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Abstract

The practice of journalism affects bioethics in that media framing of medical issues tells readers and viewers how to think about the medical issue or event. Journalism ethics, which describes and justiﬁes the conventions and standards for how news stories, including medical stories, should be shaped in their presentation, evolves with the development of technology. Major changes in the gathering, reporting, and transmitting of news have come about because of the development of digital communication. Legacy news organizations no longer serve as gatekeepers for important information. Entrepreneurial individuals along with governmental agencies, nonproﬁt organizations, and corporations provide information for targeted audiences without relying on traditional media to tell their stories. Educating citizens about bioethics issues and events now requires active involvement of all information providers and consumers.

Introduction

By mid-October 2014, coverage of Ebola dominated US news. Thousands of victims had been identiﬁed in affected countries in Africa, including Liberia, Guinea, Nigeria, Senegal, and Sierra Leone. As the disease made its way to the shores of Europe and the United States, identiﬁable, named individuals emerged out of the pictorial sea of unnamed dead and dying.

A nurse’s aid contracted Ebola in Spain while treating a missionary who had returned home from West Africa with the disease. A visitor from Liberia became ill while visiting relatives in Dallas, Texas, and ultimately infected two members of the medical team who had cared for him. The Centers for Disease Control and Prevention (CDC) and the World Health Organization were predicting as many as 10,000 new cases per week, worldwide, by the start of December. Some US universities had canceled programs scheduled within 21 days of potential visitors’ departures from affected countries, as this was said to be the Ebola incubation period.

It was still weeks away from the US government creating policy that routed visitors from affected countries through ﬁve airports and staffed those airports with personnel able to screen for infected passengers. Ofﬁcials instructed US returning citizens who had had contact with Ebola victims to remain isolated from the public and take their temperatures. More than a month later, the United States had not yet adopted any of the border controls that had been established months before by unaffected African countries: denial of entry to those from affected countries, disallowing all but essential travel for their own citizens.

The US mainstream news media covered the story in a predictable manner. The media focused on the few victims within the US borders. They focused on conﬂicts between US citizens who claimed they had a right to freedom upon return from affected countries as local, state, and Federal government sought to isolate them from others just in case they were affected. Print media ran pictures of infected people from Ebola’s epicenter in West African countries. The squalor visible in those photos illustrated the breakdown of infrastructure needed to control the spread of the disease. The lack of identiﬁcation of those ill, the lack of geographical or resource context, and the dimly lit images served up the photo subjects created as mere metaphors for the horror of the disease.

Harder or impossible to ﬁnd were stories that explained why warehouses of vaccine to prevent the Ebola strain or drugs to treat the disease were not at the ready, despite previous outbreaks and the predictability of future outbreaks. Stories that described how and why governments in non-affected African countries were protecting their citizens from outbreaks were not to be found. Stories that analyzed CDC responses, Transportation Security Administration guidelines for travelers, and other ofﬁcial reactions in the United States were few. Stories that assessed the US readiness to respond to a pandemic of any type were nonexistent.

There were many Ebola stories that could have been told by the US-based media, but only a few were told. Despite the proliferation of information sites available on the web, legacy news media deﬁned the boundaries of the mediated Ebola discussions. Those boundaries followed the traditional framing practices of local, event-driven news coverage. A single infected American was considered breaking news. The worldwide lack of vaccine was not.

Overview

Journalism is the practice of seeking, gathering, and sharing information in a textual or visual form to inform a mass audience about events and issues that are important to audience members’ ability to self-govern. The mode of dissemination may be print, broadcast, or web-based. This entry includes a short history of journalism ethics, including how ethical expectations evolve with the growth of technology and how the most recent technological change from physical tangible news product to virtual news process has changed the practice of journalism.

