The pharmaceutical industry works within rigid regulations that govern its behaviour in both the development and promotion of its medicines and understands all-too-well the financial and reputational penalties of getting it wrong. The digital and social media revolution therefore represents a huge challenge to the way the industry and healthcare communications agencies operate.

Whereas regulation is bounded by country borders, digital communication is boundless. Whereas regulation brings restriction to what is communicated, the internet brings freedom. For pharma there appears a magnificent opportunity to communicate alongside the spectre of swingeing regulatory retribution if that communication is judged wrong. Consequence; inaction and hand-sitting whilst the world moves on and people get their medicines information from less reputable sources.

The solution for some has been to seek more regulation. Tell us what we can do and then we can get creative. This is flawed and ultimately doomed to failure. Over the past few years the governments of Europe have been wrangling as to what information pharma companies can reasonably pass to patients (and a lot more besides). This is not an argument about whether promotion of medicines to patients should remain unlawful (all are agreed on that) but rather what constitutes promotion of a medicine by a company. Consequence; inaction and hand-sitting whilst the world moves on and people get their medicines information from less reputable sources.

What then is the resolution to this double impasse in a world where even a few of its countries cannot agree in a common cause? It is, perhaps, by re-engaging with the concept of morality.

What humans view as good or bad, kind or hurtful, wrong or right can be traced back to a few basic principles that remain very constant over time and geography, across races and cultures. Bring benefit and minimise harm to others, respect the rights of others to make their own choices and be fair in how you treat other people. ‘Others’ – morality is about what we do to others. Of course people interpret the principles in different ways, value them differently and balance them differently so people reach different decisions about what is right or wrong; as do regulators.

There are few pharma regulations, if any, that cannot be traced to a home in one or more moral principles but we appear to have forgotten the path. Rules are meaningless without their moral foundations and are too often considered a rote learning exercise – we can do this, we can’t do that. This has tragically left us bereft of initiative when the rules aren’t there.

Worse; the public, the great morass of rapidly digitally communicating beings out there don’t give a fig for our rules or whether we have kept to them; they care about what they perceive to be moral. If your defence is ‘We kept within the rules’, when the un-nameable hits the social media fan, you are lost. You may as well pack up, you have failed to act as a human.

Morality is the connection between compliance to rules and good patient and health professional communication. Compliance rules and law are born in moral principles and in particular in our obligation not to harm. Truly great communication must be ethical in that morality is concerned with our treatment of others. If you really care about your audience, if you are truly people focused you must be acting morally.

Communicators must escape from the tragic dichotomy that currently prevails between the creative process from the compliance process. Of course we must respect the laws and codes that apply in jurisdictions where healthcare communication is targeted but our first responsibility is to recognise those moral principles that make us human. Do that first, and not only will your activities be more likely to align with regulatory requirements wherever you are, but your communication will inevitably be clearer.