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Title: Medicine in the News


1
Medicine in the News
  • Mary Dixon-Woods

2
Nuffield Council on Bioethics, human behaviour
the ethical context (2001)
  •  The media is one of the most important means by
    which the general public receives information
    about scientific issues and will therefore have a
    key role to play in informing people about new
    developments.  

3
Medicine and the news
  • The news is an important means of representing
    medicine and its possibilities to the public
  • It is important to understand the ways in which
    images of medicine come to be created and
    sustained

4
Objectives of this session
  • Explain, in brief, different approaches to media
    analysis
  • Give examples of media analysis applied to news
    of medicine and health

5
Ways of understanding how people respond to media
messages
  • Mathematical model of communication
  • Hypodermic needle model of media effects
  • Uses and gratifications model
  • Semiotics
  • Preferred, negotiated, and oppositional readings

6
Mathematical model of communication (Shannon and
Weaver, 1949)
7
Hypodermic needle model
  • Based on crude form of behaviourist pyschology
  • Idea that the makers of media messages can
    manipulate their audiences
  • Success of fascist propaganda in 1930s Germany

8
Hypodermic needle model
  • Largely dismissed by most serious academics but
    continues to find popular support in media
    discourses e.g. the James Bulger case.
  • Lies behind moral panics about the media.

9
Uses and gratifications model
  • Uses and gratifications approach suggests that
    people are purposeful and strategic in using the
    media
  • They choose what they watch and watch things in
    order to fulfil particular needs (eg to relax)
  • Rejects simplistic assumptions of hypodermic
    model

10
Uses and gratifications model
  • Two-step flow model tried to account for the
    fact that people belong to different social
    groups
  • HoweverUG tends to exaggerate active and
    conscious choice
  • Interprets all effects of media in terms of
    gratifications

11
Semiotics
  • The science of the sign.
  • Polysemy the multiple meanings that a message
    can have.
  • Closure how the range of meanings can be closed
    down.
  • Preferred readings what the message sender
    wants you to understand.

12
Semiotics how is the preferred reading indicated?
  • Epilepsy gene identified
  • http//news.bbc.co.uk/hi/english/health/newsid_196
    2000/1962724.stm

13
Preferred, negotiated and oppositional readings
  • Preferred reading the intended one (can be
    achieved by framing, use of captions etc)
  • Negotiated reading dominant values and social
    structure is accepted, but specific message may
    not be
  • Oppositional reading reader subverts the
    intended message

14
Types of media analysis
  • Content analysis
  • Discourse analysis
  • Reception analysis

15
Content analysis
  • A primarily quantitative technique
  • Used to identify frequency of phrases or concepts
    within a text
  • Usually done using computers

16
Discourse analysis
  • Focuses on text and talk as social practices
  • Focuses on the resources/interpretative
    repertoires drawn on to enable those practices
    (eg stereotypes)
  • Interested on how discourses are organised to be
    persuasive

17
Principles of DA
  • Discourse refers to all forms of talk and texts
    DA is interested in the content and
    organisation of these. Draws on many ideas from
    semiotics.
  • All language is constructive manufactured from
    pre-existing resources the assembly of the
    account involves selecting between different
    possibilities the way we deal with the world is
    mediated by language.

18
Doing DA
  • No cookbook set of procedures perhaps the
    least systematic of all qualitative approaches.
    Does not usually involve computers.
  • Ask yourself what features produce this
    reading?
  • Search for patterns in the data, including
    interpretative repertoires (eg notion of genetic
    modified foods as frankenstein foods).
  • Search for the functions of the discourse.

19
Examples of discourses
  • Discourse around cloning
  • Discourse around NHS managers
  • Discourse around waiting lists

20
Reception analysis
  • Asks not what do media do to people? but what
    do people do to media?
  • Combines semiology and (usually qualitative)
    audience research
  • Audience seen as active creators of meaning
  • Notion of interpretative communities

21
Doing reception analysis
  • Involves ethnographic techniques watching a
    family watch television, using focus groups,
    interviews etc.
  • Computers may be used to assist in the analysis.

22
More important concepts
  • Moral panics
  • Bias towards positive results
  • Bias towards human interest

23
Moral panics
  • Certain groups (folk devils) periodically
    become the focus of moral panics.
  • Labelled as being outside the core values of a
    society, seen as a threat.
  • Achieved by framing of stories. Use of resources
    such as authoritative voices (eg scientists,
    judges).

24
Moral panics and medicine
  • Designer babies
  • Incompetent practices
  • Villainous doctors
  • Bizarre health policies
  • Medical researchers
  • Killer diseases

25
Moral panic about cloning
  • The characterization of cloning as an ethical
    issue centers around three connected concerns
  • the loss of human uniqueness and individuality
  • the pathological motivations of a cloner
  • the fear of out-of-control scientists.

26
Bias towards positive results
  • As with professional journals, the mass media are
    more likely to report a positive finding.
  • Increasingly evident that scientists attempt to
    manipulate media eg by early release of findings.
  • Newsworthiness gatekeeping.

27
Bias towards human interest
  • Stories focusing on particular individuals
  • Emphasis on hope or destruction
  • Individuals themselves recruited to serve
    particular discursive functions
  • http//news.bbc.co.uk/hi/english/health/newsid_190
    6000/1906999.stm
  • News values 'news hooks', 'relevance',
    'accessibility' and 'controversy' .

28
Examples of studies
  • Henderson L, Kitzinger J (1999) The human drama
    of genetics hard and soft representations of
    inherited breast cancer. Sociology of Health and
    Illness 21(5) 560-578
  • Content analysis of British newspapers and
    magazines

29
Henderson and Kitzingers findings
  • Breast cancer reported 7 times more often than
    lung cancer
  • Constructed as a inherited genetic condition
  • Heavy emphasis on prophylactic mastectomies
  • Human interest generated by stories of women
    faced with dilemmas (22 of stories)

30
Examples of studies
  • Entwistle et al (2000) The case of Norplant as an
    example of media coverage The Lancet 355 1633
  • Analysis of 101 newspaper articles

31
Norplant
  • Early reports presented Norplant very positively
    disadvantages downplayed.
  • Reports that it was in great demand but women
    might be denied access to it.
  • Less than a year later, newspaper reports about
    Norplant were dominated by the stories of
    individual women who had had bad experiences with
    the product.

32
Examples of studies
  • Henderson et al (2000) Representing infant
    feeding. BMJ 321 1196-1198
  • Content analysis of references to infant feeding
    in UK newspapers and tv programmes

33
Infant feeding
  • Breast-feeding rarely shown on tv
  • Problems were often described with
    breast-feeding, none with bottle feeding
  • Breast-feeding used as a signifier of social
    class associated with middle class women or
    celebs
  • May discourage acceptance of breast-feeding

34
And finally
  • Bad press for doctors http//bmj.com/cgi/content/f
    ull/323/7316/782?
  • Daily Telegraph, Guardian, and Daily Mail
    contained more than twice as many negative
    stories about doctors as positive ones, but there
    was no significant change in the ratio of
    negative to positive stories over time.
  • The total number of articles about doctors
    increased over time.

35
Conclusions
  • Mass media are an important source of images
    about medicine.
  • It is important that doctors are responsible in
    their relationships with the mass media.
  • More research (particularly reception analysis)
    is needed.
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