Wednesday, June 25, 2014

Who is responsible for bad medical advice on TV?

I am not sure whether you have missed the storm in a teapot caused by an ongoing hearing of a US Senate Committee. The committee is investigating bogus claims by producers of dietary supplements. Dr Oz of The Dr Oz Show was castigated by Senator Claire McCaskill for ‘melding medical advice, news, and entertainment in a way that harms consumers.’ Dr Oz is an interesting character. Like the unfortunate Dr Phil he is also a product of Oprah, that masterful purveyor of everything pseudo-science. He is known to support faith healing, and homeopathy among other goodies. Dr Oz actually is a medical doctor with impeccable specialist credentials. He holds a professorship at Columbia University’s department of surgery. I have no reason to doubt that Dr Oz is anything but a superb cardiovascular surgeon. The problem with him – essentially – is that he uses his medical credentials during his show to peddle quackery. The lay audience that his show targets (courtesy of CTV in our neck of the woods) has every reason to assume that his advice has been vetted as far as the supporting evidence is concerned. That does not appear to be the case. McCaskill confronted Oz during the hearing I mentioned with the following three examples of miracle drugs promoted by him on his show: (Green coffee extract) — “You may think magic is make-believe, but this little bean has scientists saying they found the magic weight-loss for every body type.”(Raspberry ketone) — “I’ve got the number one miracle in a bottle to burn your fat.” (Garcinia cambogia) — “It may be the simple solution you’ve been looking for to bust your body fat for good.” All of these supposed miracle drugs are at best placebos. Oz proceeds to calling his ‘magic’ and ’miracular’ weight-loss placebos during the hearing ‘crutches’. He claims that they help people jump-start their weight-loss programs. There is zero evidence for that claim.Oz also promoted an anti-aging substance for the efficacy of which existed no evidence at the time or today. This kind of stuff made the man a household name and pretty rich. I do think that medical professionals presenting such shows should stick to medical mainstream evidence as opposed to abusing their credentials and the trust they engender among us audience members to peddle nonsense. Ultimately, Dr Oz professional oath obliges him to ‘first do no harm’. Encouraging his audience members to purchase unproven – or worse, known not to work – concoctions is professionally unacceptable, and yes, it does cause harm.

Oprah meanwhile, who discovered and ‘made’ Dr Oz, promoted during two specials of her, at that time, top-ranking talk show a book called The Secret, a bunch of new age self-help nonsense. It sold the reading audience such remarkable insights as this: ‘You cannot ‘catch’ anything unless you think you can, and thinking you can is inviting it to you with your thought.’ So everyone, the flu you picked up, HIV you acquired, it was all a matter of inviting it with your thoughts. Oprah presented on one of her shows a woman who had developed breast cancer, proudly pronouncing that she would eschew all mainstream medicine in favour of thinking good thoughts. I don’t know how that one went for her. Oprah, whenever there was an opportunity to promote quacks on her show, went right for it. She busily promoted notorious actress Jennifer McCarthy’s conspiracy theories about vaccines and autism. On Oprah’s website under the header ‘Inspiration’ she has this to say about McCarthy: ‘ Since her son, Evan, was diagnosed with autism in 2004, Jenny has been an outspoken advocate for parents fighting the same battle.’ McCarthy actually campaigned against childhood vaccination, resulting in untold suffering among children who were not protected by their parents. McCarthy’s theories were known to be false at the time Oprah decided to promote her as much as they are known to be false today. The number of autism cases scientifically linked to vaccines is zero at the time of writing.

David T. Tayloe, a past president of the American Academy of Pediatricians expressed his concerns about the high media profile quacks can receive all too easily these days for their views this way: "I think show business crosses the line when they give contracts to people like Jenny McCarthy. If you give her a bully pulpit, McCarthy is going to make people hesitate to vaccinate their children. She has no medical or scientific credentials. It disturbs us that she's given all these opportunities to make her pitch about vaccines on Oprah or Larry King or U.S. News or whatever. We have to scramble to get equal time—and who wants to see a gray-haired pediatrician talking about a serious topic like childhood vaccines when she's out there blasting the academy and blasting the federal government?"

Now, you’d say, let the buyer beware, and there is some truth in that. But, in the case of Dr Oz there are the necessary medical credentials to assume the man is not selling me snake oil. Sadly he does so frequently. In Oprah’s case we all knew that she had funny ideas about self-empowerment and strong thoughts and whatnot, and we also knew that she was clueless about medicine. At the same time, she managed to pick titles for her book club that outsold Stephen King. People, in very large numbers, listened to Oprah. That’s why what these sorts of people sell to us in matters of health and medicine should be held to higher standards. I wonder what obligations TV companies and cable companies have with regard to the information they transmit, too. After all, having folks like Dr Oz on your line-up and knowing that they frequently transmit health related bogus advice to your lay audience makes you to some extent responsible for bad choices audience members will make based on the advice of your medical doctor.

Udo Schuklenk teaches bioethics at Queen’s, he tweets @schuklenk

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