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e-health networks and social transformations 299offers an auction service in which patients can elicit physician bids for surgeries(Baur et al., 2001). More typical is HealthCentral.com, which allowsusers to create their own health profiles and provide personal feedback (Allen,1999). However, such interactive websites are not without problems.One particularly sensitive area is that of privacy. An online pharmacy, drugstore.com,sold information it collected from visitors to its website to a pharmaceuticalmarketing company. Thus, if someone purchased or asked aboutdrug X from drugstore.com, that person might find herself solicited or“couponed” by the maker of drug Y, a competitor of drug X. The webcompany drkoop.com sold, as part of its bankruptcy liquidation, some of thepersonal information about site visitors that it had collected. These dataincluded personal medical and financial information on many consumers whocollected or shared information via interactive chat rooms or used interactivetools for searching the web (Health Data Management, 2003).Other types of e-health privacy abuses are more subtle. Companies includingDoubleclick.com and Amazon.com work with their partner sites to collectindividually identifiable data on web surfers through “cookies,” which serveto draw ever-more precise pictures of an Internet user. So, for instance, a surferwho reads an Amazon.com review about a book on depression and later clickson a bulletin about a Hollywood star’s suicide could potentially have data onhis book-buying and news-reading habits, his name, address, and phonenumber, and much else besides, sold to a life insurance company (who mightcancel his policy), a drug marketer (who would send him product solicitations),or even a cemetery (offering “pre-planning”). The more participatingsites a user visits, the more detailed and inter-related becomes the personalportrait. Privacy-abusive practices are disturbing to privacy advocates, andalarming to e-health seekers, and in some cases are deterring surfers fromusing Internet resources. Ultimately, these practices could erode the ability ofthe Internet to provide services to precisely those who would most benefitfrom the web.Quality of Online Health InformationThe prospect of easily accessible, high-quality health information was anotherearly appeal of the Internet. The hope was that, by having quality certification(such as is offered by the “Health on the Net” [HON] Foundation[www.hon.ch], created in 1995), users would patronize certified cites, andinaccurate medical information or practices would be disputed and diminished.Yet researchers consistently find problems with the quality of onlinehealth information, in commercial sites as well as discussion lists, usenetnewsgroups, and online support groups (Kassirer, 1995; Jadad and Gagliardi,1998; Consumers International, 2003).