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Winker MA, Flanagin A, Chi-Lum B, et al. Guidelines for Medical and Health Information Sites on the Internet: Principles Governing AMA Web Sites. JAMA. 2000;283(12):1600–1606. doi:10.1001/jama.283.12.1600
Author Affiliations: American Medical Association, Chicago, Ill.
Access to medical information via the Internet has the potential to
speed the transformation of the patient-physician relationship from that of
physician authority ministering advice and treatment to that of shared decision
making between patient and physician. However, barriers impeding this transformation
include wide variations in quality of content on the Web, potential for commercial
interests to influence online content, and uncertain preservation of personal
privacy. To address these issues, the American Medical Association (AMA) has
developed principles to guide development and posting of Web site content,
govern acquisition and posting of online advertising and sponsorship, ensure
site visitors' and patients' rights to privacy and confidentiality, and provide
effective and secure means of e-commerce. While these guidelines were developed
for the AMA Web sites and visitors to these sites, they also may be useful
to other providers and users of medical information on the Web. These principles
have been developed with the understanding that they will require frequent
revision to keep pace with evolving technology and practices on the Internet.
The AMA encourages review and feedback from readers, Web site visitors, policymakers,
and all others interested in providing reliable quality information via the
The Internet has permitted physicians, other health care professionals,
patients, and other consumers to quickly access medical information in unprecedented
volume. Such access has the potential to speed the transformation of the patient-physician
relationship from that of physician authority ministering advice and treatment
(with sometimes questionable patient understanding and adherence to recommendations)
to that of shared decision making between patient and physician. However,
several substantial barriers remain before this relationship can be realized.
These barriers include equitable access to information, imbalance between
patient health literacy and the information provided, extreme variability
in the quality of the content, potential for commercial interests to influence
content, and uncertain preservation of personal privacy.1-4
Web users have been warned regarding the incomplete, misleading, or
inaccurate medical information available on the Web.3
For those seeking easy ways to identify high-quality, reliable information,
some Web sites and organizations have provided rating systems to evaluate
quality of information on the Internet. However, these systems often do not
provide the criteria used to assess quality, nor do they provide the reliability
and validity of their measures.2,4,5
Ultimately, assessing the quality of content depends on the same factors that
readers of print publications depend on: authorship of the content, attribution
to the sources of content, disclosure of funding and competing interests,
and timeliness of the information presented.3
Among Internet users who seek medical information, personal privacy
was ranked as their most important concern.6
A recent study found that while many Internet health information sites provide
privacy policies, most do not follow them.7
More than nearly any other type of information provided via the Web, medical
Web sites must adhere to strict personal privacy codes to prevent individuals'
personal medical information, including patterns of use and interests, from
involuntarily entering the hands of marketers, employers, and insurers.
Information from the American Medical Association (AMA), including the
tables of contents and abstracts of JAMA and the Archives Journals, has been available on the Web since 1995. Physician Select,
a database of physicians that is intended for the public and is searchable
by name, specialty, and location, has been online since July 1996. Health
Insight, a health information site for consumers, was launched in spring 1997. JAMA
and the Archives Journals have been available in
full text and fully searchable online since September 30, 1999.
The AMA has developed and followed a number of guidelines to govern
aspects of its Web offerings. For example, in 1995, the Principles Governing Advertising in Publications of the American Medical Association8 were revised from guidelines that
addressed only print publications to guidelines addressing advertising on
the Web sites of JAMA and the Archives Journals.
In 1997, an editorial in JAMA proposed a set of quality standards for medical
information on the Internet.3 These standards
include proper identification of authors and contributors; attribution for
all sources of information; disclosures of site ownership, financing, advertising,
and conflicts of interest; and indication of the dates content is posted and
updated. In October 1999, the AMA Board of Trustees approved Web Site Linking
Now, in addition to the AMA Publications site and the AMA Web site,
the AMA and 6 other founding societies are preparing to launch Medem, a health
information Web site for the public. To provide guidance for all these sites,
the Guidelines for the AMA Web Sites, provided herein
(see below), address the creation and updating of content, acquisition and
posting of advertising, the preservation of privacy and confidentiality, and
the provision of reliable and efficient e-commerce.
