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When Medical Inaccuracies Shape Mass Media Coverage Print E-mail
Living - The Dialogue
TS-Si News Service   
Saturday, 09 August 2008 17:30
Theresa Schiavo.
TS-Si Medical Horizons
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Media coverage of the persistent vegetative state and end-of-life decision-making. Éric Racine, Rakesh Amaram, Matthew Seidler, Marta Karczewska, Judy Illes. Neurology published 6 August 2008. doi: 10.1212 / 01.wnl.0000320507.64683.ee

 
A team of bioethicists [N1] examined the media coverage featuring the famous and controversial case of an American, Theresa Schiavo. She had a cardiac arrest in 1990 that caused irreversible brain damage, which led to a persistent vegetative state diagnosis. A few years later, this diagnosis became a source of conflict over the interruption of artificial nutrition.
 
The "Schiavo Case" was widely discussed from a medical, ethical and social standpoint in the United States and elsewhere. In an article published in Neurology, a research team examines the media coverage featuring this famous case. The team was composed of Dr. Éric Racine [N2] of the Institut de recherches cliniques de Montréal (IRCM) and experts from Stanford University and the University of British Columbia (UBC).
 
The study reviewed American daily newspapers that were most prolific about this story. A total of 1,141 articles and over 400 letters to the editor were analyzed from the:
Never before had the media coverage of such a clinical case been studied so extensively. The accuracy and the nature of the statements on Terri Schiavo's neurological condition, her behaviours, her behavioural repertoire, her prognosis and the withdrawal of treatment were examined.
 
"In the course of our research, we were surprised by the amount of medical inaccuracies that these newspapers had published, said Dr. Racine. Some journalists even wrote about Mrs. Schiavo's reactions to specific words or expressions supposedly showing that she was conscious." More than scientific and medical information, the legal, political and ethical dimensions made the headlines.
 
Only 1% of the articles examined gave a definition of the "persistent vegetative state," an essential concept to understand the issues at stake. The persistent vegetative state is an established neurological condition characterized by severe lesions to the cerebral cortex, which eliminate higher functions: inability to communicate, absence of memory, absence of pain, etc.
 
However, the brain stem responsible for vital functions is not damaged, which accounts for the patients' reflexes and their ability to breathe and swallow independently. Despite the fact that Terri Schiavo's medical condition did not allow any reasonable hope of recovery, a fifth of all articles (21%) contained statements according to which her condition would improve.
 
"Our observations show that the press capitalized on the controversy to a large extent, and selling copies mattered more than delivering scientific information. Media coverage sustained myths and false hopes," explains Éric Racine.
 
The Neurology article provides an objective measure of misinformation, which underlined that the information available to the media had limitations. "The public debate surrounding this case showed that the medical, ethical and legal consensuses on the legitimacy of the withdrawal of treatment in accordance to a patient's will were challenged."
 
In fact, Racine points out that while in the 60's and 70's people mostly rallied over the right to refuse treatment, an opposite pressure was applied in the Schiavo Case by relatives and public opinion. "This case is quite original because it reveals the emergence of a pro-life social stream, a trend that has now reached Canada," adds the researcher.
 
For their misunderstanding of the subject matter or their bias, are journalists to be blamed? Mass media have become a space of complex social interaction where the public takes its information and reacts to it. However, the Internet and the media cannot replace official sources, be they medical, legal or political.
 
In order to improve the quality of the information that is relayed to the public, families and key-actors, specialists must adopt strategies that will take into account the limitations identified in the media coverage of the Schiavo Case. Such ethical and medical debates would certainly benefit from information that is both more accurate and more accessible to the layperson.
 


[N1] This research was funded by the Institut de recherches cliniques de Montréal (IRCM), the US National Institutes of Health (NIH), the Social Sciences and Humanities Research Council of Canada (SSHRC/CRSH), and the Greenwall Foundation.

[N2] Éric Racine is Director of the Neuroethics Research Unit at the Institut de recherches cliniques de Montréal (IRCM). He is also Associate Researcher at Université de Montréal and Adjunct Professor in the Department of Neurology and Neurosurgery at McGill University.

 


Media coverage of the persistent vegetative state and end-of-life decision-making. Éric Racine, Rakesh Amaram, Matthew Seidler, Marta Karczewska, Judy Illes. Neurology published 6 August 2008. doi: 10.1212 / 01.wnl.0000320507.64683.ee

Abstract

Background. Conflicting perspectives about the diagnosis and prognosis of the persistent vegetative state (PVS) as well as end-of-life (EOL) decision-making were disseminated in the Terri Schiavo case. This study examined print media coverage of these features of the case.

Methods. We retrieved print media coverage of the Schiavo case from the LexisNexis Academic database and used content analysis to examine headlines and text of articles describing Schiavo's neurologic condition, behavioral repertoire, prognosis, and withdrawal of life support. The accuracy of claims about PVS was assessed.

Results. Our search yielded 1,141 relevant articles published (1990–2005) in the four most prolific American newspapers for this case. The most frequent headline themes featured legal (31%), EOL (25%), and political (22%) aspects of the case. Of the articles analyzed, 21% reported that Schiavo "might improve" and 7% that she "might recover." Statements explicitly denying the PVS diagnosis were found in 6% of articles. Explanations of PVS and other chronic disorders of consciousness were rare (1%). Most frequently cited descriptions of behaviors were that the patient responds (10%), reacts (9%), is incapacitated (6%), smiles (5%), and laughs (5%). Withdrawal of life support was described as murder in 9% of articles.

Conclusions. Media coverage included refutations of the persistent vegetative state (PVS) diagnosis, attributed behaviors inconsistent with PVS, and used charged language to describe end of life decision-making. Strategies are needed to achieve better internal agreement within the professional community and effective communication with patient communities, families, the media, and stakeholders.

 
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TS-Si is dedicated to the acceptance, medical treatment, and legal protection of individuals correcting the misalignment of their brains and their anatomical sex, while supporting their transition into society as hormonally reconstituted and surgically corrected citizens.


 
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Last Updated on Tuesday, 09 September 2008 18:09