As journals’ presence on the Internet has increased, new ethical concerns have appeared. How do policies about print advertising translate into the digital world? What are the ethical issues around linking ads to journal topics? What ethical concerns are involved with open-access (OA) fees? What are the ethical issues around presenting readers with content that they may be interested in versus preserving their privacy?

The moderators of this ethics clinic (which had not been advertised as such in the program) presented five case studies, but time allowed for discussion of only three of them in groups.

The OA publishing model “opens a whole can of worms” as it shifts the burden of costs onto authors. One of the concerns is that it will create a two-tier model: Those who can afford to pay will be more likely to be published than those who cannot. In the first case study, a publisher asks the editors to reconsider the rejection of three manuscripts by authors at the same institution after the research director of the institution contacts the publisher and indicates that his institution would be willing to pay the $5,000 OA fee for each of the manuscripts. The group felt that it was not ethical for the research director to approach the publisher with such a request. Today more than ever, editorial decisions should be made independently of the business aspect, and the publisher should not be allowed to interfere. Therefore, a “firewall” should be put in place between the editor and the publisher. For journals that provide an OA option, such an option should not be discussed until the manuscript has been accepted. The editor should have flexibility in being able to make some articles OA even if authors cannot afford to pay.

What about linking ads and editorial content? Advertisers want their ads embedded as close as possible to relevant content. Publishers are struggling to increase their online income. In the second case discussed, a publisher is keen to be able to offer online ads on pages of related content—in this hypothetical case, the ads will display on journal-content pages that deal with medical conditions related to the products advertised. Several attendees mentioned that their journals had online ads only on their home pages, not on content pages. Certainly the publications or editorial committee of a society must establish clear guidelines regarding advertising. If the Web site uses cookies to track reader affinities, that should be clearly stated on the Web site.

Some funding organizations, such as the Research Councils UK, stipulate that research that they fund must be published in OA journals that offer a Creative Commons by Attribution (CC BY) license. This type of license allows figures to be reproduced by anyone, even for commercial purposes. In the third case discussed, an author has obtained permission to publish a patient’s clinical image. After publication, a for-profit company resells the image to an advertising firm, which uses it in a public marketing campaign. Needless to say, the consent form has to be explained in detail to patients, and authors have to be aware that there is a possibility of commercial use of patient images under a Creative Commons BY license. Many attendees reported that to avoid this situation, their journals never publish images with recognizable patient faces.

This session met its objectives of raising awareness of ethical issues surrounding digital advertising, author-pays publishing models, and tracking reader engagement and targeting. Ethical questions regarding these topics will require the attention of publishers and societies.