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The medium is the message: assisted conception and the role of the media

08 September 2008

By Professor Marcus Pembrey

Chair of Progress Educational Trust, based on a talk given to the British Fertility Society Ethics Meeting: 'Principles and Practice in Reproductive Medicine', Liverpool, 5 Sept 2008.

Appeared in BioNews 474
'The Medium is the Message' - a phrase coined by Marshal McLuhan in 1964 - implies that the type of presentation as much as the content of the message determines what gets incorporated into personal and societal views. This 'spin' element has and continues to be a significant component in the media coverage of assisted conception and related technologies.

The media got off to a flying start with the 'World Exclusive' Daily Mail front page photo of Louise Brown and huge headline 'AND HERE SHE IS ...THE LOVELY LOUISE', in July 1978. How different it would have been if she had not been healthy! Since then, 30 years of reporting has seen both ups and downs.

Media coverage of developments in this area of science - and the ethical issues surrounding it - is both necessary and important. Scientists and clinicians have a responsibility to inform the public about their research plans, including the potential benefits (and harms) that may come from them, and should engage with the media. But those headlines can be exasperating! Clearly there are agendas being played out that go beyond simple science communication; this is particularly evident when we see stories about the same research results presented with different 'spins'.

Emotive phrases are often used: the phrase 'production-line children', for example, spins the commodification argument - as used in a comment piece on the House of Commons vote on 'saviour siblings' earlier this year (1). What is behind this extreme polarisation tendency in science news coverage? It probably stems from the way new biomedical advances tend to be assimilated by society: the language of Hopes and Fears sells newspapers and holds the TV viewers. Headline editors and TV producers know this instinctively. However, the same language can also be used positively: it also creates debate which can be a powerful driver for spreading information - if exploited appropriately.

Some work by John Durant on the Human Genome Project when he was at the Science Museum in the early 1990s showed that despite having only fragments of knowledge about a subject, the public tend to arrange these fragments into a framework of hopes and fears - a discourse of great promise and a discourse of concern (2). This is not necessarily problematic: tension can be a good thing and is the only safe state when considering true ethical dilemmas.

Sometimes the source of such tension is relatively straightforward - for example the religious 'pro-life' stance (often reflected in the more sensationalist press) that 'personhood' is God-given at conception - hence use of the word 'children' in headlines - versus the secular view and use of the word 'embryo' (3). Sometimes it results from the more usual science communication issues, and sometimes just from sheer sloppiness, such as about explaining risk in a balanced way: '85 per cent fat free' is the same as '15 per cent full fat'.

Sometimes, however, there are genuinely tricky issues of conveying uncertainty about causes - proven association is not proven cause. The association of (still) rare imprinting disorders with ICSI does not mean that ICSI procedures cause Beckwith-Weidemann or Angelman syndromes, for example. It could be that some conditions that lead men to have sub-fertility and therefore seek ICSI also disturb imprinting of the sperm and it is this that causes the increased incidence of BWS and AS. The jury is still out - but this all needs to be reported accurately and with care. It is exactly with this sort of issue that sensationalist headlines do not help. That said, it might be argued that reporting is not as bad as it was!

Another medium (often forgotten in all the serious debates about the science and ethics of reproductive medicine) is humour. Numerous cartoons have appeared in newspapers over the years illustrating some of the points made here. There was also an excellent 'spoof' story in the Sunday Sport newspaper in 1994, titled: 'Dog, 59, Gives Birth to Twin Kittens. Vet Hounded Over Test-Tube Pussies!' (4) This is a classic - it describes the fury unleashed (pardon the pun!) as the dog has the amazing operation and then goes on to cover every issue in the IVF and cloning book, almost rivalling the 'B52 bomber found on the Moon' story! The point is this: it is laudable to aim for accurate reporting of real data, but public understanding of the issues can also be enhanced through this sort of 'rubbish', if it is cleverly done.

So, what is the future? Media coverage has improved over the last 30 years and especially in the last 6 years with the help of the Science Media Centre (SMC). Scientists and clinicians must continue to engage with the media - and the SMC is a good medium for this (5). Further, proactive debate of new issues is essential - something Progress Educational Trust is keen to encourage with its debate and conferences, and by publishing BioNews. Not only do we try and ensure that scientific, ethical and political developments are accurately and impassionately reported, we also offer those more closely involved in assisted conception to personally comment on developments and the way they have been reported in the popular press (6).

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