The unique role-related responsibility of professional journalists is to communicate information to audience members what they can expect from the society and what the society can expect from them. This broad statement of responsibility is universal. It is the same regardless of the political ideology within which journalists operate. At its base, journalism is a conduit that allows the powerful to deliver messages to the less powerful. Journalism allows the stories of those affected by power to be heard and monitored by the powerful. However, in nations that are even vaguely democratic in structure in that they claim to depend on citizen participation, journalist role-related responsibility can be more precise: “The primary purpose of journalism is to provide citizens with the information they need to be free and self-governing” (Kovach and Rosenstiel 2007, p. 12).

Journalism may perform additional services, such as holding up models of good and evil through proﬁle stories and providing a forum for opinion and reader commentary to stories. Journalistic products are often vehicles for sales through commercials wrapped around broadcast news or banners and pop-ups hovering around web-based products or display and classiﬁed advertising. But if news providers are not giving citizens information necessary for self-governance, regardless of the audience members’ actual use of the information, then the news providers are not doing their jobs.

The role-related responsibility of news media – provide information that citizens need for self-governance – is a voluntary responsibility expressed by news organizations and entrepreneurial journalists. News providers say it in different ways: to provide “all the news ﬁt to print,” (New York Times); to be “a voice of, by and about Africa” (AllAfrica); “to be recognized as the world’s leading and most trusted media network, reaching people no matter who or where they are” (Aljazeera); and to produce “journalism that shines alight on exploitation of the weak by the strong and on failures of those with power to vindicate the trust placed in them” (ProPublica). However the mission is expressed, when news providers claim to give people information that they need to know, their statements, ethically speaking, become promises. Promises are per formatives that, in the making of the promise, make actions ethically required. In stating what the individual or organization will provide, the promiser has created a reasonable expectation in others that he or she will do as promised. That is the source of ethical expectation of journalism.

The journalism profession has always stood apart from other powerful societal positions, such as physicians, nurses, accountants, and lawyers in that no particular academic curriculum, license or credential is necessary for someone to declare oneself a journalist. In the twentieth century, journalists could be identiﬁed in most countries as those who produced work for businesses that called themselves news organizations. Some countries had state media, which might be governmentally funded and controlled or governmentally funded with no editorial control. Some countries had independent press that operated on a commercial for-proﬁt basis or a not-for-proﬁt basis or a combination. Some countries had a smattering of all of these models with complex accountability models that ranged from consumer-based national media councils that had the power to ﬁne offending journalists to judicial-based legal prosecution for violations.

By the turn of the twenty-ﬁrst century, most nations, in addition, were home to entrepreneurial web-based information outlets run by individuals or small groups. Through the Web 2.0, it became possible for individuals to communicate with mass audiences with no corporate, governmental, or institutional ﬁlter between. Audience members could ﬁnd information without depending on news organizations to provide it. It became less possible to hold journalists accountable to professional associations or guilds that could discipline those who failed to do their jobs. Journalists could still be held accountable for causing some unjustiﬁed harms through law in some countries, but the major force of accountability became increasingly the growth or decline of credibility. Without an audience, journalists cannot communicate their messages. Regardless of size, funding, or share of the market, news providers are dependent on the trust of their audience members.

A major change from the twentieth-century professional-to-citizen model of journalism to the twenty-ﬁrst-century interactive model was that journalism could no longer claim a gatekeeper function. Gatekeepers ﬁlter information, deciding which events and issues their audiences need to know and which material out of the inﬁnite array to eliminate due to limits of space and time or perceived level of interest. Gatekeepers frame the information that they provide based on their own interpretation of public interest or, less ethically, to meet perceived need of audience members or to meet demands of advertisers. Gatekeeping intent is rarely disclosed with the stories. So, the reasoning behind what is included and how the story is framed is not transparent to the audience members or open for their review. But, even with the proliferation of web-based media outlets, legacy news media often follow the formulaic framing that prioritizes one or more newsworthy elements – unusual event, occurring now and near audience members, representing conﬂict, with obvious consequence important to audience members – and often concentrate on building the same formulaic story within the same frame.

