Dark Patterns in User Interfaces — Business Needs vs. User Needs

Engaging, easy-to-use products don’t appear fully developed in the minds of designers and product teams. They are the result of careful deliberation, collaboration, exploration, and study. Interaction architects are crucial players in the product design process because they observe human behavior and use that knowledge to thoughtfully craft products that meet specific needs. The foundational processes and techniques required for interactive design begin with key psychological concepts, which help us to better understand how people feel, think, and behave.

Dark patterns in user interface designs are techniques sometimes used to trick or entice customers into performing specific actions as they traverse the interface. These techniques work because users don’t question the interface’s intent or don’t recognize that they’re being led astray.

Just like most people don’t read every word of the fine print on a web site or app. They might skim the agreement terms and make assumptions based on bits and pieces of text, pictures, and information. They may be motivated into making a selection that they believe to be the best option when in actuality their choice is being influenced by a dark pattern in the design of the software.

Some companies take advantage of this by modifying the design so that different messages are sent or specific choices are suggested.

You’ve probably heard about the opioid crisis and how it has affected the nation, but dark patterns in the interface design of a San Francisco based SaaS business have been recently linked to a medical software company in cahoots with big pharma. If you watch the news, you’re probably keenly aware of the story about the drug and its manufacturer, but you may not have heard about the software behind it all.

The case involves a cloud-based medical records management service. Due to unscrupulous methodology in its product development, the company was recently involved in a lawsuit that resulted in fines and settlements of $145 million dollars. However, this doesn’t nearly cover the amount of damage that was done.

The software company was found to have manipulated user experience to such an extent that it influenced unsuspecting physicians into pushing pain medications to their patients, unnecessarily and for financial gain.

The company faced multiple civil actions and criminal charges relating to U.S. anti-kickback laws. To add gasoline to the fire, a giant pharmaceutical company actually helped to write and design the interface prompts in the software which yielded vast profits for the pharma company. This unethical UI/UX methodology played a huge role in the case against them.

Although the pharmaceutical company involved was not named in the suit, a specific painkiller was found to have been over-prescribed by the physicians utilizing this cloud-based service.

Big pharma has often been accused of providing kickbacks to vendors, but the service company in the lawsuit claimed to be providing “unbiased medical information” in electronic health records software.

The software company built a cloud-based app that counseled physicians to prescribe addictive painkillers. They received kickbacks when they sold their service to big pharma companies, promising that they would increase revenue by guiding physicians to make medical decisions based on their platform’s drop-down menus and alerts. They enlisted the pharmaceutical company’s participation in designing the physician alerts and setting the criteria to determine when a physician received an alert, which would then direct the doctor to an option of prescribing an opioid painkiller.

This medical records software, used by many physicians in their treatment of patients, utilized dark patterns to govern the choice of treatment made by the doctors (in this case, prompting the use of specific branded painkillers), instead of other available, non-opioid options for treatment. Because the makers of the painkiller knowingly helped to design and write the prompts in the software’s user interface to promote their product, the pharmaceutical company made huge sums of money in the process. Huge sums. Over many years.

Once the dark pattern was discovered and the federal government intervened, doctors were advised to discontinue prescribing these highly addictive drugs. But in the process, the intervention neglected to consider the fact that many of the patients had developed addictions to these painkillers. Government intervention regulated the wide-spread distribution of the medication by limiting the amount that doctors could legally prescribe, even for legitimate cases of pain treatment.

Once patients were cut off from their abundant supply of the prescribed painkillers, they would often have severe withdrawal symptoms, often with deadly results. Many of these patients seeking relief from withdrawals found an easily accessible but illegal substance, heroin, which has had a similar effect to the synthetic drug that was being over-prescribed.

Unfortunately, heroin dosing isn’t regulated by the FDA and there’s no oversite when a person is self-medicating. The abuse of heroin, mixed with other non-prescribed medications, caused an epidemic of lethal overdoses. Because the prevalence of painkiller prescriptions was so widespread, the cases of opioid addiction spiked across the US, leading many victims and victim families in its deadly wake.

According to the CDC (Center for Disease Control), in a one-year period alone (February 2018 to February 2019), an estimated 69,029 people died of a drug overdose. Nearly 7 out of 10 of these overdose deaths were due to opioids. Over 770,000 Americans have died from drug overdoses since 1999, and the total number of deaths leaped from 16,849 in 1999 to a high mark of 70,237 in 2017.

This is just one extreme case where one company’s user interface software design had a nation-wide impact, with devastating results that have negatively impacted hundreds of thousands of lives. There are countless other instances where the UI has been used for promoting, selling or over-promising a product or service, perhaps without such devastating effects, but where is the line drawn?

The culture of experimentation has made companies like the hotel rental site Booking.com successful, but at the same time, it’s regarded as the company with some of the  highest density of dark patterns per UI elements, a result of A/B testing in their products.

