New calls for “regulation” of health information: Censorship much?
| By Dr. Ronald Hoffman
Last week, the Journal of the American Medical Association (JAMA)rolled out a new proposal: “Counteracting Health Misinformation: A Role for Medical Journals?”
I was shocked and dismayed. The authors proclaim:
“The growing toll of popular fallacies about health and illness is evident given outbreaks of measles and other preventable communicable diseases in many nations. This ‘medical misinformation’ phenomenon has been described as ‘a health-related claim of fact that is currently false due to a lack of scientific evidence,’ but that may be a generous interpretation. Complementary and alternative medical approaches, without firm evidentiary bases, have coexisted uncomfortably with mainstream scientific medicine for decades, and they persist. By contrast, contemporary misinformation of greatest concern is supplanting well-proven interventions and ideas with unproven ones that are clearly false and, in some cases, harmful.”
The authors of this ambitious manifesto take aim at the legitimacy of complementary and alternative medicine. They conflate all forms of dissent from mainstream orthodoxy with extreme vaccine denialism and invoke media-stoked hysteria over measles resurgence as a rationale for policing content deemed “unscientific.” Like dangerous antibiotic-resistant pathogens, complementary and alternative medical approaches are said to “persist” despite efforts to eradicate them.
The quacks are said to include “phony experts, celebrities with armies of Twitter followers, and legions of independent digital scammers, including some physicians.”
That’s a little too close to home!
And here are some of the dangerous ideas the alleged “scammers” are pitching: “…torrents of misinformation on topics as varied as the safety and effectiveness of vaccinations, the Zika virus outbreak, water fluoridation, genetically modified foods, and treatments for common diseases.”
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What’s more, the JAMA authors state dissenting views about mainstream medicine undermine faith in government—as if that were an incontrovertible evil! They write “…negative attitudes about science appear to have risen in lockstep with ultranationalist sentiments and the emergence of populist leaders and movements.”
Really? What has undermined people’s trust in government is its persistent inaction in relation to dangerous environmental pollutants and harmful food additives, its permissive regulation of drugs and devices with ultimately devastating side effects, its condoning of aggressive marketing of opiates, its wasteful and inefficient administration of government health programs like Medicaid and the VA, and its dogged adherence to anachronistic diet recommendations that have fostered obesity and disease! In baseball they call those “unforced errors.”
The JAMA op-ed outlines a sweeping action plan to stem the tide of “misinformation”. As befits a medical journal, they couch their language in terms reminiscent of efforts to contain viral pandemics. Pathogenic ideas need to be rooted out and rapidly quarantined. Young people need to be “immunized” (the word they use!) against false information via concerted re-education programs in secondary schools and colleges.
They say journalists and social media content reviewers need to be enlisted to quash misinformation. Media platforms need to be leveraged to counteract “common misconceptions”; health professionals must be “prepared to navigate a world of ‘truthiness’ and pseudoscience.” Editors must be taught to “avoid legitimizing falsehoods about health and illness in the name of ‘balance’.”
Is this what we need—less balance in our health reporting, fewer dissenting voices? That implies a rather cynical view of the critical faculties of consumers of health information like you.
We already have censorship of truthful health claims about supplements. It’s called DSHEA, the Dietary Supplement and Health Education Act of 1994. DSHEA prevents supplement manufacturers from promoting products by invoking results of even peer-reviewed, journal-published scientific studies. They must aver that a supplement “is not intended to diagnose, treat, cure, or prevent any disease.” Instead, they need to use circuitous language like “supports optimal blood pressure within normal limits” or “calcium helps build strong bones.”
Let’s presume for a moment that the JAMA editors are well-meaning and will be impartial referees of “truth” in service to the public’s well-being. What’s wrong with a little policing of content?
I found out what a slippery slope that could be after I ventured into the scary precincts of Twitter, posting what I thought was a rather innocuous comment on a link to the JAMA article:
“A blueprint for #censorship?”
I wasn’t prepared for the Tweetstorm that ensued. Within hours, the white-hot fury of a cadre of determined quackbusters hit my feed:
“Integrative and functional medicine quacks are some of the biggest spreaders of false and misleading health information.”
“Yep, we’re WAYYYYY overdue for some serious regulatory & institutional changes to prevent charlatans from peddling harmful, bogus medical misinformation.”
“The basis for a profession is that the members will follow a set of standards. That implies submitting to #censorship You cannot call yourself a medical professional and also to be free to tell your patients anything that pops into your head.”
I tweeted: “‘Consensus’ used to be: Don’t bother washing your hands after examining patients; the earth is flat; the sun and planets revolve around the earth; saturated fat and cholesterol are the prime drivers of cardiovascular disease; bloodletting; mercurials for syphilis.”
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That’s when it got ugly:
“It used to be only naturopaths, homeopaths, and other assorted charlatans using the Ignaz Semmelweis defence. To see a medical doctor using it in support of unsubstantiated quackery is disheartening.”
“Integrative and functional medicine are still marketing terms for quackery no matter how much you wish to distract from it.”
It got worse, but I’ll spare you those comments, which often amounted to ad hominem attacks.
I then tweeted: “So happy that the Twitter platform is contributing to such an edifying and nuanced discussion…” and signed off.
This being the Wild West of Twitterland, you tend to harvest the most hot-headed, polarized opinions. But the comments I received suggest that there are lots of health and medicine “Truth” vigilantes anxious to be unleashed to corral “misinformation.” When they manage to convince social media content arbiters, expect a drastic throttling down of any but the most mainstream content. “Shadow-banning” is already affecting many of my colleagues and my favorite organizations.
Not that there’s not a lot of junk out there. Commercialism is rampant, and misleading claims abound. Part of my mission statement on Intelligent Medicine is to call out the BS. I’ve done so when it’s deserved even at the risk of alienating some of my integrative medicine colleagues. Crazy, unfounded conspiracy theories need to be credibly challenged. But a concerted campaign of censorship—undertaken by biased stakeholders in Big Medicine, Big Pharma, Big Food, Big Government and their abettors in Big Media—is not the way to go.
Send your comments to me at Radioprogram@aol.com