The development of these guidelines began in 1999. An AMA staff committee,
composed of the listed authors, was organized to review the existing individual
guidelines and draft a single document that would provide principles to govern
the presentation and functionality of the 4 major areas for which quality
standards were needed: content, advertising and sponsorship, privacy and confidentiality,
and e-commerce. Initial drafts were reviewed by committee members and consensus
was reached on the content of each of the 4 principles. The document was then
reviewed internally and externally by experts in ethics, publishing, government
regulations, law, and medical informatics and by the AMA Online Oversight
Panel. After subsequent revision, the document was reviewed by the Executive
Committee of the AMA Board of Trustees and was approved on February 28, 2000.
The dissemination of medical and health information via the AMA Web
sites has been evolving since 1995. During the last 5 years, the AMA has had
substantial experience providing online content, some experience with online
advertising and sponsorship, and limited experience with e-commerce. The Guidelines for AMA Web Sites were created to facilitate
the maturation and implementation of these and other Web-based functions,
while simultaneously assuring site visitors' rights to privacy and confidentiality.
Many of the principles outlined in these guidelines have served the AMA Web
sites during their 5-year evolution. However, the guidelines will be fully
operational on the AMA Web sites in conjunction with the implementation of
registration and access control in the near future.
The primary goal in creating these guidelines was to guide the development
and maintenance of the AMA Web sites. However, these guidelines may be helpful
to others providing medical information on the Web, as well as to viewers
who want to know what to look for as they search for reliable high-quality
These guidelines are not static; the constant evolution of the Web ensures
that guidelines will need ongoing reevaluation and frequent revision. We encourage
readers, viewers, others interested in the provision of online medical information,
and policymakers to review and comment on these guidelines. Future revisions
will consider these comments while retaining the guidelines' fundamental principles:
authorship, attribution, and disclosure must always be clearly provided; editorial
content must be current and the way in which quality is ensured explicitly
stated; advertising and commercial sponsorship must not influence any editorial
content and advertising must be easily discernible from editorial content;
privacy and confidentiality policies must be explicit and adhered to, ensuring
that individuals' rights to privacy and confidentiality are preserved; and
e-commerce must function efficiently and securely. Adherence to these fundamental
principles will facilitate acquisition and application of medical information
by patients, the public, physicians, and other health care professionals.
The following guidelines apply to all American Medical Association (AMA)
Web sites, including any Web sites with which the AMA's name is associated
in any way other than a simple link to any of the AMA Web sites. These guidelines
are the AMA's policy for its Web sites but also are intended to provide guidance
for creators of Web sites that provide medical and health information for
professionals and consumers. These guidelines are established with the understanding
that the World Wide Web is a constantly evolving technology, and the guidelines
must be reviewed and revised frequently to ensure that they reflect the current
state of technology and practice on the Web.
A standing committee composed of AMA staff members from the Scientific
Publications and Multimedia, Publishing and Business Development, Ethical
Standards, and Internet and Database Services areas will review the guidelines
regularly and revise as necessary. The committee will seek review and comment
from an advisory panel of individuals outside the AMA with expertise in Web-based
content, advertising, privacy and confidentiality, and e-commerce.
The AMA is committed to providing medical and health information of
high quality via its Web sites. Visitors to AMA Web sites will be given information,
navigational direction, and tools needed to judge the quality, reliability,
objectivity, sources, and funding of content and to make effective use of
Content is defined as all material (including
text, graphics, tables, equations, audio, and video) and menu/directional
icons, bars, indicators, listings, and indexes. These principles also address
functions that support content (eg, links, navigation, searches, calculations).
Web site ownership, including affiliations, strategic alliances, and
significant investors, should be clearly indicated on the home screen or directly
accessible from a link on the home screen.
Copyright ownership of specific content should be clearly indicated
on screen and on items printed from the site.
The site should provide information about the platform(s) and browser(s)
that permit optimal viewing in a location that is easy to find.
Information about restrictions on access to content, required registration,
and password protection (if applicable) should be provided and easy to find.
Information about payment (ie, subscriptions, document delivery, pay
per view, etc) should be provided and easy to find. See "Principles for E-commerce"
Information about privacy should be provided and easy to find. See "Principles
for Privacy and Confidentiality" herein.
Funding or other sponsorship for any specific content should be clearly
indicated and should comply with the "Principles for Advertising and Sponsorship"
Content should be easily distinguished from advertising as described
in "Principles for Advertising and Sponsorship."
Guidelines for editorial content review, posting dates, and sources
were developed based on experience with the AMA Scientific Publications' sites.
