Medicine And The Media

Marketing and public policy

BMJ 1994; 309 doi: (Published 10 December 1994) Cite this as: BMJ 1994;309:1588
  1. Harvey Marcovitch

    ITV (Granada) World in Action: “Shot in the Dark” 28 November

    Critics of the current measles and rubella immunisation campaign say that it was conceived in haste and executed carelessly. World in Action's attempt at highlighting this suffered from exactly the same faults.

    In vitro fertilisation: examining a four cell embryo

    The Infertility Maze at the Science Museum is the first exhibition in the United Kingdom to explore the medical and moral issues surrounding infertility treatment. Exhibits include a pinball machine which illustrates the difficulties of conception by getting the player to aim at elusive targets. Frustrated by this game, visitors to the exhibition can follow a computer generated couple as they are referred to a specialist for investigation of their infertility. The couple become increasingly medicalised as they pass through a maze of tests and results in their efforts to conceive. Descriptions and demonstrations of the currently available treatments include a video of intracytoplasmic sperm injection, a technique recently developed to treat male infertility. At the end of the display, an interactive computer polls public opinion about the availability of treatment and whether everyone has the right to have children.

    The Infertility Maze is at the Science Museum until 26 February 1995.

    Some real issues are these: conflict between public health measures and the prevention of individual illness; whether special recompense is due to those alleging that an issue of public policy has injured them; and whether truth is the first casualty of the public relations industry, so that information given to children and parents was inadequate for informed consent.

    So far as these issues were concerned, “Shot in the Dark” was well titled. Rather than concentrate on the arguments it took the easy way out. There is a formula. First find a pressure group, then film members whose suffering deserves all our compassion. Allow them to blame a medical procedure without adducing evidence, stir in a lawyer, and set up a doctor, separated from the viewer by a desk and polysyllables. The resulting innuendo is predictable—no smoke without fire.

    The implication is that the government is carelessly risking lives and health with a vaccine that a pressure group claims may be damaging. Why no mention of the opposite side of the coin—that there are parents who have caused their children's handicap and death by permitting them to fall prey to a complication of the wild disease? Even a rough attempt at assessing risk and benefit could have put the dilemma in perspective.

    Instead all that was allowed to the expert, Professor Banatvala, was a simple statement that the benefit outweighs the risk. How cheap and easy to follow by editing in a parent of a child said to have been damaged by vaccine saying, with feeling, “They should try looking after him for a while and then they'd know.” I could have suggested an equally superficial emotion puller—an interview with parents of a child in remission from leukaemia with every hope of cure, killed by catching his unimmunised neighbour's measles.

    Of course, it is not the job of Granada to act as a university of the air. What a pity, though, that titillation, tearjerking, and sound bites come before any attempt at analysing a complex debate.

    Scattered around were points of genuine scandal: a parent complained that the campaign treated the public “like a herd,” not realising how literally accurate she was. Others reported their children being immunised even though they had withheld consent. Charles Medawar, of Social Audit, reasonably suggested that people had been put under unfair pressure to have their children reimmunised.

    Lord Ennals, architect of the illogical and inadequate vaccine damage compensation scheme, seemed to be arguing for no fault awards. But no mention followed of how daft this would be without a similar system for all alleged medical accidents.

    If only the programme had been stronger it might even have provoked the government to reconsider its patronising and inaccurate marketing of immunisation and kick started the profession into serious debate about the validity of the current campaign.

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