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Abstract

Media ethics, as an applied approach to assessing and understanding media performance, is premised upon a complex set of ideas drawing on philosophical principles, psychological theories of moral development, and contextual understanding of the ethical issues being discussed including societal culture and values and organizational norms. How bioethical debates are presented in the media, through framing and agenda setting by media professionals, shapes how audiences feel or think about a bioethics issue. The case of the 2013 pediatric anthrax vaccine trials is discussed to illustrate the complex interplay between public relations and news in shaping news coverage about bioethics issues.

Introduction

Media ethics focuses on evaluating communicative performance and behavior. Ethics, as a branch of knowledge and a liberal arts discipline, uses determinative principles to appraise voluntary human conduct insofar as it can be judged right or wrong. To put it simply, ethics is a systematic study of right and wrong.

When ethical values – or the motivations that drive one’s action – collide, ethical dilemmas emerge – requiring media professionals to engage in ethical reasoning to determine what is the right thing to do when confronted by competing values that are seemingly equally compelling. As noted by Kidder (1995), ethical dilemmas are right versus-right situations. Ethical dilemmas, which have good and right arguments to commend them on all sides of the situation, require careful moral deliberation to arrive at the most appropriate action. In media ethics, ethical dilemmas are typically shaped by tensions between these four sets of competing values, or dilemma paradigms: truth versus loyalty, individual versus community, short-term versus long-term, and justice versus mercy. These four paradigms are also relevant in discussions of bioethics, as it grapples with an array of difﬁcult questions about the value and dignity of human life and the beneﬁts and harms to individuals and societies, and engages in a reﬂexive exercise about health care, health science, and health policy.

Media, typically viewed as the collective mass communication outlets or tools used to disseminate and deliver information and news to media audiences locally or globally, are not a monolithic entity. Traditionally, mass media are primarily organized based on news media (print, radio, and television), public relations, and advertising. Oftentimes, discussions of media ethics rarely go beyond media bashing. However, as an applied approach, media ethics is grounded in a complex set of ideas drawing on philosophical principles, psychological theories of moral development, and contextual understanding of the ethical issues being discussed including societal culture and values and organizational norms. News media are one of the most well-established sources of bioethics information for the public. Bioethics, as a branch of applied ethics, focuses on studying and understanding how decisions in medicine and science affect individuals’ and communities’ health and lives at every level, from the personal to the institutional. Bioethical issues – including compulsory vaccination, euthanasia, genetic screening, and abortion – have been the subject of intense debates in the news media, in the public arena, and within professional and academic community circles. How these bioethical debates are presented in the media, through framing and agenda setting by media professionals, shapes how audiences feel or think about a bioethics issue.

Framing, Information Subsidies, And News

Grounded in cognitive psychology, framing relies on an associative network model of human memory, in which an idea, feeling, or concept is stored as a node and connected to others by semantic paths (Price et al. 1997). Media frames in news, by serving as ﬁlters or interpretive schema to activate certain ideas, feelings, or concepts for further information processing or judgment formation, could result in predictable reactions from individuals. Individuals also use media coverage as a cognitive shortcut to organize complex phenomena into easy-to-understand events to make sense of issues and interpret the world around them. How bioethics issues are framed in the news impacts media audiences’ understanding of bioethics issues, individuals’ attitudes and behaviors that shape their support or disapproval of certain bioethics initiatives, as well as overall public opinions that have important ramiﬁcations, both politically and in the allocation of economic resources, on broader policymaking decisions in a society.

