In 1993 Gloria Steinem and the Ms. Foundation for Women (as in the magazine Ms.) founded the Take Our Daughters to Work program. Ten years later it was officially expanded to include boys, although many schools (which had to participate by excusing students from classes) and businesses had insisted from the beginning that it be gender-neutral. The central purpose of the program was to encourage girls to engage in career exploration at an age when their ideas about gender roles are flexible. The day for this exercise is the fourth Thursday of April.
This year I have had the delightful experience of a take-your-daughter-to-work summer.
My younger daughter, Rose, decided years ago that she wanted to be a physician. There is no longer much of an issue of gender roles in this profession, as many medical school classes are about 50-50. She has just returned to college for her sophomore year of a pre-medical curriculum. Midway through her freshman year I investigated the possibility that she could accompany me during some shifts in the emergency department as an observer. This is sometimes called a "shadowing" experience. (While particular words and phrases sometimes make me think of songs, the famous duet performance of "Me and My Shadow" by Frank Sinatra and Sammy Davis, Jr. really didn't fit.)
Rose embraced this opportunity with greater enthusiasm than I had expected. She spent part of her summer completing a training course to become an Emergency Medical Technician (EMT), so she will be able to serve in her college campus EMS organization for the next three years. Whenever she wasn't in class, she was in the ED with me for nearly every shift I worked. Evenings, nights, weekends, all of them. When her mother asked why so many, and especially why the night shifts, Rose astutely pointed out that every shift is different and that night shifts are different from the rest. It rather reminded me of the famous story about the chair of surgery at Duke University who said the only bad thing about being on call every other night during surgical residency training is that you miss half the interesting cases. She accumulated about 300 hours of experience. That is more time in the ED than many medical students have spent before they must, in the fourth year, decide what specialty they are choosing for post-graduate residency training.
Despite my obvious source of paternal bias, I will assert that she was a model of professionalism in both behavior and dress, her short white coat always quite neat and clean over blouse and slacks, and her manner of interacting with nurses, residents, attending physicians and patients always exhibiting proper decorum.
Because I have the good fortune to be practicing my specialty at a tertiary care, academic medical center, Rose got to see not only what it is like to take care of patients but also what it is like to be a trainee and what it is like to teach them. In our department we have medical students; students in training to become physician assistants; residents training in the specialty of emergency medicine; and residents from other specialties completing required rotations in the ED.
The great value of the emergency medicine rotation for trainees who do not intend to pursue the specialty as a career is that it teaches them how to approach what we call the "undifferentiated" patient. In the ED we see patients who are seeking help with every kind of medical problem imaginable - as well as some problems that don't really seem to be medical at all. As you might imagine, for a college student who wants to get some sense of what it is like to be a doctor, this is perfect.
My colleagues were most welcoming, gracious, and generous. They answered all of her questions that weren't, for whatever reason, directed to me, and they sought her out when there was an opportunity to observe something they thought she might not have seen yet. She was able to observe as the trauma surgeons opened the chest of a patient with what ultimately proved to be a fatal gunshot wound; as the neurosurgeons placed a drain through the skull of a head-injured patient with critically elevated intracranial pressure from a hemorrhage; as the residents and I used bedside ultrasound to try to sort out what was going on in the chest or abdomen of a gravely ill patient; as gastroenterologists used an endoscope to peer into the gut of a bleeding patient to find the source and put a stop to it; as young doctors painstakingly pieced together traumatic wounds so they would heal and the injured body part would look as much as possible like it did before. She saw patients who were crazy, intoxicated, or both. (Very often both!) And she saw the wide spectrum of intensity of interaction between doctor and patient, from kind and gentle reassurance to the fervent efforts applied to snatch a human being from the jaws of death.
When I was a high school student I decided I wanted to enter the medical profession with only the vaguest notion of what that meant. In the thirty years since I graduated from medical school I have realized that the same was true of many of my colleagues. One of the consequences of making inadequately informed decisions with lifelong consequences is that some will turn out to be regrettable. The medical profession is very demanding. For those who have a passion for it, the rewards are great. For those lacking that passion ... suffice it to say that some of the most unhappy people I have met over the last three decades have been doctors who really don't like doctoring.
Assuming Rose stays on her chosen path, her decision to do so will be very well informed. And for that reason I am most grateful that she could spend so much time with me this summer. Even more, though, I am grateful for having had the opportunity to gain a fuller appreciation for what a delightful young lady she is. I suspected when, at the age of 12, she helped care for her grandmother, who was dying of emphysema, that she would some day be a fine physician. And this summer she was tremendously helpful to her mother, who is recovering from surgery for a serious injury to her foot. She parlayed her excellence in the organic chemistry laboratory during the freshman year into gourmet cooking in our kitchen.