All scientific publications and consumer site information adhere to these
guidelines. As of publication of these guidelines, content posted on the AMA
corporate site will adhere to these guidelines as well.
Review. Content should be reviewed for quality (including originality, accuracy,
and reliability) before posting. Clinical editorial content should be reviewed
by content experts not involved in creation of the content, and the content
should be revised appropriately in response to such review. The method of
review will be determined by individual sites. (For example, Scientific Publications
sites include peer review. Other sites rely on review by editorial boards.)
The language complexity of the content should be appropriate for the
site's audience. Content should be reviewed for grammar, spelling, and composition
A description of the editorial process and method of content review
should be posted on the site.
A list of staff members and other individuals (eg, editorial board)
responsible for content quality, other than anonymous peer reviewers, should
be posted on the site.
Date of Posting, Revising, and Updating and Timeliness of Editorial
Content. The dates that content is posted, revised, and updated should be clearly
indicated. Procedures for updating and removing time-sensitive content should
be developed, implemented, and periodically reviewed to ensure that the updating
and review schedule is appropriate. (For example, content can be sorted by
date posted and all content older than 6 months reviewed for timeliness and
accuracy.) An indication of significant revisions to any specific content
should be posted and may include instructions to discard copies of versions
previously printed or downloaded.
Sources of Editorial Content. Source for specific content should be clearly identified (ie, author
byline or names of individual, organizational, departmental, institutional,
agency, or commercial provider/producer).
Affiliations and relevant financial disclosures for authors and content
producers should be clearly indicated.
Individuals who post content in online discussions, chat rooms, and
e-lists should be instructed to disclose financial interests and commercial
funding or affiliations related to the subject of the posted content discussion,
chat, or list.
Reference material used to develop content should be cited in a manner
appropriate for the site's audience.
Intrasite content links should be reviewed before posting and maintained
and monitored. If links are not functional, links should be repaired in a
External site links should be reviewed before posting and maintained
and monitored. If links are not functional, these links should be repaired
in a timely manner.
External links to commercial sites must comply with the "Principles
for Advertising and Sponsorship."
Sites should not prevent viewers from returning to a previous site.
Sites should not redirect the viewer to a site the viewer did not intend
Sites should not frame other sites without permission.
If content can be downloaded in a portable document file (PDF) format,
instructions regarding how to download the PDF file and how to obtain the
necessary software should be provided and easy to find. A link to such software
should be provided.
Features that facilitate use of the site should be provided and easy
to find, and should include a site map or other site organizational guide,
a help function or frequently-asked-questions page, a feedback mechanism,
and customer service information (if available).
Each distinct site should provide a search engine or appropriate navigation
tool to facilitate use. If the site provides a search engine, instructions
specifying how to use the search function and how to conduct different types
of searches may be provided.
Graphics files should include a "mouse over" indication of the graphical
content. For large files, the space where the file resides should include
the size of the file. As a courtesy to the viewer, when possible, when a large
file can be downloaded by clicking, the viewer may be informed of the size
of the file before the file begins downloading and should have the opportunity
to cancel the download.
These principles are revised from the Principles Governing
Advertising in Publications of the American Medical Association, previously
revised in May 1999.
These principles are applied by the AMA to ensure adherence to the highest
ethical standards of advertising and to determine the eligibility of products
and services for advertising on the AMA Web sites.
The appearance of advertising on the AMA Web sites is neither a guarantee
nor an endorsement by the AMA of the product, service, or company or the claims
made for the product in such advertising. The fact that an advertisement for
a product, service, or company has appeared on the AMA Web sites shall not
be referred to in collateral advertising.
As a matter of policy, the AMA will sell advertising space on its Web
sites when the inclusion of advertising does not interfere with the mission
or objectives of the AMA or its publications.
To maintain the integrity of the AMA Web sites, advertising (ie, promotional
material, advertising representatives, companies, or manufacturers) cannot
influence editorial decisions or editorial content (as defined in "Principles
for Content"). Decisions to sell advertising space are made independently
of and without information pertinent to specific editorial content. The AMA
Web sites' advertising sales representatives have no prior knowledge of specific
editorial content before it is published.
