Once every few weeks I get to write something extremely serious in the BMJ.BMJ 2007;335:480 (8 September), doi:10.1136/bmj.39328.450000.59 Observations – Media watch Journalists: anything to declare? Ben Goldacre, doctor and writer, London
“Drug companies wouldn’t pay for the media to attend their events if they didn’t think it would affect coverage, yet journalists’ competing interests usually remain undeclared.”
Much as I like to fantasise that I am cynical and worldly, as a doctor and a journalist, the world still holds some surprises. Conflict of interest is a subject that creates heat and concern, not least for journalists, who often stumble upon a banal and openly declared interest, and use it to build fantasies of medical corruption and Pullitzer prizes.
Now, while there is good evidence for the venality of pharmaceutical PR – and its success in influencing published academic work – it’s often tempting to point out that the entire culture of academic funding has changed over the past 20 years: and that politicians, journalists, and the public themselves might take some responsibility for the fact that governments choose not to fund academic work.
But that’s a digression: in light of the puritanical stance of so many journalists, I was surprised last week to receive an email circular, from a science writers mailing list. It was from the Aspirin Foundation, a group funded by the pharmaceutical industry, and it was offering – on behalf of Bayer Healthcare – to pay expenses for journalists to attend the European Society of Cardiology conference in Vienna.
Aspirin is without doubt an excellent and cheap drug, but in my naivety I had no idea such things went on. I pinged off a few emails to friends and colleagues, and most poked fun at my innocence – quite rightly – but some were very helpful. Not only is it extremely common for journalists to take money from pharmaceutical companies, but there have been some astonishing cases over recent history, including one memorable case where a PR company invited journalists to “an exclusive preview” of new laser eye technology, with the offer to “discuss free treatment in return for editorial features”.
“I organise the media programmes for a number of medical conferences run by scientific societies”, said one person who, without wishing to be melodramatic, has asked to remain anonymous: “and I reckon at least 50% of the journalists present are paid for by drug companies. They get pretty well looked after too – first class travel, 5 star hotels, posh dinners etc. Some of them indulge in double-dipping… where they are paid a per diem by the drug company and then by the publication that takes whatever they have written. Sometimes they don’t even use the press room, spend all their time in company hospitality suites, and just go to company sponsored satellite sessions and press conferences.”
What was more striking was the range of responses: some laughed at my naivety; some wrote expressing outrage at the insightless venality of their colleagues; and some were emotive and defensive, belittling the notion that there was anything to worry about, and explaining that a journalist can detach themselves and be impartial. It was, in fact, almost exactly the same as the arguments amongst medics, played out in editorials and letters about conflict of interest in academia, over 15 years ago.
Then, as now, it’s easy to become histrionic about conflict of interests (or “competing interests” to give them their more metered title). A conflict of interest is “a situation not a behaviour”, as they say, and simply because somebody receives funding or jollies, that does not mean they will change their minds. But it’s a discussion worth having: only one journalist friend mentioned seeing a declaration of competing interest appear next to their article (it was in the Guardian) and few journalists I spoke to could think of any explicit policies on the subject.
And there are very real dangers in being too close to public relations people: lovely though they may be, their trade is – by definition – manipulation. Drug companies are businesses, with responsibilities to their shareholders, and they wouldn’t pay for journalists to attend their events if they didn’t think it would affect coverage. A journalist’s article is far more credible than a paid advert, after all, for anybody’s money, and more likely to be read by potential consumers.
As we know from medicine and academia, the ways of conflict of interest can be subtle: not just money, hotels, and free eye surgery, but also the “revolving door”: the free movement between “mass media journalist” and “industry copywriter” is every bit as worrying as the gay dance from FDA regulator to drug company.
But most often, it is simply a matter of fostering a relationship. In the 1980s, as any medical student could tell you, the link between aspirin and Reye’s Syndrome had recently been discovered. For non medical readers, Reye’s affects children and is frequently fatal.
And in 1982, the Aspirin Foundation of America – a similar body to the one offering money from Bayer this time – was fighting a successful media campaign against the government’s proposed warning labels on aspirin packages. “The Aspirin Who? Foundation?” It’s much easier to get someone to take your calls when they’ve eaten your food, slept in your bed, or taken your money. And I, for one, in future, will read journalists’ hysteria about academic conflicts of interest with a very wry smile indeed.
I think this might count, I’ve won it twice, as have most newspapers:
Other than these journalism prizes, I have received no money, no conference travel, no free gifts, no research funding, no paid work, no speaking engagements, no educational grants, no golf club memberships, no nothing. That’s not to say I think it’s bad if people do work for big pharma, or accept this stuff: I just think it’s interesting that there are no routine mechanisms by which journalists can declare them.