The 2013 Pediatric Anthrax Vaccine Trials

The following example illustrates the complex interplay between public relations and news in shaping media coverage about bioethics issues. In March 2013, the U.S. Presidential Commission for the Study of Bioethical Issues released a report on trials on anthrax vaccine for children. Understanding of such a vaccine’s effects in children is not known, as the vaccine has never been tested in children. The Commission was responding to a formal request from U.S. Health and Human Services Secretary Kathleen Sebelius, who earlier asked the Commission’s members to study the question of anthrax vaccine trials with children, after receiving a recommendation from another federal committee that such research be initiated, pending ethical review. The news release issued by the Commission about its report was titled “President’s Bioethics Commission Releases Report on Pediatric Medical Countermeasure.” News releases are a form of information subsidies provided by an organization through public relations efforts to the news media. Gandy (1980, 1981, 1982) coined the term information subsidies to describe controlled access to information and materials that come with little effort or cost to the recipient.

Through news releases and other forms of information subsidies, practitioners frame the information provided to journalists through selection, emphasis, and omission of certain attributes out of all that is available about an issue or event. Framing explains a signiﬁcant part of what public relations is about. Much of the material from public relations practitioners is delivered to the news media via information subsidies. As much as 90 % of news originates from the efforts of public relations. Information subsidies such as press releases and other targeted public relations materials thus play a signiﬁcant role in the production and framing of news. Journalists’ access to information subsidies such as press releases, contact with newsmakers, and other practitioner produced information such as third-party advocacy and reviews has a positive impact on news coverage and aids the transfer of an organization’s perspectives into news coverage.

In essence, information subsidies are framed products. Although information subsidies relieve journalists from some burden of collecting information themselves and shorten the time to publication, journalists are cognizant that such information often lacks objectivity and balance and should not be published in its own right without some form of media gatekeeping. However, the exigencies of daily news work often compel journalists to overcome such reservations. How such framed information is used by journalists, who are active framers of information, helps us understand the dynamics of news coverage, in particular in a context of issues such as bioethics that are likely be highly technical in nature due to the subject matter. For topics that involve high technical and expert knowledge, journalists are even more dependent on press releases. Releases are ofﬁcial and publicly disseminated documents. It would be difﬁcult for news sources to change their minds or claim they were misquoted. Public relations practitioners who can provide journalists with readily assembled news are more likely to have their voices heard. News releases, typically based on the inverted pyramid structure of writing, not only provide news media with information but also help advance their organizations’ perspectives and goals.

Framing, when considered from an ethical point of view, is related to one of the most fundamental issues in communication. In order to communicate, one has to be believed. Truth telling is a complex concept. Truth may be a universal value, but at least a quarter of all human communication involves deception, or a message knowingly transmitted by a sender to foster a false belief in the receiver. Deception, widely acknowledged to be wrong, remains a systemic occurrence in interpersonal human interaction. The processes of media framing have many implications for truth, or how factuality is being compromised. To what extent does framing alter the truth and comprehensive understanding about a bioethics issue, and to what extent are media audiences disempowered by being presented with untruths or partial truths to the extent that they are deceived about the true state of an event or issue? When deceived, individuals are denied autonomy because their control over their reasoning processes is reduced. The situation is considered more egregious if the media message is motivated by the media professional’s intent to mislead his or her audiences rather than without intent as in the case of a genuinely inadvertent mistake – or if the persuasive action were motivated by good intention, which unexpectedly resulted in bad outcomes.

In the case of the news release issued by the Bioethics Commission about pediatric anthrax vaccine trials, the release was written in neutral language and focused on the factual information about the case and its background. A synopsis provided right under the report’s headline states the following: “Recommends that multiple steps must be taken before ethical pediatric anthrax vaccine trials can be considered by the U.S. government” (Commission for the Study of Bioethical Issues 2013). The report emphasized that it is important to “ensure the highest standards of protection for children that reﬂect an unwavering commitment to safeguard all children from unacceptable risks in research and through research promotes their health and well-being.” According to the report, “the Bioethics Commission concluded that many signiﬁcant steps would have to be taken, including additional minimalrisk research with adult volunteers, before pediatric anthrax vaccine trials prior to an attack should be considered.” In addition, the report proposed that the studies should only be undertaken after a “national-level ethical review” (Commission for the Study of Bioethical Issues 2013).

