CHAPTER ONE Commencement Provisions
Objective ARTICLE 1- (1) The objective of this Regulation is to determine the fundamental principles and criteria regarding promotional and informational activities in healthcare services, to regulate the procedures and principles for the supervision of these activities, and the sanctions to be applied.
Scope ARTICLE 2- (1) This Regulation covers promotional and informational activities carried out by healthcare professionals, all health institutions, organizations, establishments belonging to real persons and private law legal entities that provide healthcare services and operate with permission, conformity certificates, or licenses granted by the Ministry of Health pursuant to the relevant legislation, and international health tourism intermediary organizations, as well as promotional and informational activities carried out by individuals, institutions, and organizations that do not have the authority, permission, or license to provide healthcare services.
Legal Basis ARTICLE 3- (1) This Regulation has been prepared based on the Law on the Manner of Practice of Medicine and Its Branches (Law No. 1219) dated 11/4/1928, subparagraph (c) of the 9th article and the additional 11th article of the Fundamental Law on Health Services (Law No. 3359) dated 7/5/1987, subparagraph (e) of the first paragraph of the 355th article and the 508th article of the Presidential Decree on the Presidential Organization (Presidential Decree No. 1).
Definitions ARTICLE 4- (1) In this Regulation, the terms below refer to: a) Ministry: The Ministry of Health. b) General Directorate: The General Directorate of Health Services. c) Commission: The Provincial Evaluation Commission for Promotional and Informational Activities in Health. ç) Directorate: The Provincial Health Directorate. d) Advertising: Announcements of a commercial marketing communication nature carried out in any medium, in written, visual, audio, and similar ways, for the purpose of creating or increasing demand for a product or service and persuading individuals, in connection with private health facilities, the provision of health services, or medical professions in the field of health. e) Healthcare Professional: Physicians, dentists, pharmacists, nurses, midwives, and opticians, as well as other professionals defined in the additional Article 13 of Law No. 1219. f) Health Facility: All health institutions, organizations, and establishments belonging to real persons and private law legal entities where health services are provided. g) Promotional and Informational Activities: For private health facilities, information of a protective and developmental nature related to the health field served, including the specialties where patients are accepted and treated, address and contact information; and for physicians, professional and academic titles, major and minor branch specialties determined by Law No. 1219, examination days and hours, time and place of patient acceptance, and information of a protective and developmental nature related to the healthcare service they are authorized to provide; activities that are not misleading or deceptive, do not endanger human health, do not create an environment of demand and unfair competition, and do not fall within the scope of the definition of advertising.
CHAPTER TWO Fundamental Principles in Promotion and Information, Respect for Privacy and Confidentiality of Information, Use of Visual Content
Fundamental principles in health promotion and information ARTICLE 5- (1) Implicit or explicit advertising for the provision of healthcare services is forbidden. Promotion and information may be provided, provided that the following principles and bases are adhered to: a) It is mandatory to comply with general morality, medical deontology, and professional ethics rules in promotion and information. b) Information related to the provision of healthcare services can only be provided by healthcare professionals legally authorized in that subject. c) Promotion and information that misleads the public, misdirects, endangers individual and public health, and creates an environment of demand and unfair competition, in a way that suggests that health facilities accept and treat patients in specialties other than those for which they are licensed, cannot be carried out. ç) In promotion and information, even if carried out by a healthcare professional, explanations about medical and treatment methods that have not been scientifically and clinically proven, have not become an established medical method, or have not been defined and regulated by the Ministry as a medical procedure, cannot be included, and statements claiming that diseases are treated or treatment is assisted with these methods cannot be used. d) Promotion and information is limited to: for health facilities, the specialties where patients are accepted and treated, address and contact information, and information of a protective and developmental nature related to the health field served; and for physicians and dentists, major and minor branch specialties determined by Law No. 1219, academic title, examination days and hours, time and place of patient acceptance, and information of a protective and developmental nature related to the healthcare service they are authorized to provide. e) In promotion and information, no specialty title other than the major and minor branch specialties specified in Law No. 1219 can be written or used. f) Activities that create the impression that patients have posted thank you announcements regarding healthcare services cannot be engaged in. g) Promotion and information content cannot directly or indirectly steer the patient towards a specific healthcare professional or health institution. ğ) Steering towards a specific healthcare professional or health institution cannot be done through intermediary organizations, broadcasting, and communication channels for reasons such as medical aid services, general health check-up, health screening, consultancy, or information. h) Scientific terms, research results, or excerpts from scientific publications and statistical data cannot be presented in a way that leads to results different from the reality. ı) Promotion and information that abuses people's trust or exploits lack of