Aurora Comms Blog

Is Fox Mulder right? Should we trust no one?

Posted on 12. May, 2009 by NW1er in Communications, Health, Industry, Web 2.0

In the final episodes of season 9 of the X Files, the cynical and sardonic FBI agent Fox Mulder is being tried by an unbalanced military jury that has a short-sighted view of societal well-being. The fictitious jury, and those people it serves, believe that it is often best to keep information from the public, because the public won’t be able to act rationally when presented with it.

The X Files was filled with far-out sci-fi that bore little or no relation to day-to-day reality but its content was engaging, entertaining and sparked discussion – something that Aurora loves being involved with! And something we have been debating a lot recently is web 2.0 – both as a communications tool but also in terms of the implications of this technology for the structure of knowledge in society.

Whilst web 2.0 should not be used as a tool to promote prescription medicines to the public, we certainly feel there is a strong argument for regulatory bodies empowering the pharmaceutical industry to provide accurate and fair information about medicines in the online conversations of non-professional audiences, as long as it is done in a fair and balanced way.

Let’s imagine the idea of the pharmaceutical industry discussing medicines with non-healthcare professional using web 2.0 is on trial – what might the arguments be? Firstly, let’s look at the defence’s starting position:

“Much information and opinion on the web is inaccurate. The manufacturers of medicines should be able to engage in rapid, online conversations about diseases and treatments so that they can share their knowledge and expertise with the online community.”

The opposing counsel would undoubtedly have a number of arguments against this position. A few spring to mind:

1. “The pharmaceutical industry can not be trusted to provide unbiased, non-promotional information to online audiences.”

2. “Patients who are not medical professionals do not have appropriate levels of knowledge and understanding to make decisions about the best treatments for them. As such, the pharmaceutical industry should not be able to provide such information, either on or offline.”

3. “Encouraging conversations about medicines will encourage off-label discussion,  and this poses a risk to patients that is not balanced by the provision of information online.”

Step forth the defence to provide a first-line counter against each of these points:

1. “Information provision is a non-promotional activity, as long as it is done in a fair and balanced way. Institutions, codes and laws are in place that would monitor the provision of information by pharmaceutical companies to ensure it complies with these standards.”

2. “This position assumes that the public is unable to digest information that is presented to them in a clear, accurate and fair way. This is condescending and ignores the fact that healthcare providers would develop resources in an appropriate way for patients to base decisions upon. The Government’s ‘informed patient’ agenda is testament to the fact that people can make sensible decisions when provided with accurate information.”

3. “People are already having conversations that encourage the inappropriate use of medicines. The pharmaceutical industry should be allowed to take responsibility and engage in these conversations and provide accurate information. If the industry corrected off-label discussion, it would be providing a social service of benefit.”

As I envisage this drama unfolding in my mind, pen in hand to write the script, I can already see the counter responses of the prosecution, the hearty argument of the defence, and the ongoing court room kick about of this argument. Will a decision be reached, or will we face a hung jury?

As we know, these issues are being debated in real life in the EU and the outcome will undoubtedly shape how the pharmaceutical industry communicates to the public about medicines. Whilst these decisions are being reached, people and patients will of course continue to talk about their health and well-being with their peers, and they will do this on and offline.

Sometimes the views and ideas of our peers are right, sometimes they are wrong. But what their ideas tend to rest upon is the information they access – whether accurate or inaccurate – and this applies to all aspects of life, from the trivial to the crucial. So when it comes to patients talking to each other about medicines and treatments, the critical question for us to consider is: how accurate is the medical information that is being accessed online? In X Files speak, should we “trust no one” or, instead, should we rest assured that the “the truth is out there?”

This is a question that is open to discussion and we’d like to hear your views. Fox Mulder’s closing courtroom speech does bring something to mind when he says: “If I am a guilty man, my crime is in daring to believe that the truth will out and that no one lie can live forever.” Personally, I’d shoulder Mulder’s guilt, but I’d also realise that, sometimes, the truth needs a little help to come to the surface.

So in terms of healthcare, where does the responsibility lie for making sure people find true information? Who can help bring useful information to the top of the pile? The State? The pharmaceutical industry? Patient groups and charities? Doctors and other healthcare professionals? Clever online algorithms and rating systems?

It needs to lie somewhere or else inaccurate ideas, beliefs and subsequent behaviours will proliferate. At best, patients will use ineffective but unharmful remedies, at worst, they may embark on life-threatening activities in the hope of improving their health.  As medically qualified doctor Dana Scully, Mulder’s long suffering partner, once said in bewilderment to his unfounded ideas about medicine, “Mulder, mushrooms aren’t medication. They taste good on hamburgers, but they don’t raise the dead.”

Tags: geeking it, Social media