July 27, 2017

Truth or Consequences

Don Shifrin MD FAAP
Mercer Island WA

Here’s my question for all AAP ‘Mediatricians’ (apologies to the original Mediatrician, Michael Rich FAAP,  of Harvard’s Center on Media and Child Health).

Which of these statements do you envision as the most important when you go on record advocating for children in media interviews?

1)      You calmly and quickly establish your single overriding communication objective (SOCO). Then consistently reinforce that message. 

2)      No matter how uniformed, hostile, or far afield your interviewer seems,  you can comfortably bridge back to your SOCO.

3)      Despite being pushed, prompted, or provoked you remain undaunted and steadfast while always remaining truthful.

Full marks to those who selected number three. As Mediatricians we have had personal and painful media experiences when science succumbs to ‘alternative facts’ and belief systems.  As clinicians we repartee with families, or in public such subjects as spanking, guns, screen-time, and vaccinations.  How many times have we debated Dr. Google during clinical interactions?

However, in the last 18 months pre-and post the November 2016 presidential election Americans have noted a significant and seismic shift in what could be reasonably interpreted as the ‘truth’. We can find ample evidence for the Oxford Dictionary’s choice for their 2016 Word of the Year to be “post-truth,” an adjective defined as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion or personal belief”.

A clarifying explanation comes from the Yale professor Jason Stanley, whose 2016 book, “How Propaganda Works”, analyzes modern propaganda. In his New York Times Op-Ed of November 4, he stated that Americans heard candidates that “engaged in rhetorical tactics unprecedented in recent electoral history” and repeatedly “endorsed false claims.”  Professor Stanley’s book reinforced that calling someone a liar “misses the point of authoritarian propaganda altogether.” Stanley’s message is that the speaker attempts to convey power by defining a reality that will change listener’s value systems. Once that power is granted it can effectively supersede accuracy and honesty. and erode public trust.

We are familiar with  Daniel Moynihan’s dictum that, “everyone is entitled to his own opinion, but not his own facts.” However, that statement seems unlikely to be validated in viewing today’s mass media communications. Everyone has access to their own version of ‘the truth.’ 

Pediatricians can verify that when patients come to us with a particular purpose in mind, that purpose often isn’t to uncover the truth, but to defend themselves or attack  the current science topic.

Parents and the public will continue to rely on motivated reasoning to accept authoritarian propaganda that conforms to their opinions. Perhaps then if a vaccine is not 100% effective it could be 100% dangerous. Fear often leverages science. Fears that appeal to the vaccine-hesitant are no secret to our pediatric community. Paul Offit summarizes this when he states, “It is easier to scare people. It’s harder to unscare them.”

Of the seven Cs of communicating media content, - be current, clear, concise, consistent, compelling, caring, and correct - which would you rate highest? 

ABC: always be correct! 

If you do not know, do not bluff, bluster, or be boorish. Do not speculate. Admit what you do know (SOCO) and that certain questions do not currently have accurate answers backed by solid science.  When that occurs, you can and will follow up with accuracy.

To be credible we must be believable. And to be believable we must not misconstrue the truth. Truth or Consequences is not just an arcane reference to a 1950’s TV show. All Mediatricians should remember one of your mother’s most oft-repeated mantras (other than wash your hands or wear clean underwear): no matter how much it may hurt, always tell the truth.

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