MD, PhD, FMedSci, FRSB, FRCP, FRCPEd.

Anyone who has followed the comments’ section of this blog knows that science communicators don’t always have it easy. In fact, they have to endure regular attacks. Now, this phenomenon has (as far as I know, for the first time) been investigated systematically.

The objective in this survey was to establish a taxonomy of common negative experiences encountered by those communicating medical science, and suggest guidelines so that they may be circumvented. A total of 142 prominent medical science communicators (defined as having >1000 Twitter followers and experience communicating medical science on social and traditional media platforms) were invited to take part in the survey. One hundred and one responses could be analysed.

The results show that:

  • 92% of the participants has experienced abusive behaviour (91.9%), including persistent harassment (69.3%) and physical violence and intimidation (5.9%).
  • 39% had received vexatious complaints to their employers, professional bodies or legal intimidation.
  • 62% reported negative mental health sequelae due to public outreach, including depression, anxiety and stress.
  • 20% had been obligated to seek police advice or legal counsel due to actions associated with their outreach work.
  • the majority targeted with vexatious complaints felt supported by their employer/professional body and 32% reported neutral, poor or non-existent support.

Here is a selection of the responses from the participants:

  • Accusations—including by one Senator—that [we are] uncaring, dismissive, neglectful, arrogant, or paid by pharma companies when advocating for vaccines. (Misrepresentation)
  • I find my expertise is questioned—this often seems to be when men find it difficult to accept women with intelligence and qualifications. Sexist insults are a typical go-to response. (Discreditation)
  • The worst one that hurt me professionally and personally was that activists gathered my emails using [Freedom of Information Requests] and handed chosen packets of them with a story to different reporters. (Misrepresentation/Discreditation/Dubious Amplification)
  • Persistent negative comments on twitter; usually it doesn’t last long but it can feel very intense while it’s happening! (Intimidation)
  • I have been served with a SLAPP lawsuit in order to silence my outreach work. Frequently receive harassing emails, malicious comments made on blog. (Malicious Complaints)
  • Social media co-ordinated intimidation, implied threats of legal action (for defamation). Mocking, undermining, condescension and attacks for being an industry shill, although. I am just a patient advocate. Being called a liar, that I never had cancer, that I deserved cancer due to my attitude, that I have been mutilated by conventional medical treatment, and that I am no longer a woman (having had mastectomy for cancer). That my cancer will return and I deserve that. (Dubious Amplification/Misrepresentation/Discreditation)
  • I have had anti-vaccine organizations and individuals attempt to prevent my public appearances and have been the subject of numerous online smear campaigns accusing me of being ‘a shill for Big Pharma’ etc. (Discreditation/Dubious Amplification)
  • Those who attack me very frequently try to do it by targeting me at my job, sending bogus complaints to my bosses and the university. From my observation, that is the go-to attack, the first thing these groups do. (Malicious Complaints)
  • I had to contact the police, who visited the person who was harassing me. I also involved social services. We bought a CCTV to monitor our front door after a strange envelope was hand delivered. The person involved has targeted several people before and continues to target individuals who advocate vaccination. (Intimidation)
  • Abuse and accusations of corruption are the most common adverse reaction I get. Sometimes a particular group petition one’s employer and try to create trouble for them. I have been lucky in the past when this happened to have had supportive universities who appreciate my outreach work. I have in the past had slightly unhinged individuals writing rambling, implicitly threatening letters to my office which ultimately required police intervention. (Discreditation/Malicious Complaints/Intimidation)
  • The worst are gendered insults (being called a cunt, etc.) and rape/death threats. I have had one empty legal threat that was widely publicized. (Intimidation/Malicious Complaints)
  • Regular threats to sue for defamation. (Malicious Complaints)
  • Attempts to get me fired, public records act requests for emails, verbal attacks on my children. (Malicious Complaints, Intimidation)
  • One of the most unpleasant things is that certain people or groupings will use very underhanded tactics to respond to perceived criticism. If they can’t refute the science, it isn’t uncommon for them to go after you personally, alleging all manner of things to anyone who’ll listen; that you’re incompetent, or unethical, or perverted. It seems they throw things wildly to see what sticks, but it can be extraordinarily unpleasant to endure. (Dubious Amplification/Discreditation)
  • My main concern has been obsessed individuals who declare their enmity and seem to be unconstrained by civil norms. (Intimidation)
  • Homeopathy advocates looked up my LinkedIn profile and called my employer to complain about my comments on the radio. My employer did not support me and I ended up having to stop the activity I had been planning. (Misrepresentation/Malicious Complaints)
  • Being threatened with physical violence. (Intimidation)
  • A delusional supporter of [an individual] I wrote about accused me and my lawyer of stalking him and killing his in-laws. He sent accusing emails to the faculty of my school and all the police departments in my state. [They] also accused me of being a terrorist and complained about me to the FBIs Terrorism Joint Task Force. That gave me many nervous, sleepless nights. (Discreditation/Malicious Complaints)
  • Death threats received, employer unhelpful, sorted myself. (Intimidation)
  • I haven’t experienced many negative encounters because I would say I am only lightly involved in public engagement. However the reason I don’t become more heavily involved in this area is fear of this kind of abuse and vexatious complaints to my employer or regulatory body. (Malicious Complaints)

