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March 2008


The Ethics of LASIK Marketing 

The September EyeNet featured a story titled “High-Road Ethics for a High-Tech Era.” As doctors, we all bear responsibility for maintaining the highest ethical standards for the sake of our patients. While the story was important and well-written, I was taken by what it did not say.

LASIK is the zenith of our high-tech era, and having had the procedure, I truly understand how miraculous it is. However, the zealous marketing of LASIK to the general public has led us steadily down a slippery ethical slope. In my area, there are several LASIK providers who advertise aggressively. I, too, advertise my LASIK practice, so I am not against advertising or marketing. However, we have to remember that we are not used-car salesmen. We have to maintain a different standard or we lose the trust of those for whom we care. For example, one laser center offers “two-for-one LASIK.” Of course, there is so much fine print in the offer that it is akin to the bait-and-switch tactics of discount electronics stores. Is that how we garner trust when we are asking patients to put their most valued sense in our hands?

Intralase femtosecond technology is growing in popularity. Again, I am not against it, though I am not entirely convinced that it is worth the additional $1,000 charged to the consumer. Whether or not we think it is better, the ethical issue is in the marketing to the public. There are large billboards advertising “bladeless” LASIK and radio ads that suggest that LASIK can be done without going under the knife. As doctors, we should all take pause. This is absolutely and grossly misleading to the public! Patients come in thinking they will have LASIK without cutting a flap. Except there is a flap and there are still associated flap risks. Again, I ask, should we be purposely misleading the general public? Should we trick them into coming into our offices?

With this amazing technology, we provide truly miraculous services to our patients. We should take enormous pride in the life-altering care we can give. There is no need to degrade it with misleading advertising. There are enough people with refractive errors to keep all the refractive surgeons busy. I’m afraid we will all be sorry if we let “pseudo experts” of marketing and business lead us to a place where we betray the trust of the people we are privileged to care for. We need to collectively look ourselves in the eye (pun intended) and raise the bar. We must maintain the highest ethical standards for our own integrity and for the good of our patients. Sooner or later, if we do not stem the tide ourselves, someone else will.

Barry N. Wasserman, MD
Princeton, N.J.

Addendum from Charles M. Zacks, MD, chairman of the Academy’s Ethics Committee.

The concerns regarding marketing surgical services that Dr. Wasserman so clearly articulates are summarized in the Academy’s Code of Ethics, Rule 13. These guidelines will help maintain both high ethical standards and compliance with Federal Trade Commission regulations as we market LASIK and other procedures. For more information, go to and click “Ethics.”


The Question of Stem Cell Research 

The (November/December feature) “The Man Who Made Blood Flow Backward” was very interesting and informative. However, at one point it be-came rather biased, namely when the question turned to stem cell research.

It should be made clear that the majority of those who oppose stem cell research are really opposed to embryonic stem cell research. The latter requires embryo production for research and experimental purposes that destroy embryos, which are, in fact, human life. Hardly anyone opposes adult stem cell research or research on stem cells gained from amniotic fluids, umbilical cords, etc.

This should be made clear before a blanket condemnation is issued against everyone who feels uneasy with certain types of research, such as embryonic stem cell research. I also hope the current development in the field will make this debate moot.

John J. Alpar, MD
Amarillo, Texas


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