not applicable.

Ethics approval

This study involves human participants. Ethical approval was obtained through the University of Helsinki Ethical Review Board in Humanities and Social and Behavioural Sciences (Statement: 18/2022). Participants gave informed consent to participate in the study before taking part.

Acknowledgments

All participants of the focus group discussions, the members of the EAHP's Special Interest Group for the Investigation of Medication Errors in Intensive Care Units, Lena Sheehan and Sufian Muhammad, Stephanie Kohl, and Gonzalo Marzal-Lopez.

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EAHP Statement 5: Patient Safety and Quality Assurance.

X @virgisilvari

Contributors RL designed the study, facilitated the focus group discussions, analysed and interpreted the data, drafted, revised the paper, and is the guarantor of the study. VS designed the study, supported the facilitator while conducting the focus group discussions, analysed and interpreted the data, drafted and revised the paper. AB and JL reviewed the data analysis and drafted and revised the paper. MH and SMcC supported the facilitator while conducting the focus group discussions and revised the paper.

Funding The work of the EAHP Special Interest Group for the Investigation of Medication Errors in Intensive Care Units was financially supported by Becton Dickinson (BD).This is an independent research supported by BD. The views expressed are those of the author(s) and not necessarily those of the BD.

Competing interests RL and VS are associate editors of the European Journal of Hospital Pharmacy . All other authors declare no competing interests.

Provenance and peer review Not commissioned; internally peer reviewed.

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