Sins of Omission

Medical writers and editors for the general press don't intend to inflict cruelty on suffering people. But that's what they often deliver in the rote-journalism pursuit of informing the public of new developments in medical research, no matter how distant they may be from therapeutic application. News of direct health value to the public deserves the prompt coverage that it regularly receives. But not so the mere research fragments that raise unrealistic hopes, leaving distressed people empty-handed, dismayed, and uncomprehending when they rush to the doctor pleading for the help that they "saw in the paper." Harvested from medical and scientific journals and university and corporate press-release hype, scientific scraps are routinely ingested by the news media and regurgitated in lay translation, with hopeful implications or direct assertions of progress, advances, and new treatment possibilities. That no treatment is available now, soon, or possibly ever, may or may not make it into the story. But when it does, the story's pitch for attention and the excitement of discovery usually obscure a stubborn reality: Science normally moves slowly and uncertainly, often stuck in blind alleys. Breakthroughs are rare, and when they occur, they are usually upstream in the complex process of turning scientific knowledge into medical treatment. Relatively few scientific papers lead to pharmaceutical patents, and even fewer make it to the marketplace--facts not readily deducible from most scientific news stories. Let's look at some examples. A recent press report, derived from a peer-reviewed journal, tells of the discovery of a gene that may prevent ovarian cancer. Another report describes an engineered virus that might be useful for treating Parkinson disease. Though of value to scientists, neither report makes it clear that a pill or treatment, if ever, is a long way off. To analogize to foreign-affairs reporting, they are on a par with news that the State Department may add a wing to one of its embassies. Reports on Alzheimer have been on a roller coaster of hope and despair for several years, with bursts of excitement about this or that drug, followed by disappointing clinical trials. "It has been junk after junk for 12 years," a researcher told The New York Times, as he welcomed the discovery of an enzyme, linked to the disease, that might lead to a drug. Gene therapy has experienced a similar ride. As a book reviewer noted in Science,1 scientific enthusiasm "was quickly communicated to the lay press, who touted gene therapy as the answer to many previously untreatable diseases from cancer to heart disease and AIDS. This exuberant optimism only increased the frustration and disappointment as one major human gene therapy after another failed to demonstrate any clinical efficacy." The 30-year, multibillion-dollar War on Cancer has produced genuine progress in diagnosis, prevention, and treatment--tangible, long-awaited achievements worthy of celebration in the press. But here, too, cheery wisps of science, remote from the bedside, are constantly extracted from research journals and repackaged for popular consumption, with rarely a mention that, despite progress, cancer still claims more than 500,000 lives a year in the United States. The result is a bizarre dissonance between the health pages and the obituary pages. Thus, a partially successful clinical trial of a tumor treatment in a mere 17 patients zipped around the world in a wire-service report, properly accompanied by caveats that the enrollment was small and that natural remission might have been a factor. Nevertheless, a headline in The New York Times read: "Tumors Reduced in Study." The journalistic zest for scientific minutiae and silver bullets for health afflictions provide easy prey for stock-market manipulation. This is particularly true in the turbulent, product-hungry biotech industry, where share prices can zoom on hints of product-development progress. Scientists with stock options are sometimes complicit in the process. No wonder, then, that biotech firms routinely barrage the science press with promising reports of wondrous things to come, though many have yet to arrive. Even so, favorable stories in mainstream publications are deeply cherished for their market-moving prowess, and efforts to obtain press attention occupy the working time of many clever, well-paid press relations specialists. And the efforts pay off, abetted by competitive pressures among news organizations and the ingrained reportorial practice of rummaging through scientific and medical journals and press releases for anything that might be sold to editors--most of whom are scientific illiterates. As I said, cruelty isn't the media's intent when they run a scientific story that holds no realistic promise and reveals no sobering caveats. It just works out that way. Daniel S. Greenberg, a Washington journalist, is the author of Science, Money, and Politics: Political Triumph and Ethical Erosion (University of Chicago Press). 1. J.M. Leiden, "Gene therapy enters adolescence," Science, 285:1215-6, 1999. function sendData() { document.frm.pathName.value = location.pathname; result = false if (document.frm.score[0].checked) result = true; if (document.frm.score[1].checked) result = true; if (document.frm.score[2].checked) result = true; if (document.frm.score[3].checked) result = true; if (document.frm.score[4].checked) result = true; if (!result) alert("Please select") return result; } .myradio{background-color : #94bee5} Please indicate on a 1 - 5 scale how strongly you would recommend this article to your colleagues? Not recommended 1 2 3 4 5 Highly recommended Please register your vote

Sins of Omission

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