Eli Stone and autism: how factual does fiction have to be?

Everyone knows by now that the show Eli Stone misrepresents the facts about thimerosal and autism in it's fictional story of a lawyer going after a pharmaceutical after they put "mercuritol" in vaccines. It's clear that the story is supposed to mimic the thimerosal issue but as some defenders of the show say, hey, it's fiction.

So, when is fiction allowed to be fiction and when is it not? For example, look at The Da Vinci Code. Most of it is made up crap but even though it's fiction, people believed the 'facts' used in the book. Should that be permisible? The Dan Brown book is different in two ways, 1) it was good entertainment 2) it people it misrepresented were mostly Catholics and therefore not a public safety matter. But still, under the same thinking for demanding that Eli Stone be taken off the air, The Da Vinci Code would be libelous and should have been taken off the shelves.

From another angle, take '24'. It's good entertainment but it reinforces ideas about terrorism that many would say are harmful both in the fight against terrorism and for the national psyche. But that really depends what you think about that issue in the first place. Even so, I doubt '24' gets many letters telling them they are harming the public good.

I don't really have any conclusions on this matter, but I do think that if writers (shows or books) are going to place their story in a real world context, they have some responsibility to facts. How much? I don't know. I do know this:

1) People up in arms about Eli Stone should calm down about three levels (currently they are sending out the threat level 'red'. It's just a show. It's not going to enlarge the thimerosal-autism link contingent. It may cause some entrenchment of those already there, but c'mon, did you really think they were going to change their minds if they hadn't already? If your kid has autism, you know about the controversy already and have made up your mind one way or the other (and most don't think there is a link, either). A silly ABC drama isn't going to change anyone's mind. It's entertainment; we know that. Also, what's the alternative? Making sure every piece of art out there is accurate according to some chosen facts and not harmful to the public? Some people will be wrong and make bad decisions; so be it. We live in a culture where we assume that people are smart and make good decisions for themselves*. That is the basis of democracy and the economic system of the entire western world. I'm sick and tired of people saying that the public is too stupid to firgure things out for themselves. Stop your paternalism and get out of public health if you have no repsect for people.

2) ABC should have known better. This was stupid.

I've had more to say on thimerosal here, here, and here. I don't feel I need to say it again.

*Sorry to get all James Madison on you. The old boy had some good points, even if he didn't want a bill of rights...

"A man has a property in his opinions and the free communication of them."
"As long as the reason of man continues fallible, and he is at liberty to exercise it, different opinions will be formed. "

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'I'm sick and tired of people saying that the public is too stupid to firgure things out for themselves.' Who wouldn't be? But sadly, it appears to be mostly true. How else would've Dubya gotten elected?

The problem isn't that the public is too stupid to figure things out for themselves, it's that the public are not guaranteed to arrive at the right solution to a problem on their own. Most of the problems in this debate come from the fact that there's so much misinformation available, it takes an entirely separate process of information gathering to determine what is true and what is bunk. Finding things out isn't the problem. Filtering out crap is the problem.

And Dubya got elected because he pressed the one issue that no one needed a filter to understand: "Tax Cuts."

That's how his dad won too, remember? Except Sr. didn't get us stuck in a quagmire, so he had no insurance policy when he broke his word. Jr. is so clever!

I don't think it is meaningful to talk about "the public" as if you can make any generalizations about them. Some members of the public are savvy, others are profoundly unsophisticated, most are somewhere in between.

The problem is that there is clear evidence that myths tend to spread and be believed. Even attempts to correct myths, if done sloppily, can increase belief in a myth. With this show I am not worried about parents with autistic kids, or members of the mercury militia. I am worried about perpetuating the myth of a connection between vaccines and autism in popular culture, and that this will have a statistically negative effect on vaccine compliance. To deny this is to hold the position that not a single young parent, upon seeing this program will learn of the vaccine myth for the first time (or have it reinforced) and decide not to vaccinate their kids just to be on the safe side. This is naive.

By Steven Novella (not verified) on 31 Jan 2008 #permalink

Steven,
You bring up a good point (myth spreading). I am, indeed, worried about this as well. However, given the society we live in (one that I happen to like more often than not), what are the options? In the name of creating a positive impression of vaccines, many public health professionals, particularly a lot at the CDC have not been forthright about vaccine problems or possible problems over the years. This has created a large amount of distrust and the blowback has been intense. The outcome is that despite the overwhelming safety of vaccines, especially when considered as a risk/benefit, people are not trusting. We can't get that trust back by telling people what they can and can't watch or what they must do.

Despite, our current situation, we, the public, usually find our way eventually. Those who are interested, may want to look at the history of McKinley. That other repuclican was in the pocket of big business and rode a strong nationalist sentiment into popularity. He provoked, and then had trouble with once it was "over", an overseas war of conquest that he called a 'liberation' (Philippines). The administration was wildly incompetent. Sound familar? The next president Teddy R., was a maverick Republican and a reformer. Hmm, that also sounds familiar.

The comments about people who voted for Bush, above, are exactly the naive BS, I'm talking about. As if anyone who voted for him was just plain stupid. Is it too much for you to imagine that an intelligent and good person could think differently? If it is, I feel ashamed to even be on the same voting side as you.

Hi and thanks for your always interesting column.

re your comments on "24" and torture--here's a few lines from an article in the New Yorker about this very issue, referring to a visit to the "24" producers made by Brig. Gen. Patrick Finnegan:
"In fact, Finnegan and the others had come to voice their concern that the show�s central political premise�that the letter of American law must be sacrificed for the country�s security�was having a toxic effect. In their view, the show promoted unethical and illegal behavior and had adversely affected the training and performance of real American soldiers."
Jane Mayer's excellent article can be found at http://www.newyorker.com/reporting/2007/02/19/070219fa_fact_mayer
Best wishes,

Thank you for your work, it is ironically I believe, the answer to the problem you state. The more misinformation and "crap" that is put into the public domain, the more intelligent discourse and education is needed.

It seems to me education not censorship would be the answer.