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Trial Lenses for Sale: (Ethics and the Profession)

BY SHERI M. MORNEAULT, OD, PHD
June 1999

A patient of mine purchased a 6-month supply of lenses from a licensed provider in the United States. After one month of wear, he presented to my office wanting to know if the lenses marked sm

"sample only" were okay to wear full time. He had 12 boxes of contact lenses, each marked "sample, not for sale."

A second patient responded to an advertisement that stated, "Purchase four boxes of disposable contact lenses, get four lenses free." She came to me wanting to know if she should return the bonus contact lenses, which were marked "sample, not for resale."

The practice of optometry is shaped by cultural factors which govern the perception, labeling, explanation and valuation of our professional abilities. Although the optometric experience is strongly influenced by the culture of our ethical value, surprisingly, the codes of optometric and medical ethics have traditionally ignored obligations of and devotion to the truth. The Hippocratic Oath does not recommend veracity, nor does the Code of Ethics of the American Optometric Association (AOA). The standards of conduct for the profession, adopted by the AOA in 1976, make no mention of an obligation or virtue of veracity, giving optometrists unrestricted discretion about what to divulge to a patient. In opposition to this traditional disregard of veracity, virtues of candor and truthfulness are among the most widely praised character traits of health professionals.

The Truth is Out There

Optometrists have an absolute obligation to the truth. This truth is implied during both the doctor-patient interaction and the relationship between optometrists and contact lens manufacturers. Unfortunately, a few agents of our profession have not regarded truthfulness as an absolute obligation. They have disregarded this virtue by selling contact lenses marked as "sample only."

In the context of biomedical ethics, a specific, implicit contract or promise is often identifiable. In the case of trial contact lenses being sold for profit, the obligation to the truth has been breached. When a manufacturer offers us trial lenses for free, we implicitly promise when we accept those lenses that we will speak truthfully and that we will not deceive our patients.

The practice of selling contact lenses marked "sample only" must end. It is evident that the failure for retribution on behalf of the contact lens manufacturers has contributed to this practice. We, however, need not wait for the manufacturers to lend a firm hand in this type of regulation. Let us, as ethical majorities, with reverence for the truth, disregard those members of the eyecare profession who so boldly practice selling free trial contact lenses for their own profit.

Today, the role of an optometrist should incorporate the virtue of veracity with an obligation to the profession as a whole. The current code of optometric ethics should serve as a guide only. Contemporary biomedical ethics commands that we value candor and truthfulness in our daily professional lives. Optometry is one of the most widely praised public health professions today. Let's keep it that way.

Dr. Morneault is the director of the Contact Lens Service at Massachusetts Eye and Ear Infirmary in Boston. She is an instructor in Ophthalmology at Harvard Medical School and an adjunct clinical professor at the New England College of Optometry.