knowledge, in a way that creates the perception that the good or service subject to the healthcare service is different or superior to others, cannot be carried out. i) The date of the last update of the information on the internet sites and the contact information to reach the internet site editor must be clearly stated. j) Health facilities and physicians may register with internet search engines. However, the keywords to be used and all information appearing on the search engine results page cannot violate the principles in this Regulation. k) Without the knowledge and consent of individuals, personal phones cannot be called, and advertisements and promotions cannot be made by sending letters, text messages, electronic mail, and messages via social sharing tools. l) Healthcare services cannot be presented for marketing purposes such as incentives, sweepstakes, and gifts, and advertisements, promotions, and information for this purpose cannot be made. (2) It is mandatory to comply with the principles stipulated in this Regulation for promotion and information made on social sharing and internet sites. Those who engage in promotional and informational activities contrary to these principles and those who share them are equally responsible. (3) It is mandatory to obtain permission from the Ministry before carrying out promotional and informational activities within the scope of social responsibility projects and campaigns to be conducted for healthcare services. Promotion and information are limited to the scope and duration of the social responsibility project and only to the individuals or organizations that will benefit from the project. (4) Promotional and informational activities within the scope of international health tourism are carried out in accordance with the provisions of the Regulation on International Health Tourism and Tourist Health, published in the Official Gazette dated 13/7/2017 and numbered 30123. (5) Except for cases of scientific, statistical, and news-worthy information distribution, all kinds of advertising, promotion, and similar activities related to the procurement and transfer of organs and tissues are prohibited.
Respect for privacy and confidentiality of information ARTICLE 6- (1) In promotional and informational activities, it is mandatory to comply with the provisions of the Patient Rights Regulation, published in the Official Gazette dated 1/8/1998 and numbered 23420, in order to prevent violations of patient rights and the problems arising from them, and to enable the actual use of legal remedies when necessary. (2) Promotional and informational activities shall be conducted in accordance with the provisions of the Law on the Protection of Personal Data (Law No. 6698) dated 24/3/2016 and the Regulation on Personal Health Data, published in the Official Gazette dated 21/6/2019 and numbered 30808.
Use of visual content in promotion and information ARTICLE 7- (1) It is prohibited for healthcare professionals and health facilities to include before and/or after visuals in their promotions and information related to the healthcare services they provide, if these visuals are comparative of the treatment effects and create demand. Visual content can be used provided that the following principles and bases are adhered to: a) Visual content to be shared cannot contain images and statements that are contrary to general morality rules, pose a threat to public health and welfare, violate the rights and freedoms of individuals, exploit the patient's private or social life, or cause public anxiety or be misleading. b) The use of visual content belonging to the patient is subject to obtaining the explicit consent of the patient himself, or his guardian or custodian if he is a minor or under interdiction, and compliance with the Patient Rights Regulation. The Visual Content Recording and Processing Consent Form in ANNEX-1 is used when obtaining explicit consent. c) The patient has the right to see the visual content to be shared beforehand. Visual sharing permission can be withdrawn at any time without being subject to any procedure or condition, upon the request of the patient himself, or his guardian or custodian if he is a minor or under interdiction. The health facility or the relevant healthcare professional is obliged to immediately process and finalize the patient's withdrawal request. ç) It is mandatory to provide information and assurance that there will be no change in the diagnostic and treatment applications and the fees to be charged to patients who do not give permission for visual sharing. d) No payment or discount can be made, or gift can be given to the patient in return for the permission obtained for the use of visual content. e) It is mandatory that the environments and techniques used for the videos and photographs to be used in promotion and information are not contrary to reality, and are displayed without misleading make-up. No subsequent technological changes or corrections can be applied to visual content. It is mandatory to specify the processing date and the date the visual was displayed in the visual content. f) Patient comments or expressions that constitute a thank you announcement regarding visual content, even if made in other media, cannot be shared. It is mandatory to completely close the comment sections for shares related to visual content. g) Patient images cannot be shared during surgery or medical intervention and in the operating room. ğ) Visual content belonging to the private areas of the body that constitute a violation of general morality rules cannot be shared. h) Visual content shares must be made by the health facility or the relevant healthcare professional itself. The fact that these shares are made by others does not remove the responsibility of the relevant health facility or healthcare professional. ı) Shared visual content cannot be published as sponsored or for a fee in media such as written, visual press, social media platforms, internet sites. i) No visual related to the region, venue, medical device, equipment, tool, material, or personnel, or any similar element can be shared in a way that gives the impression that the healthcare professional or health institution is superior or better than other healthcare professionals or health institutions.