Placement of advertising adjacent to (ie, next to or within) editorial
content on the same topic is prohibited (for the table of contents, a banner
advertisement must not appear next to the title of a related article). Just
as a print advertisement should not be placed next to an editorial page on
the same topic, a digital advertisement should not be adjacent to editorial
content on the same topic, either by linking or appearing adjacent in the
content section of the same screen. Similarly, just as a print reader can
choose to read an advertisement or skip over it, a computer user should have
the option to click or not click on an advertisement. Viewers will not be
sent to a commercial site unless they choose to do so by clicking on an advertisement.
The AMA, in its sole discretion, retains the right to decline any submitted
advertisement or to discontinue posting of any advertisement previously accepted.
1. Digital advertising may be placed on the AMA Web site.
2. Digital advertisements must be readily distinguishable from editorial
content. If the distinction is unclear, the word "advertisement" should be
3. Digital advertisements may appear as fixed banners or as rotating
4. Digital advertisements may not be juxtaposed with, appear in line
with, or appear adjacent to editorial content on the same topic, or be linked
with editorial content on the same topic.
5. Digital advertisements that are fixed in relation to the viewer's
screen or that rotate should be placed to ensure that juxtaposition (as defined
in item 4 above) will not occur as screen content changes.
6. Digital banner advertisements should be limited to 1 advertisement
per screen view.
7. Advertisements and promotional icons may not appear on the home page
of the AMA Web site (http://www.ama-assn.org) or the home pages
of JAMA (http://www.jama.com) or the AMA
8. AMA, JAMA, and Archives Journals logos
may not appear on commercial Web sites as a logo or in any other form without
prior written approval by the individuals responsible for the respective areas
9. Advertisements may link to additional promotional content that resides
on the AMA Web site.
10. Advertisements may link off-site to a commercial Web site, provided
that the viewer is clearly informed with a buffer page that to proceed by
clicking would mean the viewer would leave the AMA Web site and that the AMA
Web site does not vouch for or assume any responsibility for any material
contained on the Web site to which it links. The buffer page will display
the following statement:
You are leaving the AMA Web site. If you wish to link to a Web
site maintained by [company name], please click below. If you do not wish
to leave the AMA Web site, please click on the "back" button of your browser
to return to the site. The AMA does not assume responsibility for content
of other Web sites.
The AMA will not link to Web sites that frame the AMA Web site content
without express permission of the AMA; prevent the viewer from returning to
the AMA Web site or other previously viewed screens, such as by disabling
the viewer's "back" button; or redirect the viewer to a Web site the viewer
did not intend to visit.
The AMA reserves the right to not link to or to remove links to other
11. Methods of corporate funding should be described in the Web site's
information about advertising or the digital rate card.
1. All financial or material support for electronic collections of articles,
Web site content, and other types of online products (such as condition-specific
Web sites, online databases, or material on CD-ROM) will be acknowledged and
clearly indicated on the home screen or via a link from the home screen.
2. Acknowledgment of support will appear on the home page, on the running
foot of all pages, on any packaging and collateral material included (eg,
CD-ROM jewel case and companion print insert), and on any materials used to
publicize the online product. Content accessed through the site that does
not reside on the site (eg, abstracts or articles from another site) will
not include sponsorship information.
3. These acknowledgments will not make any claim for any supporting
company product(s). The final wording and positioning of the acknowledgment
will be determined by the AMA. The wording will be similar to "Produced by
[AMA publication] with support from [Company]."
4. The home page acknowledgment of digital products may be linked to
an on-site "About [Company]" page or may link to the company's Web site through
the intervening buffer page referred to in "Advertising," item 10.
5. The "About [Company]" page may be linked to other on-site pages provided
by the supporting company. These pages must be readily distinguishable from
editorial content, must be clearly labeled as provided by the supporting company,
and must not be linked to related AMA editorial content.
6. The running foot acknowledgment will not be linked to any other materials.
7. Other acknowledgments and disclosures may be required, as deemed
necessary by the AMA.
8. AMA, JAMA, and Archives Journals logos
may not appear on the sponsoring company Web site as a logo or in any other
form without prior written approval by the individuals responsible for the
respective areas within the AMA.
The following principles reflect the AMA's commitment to maintain the
Web site visitor's rights to privacy and the confidentiality of personal information.
In this context, privacy refers to the right of the
individual site visitor to choose whether to allow personal information to
be collected, by the host site (in this case, the AMA) or by third parties,
and to know what type of information is collected and how that information
is used. Confidentiality is the right of an individual
to not have personally identifiable medical or other information disclosed
to others without that individual's express informed consent.
