Pedagogía crítica y comunicación transgresora del cambio social

Bostwick and Lineberry (2007) distinguish ‘legitimate’ providers of online medicine, which are comparable to authorised offline pharmacies where prescriptions are received from doctors, from pharmacies that use online questionnaires, which may be reviewed by doctors in place of prescriptions, and outlets that dispense medicine without requiring prescription. Using this typology, purchasers were asked whether they had ever needed a prescription, used an online questionnaire, had to undergo a face-to-face or email

consultation, or were not asked for/ to participate in anything in order to obtain medicines. These data give some indication of the processes used, although not all the purchases discussed necessarily require a prescription.

However, the data on the types of medicine purchased by the survey

respondents previously discussed showed that prescription medicine was the most popular. Linking the information across the dataset I was able to

conclude that the majority of purchases for controlled medicines such as antidepressants/ antipsychotics, painkillers and lifestyle substances including slimming pills and erectile dysfunction treatment, featured significantly within the category where people were not required to provide or take part in

anything to procure their medicine.

Figure 12 Online Pharmacy Requirements

Only half of the respondents experienced formal checks before purchasing.

This highlights previous studies, where no formal checks were made before the medicine was sold online (Gernburd and Jadad, 2007; Memmel et al., 2006;

Schifano et al., 2006a). The most common requirement was the online questionnaire (26%), which has been associated with ‘rogue’ pharmacies

(Bostwick and Lineberry, 2007) as there is no guarantee that a qualified doctor is reviewing the questionnaire. In addition patients can exploit the anonymity of the process and provide tailored answers to obtain the medicine of their choice. This suggests that the Web is allowing illegitimate purchasing to occur on a large scale, as the authorities fear.

In the interviews participants also noted that they were able to buy prescription medicine without having a consultation with a healthcare professional first or having a prescription. Rosie talked about how online vendors do not conduct proper checks:

They asked have you taken it before and what doses have you taken before, and I’m not sure if they actually used checks for that, or whether it's a formality thing [Rosie F22]

This example highlights the deficiency of the online questionnaire as a viable alternative to a proper consultation with a healthcare professional, as

unscrupulous sellers can easily manipulate it. In questioning whether this was a ‘formality thing,’ Rosie indicated that she knew it could be a facade, just to keep up the appearance of a legitimate pharmacy. Also the questions that were asked of her did not relate to whether the medicine was suitable for her, rather it appears that the site wanted her to clarify the medicine and the dosage.

Esther also spoke about having to confirm her age via a pop up box (that she was over 16) before being able to buy OTC medicine, and having to complete an online questionnaire in order to purchase prescription medicine online

I think there were some questions re: my general health (blood pressure, previous adverse reactions to any meds, am I using any other meds etc.) [Esther E5]

These questions are more appropriate than those Rosie encountered, and the process appears to be more authentic. The medicine was ‘virtually prescribed’

by a doctor, who provided a prescription, which was then passed on to a pharmacist, who dispensed the medicine to Esther. This suggests that this website was an example of Bostwick and Lineberry’s third type of pharmacy, although this is still considered a ‘rogue’ pharmacy by some.

The data shows the wide variety of medicines available to buy online and indicates that there are websites that do not follow regulatory standards in requiring prescriptions and consultations for prescription-only medicine.

5.8. Summary

This chapter has explored web users’ views about online medicine purchasing, and contextualised purchasing medicine online. The survey data provide novel information about the characteristics of online medicine purchasers and

non-purchasers, and some beliefs and behaviours. There are no significant

differences in gender or age between those who purchase medicine online and those who do not in the particular sample in this study.

The chapter has demonstrated how the Web is changing how people obtain medicine: the Web is one of the main places that people find out about

purchasing medicine online, and provides a route for purchasing. It seems that people are not accessing websites accredited by professional healthcare, but rely on information from online peers. The forum data highlight how peer influence is a factor in online medicine purchasing as per the literature. Forum members make enquiries and provide information about medicine and where to obtain it. Within the community of networked spaces, people acquire the knowledge to make purchases of medicine online. However, the survey data indicates that many online consumers continue to use traditional offline sources for medicine purchasing. This suggests that not all online medicine purchasing can be construed as challenging the marketplace, governance and expertise.

The survey data highlighted some interesting contradictions relating to whether respondents admitted having purchased medicine online. Some respondents, who had ticked the box stating that they had never bought medicine from the Web, later chose ‘the Web’ as a place that they ordinarily obtain their medicine from. This could be a response to the risk discourse surrounding online medicine purchasing. Utilising the interview data, further investigations into these contradictions will be undertaken, and the concept of respectable deviance will be applied to understand this presentation of self in online medicine purchasing.

My data show that both purchasers and non-purchasers are able to distinguish between legitimate and illegitimate online medicine purchasing. They

understand that there are different routes to obtaining medicine that are not necessarily authorised and are aware of the risks. Illegitimately purchasing medicine online is acknowledged as an action that can evoke negative reactions. This appears to be impacting on how some purchasers are constructing their actions.

The Web appears to be used for infrequent purchases of medicine, although the survey data did not address the quantity when purchasing, and so