Website accuses Jennifer Ashton & CBS Early Show of bias on mammography “debate”

The CBS Early Show, saying it was “looking for clarity” on the mammography debate after the American College of Ob-Gyn statement last week, turned to “medical correspondent” Dr. Jennifer Ashton, who appeared in the studio with Nancy Brinker of the Susan G. Komen Foundation.

Now, the Komen Foundation has a one-sided view of the mammography debate (entirely pro-screening) – one not shared by all breast cancer advocacy organizations – e.g., Breast Cancer Action or the National Breast Cancer Coalition. So there’s a bias there.

drjashton.jpgBut the KomenWatch.org website pointed out that the supposedly clarifiying correspondent showed up wearing “Komen’s embroidered logo on her blouse.” (Picture at left from the KomenWatch.org website from Dr. Ashton’s on-air appearance.) They asked:

“Is Dr. Ashton an employee of the Komen organization? Is CBS running an advertorial for Komen? Is the television spot another marketing strategy involving Komen product placement?”

Here’s the CBS clip:

I’m not addressing the science in this post.

I’m addressing journalism ethics.

Journalists shouldn’t wear endorsements – not while reporting on controversial topics – not anytime.

We’ve commented frequently on examples of media bias for mammography – and for various screening tests.

• A recent example by a CNN reporter.

• A recent example by ABC News.

• A recent analysis in a journal article ending with the conclusion of media bias for screening. (Addendum on July 29: I should have pointed this out right away: there are methodologic issues with this study, e.g., pooling major news sources with tweets and with PR Newswire (!?). Although flawed, it is one more look at this issue.)

It violates any principles of sound, fundamental journalism ethics. And I’m going to keep writing about it whenever I see it.

Addendum two hours after original post:

This interesting exchange took place on Twitter after this post was published:

See this amazing exchange today:

@IvanOransky wrote:
Why did @DrJAshton wear a @komenforthecure logo during Nancy Brinker intvw? asks Komen Watch http://ht.ly/5OSP5 via @garyschwitzer

@DrJAshton responded:
@ivanoransky b/c as a women’s health specialist, I support breast cancer awareness. On AHA women go red day, I wear red.

@garyschwitzer responded:
SPJ code of ethics. http://bit.ly/4r4BR “distinquish between advocacy & reporting” @DrJAshton: @ivanoransky as women’s health specialist, I support breast CA awareness. On AHA women go red day, I wear red.

Ashton responded:
@garyschwitzer real MD’s r patient advocates 1st/ foremost,& I m a real doctor. As “reporter” I try 2 give both sides,but I m not an anchor.

To which I finally responded:
.@DrJAshton: Sounds lk U suggest anchors & reporters have difft ethics on balance/advocacy;Reporter side of u shld read http://bit.ly/4r4BR

I’ve written about ethical issues involving network TV physician-reporters before (See this example.) But this admission that she views herself as an advocate, and the suggestion that reporters have a different ethical standard than anchors is striking. As a physician wrote when he saw that a CNN reporter tweeted a breast cancer advocacy message last week, “Could a political reporter say ‘Vote for Smith?’!”

This is a troubling lapse in journalism ethics from someone who has – in all fairness – probably never been given any training in journalism ethics. So don’t just blame the reporter in this case; blame the corporation that thought it was a marketable idea to put a young female physician on the air as a journalist.

Comments

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David Gruen,MD

July 27, 2011 at 3:15 pm

Give me a break. Just this week we diagnosed another woman with advanced stage breast cancer. She had screening mammograms every year up until 2009, but skipped the past two because she lost her health insurance. There’s no doubt that her likelihood of survival would be better if she hadn’t missed her mammograms, and didn’t have metastases. The gynecologists are spot-on, no pun intended. The mortality of breast cancer has decreased EVERY year since 1990, thanks in large part to adoption of mammographic screening. GO KOMEN, AVON, ACS, ACR, AND EVERY ORGANIZATION THAT SUPPORTS MAMMOGRAPHY!!

Gary Schwitzer

July 27, 2011 at 3:41 pm

Dr. Gruen,
I did give you a break, and posted your comment despite the fact that you missed/ignored what I wrote.
I wrote:
“I’m not addressing the science in this post. I’m addressing journalism ethics.”
I’ve worked to improve the ethics and the evidence-based practice of health care journalism for 37 years.
The Society of Professional Journalists’ code of ethics states: “Distinguish between advocacy and news reporting.” Dr. Ashton in this context is working as a self-described “medical correspondent” or journalist. Such blatant advocacy is a violation of the journalists’ code of ethics.
Journalism ethics is the issue to which I drew attention in my blog post above.
But since you brought up the science: to your first point, I’ll remind you that the plural of anecdote is not data. And to your second point, see this week’s BMJ when it is published. You’ll find an article relevant to the point you thought you made.