The Internet has the potential to allow information about Web site use
to be tracked in aggregate (which can help site developers understand site
use and improve the experience of the viewer) and at the individual user level.
Individual user information can improve the visitor's experience of the site
by permitting personalization of the site related to the individual's particular
interests or concerns. However, tracking of personal medical and health information
(ie, medical conditions, health-seeking behaviors and questions, and requests
about drug therapies or medical devices or information pertaining to them)
could breach an individual's personal privacy and reveal an individual's health
Thus, health and medical Web sites have a particular obligation to protect
the privacy and confidentiality of individuals. Patients and individuals with
interest in particular medical conditions should feel confident in obtaining
information and using resources on the site, without concern that such use
will be identified with them without their permission. The AMA believes that
all site visitors should have the opportunity to opt in or out of allowing
personal information to be tracked. In addition, the AMA takes extensive measures
to ensure the safety and security of its Web site servers and to guard against
divulging private information. The AMA believes that Web site visitors should
know who (eg, the site organization or third party) is tracking personal information
and the types of personal information that are tracked and should have the
right to opt out of such information being collected at any time.
Protection of patients' rights to confidentiality is fundamental to
medical publishing. Health care professionals must adhere to privacy and confidentiality
principles to legally and ethically share important information about medical
conditions of individual patients. The sharing of such information may improve
clinical care for the individual or improve the general state of knowledge
about medical and health care through medical research. Medical publications,
whether in print or online, must not reveal identifiable information about
an individual without that person's express informed consent. These principles
apply to information in medical publications (eg, JAMA) as well as less
formal venues used by health care professionals, such as online discussion
groups, chat rooms, and e-lists.
the home page or the site navigational bar and should be easily accessible
to the user. The Web site should adhere to the privacy principles posted.
2. Individuals responsible for Web sites that post advertising should
be aware of current technology and access possessed by third parties that
post or link to advertisements. Web sites should ensure that the technology
and access used by third parties adheres to the Web site's privacy policies.
3. The site should not collect name, e-mail address, or any other personal
information unless voluntarily provided by the visitor after the visitor is
informed about the potential use of such information.
4. The process of opting in to any functionality that includes collection
of personal information should include an explicit notice that personal information
will be saved, with explanation of how the information will be used and by
whom. The opt-in statement should not be embedded in a lengthy document and
should be explicit and clear to the viewer.
5. Collection, retention, and use of nonmedical personal information
about site visitors may be offered to viewers when the AMA believes that such
information would be useful in providing site visitors with products, services,
and other opportunities, provided such use adheres to these principles and
is within bounds of current regalations and law
(http://www.ftc.gov/privacy/index.html). Individuals may agree to have such nonmedical personal information
collected or may choose not to, with the understanding that opting out of
having such information collected prevents the site from being tailored to
their particular needs and interests. Such information will not include personal
health information, such as any information about medical conditions or medications
6. Names and e-mail addresses of site visitors should not be provided
or released to a third party without the site visitor's express permission.
7. E-mail information, personal information about specific visitor's
access and navigation, and information volunteered by site visitors, such
as survey information and site registration information, may be used by the
site owner to improve the site but should not be shared with or sold to other
organizations for commercial purposes without the site visitor's express permission.
8. The AMA will use e-mail addresses voluntarily provided by site visitors
to notify them about updates, products, services, activities, or upcoming
events. Site visitors who do not wish to receive such notifications via e-mail
should be able to opt out of receiving such information at any time.
9. The AMA has licensed its physician and medical student list to third
parties for more than 50 years. This information is licensed to database licensees
under strict guidelines. The names and addresses of physicians in the AMA
Physician Masterfile are made available only for communications that are germane
to the practice of medicine or of interest to physicians or medical students
as consumers. E-mail addresses are excluded from such licensing agreements.
10. Nonidentifiable Web site visitor data may be collected and used
in aggregate to help shape and direct the creation and maintenance of content
and to determine the type of advertisement to be seen by site visitors while
on the AMA site.
11. The AMA will not collect and will not allow third parties to collect
personal medical information (medical conditions, health-seeking behaviors
and questions, and use of or requests for information about drugs, therapies,
or medical devices) without the express consent of the site visitor after
explanation of the potential uses of such information.
12. A cookie is a small file stored on the
site user's computer or Web server and is used to aid Web page navigation.