Journalism ethics can be considered at the macro-level, which describes and criticizes the practices of news organizations and the role that journalism plays in the society. Drawing on the disciplines of history, sociology, philosophy, and political theory, at the macro-level, scholars work to articulate standards that distinguish those journalistic practices that are ethically required, permitted, ideal, and prohibited. These macro issues are apparent in how medical policy, disease, and treatments get reported and which get ignored. At a macro-level, such issues include critical assessment of (1) the domination of media attention and framing determined by powerful story sources and subjects; (2) the presence of less powerful individuals and groups often not considered immediately newsworthy; (3) the determination of events, issues, and people as newsworthy based on audience interest, government promotion, or corporate inﬂuence; and (4) the issue of framing, which may occur unintentionally but may ultimately be the reason for news providers to miss stories that need to be told.

Journalism ethics can also be considered at the microlevel, which includes analysis of normative behaviors of individual practitioners and the profession against articulated standards. At the microlevel, journalists must deal with their own conﬂicts of interest or commitment, which may lead to reporting that fails to meet role-related responsibilities.

These classiﬁcations of macro and microethical issues are consistent across time, place, culture, and news organization size. The potential ethical problems of power are universal.

Mid-level issues, such as sourcing, privacy, and consequences of publication, change based on variables including technological abilities. Examples that illustrate these issues in web-based mass communication as differentiated from print and broadcast models are included below.

Technology And Economics As A Source For Journalism Ethics Throughout History

The practice of journalism has emerged parallel with the development of technologies for the rapid, mass dissemination of written texts and broadcast messages.

The ﬁrst modern newssheets appeared in the 1450s in Germany, where Johannes Gutenberg (c. 1398–1468) invented the printing press. Newspapers then became within the ﬁnancial grasp of an increasingly literate public, particularly in countries throughout Europe and the United States. The Bible, which had been interpreted by clergy for the masses, was now available for direct reading and interpretation by individuals. Equally important to print communication’s new reach was technology’s challenge to the economic control by religious organizations. The Gutenberg press could create, within hours, hundreds of “indulgences” that had previously required days of monastic hand-lettering. The “indulgences” were bought by Christians to secure the passage of recently dead relatives from purgatory to heaven. As they were far cheaper to produce by mechanical press than individual hand-lettered missives, economic incentives transferred from the church to penitents and printers. Machine-printed advertisements also increased the reach of authors; particularly those works were published by the owner of the printing press (Eisenstein 1979).

A period of activist journalism in England and Europe and the United states, best illustrated by Times of London wartime dispatches from correspondents at the scene during the late 1700s Napoleonic Wars and Benjamin Franklin’s publication of revolutionary broadsheets in the same period of time, further showed the power of mass printed communication to stimulate public action and response, ultimately providing the argument for the inclusion of freedom of the press in the First Amendment to the United States Constitution.

Throughout the 1800s, the proliferation of printing press owners provided vehicles for advertising by local businesses. Advertising set off the costs of production, which allowed publishers to lower their prices to reach a mass rather than elite audience. The “penny press” was descriptive in that news was now available to everyone at the cost of a mere penny. News providers worked to become popular with larger audiences, with greater circulation used as the basis for increasing their charges to advertisers. A symbiotic relationship between publishers and advertisers formed that created, for news providers, their ﬁrst conﬂict of interests. Publishers, who were eager to show off their goods and services, adapted their reporting standards and writing styles to appeal to the working and immigrant classes.

Dismissed as “yellow journalism” by the elite press, because of the penny press’ use of sensationalism and hoax to draw readers, these inexpensive newspapers induced the more elite papers to highlight higher standards and professionalism for the practice of journalism. At the turn of the nineteenth to the twentieth century, Joseph Pulitzer created Columbia University’s School of Journalism, the ﬁrst in the United States, and journalists from elite newspapers such as The New York Times and Washington Post formed the ﬁrst professional guild, ﬁrst called the Sigma Delta Chi fraternity, now called The Society of Professional Journalists, and wrote the nation’s ﬁrst Code of Ethics for journalistic practice. Two organizations focused on science writing emerged at about the same time. The American Medical Writers Association was formed in 1924, with the development of its own Code of Ethics in 1973. The National Association of Science Writers was formed in 1934 to promote the dissemination of accurate information regarding science.

