With celebrity comes duties: Jenny McCarthy, Oprah Winfrey, and the ethical burden of a soapbox.

At White Coat Underground, PalMD explores the question of what kind of responsibilities might fall on celebrities, especially those who use their soapboxes in a way that exceeds the tether of their expertise. The particular celebrities under examination are Jenny McCarthy, who has used her celebrity to spread her views on the proper treatment and prevention of autism, and Oprah Winfrey, who has used her media empire to give McCarthy a soapbox with more reach.

Pal writes:

Jenny claims an expertise based on her personal experience. Whether one views themselves as an expert is largely irrelevant, unless others so christen them. In Jenny's case, various fake experts have helped promote her status as an expert (making her a 2nd generation fake expert?) and she has embraced this status.

Being a public figure confers a certain status in our society, whether or not it should. It gives one great reach and influence. While Jenny's putative lack of intelligence certainly makes her susceptible to having her status used by others, it does not absolve her of her responsibilities. She has made a conscious choice to use her status to spread a message, and has chosen to listen to some experts over others. The moral culpability is hers. ...

When it comes to medical issues, the only thing consistent about Oprah is her own inconsistency. It appears that she christens experts based on her personal preference rather than any objective criteria. This is a problem. Oprah's influence is inversely proportional to her ability to choose good experts, which is a troubling trend. One thing she is good at is picking a winner; Dr. Phil may or may not be a good therapist, but he's great TV. Time will tell whether Jenny is equally lucrative, but Oprah doesn't pick losers, so we're likely to be seeing Jenny under Oprah's banner for a long time to come.

Rather than hewing to close to the specifics of Jenny McCarthy or Oprah Winfrey, I'd like to raise the questions more generally:

What are your obligations as a parent with no medical training when it comes to giving advice to other parents about the medical care of their children?

I don't know anyone who argues against the idea that parents have duties toward their children, and that these include doing what they can to keep those children safe and healthy -- including seeking medical care for the children when appropriate. There is a good deal of variation in the details of how parents fulfill these duties, and no doubt particular calls parents make in trying to fulfill them may be open to criticism (and are sometimes criticized by strangers on the bus or at the playground). Still, as a society, we seem inclined to grant parents a fair bit of autonomy in working out how to keep their kids safe and healthy, and at least some of this autonomy extends to their medical decisions.

We could argue about how much autonomy parents ought to have here (and probably too about what kind of health care system and access would need to be put into place in order to standardize some kinds of medical care for kids that currently happen or don't at the parent's discretion). But for the moment, let's take that autonomy as a given. If you're a parent with wide latitude in your decisions about when to secure medical care for your children, what kind of medical care to seek, and from whom to seek it, do you have any obligations to other parents to whom you might offer advice about the medical care of their own children?

You probably have a few. The first is to emphasize the fact that you have no medical training. The second is to be clear that your direct experiences are with a very limited sample size (your own children), which very much limits your ability to make accurate predictions about whether another child following the same course of treatment will experience the same outcomes. The third is to be as accurate as possible in conveying upsides and downsides you are aware of in the course of treatment you are advocating. The fourth is to be clear about the sources of information (whether personal experiments, expert advice, or some combination of these) you are relying upon to guide the advice you are giving. Finally, you have a duty to acknowledge what you do not know.

What if you are a parent with no medical training who is also a celebrity -- meaning that you have a soapbox from which to speak to a large audience?

Here, I think the obligations are the same, but at higher strength.

Celebrities have to recognize that there are more people who listen to them because they are celebrities -- and that this is so even on topics other than how to become a celebrity or how to live with the day to day demands of being a celebrity. Whether or not people ought to be listening to them does not stop the fact that they are. This means that bad advice (even if well meaning) has the potential to hurt more people when offered by a celebrity rather than just by some other parent at the playgroup.

Among other things, I think it can be argued that a celebrity has a greater duty to scope out the credibility of the experts on whose advice he or she has relied, to make sure those experts really know what they're talking about -- and to make sure that they are not offering their advice primarily in the hopes that the celebrity will broadcast it and drum up more business for their miracle cure.

As well, given that the public seems to credit celebrities with more knowledge than they should, celebrities probably have an extra duty to be clear about the gaps in their knowledge -- especially in areas where they might be inclined to offer advice as one parent to another.

What are your obligations if you are a talk show host with no medical training and you provide a soapbox from which celebrities can speak to a huge audience -- including celebrities with no medical training who give advice to parents about the medical care of their children?

Here, the duties may depend a great deal on how your show is presented to the public. Is it a collection of thought-provoking guests whose main purpose is to entertain rather than inform? Is it a careful examination of important topics with clear applications to the lives of the viewing audience? Is it a chair-throwing hate-fest?

The general tenor of the show promises, at least implicitly, a certain level of credibility from the guests who appear on the show. Letting celebrity advice on medical matters ride on that tacit promise of credibility is falling down on a duty to your audience.

Since you are (in this scenario) a talk show host with no medical training, seeking the advice of multiple experts with medical training -- and who are not also peddling a book, diet plan, exercise system, or acne treatment -- would be a good way to live up to your obligations to your audience.

What are your obligations if you are the booker for a talk show?

The job of the booker imposes a pretty clear obligation to line up guests who make for good television (or radio, or whatever). However, since the long term success of the talk show is at least connected to the relationship established with the audience, lining up guests whose credibility meets or exceeds what the audience expects is a good idea. Assuming you are a booker with no medical training, you probably have a duty to work out some reliable criteria for vetting guests who claim medical expertise.

What are your obligations if you are the distributor of a talk show?

You shouldn't sell the show as something it isn't. If it delivers a careful examination of important topics with clear applications to the lives of the viewing audience, you can sell it as such. If it delivers a chair-throwing hate-fest, you cannot sell it as a careful examination of important topics with clear applications to the lives of the viewing audience. To do so would be deceptive.

What are your obligations if you are a parent who watches a talk show whose guests give medical advice to parents about the medical care of their children?

Evaluate the credibility of the person offering the advice. Consider what he or she may have to gain, personally, by going on a talk show to give such advice. Consider what others may have to gain by putting this advice-giving celebrity on a talk show. Most of all, consider the potential harms to your child of mistaking bad advice for good advice, and put in the work to find good advice and the people with the knowledge (and lack of ulterior motives) you can trust to deliver such good advice.