The mindset of A/B testing is deeply ingrained in many organizations, where employee input is highly valued, access to data is transparent, and there is complete freedom when it comes to testing and interpretation of results.

In Feb 2019, CMA (Competition and Market Authority — part of the UK government—took enforcement action against Booking.com and other travel companies due to their misleading tactics. In this case, a government agency ended up deciding what the user experience should be instead of the company’s UX designers (who were focused on solving business needs – aka generating revenue).

Most businesses don’t welcome government oversite when building their websites or user interfaces. But as mentioned in this article, unethical practices can occur, prevention can be difficult, consequences can be great, and profit can be even greater. However, ethical companies realize that the risk might be greater than the reward.

By comparing Booking.com’s current website version with past versions, there are visible differences before and after the enforcement action. First, much of the red text, which created a sense of urgency, has disappeared.

Some examples that were visible in the past include: “Someone just booked this. In high demand!”, and “14 people are looking right now. In high demand!”, or “33 other people looking now!”

These examples above kept additional pieces of information hidden in order to convey a sense of urgency. For instance, the “Someone just booked this!” text displayed the message “Last booked: 4 hours ago” when hovering.

Today these messages have been changed to: “Booked two times for your dates in the last 24 hours on our site” and “Last booked for your dates 17 hours ago on our site”. The transparency is much clearer. It’s another example in which the UX designers made business needs a priority and focused on driving sales instead of customer experience.

User experience can be manipulated in other ways as well. In the American version of Rentalcars.com, a multinational car rental website, a common small car choice might be between two Fords (American-made cars). By navigating to the Italian version of the site, you can choose between two Fiats (Italian-made cars), while the French version gives you a selection between Renault and a Citroen (French-made cars).

This practice does not deceive the user in any way, but it triggers an emotional reaction that makes the website more appealing to the user in each country.

Using ethics in user experience design is not a binding rule. Like in every other part of life, ethical practice is a moral guideline, and professionals have the freedom to follow it, or in some cases, not. As the user experience evolves past the point of web and device interfaces, it now includes chatbots, voice-activated systems, and VR experiences. The usage of dark patterns will increase and extend to these areas as well, especially if the financial reward is far greater than the risk of getting found to be doing something unethical.

It’s no secret that user experiences can affect the bottom line in any business model. After all, if the experience is sub-par, the user will look elsewhere for that product or service. Sometimes they’ll tolerate a poor experience in lieu of perceived value, but that in turn can alter the business’ financial revenues as well, cheapening brands and the bottom line in competitive markets.  If a company is caught practicing unethical methods, it can have a significant negative effect on business revenue (lawsuits and fines) and influence the negative reputation of the company.

By facilitating open and honest discussions on the ethical use of interface elements, designers and architects can focus on addressing customer needs ethically, while also generating a more positive revenue flow. Practicing ethical design in UI/UX can also prevent government agencies from enforcing regulatory action against whole industries.

The Seattle area is home to the world’s most highly recognized brands and to some of the foremost experts in creating category-leading user experiences. 

Hitech Advisors prides itself on being an ethical leader in UX/UI and other technology realms. We believe that it is in our best interest to facilitate the exchange of ethical practices in our projects and consultations. We are involved in enterprises that depend on creating a successful and transparent experience for users in the products and services we help build.

A company must balance making money – the business model – while optimizing the user experience simultaneously. Careful considerations are made to accomplish the creation of optimum experience while also incorporating best practices, honest intent, personal and organizational values, and transparency when designing interactive UX/UI.

If you are a technology expert or business leader and would like to learn more about user experience interactive design, along with the psychology behind it all, join us at a private networking event on March 11. Our expert colleagues and partners will offer their industry knowledge and experience, to give you an opportunity to broaden your understanding.

Hitech Advisors will be introducing experts who will take a deeper dive into the methods and processes used to create thoughtful, engaging, valuable and ethical products and services. They’ll discuss the multi-dimensional components of interaction design to enhance UX/UI, including design psychology, design patterns, ethics in design, usability, accessibility, and more.

Panelists will discuss learning behaviors and theories of emotion that give delight in design, interface design principals and thought processes, classic and operant conditioning, ethical methodology, and error handling.

In addition to knowledge-building and networking, event attendees will have an opportunity to engage with the panelists, ask questions, and discover the intricate processes of manipulating behavior through usability, accessibility, and desirability, defining the pathway to beneficial outcomes from product interactions.

Panelists will include leaders from Starbucks, Nintendo, Best Buy, Microsoft, Amazon, The Gates Foundation and more marquis Seattle area enterprises. As always, there will be time for networking before and after the speaker presentation, plus plenty of great food and beverages.

You’ll also have the opportunity to learn more about UI architecture and effective means of leveraging natural human psychological instincts with the business model while following best practices. We hope to see you there!