The invention of the telegraph provided another convergence of technology, economics, and the developing ethics of journalism. Major news organizations pooled their resources to create co-ops, called wire associations, which sent their material via telegraph, then telephone lines, then satellite. The wire associations, which United Press International (UPI) and Associated Press (AP) personify, hired journalists to transmit information (ﬁrst text, then photographs) from distant scenes to the multitude of news organizations throughout the United States, who were members of the co-ops. Transmitted product had to have true mass appeal; the stories could not be targeted toward audience members with particular political points of view or regionally cultural perspectives. As the audience members that advertisers most wished to reach were members of the wealthy dominant society – Euro-Americans serving as the prototype – journalists and news organizations produced news to appeal to these consumers instead of reaching out to diverse citizens. The blander-than-better news products made the best economic sense advantage of contemporary technology. Soon, the “objective” news stories became the ethical standard for journalism, standing in comparison to the sensationalism of the local, popular, tabloid press.

The ethics of objective reporting contrasted with biased, sensationalized, or sometimes blatantly false reporting, but it also resulted in some assumptions that limited its ability to meet journalist role-related responsibilities. Among those assumptions was the belief that a balanced story is one that equally represents two reasonable but opposite points of view. This ultimately reduced reporting to repeating positions from powerful and often polarizing individuals, losing the story’s nuance in its framing as a competition between powerful points of view. For example, the attempt to establish a national health-care system in the United States in 1994 was reported by mainstream media as a political debate between the administration of President Bill Clinton and the Republican controlled Congress. The story of the need for uninsured citizens to access needed health care was overpowered by the win-lose style of the policy story’s presentation. It took more than another decade before the public issue of developing a new health-care policy could be discussed without the goal of providing health care to uninsured citizens getting lost in media framing.

Challenges To Practitioners From Web-Based Journalism

Technology has always made fraudulent practices easier, and computer technology has tremendously enhanced those possibilities. Photos are easy to fabricate through computer manipulation or the merger of multiple images into one. Recordings are easier to cut and splice to change the intent or content of a source’s quote. Changes are difﬁcult or impossible to detect.

Generations of students in journalism schools learned to report the “ﬁve W’s and an H” – who, what, when, where, why, and how – with the order determined by the newsworthiness of each in a particular story. Limitations of space in printed products or time in broadcast productions required an inverted pyramid style of reporting. Layout staff or producers could lop off material from the bottom of a story that did not ﬁt into limited space or airtime. News products are no longer singular, stable entities that can be ﬁxed to particular dates and times. They are now continually evolving productions that provide hyperlinks to further information and that can be modiﬁed. What is seen and read in one moment’s version of a web-based story may be very different from what is visible to a reader immediately following. In addition, web-based material does not follow the traditional journalistic form familiar to citizens. Web-published headlines along with the top of stories that appear on websites are more likely to focus on keywords that enhance search engine optimization (SEO) than follow the 5Ws and H format. Publication in cyberspace depends on aggregation to reach the broadest audience.

Pre-computer, it was considered a breach of ethics, conventionally speaking, for news providers to engage in second-hand reporting, the act of lifting a quote from a previous publication to include in one’s own. Although not considered as serious a sin as plagiarism – stealing the words of another journalist – presenting a quote taken from another publication as though the source had provided the statement directly raised fundamental questions of trust and credibility, at least among the journalists involved and the person quoted. While readers might not know the original source for the quote, the person quoted would certainly know that he or she had spoken to a reporter for The New York Times, for example, and had not spoken to a reporter for Time Magazine.