The press release seems innocuous enough, but it was framed very differently by news media. According to Klugman (2013), the media offered various headlines to this news, each of which lent a qualitatively different interpretation well above the statement of facts originally provided by the news release. Some news headlines suggested that the Commission actually approved of the trials. Klugman gave the example of ScienceInsider that used the headline “Bioethics Panel Gives Yellow Light to Anthrax Vaccine Trial in Children.” A yellow light at trafﬁc stop asks motorists to proceed with caution. The reference to “yellow light” suggested that with some thought, the Commission is likely to give its blessings to the pediatric anthrax vaccine trials. In essence, the ScienceInsider news story was framed by journalists and editors to emphasize approval of the vaccine trials rather than caution. According to Klugman, a similar framing approach was used by USA Today, which offered the following headline: “Panel urges limited tests of anthrax vaccine in kids.” Other news outlets such as the Washington Post, however, framed their news coverage on the hurdles that must ﬁrst be overcome before approval is given, as seen in the Post’s headline: “Ethics panel sets high bar for anthrax vaccine research in children.” Other news outlets framed their coverage of the Commission’s report as clear opposition to the vaccine trials, as seen in National Public Radio’s report (“Bioethics Panel Warns Against Anthrax Vaccine Testing On Kids”) and in FoxNews (“Panel: Thumbs down on anthrax vaccine in kids”). Based on the wide variance in the substance and meaning of the headlines provided by different news outlets based on only one news release, it is clear that news media can play a signiﬁcant role in shaping media audiences including policymakers’ understanding about bioethics issues.

Ethical issues abound in this example, which is one of many that continue to be seen in the discussion of bioethics today. Although the news media may thrive on the sensationalization of news or be swayed to serve corporate-driven proﬁt-making interests or particular political afﬁliations, as a ﬁeld, bioethics has to take some responsibility for its lack of efforts to educate and engage journalists covering bioethics issues. Science communication today continues to struggle with a number of challenges including the diversity of language, the value of social media as a new communication platform, and the symbiotic yet tension-ﬁlled relationship between journalism and science communication. Bioethics is an interdisciplinary ﬁeld and endeavor with multiple stakeholders. The nature of communication about bioethics, a subject that can seem dry and technical, poses a challenge to both scientists and journalists in condensing difﬁcult issues accurately and without misrepresentation. Although there is some progress in the communication about bioethics issues through news media, much more can be done to communicate these complex issues and to translate them into language that is clear, unambiguous, and can resonate with the ethical values and norms held by bioethics’ public and stakeholders.

Codes Of Ethics

Media ethics is heavily dependent on codes of ethics, mostly codes created by professional media organizations that articulate, in writing, the expectations for ethical behavior by a member of a professional news organization or a media organization. For example, the Society of Professional Journalists’ Code of Ethics addresses conﬂict of interest that would be applicable to news coverage about bioethics issues. According to the code, journalists should take responsibility for the accuracy of their work; verify information before releasing it; use original sources whenever possible; and provide context by taking special care not to misrepresent or oversimplify in promoting, previewing, or summarizing a story. Journalists should also gather, update, and correct information throughout the life of a news story and be vigilant and courageous about holding those with power accountable and give voice to the voiceless. These general prescriptions, provided under a normative framework for ethical newsgathering, seem reasonable when applied to news coverage about bioethics issues.

