Adventures in Ethics and Science

In the wake of some recent deaths in Edmonton of teenagers who took Ecstasy, DrugMonkey gets irritated with a doctor who made some proclamation to the press:

I’m particularly exercised over an article which quotes Charles Grob, M.D. (UCLA page):

Charles Grob believes there is a strong chance that a deadly batch of adulterated pills is making the rounds in and around Edmonton, though health officials and law-enforcement groups have issued no such public warning.

Dr. Grob, a professor of psychiatry at UCLA, was the first U. S. researcher to conduct human tests of methylenedioxymethamphetamine, or MDMA, the technical name for Ecstasy, since it was outlawed in the U. S. in 1984. It is rare for anyone to “overdose” on the drug in its pure form, he said.

There are but a few dozen deaths linked annually with Ecstasy in North America; mostly, they arise from complications, such as pre-existing heart problems or hyperthermia that occurs when high, frenetic raver kids overheat themselves.

But three girls, all within a few weeks of each other, in the same vicinity, and none of whom were observed exercising hyper-actively, he says, is too unusual to be MDMA-caused. “I think there’s something else in those pills,” Dr. Grob says. “It would be awfully coincidental if all three of these teenage girls had congenital heart problems that had not been identified earlier. I’d put my money on a drug substitute.”

Here’s my take. We don’t bloody well know. Period. Until we have a comprehensive tox report showing what was and what was not in these kids’ bodies when they died. It is quite possible, however, that MDMA is indeed the primary cause.

DrugMonkey then proceeds to lay down some reasons — grounded in research — that Dr. Grob shouldn’t be dismissing the possibility of MDMA overdose out of hand.

You should go read the whole DrugMonkey post. Here, I’m going to use it to highlight an issue we’ve discussed before: If you’re speaking to the public as a scientist (including speaking to the public through a journalist), you have some responsibilities.

Get the facts right.

Take account of the current relevant research, rather than assuming that it all falls in line with your results. (Don’t speak to journalists until you’ve acquainted yourself with that research.)

If you’re going to make a claim that outstrips the empirical evidence, flag it as a hunch rather than a well-supported conclusion.

Underline not just what is known, but also areas where uncertainty remains — especially in understanding particular cases where crucial data (like toxicological reports) is not yet in.

Think about why getting good scientific information matters to the public and about the ways the public could use the information you’re providing — not just how it could be helpful, but how it could be harmful if people don’t appreciate the complexities of the point you’re making, or if you’re wrong.

On this last point, DrugMonkey suggests that the part of the public inclined to take Ecstasy at parties is better served by a more accurate account of what the existing body of research says could have happened in the Edmonton cases than by one researcher’s hunch in the absence of conclusive toxicology results:

As I say fairly frequently, the Ecstasy user is comparatively sensitive to information on the likely risks of the drug. No, I’m not being naive. You can look at many, many user practices which are promulgated on advocacy/harm reduction websites and forums online and talk to your local users (do you talk with your undergraduates, professors?). Chill out rooms, tryptophan loading, various vitamin prescriptions, cautions on dose and frequency….you can draw direct links to available knowledge from Case Reports of medical emergency/death, on-site experience of harm reduction outfits and the preclinical research literature. Now, I’m not saying that stuff necessarily is helpful to avoid all potential adverse consequences, I’m just saying that the target audience is…receptive. And in the absence of information to the contrary, this population is going to go to the mat denying that it could possibly be MDMA itself that is the root cause of fatality.

Given that scientists complain that the public just doesn’t pay attention to scientific information even when scientists are making an effort to convey it to them clearly, scientists need to take responsibility for conveying accurate information — in case the public actually does pay attention.

Comments

  1. #1 James F
    May 6, 2009

    I wish it were standard practice for journalists to present interviewed scientists with a pre-publication copy of their article to head off problems and confusion, or at least any serious mistakes.

  2. #2 drdrA
    May 6, 2009

    While I agree with you and drugmonkey that those of us who talk to journalists have a responsibility to get the facts right, etc etc. as someone who rather regularly now deals with journalists- it took me a little while to learn that they will take the most uneducated and simple thing you said that sounds like a bullet point their readers can understand- and then THEY WILL PRINT IT,… or use it as their evening news sound bite.

    I’ve been bitten by this. I now refuse to do interviews with journalists who won’t provide me a copy of what they are going to print AND ALLOW ME TO EDIT IT in advance of print. Period.

  3. #3 DrugMonkey
    May 6, 2009

    drdrA, let’s just say that the quotes from Dr. Grob are consistent with many other statements attributed to him, his co-founding of the Heffter Institute and the association of that entity with MAPS and the clinical trials.

    Now, it IS possible that he made his statements without having heard about the 5-6 tablets consumed part, but I doubt it. Especially since the latest incident occurred several weeks after the Paul Brand First Nation events.

  4. #4 Ed Yong
    May 6, 2009

    Okay, I’ve been on the giving and receiving ends of multiple interviews so my advice would be this:

    Never ever enter an interview without some idea of what your agenda is. The journalist will have one – that’s why they want to interview you. You should (a) find out what it is and (b) get one of your own. Ask them what they’re interested in, or as James F suggests, asking for any article beforehand. You’re not obliged to do the interview if you’re not satisfied that you’re going into it prepared. Likewise, have a think about the key things you want to say, expressed in a soundbitey way that they will use. Then say those things, even if they’re only tangentially related to the questions you’ve been asked. Elaborations on all of this here.

