Ethics and the 'Oprah effect'.

There's an interesting piece in the Chicago Tribune on the "Oprah effect". The upshot is that products or people who Oprah deigns to grace with airtime tend to find enormous public acceptance.

While this is well and good if the product is a novel or the person is a television chef, it's less clear that the Oprah effect is benign in the case of people without medical expertise offering medical advice.

From the article:

In May, Winfrey, whose contract for "The Oprah Winfrey Show" expires in 2011, struck a deal with actress, author and Chicago native Jenny McCarthy, who emerged as an autism activist after her son was diagnosed with the disorder. The deal with McCarthy, who has been a guest on Winfrey's show several times, calls for McCarthy to develop a variety of projects with Harpo, one of which could be a syndicated talk show.

McCarthy's position on childhood vaccines, however, has kicked up controversy. McCarthy has said she is not "anti-vaccine" and that she is advocating for improved vaccines. But she said in an interview on Oprah.com that if she "had another child, I would not vaccinate." She also told Time that "I do believe sadly it's going to take some diseases coming back to realize that we need to change and develop vaccines that are safe."

Asked if Oprah or her show endorses McCarthy's views, a representative for Oprah's program said, "We don't take positions on the opinions of our guests. Rather, we offer a platform for guests to share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them." When McCarthy's views have been discussed on the air, statements from the Centers for Disease Control and Prevention and the American Academy of Pediatrics saying that there's no scientific evidence of a vaccine-autism link have been read.

(Bold emphasis added.)

I'm curious to hear what you all think about this. Is it acceptable to give any guest you please a soapbox without taking a position on the opinions they voice from that soapbox? Is reading official statements from the CDC and AAP enough "balance" to Jenny McCarthy's views on vaccines, or do you think the "Oprah Winfrey Show" needs to do more?

And, if Oprah and her producers are aware of the Oprah effect (which, really, they have to be, right?), should that awareness of their reach lead them to try to meet a higher ethical standard as far as the foreseeable consequences for giving Jenny McCarthy a soapbox?

Hat-tip: Liz Ditz, via Twitter

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This came up at DrKevin's blog. I don't think it's effective to question whether it's acceptable or not to air such views. If someone has a compelling argument it's going to get exposure (even without Oprah Jenny McCarthy has received intense publicity).

My question is why hasn't medicine learned from this approach? Where are the celebrity docs (and celebrity friends) mobilizing to counter this. If you look at Oprah's career, she's more than a talk-show host. She's a journalist. She would be swayed if someone like Dr. Oz offered to speak up and offer himself as a counterpoint to debate McCarthy on Oprah's show.

And, separate from Oprah, what would happen if celebrities and celeb physicians banded together for a short commercial in which everyone said over and over: "I love my children and I vaccinate them. I am not afraid. It is the safest thing you could do for your child."

The response from Oprah's people sounds a little too much like the creationist "teach the controversy" strategy for my tastes. As for the ethical side, if you are going to give someone the opportunity to reach millions of people with a message that will influence their medical decisions and affect their well-being, and the well-being of their children, friends, and loved ones, then you had damn well better know what you're talking about, and be saying things that are *at least* medically plausible.

My question is why hasn't medicine learned from this approach?

Publicizing oneself is a skill, which takes time and effort to learn. Medicine takes a great deal of time effort to learn. There are many more people with one degree than with two - and for the same reason, there are many more people with degrees in medicine and no particular skill at publicizing themselves than there are people with degrees in medicine and the skill to publicize their work.

Agreed with SteveWH. Also, if they're going to have someone like McCarthy push her unscientific theories about medicine, you have the responsibility to actually have a real doctor/scientist on at the same time providing the other side. Just stating in passing that the CDC (the man) says there's no evidence will not be heard over Jenny's passionate pleas.

"We don't take positions on the opinions of our guests. Rather, we offer a platform for guests to share their first-person stories in an effort to inform the audience and put a human face on topics relevant to them."

So Oprah's program offers a platform for a message which deludes their audience and kills children. Are they proud of that?

> Is it acceptable to give any guest you please
> a soapbox without taking a position on the
> opinions they voice from that soapbox?

That depends upon the purpose of the show and the practical impact upon the audience. MIT invited the Time Cube guy to give a talk, but it was evident to the audience that he was a nut. This is not the case with Oprah's show.

> Is reading official statements from the
> CDC and AAP enough "balance" to Jenny
> McCarthy's views on vaccines, or do you
> think the "Oprah Winfrey Show" needs to
> do more?

It is certainly not enough (in this particular case); again, taking into account the audience. If Oprah did a science talk show where the audience was composed entirely of scientists and she had a psychic on, you don't even need a counterbalance statement read. Oprah, however, hosts a show that reaches a very large population, a good percentage of which are not well versed in scientific literature. Offering a guest a platform to discuss matters without being suitably critical provides a default appearance of credibility to the guest. The "suitably critical" part is again audience dependent.

If Oprah had Jenny on, but critically interviewed her by challenging her statements, that would be fine. If Oprah had Jenny on, but also had Amanda Peet to challenge her statements, that would be fine, too, provided Oprah moderated properly. If Oprah had Jenny on, but also had some highly intelligent but ill-spoken pediatrician, that's not okay.

The point is that in the context of the social organism that is a talk show with the particular audience (both in the studio and viewers), your obligation is not to give a platform to whoever is entertaining, your obligation instead is to entertain while not simultaneously providing a disservice to your audience. You can't execute this obligation in a vacuum.

I think if Oprah and co really weren't taking a position, they'd be sure to "put a human face" on BOTH sides of this "debate".

By Joanna Holland (not verified) on 29 May 2009 #permalink

There are a few ways to look at this. On the face of it one would hope that Oprah would be more responsible about the "power" she has to influence and provide appropriate balance either on her show, or Jenny's.

Yet, giving Jenny enough rope to hang herself might prove to be the ultimate undoing of the farce that Jenny has been calling science. I hope the show will provide balance, although that seems unlikely. Further, the "counter-balancers" would have to be very effective communicators; like a previous poster mentioned, having Dr. Oz doing the rebuttal would be much more effective than having a dry scientist from the CDC talking about the misinformation from the autism camp.

It will be interesting to see how this plays out, and unfortunately it may take a lawsuit from the parents of a child that didn't get vaccinated and died from measles to make the point that yelling fire when there's no fire in a crowded theater is not free speech.

By Autodidactyl (not verified) on 29 May 2009 #permalink