The authors concluded as follows: The question of how we best communicate health science in the modern era is an area where more research is urgently required, especially on the role of social media, and optimum ways physicians, researchers and other public-facing figures can promote good medical science and mitigate falsehoods. The suggestions herein ought to be taken as a starting point, with discussion evolving as improved evidence materialises. There are wider problems implicit in all this that those communicating science cannot tackle in isolation; social media regulation particularly is a serious issue, both in regard to the spreading of misinformation/disinformation, and with respect to procedures preventing the potential weaponisation of social media platforms. Social media platforms must ultimately be made answerable to regulatory oversight, just as every other important aspect of life is; claims of innocence are unconvincing when their business model is so clearly dependent on advertising engagement at the cost of lives. The problem of poor reporting and false balance in conventional media outlets also must be considered, and there is significant scope for scientists and doctors to contribute to policy in these areas. There is ample evidence that physicians and scientists have an important role to play in combatting health disinformation, as has recently been argued by one of the authors in relation to vaccination for British Medical Journal opinion. But equally, it is crucial that those engaging in this vital work have the requisite support from their institutions, so that deleterious consequences of laudable outreach work might be circumvented. It is increasingly clear that disinformation about medicine and illness has become ubiquitous, with severe consequences for both our collective health and public understanding of medical science. Scientists and physicians must be at the vanguard of the pushback against these dangerous falsehoods—our societal well-being depends on it.

_______________________________________

This is an important paper, in my view. It is well worth reading in full.

I know many scientists who will no longer engage in science communication (other than publishing their papers and attending conferences) because they had one or two bad experiences. I certainly had hundreds of bad (some very bad) experiences, but I have taken the opposite decision.

Thus I started this blog, authored several books aimed at the consumer, give public lectures, etc. I have done this for many years despite the lack of support from my university and sometimes despite the opposite of support from my peers.

Why?

Why do I work tirelessly trying to inform consumers about so-called alternative medicine (SCAM)?

Because, in view of the plethora of (often dangerous) misinformation, it is hugely important to get the word out to the men and women in the street. I pity the ones who regularly allege that I do all this because of the money I earn from such activity (on the whole, it costs me money). In fact, I do what I do because I hope it might

  • stimulate rational thought,
  • help people to make wise therapeutic decisions,
  • make a small contribution to public health,
  • and perhaps occasionally even save a life.

And the threats which I continue to receive merely indicate that I might be doing this job well, and prove how important the task really is.

5 Responses to Threats science communicators have to endure

  • We are in agreement on the points you make here, Dr. Ernst. The public has become dangerously anti-science to everyone’s detriment. I believe much of what you write here does serve a purpose. I regret that you have to endure such unwarranted attacks.

  • The bullet points at the end of this powerful post made me think of an account in a book I have just finished reading: “Everything That Makes Us Human” by paediatric neurosurgery consultant Jay Jayamohan.

    In a chapter entitled It’s Your Decision, he recounts the case of a young boy with a sizable tumour on the back of his brain. He explains to the mother “Further specialist scans will show us the extent and we need to check the spinal cord, but it is imperative we begin the process of tackling the tumour immediately”.

    Ninety-something percent of the brain tumour is safely removed by surgery. Tragically however, there are aggressive metastases all over the spine. There was the offer of chemotherapy and radiotherapy after recovery from the operation. Heroic and gruelling interventions for a young boy, offering the possibility of a somewhat extended lifespan, but filled with illness and a lot of distress. Or, good care and family life at home, without heroic interventions, for whatever time remained. An unenviable choice.

    Rather than pick one of those alternatives, the Mum decided to take the boy to Germany for treatment, raising the funds for this by selling the family house. What was the ‘treatment’ in Germany? Crystal therapy. It failed, and the boy came home to die with his loving family. But the ‘therapist’ in Germany had their money.

    In an age of Fake News, and the possibility of publishing fake claims a) internationally and b) instantaneously by means of convincing-looking (to the unsuspicious) websites with testimonials, it is more important than ever that there should be solid public education in medical treatments. Sadly, the mainstream media are very much wanting in this area, in my opinion.

    As you may imagine, Mr. Jayamohan fees strongly about this case and those like it, though he expresses himself with professional restraint and in a most considered way.

  • I don’t know anymore, since social media rules the world now, think you might be a little off-base. 20 yrs ago you would get actual hate mail in letter form via snail mail after your article made a national in-print news article. Now, you get it instantly with way broader base because it’s easier to respond and much quicker via search engines on web and still in incognito. Social media has maimed the masses, your work is awesome but you have fell for social media posts as well.
    You have reacted to false photos with wrong caption, I pointed out once. Some people believe what they read on internet without researching and it has made a very bad environment in our world.

  • What a sad testament to the downside of the internet. All the world is there. The good, the bad and the ugly.
    Keep on trucking Edzard.

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