    My best advice is if you need to be interviewed regularly, try and wangle your way onto a media-training course.

  5. #5 Chris Clarke
    May 6, 2009

    I wish it were standard practice for journalists to present interviewed scientists with a pre-publication copy of their article to head off problems and confusion, or at least any serious mistakes.

    If we did that we’d have to do it for interviewed corporate executives, interviewed anti-vax activists, interviewed politicians and interviewed attorneys representing accused felons.

    The fact that we don’t do it is a feature, not a bug.

  6. #6 Rod
    May 6, 2009

    Scientists who do not understand how to speak to us, go here:

    http://www.doh.wa.gov/phepr/toolkit/first/

    Print the Crisis Communication Spokesperson Checklist.

    You now have a basic idea of how to talk to us. It’s not perfect, but neither are we. Some of us, however, try.

    Do not merely try to attend a media-training course. PLEASE attend a training course.

    I respectfully disagree with Ed’s allegation that ALL journalists have an agenda. If they have an agenda, they aren’t journalists — although I prefer the word “reporter.”

    Apologies to all who have been burned by irresponsible journalists — or reporters — but please, don’t assume we’re all the same.

    If those of you with scar tissue are ever again approached by a reporter, don’t immediately decline to be interviewed. Explain why you are reluctant. (We’re most of us used to be yelled at, by the way; you won’t hurt our feelings.) A reporter so informed should then try very hard to reassure you that he/she is honestly interested in writing an accurate story — and should have no problem in calling before the story is printed to verify that you did in fact say what you said in the way that you said it.

    It wouldn’t hurt to refer them to Ed’s “Scientist Heart Journalists?” link, either.

  7. #7 Mr. Gunn
    May 6, 2009

    Great tips, Janet. I was lucky to have a PI who did give public speeches/interviews with some frequency, so I was able to pick up on his techniques, particularly what Ed Yong says regarding saying what you want printed, and only what you want printed, to ensure what you want printed gets printed.

    I’m sure Dr. Grob understands this. He knew the media would run with a drug hysteria angle if given the slightest opportunity, so he said things to focus the attention away from MDMA and make the media blame adulterated unidentified substances called MDMA, which I agree is probably the likely culprit anyways.

    Yes, MDMA isn’t without its dangers, but the public doesn’t understand the difference between MDMA and the mixed bag of stuff often called Ecstasy, so the fact that he got them to print that distinction is actually an example of great media savvy on his part. I can understand de-emphasizing the dangers, too, since they’ve been wildly blown out of proportion for the past couple decades.

  8. #8 Denise Graveline
    May 6, 2009

    I train scientists and others for interviews and speeches, and am continually amazed at opinions and guesses they share without thinking through the consequences. There’s a better solution than wishing you could edit the story, however: End the interview asking “What are you taking away from this?” — a technique recommended by a New York Times science reporter in my list of 11 things you should always ask reporters in interviews, at http://bit.ly/13pyhV

  9. #9 MattK
    May 6, 2009

    Chris:

    “If we did that we’d have to do it for interviewed corporate executives, interviewed anti-vax activists, interviewed politicians and interviewed attorneys representing accused felons.

    The fact that we don’t do it is a feature, not a bug.”

    The most basic and fundamental job of journalists is to get accurate information out to the public. Of course science journalists with a familiarity with the particular subject matter can competently operate without getting the interviewees to edit their work for factually errors but it seems this situation is often not as common as we might wish. A lot of the time however the journalist has so little grasp of the fundamentals of the material that any hope of writing an objective expose is nothing more than wishful thinking. If a feature of the system is causing it not to work then it is a bug.

  10. #10 drdrA
    May 6, 2009

    DM- I wasn’t speaking so much about the specific case that you cite- which I agree, without following the whole saga of this particular individual, sound quite careless.

    Ed – I don’t think your advice is that far off the target. I’m one of those scientists that has little agenda other than good science. And honestly, I’ve been stuck in the lab and my office writing grants- who knew that there was any such thing as media-training courses.

    Rod- While I’d love to attend a media training course, I had no idea such a thing existed until this post and comments,…

  11. #11 Ed
    May 7, 2009

    Rod, to clarify, I’m not using the word “agenda” in a sinister way. I’m referring to every motivation from “I want to interview xx because they’re knowledgeable in a certain field and they’ll provide an interesting perspective” to “I’m going to try and catch them out for a juicy quote”.

    And likewise, in asking that interviewees have their own agenda, I more specifically meant to have a list of points you want to get across and, if possible, consider why you’re being interviewed, who by, and what that means for you. For example, if I’m being interviewed by someone who I know has a reputation for scare-mongering or misrepresentation, I will try to anticipate that and skew my answers to act as the voice of reason (if appropriate).

  12. #12 Rod
    July 12, 2009

    Ed,

    I’ve got to spend more time updating my posts.

    Your suggestions for interviewees are excellent, although I’d suggest if the interviewer is pro to “misrepresentation,” (which sounds so much nicer than “lies like a rug,”) the interviewee tape the session — and inform the reporter/journalist/ratings-seeker blatant errors will have consequences.

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