A proliferation of codes of ethics for the media can be seen in journalism, public relations, and advertising, although from the perspective of moral development theory (Kohlberg 1969; Piaget 1965), codes of ethics and formalized guides do not rank high in moral development, which can occur only when people go beyond a stage of being other directed by rules to an inner-directed stage where rules are internalized. The progression is from a heteronomous stage where right and wrong are deﬁned externally to an autonomous stage where persons use reﬂective judgment to assess what is right and wrong and are able to explain the meaning and relevance of a rule. Under this perspective, codes of ethics may limit moral development and might be applied more as a professional prop than as a tool for thoughtful ethical decision-making. Most codes are too broad and general to be useful for day-to-day media operations. Furthermore, knowledge of ethics appears to be implicit, localized, personal, and often difﬁcult to identify or articulate (Lee and Cheng 2011). However, codes of ethics can be valuable if they are well crafted and well deliberated, especially for media professionals who are new to the industry. The current trend of codes of ethics is to shun penalties and to adopt an educational, rather than punitive, approach, but more thought and energy should be devoted to the crafting of codes’ language, speciﬁcity, enforcement, and tone toward the fundamental goal of establishing congruence between a media organization’s formal policies and its informal norms.

Broadly, ethical thought can be separated into two main approaches: teleological and deontological. The teleological approach, which emphasizes outcomes, is best summed up by utilitarianism that values efﬁciency and results through maximizing the greatest good for the greatest number within a society’s limited resources. From this perspective, tools of persuasion including untruths in shaping public opinion about a bioethics issue may be justiﬁed. Mieth (1997) observed that truth telling is a basic norm, but people often “invoke at one moment the norm of truthfulness and at the next moment, the right to lie, depending on circumstances and context” (p. 87). However, as Bok (1978) pointed out, lying, regardless of beneﬁts, always damages trust that is essential to a society’s functioning. In contrast, the deontological approach suggests that some acts are bound by duty and must be executed regardless of consequences. The focus on the act rather than consequences is apparent in single-rule nonconsequentialist theories such as Kant’s categorical imperative and Judeo-Christian ethics, for example, in the precept of truth telling whereby a lie is a lie and cannot be mitigated by the lie’s beneﬁts. German philosopher Immanuel Kant offered the strongest objection to deception. In Grounding for the metaphysics of morals: On a supposed right to lie because of philanthropic concerns, Kant, who deﬁned a lie as any intentional statement that is untrue, considered lying to be an affront to human dignity and mankind. The Kantian approach is deontological, in that moral rightness depends on the act rather than its consequences. The inadequacies of deontological and teleological approaches have led to a resurgence of virtue ethics, with its roots in the work of Plato and Aristotle, emphasizing moral character rather than rules and consequences. Deontology, teleology, and virtue ethics are contrasted by ethical relativism that holds that there are no moral absolutes as right and wrong are based on social norms and evolve over time.

A reliance on teleological ethics, by focusing on consequences (beneﬁcence and avoidance of harm) as the main determinant of a media message’s ethicality, is debatable. A message should be assessed also for its intrinsic moral worth rather than its outcome, and focus on the message’s relative last end to distinguish it from the more immediate instrumental ends such as improved fatality rates or lower abortion rates. The ﬁnal relative end of bioethics is open to debate and involves a number of complex variables including human values, education, advocacy, and the freedom to make a voluntary choice.

From the perspective of media ethics, two ethical reasoning tools are useful.

The Potter Box

The Potter Box is an analytical and ethical reasoning tool for assessing the ethics of an action. As an applied tool for social ethics and ethical decision-making, it emphasizes four areas for ethical reﬂection and contemplation to help the moral agent consider whether the action being assessed is ethical or not. Although the Potter Box was conceived by Ralph Potter of the Harvard Divinity School as a generic tool for ethical decision-making, the framework is particularly useful for media professionals as it considers not only the context for the action but also the multiple stakeholders involved. In the Potter Box, the moral agent is asked to apply action steps in the Potter Box’s four dimensions – deﬁnition, values, principles, and loyalties. The four steps are applied in a systematic order under a linked system or an organic whole to derive an answer as to whether the action being contemplated is ethical (should be carried out) or not ethical (should be avoided). The four dimensions are

Deﬁnition: The moral agent provides an empirical deﬁnition in which to situate the action being considered.
Values: The moral agent identiﬁes values or motivations for performing the action.
Principles: The moral agent appeals to multiple ethical principles including Utilitarianism, Rawls’ Veil of Ignorance, Kant’s Categorical Imperatives, Communitarianism, Aristotle’s Golden Mean, and Ethics of Love.
Loyalties: The moral agent identiﬁes and assesses his allegiances to various stakeholders.