Two types of cookies are commonly used. A session cookie is a temporary file created whenever a Web site is accessed and is
self-terminated based either on an expiration date (eg, 3 hours from creation
of the cookie) or by closing the Web browser. A persistent
cookie is a permanent file and must be deleted manually. Cookies referred
to in the context of these Guidelines are persistent cookies.
A cookie function may be used on the site to track visitor practices
to help determine which site features and services are most important and
guide editorial direction. The cookie makes it possible for the user to access
the site without requiring entry of a user name or password, allows the user
to view different restricted areas of the site without reregistering, allows
the user to personalize the site for future use, and permits the user to make
subsequent purchases without reentering credit card information. Users who
do not desire the functionality created by the cookie should have the option
to disable the cookie function, either by indicating when asked that they
do not wish to have a cookie created or by disabling the cookie function on
their browser. Individuals should be able to opt out of cookie functions that
permit tracking of personal information at any time.
13. E-mail messages sent to a Web site may not be secure. Site visitors
should be discouraged from sending confidential information by e-mail. Site
visitors sending e-mail accept the risk that a third party may intercept e-mail
14. Market research conducted by the site or its agent to enhance the
site should be clearly identified as such.
15. E-mail alerts and newsletters should contain an "unsubscribe" option.
Content published within the AMA Web sites that includes patient information
should adhere to the patient privacy and anonymity principles followed by JAMA
and the Archives Journals, which are based on the
recommendations of the International Committee of Medical Journal Editors
(http://jama.ama-assn.org/info/auinst_req.html). These principles
apply equally to formal medical publications and the informal interactive
communication permitted by the Web, including online discussion groups, chat
rooms, or e-lists.
Patients should be aware when they provide information about their individual
medical conditions in the context of such discussions that information may
be linked with a personal identifier. However, AMA Web sites will not collect
information about individual medical conditions without the express permission
of the site visitor. Physicians and other health care professionals should
be aware that any patient information reported in the context of such venues
must adhere to the confidentiality principles listed herein. Moderators of
such sessions should make every effort to ensure that listed material adheres
to the principles stated herein and, when in doubt, should query the individual
providing the information. If the individual is a patient providing such information,
the moderator should query the patient as to whether the patient intends for
the sensitive medical information to be revealed. If the individual providing
the information is a health care professional, the moderator should query
the professional as to whether the patient reported has provided informed
consent and state so.
Patients have a right to privacy that should not be infringed without
express informed consent. Identifying patient information should not be published
in print or online descriptions, photographs, or pedigrees (illustrations
of how a disease is expressed within an extended family for purposes of determining
possible inheritance) unless the information is essential for scientific purposes
and the patient (or parent or guardian) gives express informed consent for
Identifying details should be omitted if they are not essential, but
patient data should never be altered or falsified in an attempt to attain
anonymity. Complete anonymity is difficult to achieve, and informed consent
should be obtained if there is any possibility as to whether identifiable
information may be disclosed.
When express informed consent has been obtained, it should be indicated
in the posted Web content.
The AMA e-commerce principles are intended to ensure that users and
purchasers of information, products, and services on the site will have access
to secure, efficient transactions for online and remote customer fulfillment.
All such transactions should adhere to the AMA "Principles for Privacy and
1. A link or reference to the site's policies on privacy should be clearly
2. The security software and encryption protocol used on the site for
financial transactions should be described.
3. Users should be able to select whether or not the Web host will retain
the user name and password (ie, disable cookie function, as described in "Principles
for Privacy and Confidentiality"). Users should be able to opt in or opt out
of functions that track personal information at any time.
4. A link or reference to customer service contact information (e-mail,
telephone, fax, mail), including hours of operation and time zone, should
be clearly visible.
6. Users should be able to review transaction information prior to execution
(information, products, and services listed; prices; totals; shipping and
7. As a courtesy, following execution of the transaction, users should
be provided, on a page or by e-mail, purchase information (see item 6 above)
as well as shipping tracking number, if appropriate.
8. Users will be notified on-screen when entering or leaving a secure
site and will have the option to proceed or remain on the current site.
9. If a user's browser does not support a secure connection, no financial
transactions will be permitted over the Internet.
10. Response times for feedback and fulfillment should be clearly stated.
11. Products and services will not be endorsed or cobranded by the AMA
or AMA publications. Any product promotions must adhere to the "Principles
for Advertising and Sponsorship."