Jody Schoger

July 27, 2011 at 5:15 pm

This is an important post and topic: reporting is not advocacy or activism.
The rapidly dissolving line between a reporter” and “doctor/reporter/friendly advocate” is one that I hope you continue to bring forward. I don’t need to be best girlfriends with the health reporters on TV but that’s where too much of it seems to be going.
Unfortunately, morning news shows and evening news are not the places I obtain health information. This was a good example of why I don’t. I would have been pulling out my hair.

Gayle Sulik

July 27, 2011 at 5:32 pm

I am beyond words. Really. But if I could muster any coherent thought in my baffled mind about,
1) why Dr. Ashton would support “awareness” while wearing a LOGO (i.e., Komen’s trademarked running ribbon instead of a generic pink ribbon);
2) why Dr. Ashton would think that an “anchor” would have a different ethical compass from a “reporter”; and,
3) why Dr. Gruen would ignore the entire point of your post and then focus his comment to his preferred conclusion about screening while using one data point to suggest a spurious trend;
I would have to say that the line between advocacy and advertising has blurred substantially, the ethics in reporting has given way to the most powerful voices (not the voiceless), the widespread investment in screening (which is different from diagnostic mammography) is so great that belief in this technology trumps the preponderance of data, and the use of emotional excess in place of an evidence-based argument has once again prevented useful public dialogue about a very important subject.
Okay, I’m taking a deep breath now.

Amy Durfee West

July 27, 2011 at 7:22 pm

Thank you for making the ethical point, and for the link to the Komen Watch article. A further ethical question is this: Does it fairly serve the public interest to attempt to solve massive public health issues with entrepreneurial “free market” methods? As a private citizen, Nancy Brinker is entitled to her opinion, but as the self-appointed Queen of Breast Cancer, she gets to shout down reasoned, evidence-based recommendations made by scientists with no axe to grind. People assume she knows what she’s talking about and are not equipped to question her objectivity or credentials. Having a reporter wearing an embroidered Komen trademark only adds to that bias. We really shouldn’t care what Nancy Brinker thinks, but we have somehow bought into the belief that if people are good at making or raising money then they must be good at figuring out how to serve the public interest.

Lori Marx-Rubiner

July 27, 2011 at 8:06 pm

Where to even begin? I am, by no mean, an expert on journalism and ethics, but this is a complete degradation of journalistic integrity and a keen reminder of why I hardly ever watch TV news. I find myself in the “product placement” camp, and given Komen’s direction, I’m not the least bit surprised. However, I will avoid the myriad of issues that pertain to Komen, pinkwashing, mammography screening, and who they ultimately service, ALL of which deserve serious and respectful scrutiny and debate. A word about screening mammography, though: one must wonder about those physicians who see fit to recommend medical tests on third-party blogs. If we really want to make a dent in the breast cancer rates in America, here’s a thought: let’s use MY circumstances as a universal guideline and give everyone bilateral mastectomies at 35. Truth be told, Dr. Gruen, your patient’s circumstances, terrible of course, say little about screening and much more about the current state of health coverage in America.

Kathi Kolb

July 27, 2011 at 8:21 pm

I must echo Jody’s point, that television news spots are not the places I go to seek accurate medical or healthcare information. Nor should anyone else. And this piece is a prime example of why. In the first place, it’s ludicrous to attempt a cogent discussion of this issue in a 4-minute ‘news’ spot. In the second place, what exactly was the point of this piece anyway? I’ll give Nancy Brinker a few points for at least saying that mammography isn’t perfect, and that we really ought to be able to come up with more accurate screening methods for breast cancer, but neither of these women is qualified, in my opinion, to clarify the subject. An actual, competent medical reporter and perhaps an actual, competent medical researcher would have been a better combo. Not to mention an anchor who did her homework first. Heck, I can think of at least a half dozen bloggers and writers who know more about the complexities of this subject than any of these three women apparently do.

Nancy Stordahl

July 27, 2011 at 9:04 pm

I find this issue of journalism ethics to be very interesting. In my view, all of the major television network morning “news” shows have become less focused on truth and news telling and have become too focused on entertainment. Is this unethical? Maybe not, but I no longer watch them for this reason. I think they have lost credibility. The fact that Dr. Ashton wore a Komen pin, not just a pink ribbon pin, clearly shows she overstepped her role and gave the appearance of being a Komen advocate. Again, I find this to be unacceptable/unethical. I applaud you for addressing this topic of ethics in journalism. It needs more attention. Thank you.

@chemo_babe

July 27, 2011 at 11:29 pm

One question:
Could someone please explain how a little running ribbon does more to ‘raise awareness’ than a direct conversation about screening issues? That logo has no inherent meaning. Komen has endowed it with its symbolism, and it would only resonate with people who are already aware of what it stands for.
I smell a rat.