CHAPTER THREE Supervision and Evaluation of Promotional and Informational Activities, Supervision of Promotional and Informational Activities on Radio and Television Channels, and Activity Report
Supervision and evaluation of promotional and informational activities in the health sector ARTICLE 8- (1) Promotional and informational activities are regularly scanned by the General Directorate and the Directorates through press and broadcasting organs, and internet sites. The Directorates carry out the work and procedures regarding promotional and informational activities that are found to be conducted contrary to the provisions of this Regulation in social sharing and internet sites, posters, announcements, written and visual press, and similar media, upon the instruction of the Ministry, ex officio detection, denunciation, or complaint, in accordance with the Promotional and Informational Activity Report Form in ANNEX-2, through the Ministry's Health Facilities Inspection and Monitoring System. (2) In the provinces, the Provincial Evaluation Commission for Promotional and Informational Activities in Health is established with the approval of the Governorship to evaluate the compliance of promotional and informational activities with the provisions of this Regulation and other relevant legislation. The Commission is composed of a total of seven members: the head of health services as the chairperson, a vice chairperson, the unit manager concerned according to the relevance, a specialist physician working in the public sector in the health field subject to the evaluation, an attorney working in the Directorate if one exists, or an attorney working in the public sector in the province if one does not exist, a representative from the Provincial Directorate of Commerce, and a representative from the professional organizations established by law according to the relevance. The Commission evaluates and decides on the promotional and informational activities found to be contrary within the scope of the first paragraph, within a maximum of thirty days from the date the examination is concluded and referred to the Commission. The Commission convenes upon the written invitation of the Director with the participation of at least five members and takes decisions with the absolute majority of those present. The secretariat of the Commission is carried out by the Directorate. (3) The necessary notifications are made to the Ministry of Trade or the Provincial Directorates of Trade for evaluation by the Advertising Board within the framework of the Law on the Protection of Consumers (Law No. 6502) dated 7/11/2013, regarding promotional and informational activities whose violation has been documented. (4) In the notification files submitted by the Ministry to the Ministry of Trade and by the Directorates to the Provincial Directorates of Trade regarding the advertising, promotion, and informational activities of the persons and health facilities covered by this Regulation, the following must be included: a) The decision of the Provincial Evaluation Commission for Promotional and Informational Activities in Health. b) Printed examples of the advertisements, promotions, or information subject to the complaint, with the dates and URL addresses of the internet sites, detailed, explanatory, and distinguishing information regarding which expressions in the promotions constitute a violation of which provision of the relevant legislation. c) Information and documents related to the work and procedures carried out within the framework of the relevant legislation based on the examination or inspection result made by the Directorates regarding the advertiser, the health facility and organizations making the contrary promotion and information. ç) If any, the license, notification, registration, or similar permit documents belonging to the health facility subject to the complaint or the advertised service.
