The birth of the e-clinic. Continuity or transformation in the UK governance of pharmaceutical consumption?

Traditional arrangements for the prescription and dispensing of pharmaceuticals have been challenged by the rise of Internet services enabling consumers to acquire these products online, without a face-to-face contact with a professional. This paper considers three moments in the emergence of the 'e-clinic' as an alternative route to prescription drugs in the United Kingdom: the electronic transfer of prescriptions; the development of the e-pharmacy and the 'virtual' pharmacist, and the establishment of online virtue medicine consultations. We examine the phenomenon in relation to issues of governance, considering the legal and voluntary frameworks that govern prescribing. Documentary and interview data suggest that the Internet has the potential to transform the relations between prescribers, dispensers and consumers, but that stakeholders seek continuity by applying existing governance frameworks and codes of conduct. This continuity can be explained by Rosenau's (Along the Domestic-Foreign Frontier. Cambridge University Press, Cambridge, 1997) model of a contested and fragmenting process of technology governance.