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When doctors mix their medicine with the media

Remember the 'flesh-eating bug' scare? Irresponsible medical journalism can undermine entire vaccination programmes and clog up surgeries – Jo Carlowe puts media docs under the spotlight

Put the words 'ethical health journalism' into an internet search engine and you'll draw a blank.

This omission of internet space devoted to the subject is a surprise. Articles about medicine are fraught with pitfalls. Irresponsible medical journalism can undermine entire vaccine programmes or clog up GP surgeries for weeks (who can forget the 'flesh-eating bug' scare of 1994?).

Aside from health scares, media doctors must consider confidentiality issues, ensure any advice given is accurate, resist commercial inducements to write about the next 'wonder drug' and make decisions about whether articles can include information over and above evidence-based medicine.

Professional journalists who write about health will normally follow the code of practice stipulated by the Press Complaints Commission, but media doctors may not be aware of these guidelines. Dr Michael Wilks, chair of the BMA's ethics committee, says it's time they were.

'Doctors who write or broadcast on medical issues need to be aware of the ethics of journalism just as much as the ethics of medicine,' he says. He reminds doctors that when wearing their media 'hat' they are still subject to the guidelines stipulated by the GMC.

'If a medically qualified doctor makes statements that are inaccurate, not evidence-based, or biased, then the GMC will have a possible role.'

For example, it is possible that the GMC could be involved if a patient were to come to harm after following erroneous advice contained within an article. In practice, Dr Nicolas Norwell, medicolegal adviser with the Medical Defence Union, is not aware of any legal precedent. Nonetheless, he suggests media doctors get the indemnity of publishers and TV companies before broadcasting advice.

He also reminds doctors of their duty of confidentiality and says consent should be sought from patients before they are used as case studies in articles. This is something of a grey area. Media doctors frequently allude to incidents from their day-to-day practice. It would be impossible for them not to.

But Dr Wilks believes there are certain lines that doctors should not cross and 'deplores as unethical' articles that use the illness of people in the public eye as a peg for explaining the condition concerned. When Churchill's physician, Lord Moran, wrote Winston Churchill: Struggle for Survival 15-years after the leader's death, he broke these rules and faced widespread criticism from his peers.

Moreover, Dr Norwell advises doctors to stick to evidence-based medicine and questions the ethics of media doctors who promote concepts of questionable efficacy. Dr Wilks takes a similar stance, although he believes all topics are acceptable provided the doctor explains that there may or may not be evidence to back up the statements made.

GP Dr Ian Banks, of Carlton's The Good Sex Guide Late and Channel 4's The Pulse, is less prescriptive about the moral imperative on doctor-writers to stick to evidence-based medicine as he believes the content of health articles will be dictated by circumstance.

'Pressure from events tends to drive topics. A great deal depends on the individual doctor. Regarding complementary medicine – I don't practise it so I don't write about it.'

London GP Dr Richard Halvorsen, who wrote the 'Ask the expert' column in the Daily Express, has no such qualms. 'Evidence-based medicine is a myth: 15 years ago it told us HRT protects women from heart disease, now it tells us it increases the risk of heart disease. Evidence-based medicine is a moveable feast. Most of what we do in GP surgeries is not evidence-based.'

As well as writing on health, Dr Halvorsen has been on the receiving end of publicity, having openly expressed concern about MMR.

'On occasions I have been misquoted but accept that the media works to deadlines. Most journalists are conscientious. The media is my favoured method of getting my message across.'

Moreover, Dr Halvorsen believes ethical health journalism means being true to oneself. 'Ethics are very personal. If I was to say ''I have no concerns about MMR'', I am going against my own beliefs and research. It would be dishonest. That would be unethical.'

Whether ethical health journalism means promoting established and scientific ideas, or conversely using the public platform of the media to challenge established beliefs, is open to debate. When it comes to doctors and journalism, there's only one area on which everyone is agreed: and that is on quality. Ethics experts say journalists and media doctors have a moral (if not a legal) duty to convey information in a clear, fair and balanced manner.

'When writing about health, writers should be aware that making claims, statements or raising alarm (particularly unsubstantiated) will have a greater potential impact than writing about other issues,' says Dr Wilks.

'Media doctors are acting as human textbooks and there is a burden of responsibility on the author to get the facts right, to be fair, and a good communicator,' says Dr Norwell.

Dr Banks agrees. 'Some doctors can be very good writers, but

while most doctors think they are brilliant, clever and witty writers, few actually are.'

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