Supervision of promotional and informational activities in the health sector on radio and television channels ARTICLE 9- (1) Healthcare professionals who participate in promotional and informational programs, speak, and make explanations on radio and television channels broadcasting via cable, satellite, terrestrial, and similar transmission environments are obliged to sign the Undertaking in ANNEX-3 in two copies before the program. One copy of the Undertaking is kept in the relevant broadcasting organization, and another copy is sent to the Ministry. (2) Whether the promotional and informational activities carried out on radio and television channels, and the explanations and speeches made within this scope, comply with the principles and bases determined by this Regulation is examined and reported with justification by the Review and Evaluation Commission for Promotional and Informational Activities in Health, which is created by the Ministry for each instance, specifically for the relevant health field, consisting of at least three members who are academics in the relevant field of expertise. In the justified report, those found to have provided information, spoken, or made explanations contrary to public and individual health are subject to the necessary administrative sanctions within the framework of the relevant legislation, and are also sent to the Radio and Television Supreme Council with a request for examination and action within the scope of the Law on the Establishment and Broadcasting Services of Radio and Television (Law No. 6112) dated 15/2/2011.
CHAPTER FOUR Miscellaneous and Final Provisions
Sanctions ARTICLE 10- (1) If it is determined that physicians or dentists have carried out promotion and information contrary to the provisions of this Regulation, an administrative fine shall be applied pursuant to the provisions of Article 27 or Article 44 of Law No. 1219, according to the person concerned. The administrative fines imposed shall be paid within one month from the date of notification. The necessary notifications are made to the professional organizations to which the persons concerned are affiliated for evaluation and action within the scope of the relevant legislation. (2) A health facility determined to have carried out promotional and informational activities contrary to the provisions of this Regulation shall be warned twice. If it is determined for the third time within one year that promotional and informational activities contrary to the provisions of this Regulation have been carried out, the activity of the unit in the relevant medical or specialty branch shall be suspended for three days. (3) An international health tourism health facility or international health tourism intermediary organization determined to have carried out promotion and information contrary to the provisions of this Regulation shall be warned. If detected for the second time within one year, the health tourism activity of the organization and facility shall be suspended for one month, and if detected for the third time, it shall be suspended for three months. (4) If it is determined that promotion and information contrary to the provisions of this Regulation have been carried out in medical treatment centers where organ transplants are performed, the distribution of cadaver organs of the medical treatment centers where organ transplants are performed shall be suspended for three months upon the first detection. Upon the second detection, the operating license shall be revoked for three months according to the type of transplant. (5) A criminal complaint shall be filed against individuals who advertise or publish advertisements related to organ or tissue procurement. (6) If it is determined that promotional and informational activities are carried out by individuals, institutions, and organizations that provide unauthorized, unpermitted, or unlicensed health services contrary to the relevant legislation and Ministry regulations, the activity of the places where unauthorized health services are provided shall be immediately suspended, and a criminal complaint shall be filed with the Public Prosecutor's Office against the persons concerned pursuant to the provisions of Law No. 1219 and Law No. 3359. (7) Healthcare professionals other than physicians and dentists, and other professionals working in healthcare services, who work independently within the scope of the Regulation on Opening a Workplace and Operating Licenses (Decree of the Council of Ministers No. 2005/9207) dated 14/7/2005, may carry out promotion and information in their professional areas of authority, provided that they do not contain a health claim and are not aimed at diagnosis and treatment. However, professional authority violations, activities aimed at medical treatment that contain a health claim, and promotional and informational activities carried out contrary to the provisions of this Regulation by these persons shall be evaluated as unauthorized health service provision, and a criminal complaint shall be filed with the Public Prosecutor's Office against the persons concerned pursuant to the provisions of Law No. 1219 and Law No. 3359. (8) If it is determined that the promotional and informational content related to health on social sharing and Internet sites endangers human health or negatively affects or prevents the diagnosis and treatment process, and constitutes an element of crime, a criminal complaint shall be filed for the blocking of access to the relevant content pursuant to the provisions of the Law on the Regulation of Publications Made in the Internet Environment and the Fight Against Crimes Committed Through These Publications (Law No. 5651) dated 4/5/2007. (9) If the healthcare professionals and other real persons determined to have carried out promotion and information contrary to the provisions of this Regulation are public officials, action shall be taken against them pursuant to the provisions of the relevant legislation to which they are subject.
Cases where there is no provision ARTICLE 11- (1) In cases where there is no provision in this Regulation, the provisions of other relevant legislation shall apply.
Entry into Force ARTICLE 12- (1) This Regulation shall enter into force on the date of its publication.
Execution ARTICLE 13- (1) The provisions of this Regulation shall be executed by the Minister of Health.