For media professionals, the Potter Box offers a valuable tool for ethical decision-making. This applied tool recognizes that ethical dilemmas emerge from conﬂicts and tensions that arise among values, ethics theories, and loyalties – and understands the need for a clear problem deﬁnition or facts of the situation. One challenge in applying the Potter Box is that it seemingly allows the moral agent to selectively use particular facts, values, principles, and loyalties to support a preferred solution over dispreferred solutions. Such a ﬂaw, however, is inherent in any decision-making situation involving humans and their infallibility.

TARES

TARES (Baker and Martinson 2001) offers another applied ethical decision tool for media professionals. TARES provides an important deontological framework for assessing the ethicality of media messages about bioethics, through ﬁve principles. The applied tool, designed for assessing mass-mediated persuasive messages including advertising and public relations, is the ﬁrst to examine the notion of practitioner accountability toward the message receiver in persuasive communication. TARES, using truthfulness as a core value, establishes ethical boundaries for persuasive communications through a ﬁve-part test. The normative model is named after an acronym based on the ﬁrst letters of ﬁve interconnected values: Truthfulness of the message, Authenticity of the persuader, Respect for the person being persuaded, Equity of the persuasive appeal, and Social Responsibility for the common good. Under TARES, questions are asked about the characteristics of the message. To pass the TARES test, a message must fulﬁll all ﬁve values.

In TARES, truthfulness is a multifaceted concept. Veracity of the information presented in a message is but only one dimension of truthfulness, as omission of information could still lead a message receiver to a false belief. Many messages, when disseminated through media framing, communicate only part of the truth, but not all omissions are deceptive. For deception to occur, there must exist the intent to deceive. Many persuasive messages about bioethics issues may also contain exaggerations, or what is commonly known as ﬂuff, but an exaggeration is not misleading unless there is intent to mislead. Patterson and Wilkins (2012) discussed the example of a

Cheerios commercial that omitted the fact that other components of a heart-healthy lifestyle and other breakfast cereals are equally healthful, but the commercial does not lead the consumer to make false assumptions and bad choices. From the perspective of TARES, the ad met the Truthfulness principle although it communicated only part of the truth. Persuasive messages about bioethics issues may be time limited and tightly constrained on content, thus restricting the amount of information that could be fully provided to audiences. This constraint, however, does not automatically imply a lack of truthfulness, consistent with Deaver’s (1990) deﬁnition of truth in communication. By operationalizing truth as a multifaceted ethical principle, TARES extends beyond a simplistic notion of truth as “telling it all,” and expands the ethical boundaries of persuasion through recognition of selective truth.

Ethical decision-making tools such as the Potter Box and TARES should be positioned within a holistic framework for ethical decision-making that helps moral agents to develop their moral autonomy and reﬂexivity and focuses on aligning formal ethics initiatives with informal norms and values that shape the organizational culture within media organizations and that of society at large.

Conclusion

The rise of new media has changed the media landscape signiﬁcantly. As media users increasingly interact with one another and seek information online, the roles of media professionals are changing dramatically. For one, information subsidies, especially those disseminated through ofﬁcial online newsrooms, offer much leverage for organizations to engage global publics in meaningful discourse about bioethics issues. Online pressrooms, with organizations providing news statements online and making them accessible to their publics, remove the news middlemen to expand on source-direct communication in place of mediated communication for shaping understanding and dialogue about bioethics. To communicate is to move away from a one-way communication approach toward dialogic communication. In a new global order, as communication practices are profoundly changed by the rapid evolution of information and communications technology and associated digital communications, bioethics should focus on listening to build relationships; bridge differences brought about by culture, income, technology, language, and geography; and visualize aspirations and discover solutions to issues and problems for individuals and communities.

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