Medicine in the News

Mary Dixon-Woods

Nuffield Council on Bioethics,& human behaviour: the ethical context (2001)

•  The media is one of the most important means by which the general public receives information about scientific issues and will therefore have a key role to play in informing people about new developments.”  

Medicine and the news

• The news is an important means of representing medicine and its possibilities to “the public”

• It is important to understand the ways in which images of medicine come to be created and sustained

Objectives of this session

• Explain, in brief, different approaches to media analysis

• Give examples of media analysis applied to news of medicine and health

Ways of understanding how people respond to media

messages• Mathematical model of communication

• Hypodermic needle model of media effects

• Uses and gratifications model

• Semiotics

• Preferred, negotiated, and oppositional readings

Mathematical model of communication (Shannon and

Weaver, 1949)

Hypodermic needle model

• Based on crude form of behaviourist pyschology

• Idea that the makers of media messages can manipulate their audiences

• Success of fascist propaganda in 1930s Germany

Hypodermic needle model

• Largely dismissed by most serious academics but continues to find popular support in media discourses e.g. the James Bulger case.

• Lies behind “moral panics” about the media.

Uses and gratifications model

• Uses and gratifications approach suggests that people are purposeful and strategic in using the media

• They choose what they watch and watch things in order to fulfil particular needs (eg to relax)

• Rejects simplistic assumptions of hypodermic model

Uses and gratifications model

• Two-step flow” model tried to account for the fact that people belong to different social groups

• However…U&G tends to exaggerate active and conscious choice

• Interprets all “effects” of media in terms of gratifications

Semiotics

• “The science of the sign”.

• Polysemy – the multiple meanings that a message can have.

• Closure – how the range of meanings can be closed down.

• Preferred readings – what the message sender wants you to understand.

Semiotics: how is the preferred reading indicated?

• Epilepsy gene identified

http://news.bbc.co.uk/hi/english/health/newsid_1962000/1962724.stm

Preferred, negotiated and oppositional readings

• Preferred reading – the intended one (can be achieved by framing, use of captions etc)

• Negotiated reading – dominant values and social structure is accepted, but specific message may not be

• Oppositional reading – reader subverts the intended message

Types of media analysis

• Content analysis

• Discourse analysis

• Reception analysis

Content analysis

• A primarily quantitative technique

• Used to identify frequency of phrases or concepts within a text

• Usually done using computers

Discourse analysis

• Focuses on text and talk as social practices

• Focuses on the resources/interpretative repertoires drawn on to enable those practices (eg stereotypes)

• Interested on how discourses are organised to be persuasive

Principles of DA

• “Discourse” refers to all forms of talk and texts – DA is interested in the content and organisation of these. Draws on many ideas from semiotics.

• All language is constructive: manufactured from pre-existing resources; the assembly of the account involves selecting between different possibilities; the way we deal with the world is mediated by language.

Doing DA

• No “cookbook” set of procedures; perhaps the least systematic of all qualitative approaches. Does not usually involve computers.

• Ask yourself “what features produce this reading?”

• Search for patterns in the data, including interpretative repertoires (eg notion of genetic modified foods as “frankenstein” foods).

• Search for the functions of the discourse.

Examples of discourses

• Discourse around cloning

• Discourse around NHS managers

• Discourse around waiting lists

Reception analysis

• Asks not “what do media do to people?” but “what do people do to media”?

• Combines semiology and (usually qualitative) audience research

• Audience seen as active creators of meaning

• Notion of interpretative communities

Doing reception analysis

• Involves ethnographic techniques – watching a family watch television, using focus groups, interviews etc.

• Computers may be used to assist in the analysis.

More important concepts

• Moral panics

• Bias towards positive results

• Bias towards “human interest”

Moral panics

• Certain groups (“folk devils”) periodically become the focus of moral panics.

• Labelled as being outside the core values of a society, seen as a threat.

• Achieved by framing of stories. Use of resources such as authoritative voices (eg scientists, judges).

Moral panics and medicine

• Designer babies

• Incompetent practices

• Villainous doctors

• Bizarre health policies

• Medical researchers

• Killer diseases

Moral panic about cloning

• The characterization of cloning as an ethical issue centers around three connected concerns: – the loss of human uniqueness and

individuality– the pathological motivations of a cloner– the fear of out-of-control scientists.

Bias towards positive results

• As with professional journals, the mass media are more likely to report a positive finding.

• Increasingly evident that scientists attempt to manipulate media eg by early release of findings.

• “Newsworthiness”; gatekeeping.

Bias towards human interest

• Stories focusing on particular individuals

• Emphasis on hope or destruction

• Individuals themselves recruited to serve particular discursive functions

• http://news.bbc.co.uk/hi/english/health/newsid_1906000/1906999.stm

• News values: 'news hooks', 'relevance', 'accessibility' and 'controversy' .

Examples of studies

• Henderson L, Kitzinger J (1999) The human drama of genetics: “hard” and “soft” representations of inherited breast cancer. Sociology of Health and Illness 21(5): 560-578

• Content analysis of British newspapers and magazines

Henderson and Kitzinger’s findings

• Breast cancer reported 7 times more often than lung cancer

• Constructed as a inherited “genetic” condition • Heavy emphasis on prophylactic

mastectomies• “Human interest” generated by stories of

women faced with dilemmas (22% of stories)

Examples of studies

• Entwistle et al (2000) The case of Norplant as an example of media coverage The Lancet 355: 1633

• Analysis of 101 newspaper articles

Norplant

• Early reports presented Norplant very positively; disadvantages downplayed.

• Reports that it was in great demand but women might be denied access to it.

• Less than a year later, newspaper reports about Norplant were dominated by the stories of individual women who had had bad experiences with the product.

Examples of studies

• Henderson et al (2000) Representing infant feeding. BMJ 321: 1196-1198

• Content analysis of references to infant feeding in UK newspapers and tv programmes

Infant feeding

• Breast-feeding rarely shown on tv• Problems were often described with

breast-feeding, none with bottle feeding• Breast-feeding used as a signifier of

social class – associated with middle class women or celebs

• May discourage acceptance of breast-feeding

And finally

• Bad press for doctors http://bmj.com/cgi/content/full/323/7316/782?

• Daily Telegraph, Guardian, and Daily Mail contained more than twice as many negative stories about doctors as positive ones, but there was no significant change in the ratio of negative to positive stories over time.

• The total number of articles about doctors increased over time.

Conclusions

• Mass media are an important source of images about medicine.

• It is important that doctors are responsible in their relationships with the mass media.

• More research (particularly reception analysis) is needed.