Now, with material regarding sources or story subjects an electronic search away, it is no longer considered a conventional breach of ethics for news organizations to use material obtained by downloading pictures or materials found on social media or on other virtual sites. This material is used by news providers with the assumption that the material truthfully presents the individual who is the story subject. While context is usually provided with publication so that audience members know that a particular photograph was found on Facebook and that a particular comment was tweeted, the ethical issue is one of truth-telling, the basic problem raised through second-hand reporting. What a source publishes on a social media site has intentions different from those that the source would have when talking to journalists for publication. A news organization may print accurately what appears in a previous publication or on a virtual site, but may mislead audience members by giving the quote context or credibility not deserved. News providers should always conﬁrm material through direct contact with sources or be careful not to correlate what is found elsewhere with a current newsworthy event.

Another issue for practitioners is the ubiquity of information published on websites. Pre-Internet, material published in a newspaper or as part of a broadcast news package might ﬁnd its way to a physical ﬁle but was not easy to access by anyone other than those employed by the news organization. Now, once a story is published on the web, the story subject and other information are easily searchable. In May 2014, the European Union passed what is called the “Right to be Forgotten” ruling that states that “individuals have the right – under certain conditions – to ask search engines to remove links with personal information about them. This applies where the information is inaccurate, inadequate, irrelevant or excessive” (European Commission 2014). This law stands in contrast to the US law that allows compensation for individuals defamed or who have had their privacy invaded and who win civil judgments against their offenders but is silent on any other basis for which an individual would like to have his or her personal information removed from a search engine. In the United States, few news organizations indicate that they would honor request for the removal of truthful information.

Challenges To Citizens And Sources From Web-Based Journalism

Technological advances in photo transmission made the delivery of on-the-scene images to news organizations or to social media outlets instantaneous. Cable, satellite, and the Internet turned televisions into enhanced computer monitors allowing for instantaneous delivery of information from at-the-scene viewers as well as news providers.

These technological advances have created new role-related responsibilities for citizens who are both empowered and ethically required to be certain that the information that they are trusting to guide them in self-governance is up for the task. Their new responsibilities include differentiating between on-the-scene ﬁrst impressions or image capture with fact-checked news; understanding that virtual experience through on-the-scene transmission is not the same as physical experience; and separating the visceral emotional experience that comes with instantaneous broadcast from conclusions based in rational consideration of evidence and argument.

In addition, citizens have a prudential responsibility to be active in protecting the material that they post to the web. It is far easier to protect one’s information from prying eyes and to protect oneself from being stalked in the physical world than it is in the virtual world. Citizens have a responsibility to become wise users of the Internet and to be educated about the power of the reach of corporate and governmental interests.

It is also important for citizens to remember the importance of credible journalism despite the seemingly easy world of information within everyone’s grasp. Citizens “need a guarantee of authenticity.. ..There is an ever greater need for competent, honest journalists to ﬁlter, check, and comment upon the information available” (Bertrand 2003, p. 4).

Conclusion

Journalists and scientists, including medical researchers, continue to recognize the need for collaboration between the professions and to understand the different professional conventions that make such collaboration difﬁcult. Professional societies, web resources, and workshops for scientists and journalists create a communication bridge between science and the audience.

Rather than either bypass or be completely dependent upon news organizations to create the message, medical researchers and medical spokespeople have become more sophisticated in providing information for public consumption. For example, many hospitals and medical campuses have production studios that allow for the creation of video news releases (VNR) – complete news packages describing a newly acquired piece of medical equipment, for example, that can be dropped in to a newscast in broadcast or on the web. Credible VNR provides appropriate information for a mass audience without requiring local journalists to develop the expertise necessary to comprehend and distil the story.

But when medical communicators blur commercial output with scientiﬁc journals, journalists question the value of any information offered. For example, Elsevier published a journal sponsored by Merck and presented reprinted articles favorable to the pharmaceutical company without disclosing Merck’s sponsorship of the journal (Davoudi and Jack 2009). Transparent and accurate medical communication is a responsibility shared by both journalists and medical sources.

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