RachelCCChronicles

July 28, 2011 at 5:29 am

If CBS was looking to provide clarity on the mammography debate, perhaps they might have considered inviting the likes of the National Breast Cancer Coalition or Breast Cancer Action to the table. Unfortunately I doubt that Ms Brinker would have agreed to do the segment, and nor would NBCC or BCA have agreed to wear Komens running ribbon. Instead the viewers got an advertisement for Komen, a sales pitch for mammography, and Dr Ashton’s sponsored advocacy. All that was missing was 1800-GO-KOMEN flashing across the screen, with an offer of a free bottle of Promise Me perfume for the first five callers. Fail CBS fail.

Phillipa Rispin

July 28, 2011 at 10:57 am

These are excellent critiques and comments. I hope that you’ve also sent them to the network — it needs to hear this.

TricountyWomab

July 28, 2011 at 11:51 am

Sigh. I am a journalist – not a doctor who plays one on TV – as well as a college journalism instructor and this is the most obvious breech of ethics I’ve seen in a long time. That the good doc doesn’t get that is a major problem. Honestly – different ethical standards for garden-variety broadcasters and anchors? Seriously, any first-year journalism student would pick that stupid argument apart – then again, the good doc probably hasn’t taken a journalism class ever, which is part of the issue. This kind of blatant bias should never be allowed – and the infotainers at CBS are to blame here. Complaining to them – with threats of watching The Today Show or Good Morning America (because it would upset their ratings and hence advertising revenue) will be the only thing they really understand, unfortunately.
This crap makes me sick, it really does…

Richard Michem

July 28, 2011 at 7:34 pm

Three seconds, That the WHOLE TIME, you can see the logo. Most of the logo was COVER UP by the CBS logo. Unless you were really looking and even then,it could have from a distant, look like a logo for a shirt brand, or just a pink ribbon. How do you know that Dr. Ashton , was even suppose to be in the studio, during the story. CBS lately has been bring in outside experts, to do health stories. Maybe Nancy Brinker, was suppose to be THE ONLY one giving health news, that day. Dr, Ashton does control her air time. It she had surgery , or medical matters, she does not have to show up. Possible, that surgery, may have been cancelled, so she showed up at the studio, wearing, a ribbon supporting doing something, to keep one from getting Breast Cancer. A ribbon, which until she walked in that studio, was only for the eyes of her patients, It would not surprise, me if a patient, gave it to her, WITH NO STATEMENT, MEANING. Just to thanks her, for being a good doctor for then. Dr Ashton, may have forgotten she had it on, and did not know the subject of that day”s health report.

Gary Schwitzer

July 28, 2011 at 8:59 pm

Richard,
Your hypothetical situation of “maybe…possible…may have forgotten” is, indeed, an interesting yarn. But this is not fiction or a detective novel.
Let’s deal with the facts. And the deep concerns about journalism ethics.
The point about how visible the Komen logo on Ashton’s blouse is on the video – and how long it appears on camera to the home viewing audience – strikes me as irrelevant. Would it have been acceptable to wear the endorsement logo if it were NOT visible at all on TV but visible only in the studio where the interview took place? Would that have made it ethical? I don’t think so. It was wrong, whether the viewing audience at home saw it for 0 seconds or 3 seconds or for 3 minutes – whether it was on a wide shot or a tight shot or not visible to the home audience at all.
The Statement of Principles of the Association of Health Care Journalists – the leading professional organization of health care journalists – http://www.healthjournalis?m.org/secondarypage-detail?s.php?id=56 – reads:
• PRESERVE A DISPASSIONATE RELATIONSHIP WITH SOURCES, AVOIDING CONFLICTS OF INTEREST, REAL OR PERCEIVED.
Do you think it is a dispassionate relationship to wear the logo of an organization whose founder you are interviewing? How would you view a political reporter interviewing candidate Smith while wearing a “Vote For Smith” button?
But as to the visibility of the logo, women who live with these issues every day – breast cancer survivors – caught the image on camera and they are the ones who brought this to the world’s attention. It bothered them. It bothers me. It should bother anyone who cares about the integrity and credibility of journalism.

Richard Michem

July 29, 2011 at 7:08 am

Hypothetical Situations, are only a yarn, when their not based on fact.

Gary Schwitzer

July 29, 2011 at 9:51 am

Dr. Gruen,
A followup to your statement that “The mortality of breast cancer has decreased EVERY year since 1990, thanks in large part to adoption of mammographic screening.”
I teased this the other day but could not reveal details because the information was embargoed. But this week’s BMJ has now been published with a paper concluding:
Breast screening has had little to do with falling breast cancer deaths. http://ht.ly/5Qpmt
This is not a clearcut, slam-dunk issue.

Gary Schwitzer

July 29, 2011 at 9:59 am

Richard,
What’s this?
You’re now claiming that your hypothetical suggestion is FACT?
Well then you should provide evidence and get that published somewhere, because it’s quite a tale!