Informed consent in the Googlesphere

Here's an interesting snippet

But there's also the fact that Google is stuffed full of people who just love to experiment on its users. For instance, Google Mail uses a very slightly different blue for links than the main search page. Its engineers wondered: would that change the ratio of clickthroughs? Is there an "ideal" blue that encourages clicks? To find out, incoming users were randomly assigned between 40 different shades of links – from blue-with-green-ish to blue-with-blue-ish. It turned out blue-ness encouraged clicks more than green-ness. Who would have guessed? And who would have cared? Google, of course, which wants to get people clicking around the net.

I take this sort of experimentation as utterly, boringly unproblematic

But on one view - this is surreptitious experimentation without consent including randomisation.

Would it be ethical for the NHS to trial different coloured inks on its NHS direct websites to see if some led to more clicks?

Would it be ethical for a doctors surgery to randomise users to different versions of its front page?
Would it be ethical for a doctors surgery to trial different answering machine messages?
Would it be ethical for them to randomise patients to different information leaflets (say with identical information but printed in different ways)?

The last would (I am sure) require a 40 page submission to the local HREC, plus another 40 page submission to an R+D department, and a 4 page informed consent form for patients prior to them being given one of the actual information leaflets. And I suspect that an ethics committee would reject any suggestion that this could be done without patients knowing about it.

So why the difference? Is it justified?

All of these examples involve randomisation without consent. But the reason why it is ethical to undertake this sort of study is that the information provided by such research is useful (at least minimally), the possible harm involved with such research is negligible, and the research actually could not be done if participants were aware of the nature of the research. 

There should be a way to identify research projects that meet these criteria, to encourage consumer- behaviour research in healthcare as in commerce, and to avoid wasteful and obscene bureaucratic hurdles to its performance.

Comments

[Dennis Tuchler]

There seem to be two variables: !, where the differences might affect the ability of a person to make use of the services of a government agency (NIH) and 2. where the differences might affect the welfare of the person logging on. The ethical problem with the first is that there may be some diminution in the quality or quantity of the service provided by the agency, thereby affecting the duty of the agency to the public. The ethical problem with the second, of course, is that a person might be giving something up or opening himself/herself to some disadvantage in the future (privacy loss, reduction in access to care, etc.) Both are important but only the second requires informed consent of the user.

Given that the information to be obtained from the experiments is useful and any changes excited by the new information is likely to benefit the public, the ethical problems arising from the first variable are minimal. The duty is to the public through the government and the government more likely than not approved of the experiment, taking all that into account.

As to the second, what would count as informed consent that would nevertheless allow the experiment to work? I suppose something like this work: "For the next few weeks we will be making alterations on our web site (or in our e-mail notifications, information leaflets or ...) in order to determine how we might serve you better. The changes may, in a few cases, affect your understanding of our services. If you have any question whatever concerning what the kind and manner of application of our services may affect your wellbeing, please be sure to call ... We need your comments to improve the way in which we provide information."