Monday, February 13, 2006

FDA's caution, Part 2

If you didn’t read yesterday’s post, check it out before you read this post, which picks up where I left off yesterday (if you want to, of course. There’s no coercion here at Shattering Rose-Coloured Glasses).

For those readers, who, like me will not follow the instruction to read yesterday’s post, because they were asked to, here’s a link to the article I’m discussing:

The four most dangerous words in medicine: First do no harm

So let’s start at the CBC. Being a proud Canadian, and just a little left-of-centre in my political views, I turn to our national broadcaster for most of my daily news needs. And, when I want to know about good journalistic principles, the CBC is the first place to look. Here's what they say:

Information programs must reflect established journalistic principles:

The information conforms with reality and is not in any way misleading or false. This demands not only careful and thorough research but a disciplined use of language and production techniques, including visuals.

The information is truthful, not distorted to justify a conclusion. Broadcasters do not take advantage of their power to present a personal bias.

The information reports or reflects equitably the relevant facts and significant points of view; it deals fairly and ethically with persons, institutions, issues and events.

Application of these principles will achieve the optimum objectivity and balance that must characterize the CBC's information programs.

I assume that if you’re reading my blog you’re at least as smart and thoughtful as I am – likely smarter and more thoughtful. So I’m inclined to just let you apply those journalistic principles to the following first four paragraphs of the article in question and let you draw your own conclusions about the journalistic quality of the story…

But, because I get such joy in tearing apart other people’s writing, you can follow along with my analysis and contribute your own ideas to the comments.

Now, in case you’re one of those “scan-readers,” I’m going to highlight a few key words and phrases that jump out at me and lead me to conclude that this piece of journalism is not as balanced or unbaised as it would have been had the CBC run it. (Not that the CBC is perfect…)
(NEW YORK) FORTUNE - When Friday's announcement came it was hard to see it as anything but wonderful news -- the FDA had approved a vaccine called RotaTeq, made by Merck & Co., which had the potential to stop a deadly viral epidemic in its tracks.

Here was "an important new tool," said the FDA's Jesse L. Goodman, MD, that could "effectively prevent an illness that affects almost all children within the first few years of life." The plague, called rotavirus, causes severe diarrhea, vomiting, and fever in infants and toddlers that, if unchecked, quickly leads to dehydration. And in much of the developing world, that can mean imminent death.

Estimates -- which may even be low -- are that some 600,000 children succumb each year to rotavirus gastroenteritis. On the scale of human misery, then, this bug is a biggie. So what could be wrong with a medical marvel that could conceivably end its reign?

Well, nothing -- except that this very happy ending caps a tale that is otherwise quite terrifying. You see
Merck's (Research) RotaTeq (and a competing product from GlaxoSmithKline (Research) called Rotarix that is approved in a number of countries, though not yet the United States) aren't the first miracle weapons designed to fight this disease.

And now, to draw on my annoying language deconstruction tendency that caused my parents so much grief:

wonderful news” – how could the writer (who is the editor-at-large, not some green J-school grad) draw such a conclusion unless he was imposing his bias? I think he stretches the rule of accuracy and breaks the rule of integrity here. He’s reporting that a new vaccine has been approved by the FDA. Wonderful news? Sure, if you have shares in Merck & Co and the vaccine takes off.

deadly viral epidemic” – want to define this for us? Deadly to whom? The writer will tell us later, but most readers will never finish this article. The headline, lead and first few paragraphs are all most readers have patience or interest in reading. So, a majority of readers will leave this article with the impression that rotavirus is a much larger problem than it actually is. And, probably, with a misguided idea of whom the disease is most deadly for.

And how big is the epidemic? Actually, can rotavirus even legitimately be called an epidemic? Do a google define: epidemic search and read the definitions from academic institutions. My read is that rotavirus does NOT meet the definition of an epidemic.

plague” – see “epidemic.” Same thing applies. This is a clear-cut case of fear-mongering language.

if unchecked, quickly leads to dehydration” – "if unchecked" is an easy little phrase to overlook when sandwiched as it is. If unchecked, any vomiting child, regardless of the cause of the vomiting, will become dehydrated. Dehydration is not caused by, or the result of rotavirus. It’s the result of inattentive parenting. More fear-mongering.

imminent death” – fear-mongering. And this imminent death is for children in developing countries, not the babies that the readers of this article will most care about: their own American flag-waving progeny. How many American babies die from rotavirus? Well, this article goes on to say, “In the United States, where rotavirus is rarely deadly…” We can’t quantify the risk, so how can a mom make an informed decision about her child’s need for the vaccine?

Estimates – which may even be low” – or, may even be high. If the number is an estimate, that means we don’t know how many children “succumb” to rotavirus. By saying the estimate “may be low” the reporter leads readers to conclude that, if the number is not accurate, then it is low. That's innaccurate reporting.

600,000 children succumb” – lots of kids are dieing from rotavirus. Sounds very scary. And it is – if you’re a malnourished child in a developing country who has no access to clean water. But here in North America…scary? Not so much. Say it with me, “fear mongering.”

human misery” – my heart is bleeding. Now, if this article moved to the story about how the vaccine was being made available, for free, to the countries where the human misery and deaths from rotavirus are actually occurring, then that phrase would be acceptable. But that’s not close to where the writer takes us. (At US$187 for three doses, I’m guessing it will be years before the kids who really need this vaccine will ever get it).

medical marvel” – please. Nice alliteration. Not so good for objective reporting.

a very happy ending” – again with the reporter’s (or the industry’s press release’s) biased opinion.

miracle weapons” – notice the structure of these first four paragraphs. First we’re bombarded with fear-mongering language like deadly, epidemic, plague, misery, and succumb, and then – the news we are desperate to hear – we don’t have to suffer and die! A medical marvel, the miracle weapon called RotaTeq is our salvation.

Vaccines are a frigging sacred cow in society. And using language like “miracle weapon” to describe a vaccine further entrenches the belief. Bow down before the doctor with the hypodermic needle, for He is your salvation. (Now that is my side-step into loss of integrity, accuracy, fairness and objectivity. Where’s an editor when I need one?)

There’s tons more to this article to look at…it’s a brilliant case study. I’m having so much fun I want to change my day job so I can just spend my time deconstructing stories like this one.

Maybe tomorrow I’ll pick it up again. Part three. Maybe something else will catch my interest…


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