Last October I wrote an essay for this blog titled "Hope for the Future of the Medical Profession." That essay was inspired by my having learned that the daughters of two of my emergency medicine colleagues were in residency training, one in emergency medicine, the other in internal medicine.
This summer Rose has given me so much more hope that the next generation of physicians will be able to give their patients all they need, want, and expect of their doctors.
Saturday, August 25, 2012
Thursday, August 23, 2012
Legitimate Rape
In a flash, three of my Facebook friends, one of whom formerly served as an official in the Obama Administration, posted links to a news story about Rep. Todd Akin (R-MO). As I started to read the story, I thought it had to be from The Onion. Most of the time I find The Onion funny, but sometimes its articles are a little too edgy for my taste, especially the ones that would be appalling if they were true. This was clearly one of those.
But ... no! Really? It couldn't be. No Member of Congress could possibly have said something that stupid! I assure you, coming from me, that is a very powerful exclamation, because I have many times quoted Mark Twain's old chestnut. ("Suppose you were an idiot. And suppose you were a Member of Congress. But I repeat myself.")
Representative Akin said when a woman is raped, her reproductive organs possess a sort of magic biological power that keeps the woman from getting pregnant. And he used the phrase "legitimate rape." Members of the viewing, listening, and reading audience immediately took that phrase out of context. Legitimate rape? What is that? How can a heinous violent crime be legitimate? What linguistic nonsense is this? And what kind of an absolute moron believes this old wives' tale about female biology that went out with the Dark Ages?
It is unfortunate that the phrase was taken out of context. Because placing it back in context is very revealing of the way some of the most misguided folks in the pro-life camp think.
To provide this context, I must ask you to imagine a nation without Roe v. Wade, the 1973 decision by the U.S. Supreme Court that invalidated many state abortion statutes as violating a woman's constitutional right to privacy. (I have very definite opinions about Roe v. Wade, as I do about many of the Court's most controversial cases, but I'll save those for another essay.) In the U.S. without Roe, the states are free to enact abortion laws that are very restrictive, as some of them did before 1973. A few on the pro-life side of the issue believe abortion is always wrong and should be illegal in every instance. More common, though still held by a small minority, is the view that it should be legal only when continuing the pregnancy threatens the life of the mother. Much more common is the inclusion of exceptions for rape or incest.
[As a sidebar, I should note that some who favor restrictive laws use the word "health" rather than "life" of the mother. The objection to that lies in the expectation that "health" will include mental health, and one could argue that an unwanted pregnancy has at least the potential for threatening the mental health of any woman who is sufficiently distressed by the unwanted pregnancy. Even were it restricted to physical health, there are plenty of obstetricians who specialize in high-risk pregnancies, and the risks they manage expertly are both maternal and fetal.]
So imagine that we did not have Roe, and states could enact laws restricting access to abortion to cases in which one (or more) of these three exceptions is present. Some in the pro-life camp worry that women would claim they had been raped in order to gain access to a procedure otherwise denied them.
You are now free to venture off into a thought experiment in which you imagine a woman claiming that her unwanted pregnancy was the result of a rape and think about how that would go. Would the system be set up simply to take her at her word? Would she have to have sought medical attention as the victim of a violent assault? Would she have to have filed a contemporaneous report with the police? Would she be required to help the police identify and prosecute her assailant? The way things are now, many women who are raped don't report the crime to the police because they've heard what a horrible ordeal may await them in the legal system. Some, but not all, seek medical attention even if they don't want an evidence collection exam, so they can be given the "morning after pill" to reduce the chance of pregnancy and antibiotics for common sexually transmitted infections. (Sadly, we don't have any way to keep them from coming down with HIV or hepatitis C.)
This notion of false reporting is what Akin was referring to when he spoke of "legitimate rape."
And that is where I found the most repulsive implication in what Akin said. It involves a certain circular reasoning that includes a false premise. If a woman was really raped (as opposed to just claiming she was raped because afterwards she had second thoughts and wanted to put her sexual partner through some legal torture, or because she had to say she was raped in order to get an abortion), she wouldn't get pregnant because of her body's automatic magical response (the false premise). And so a woman who says her unwanted pregnancy resulted from rape is lying.
And where does that lead us? Directly to a rationale for not including the rape exception in a severely restrictive abortion law.
This is a fundamentally flawed rationale, first because of the false premise, and second because of the inherent assumption that any woman would accuse a man of a terrible crime he didn't commit so as to gain access to a restricted medical procedure.
[Another sidebar: there is a sound rationale for not allowing the rape exception. One simply declares the question of abortion to be what it is, namely an ethical dilemma. Like most ethical dilemmas, it is characterized by competing interests, in this instance the interest of the mother in controlling her own body versus the interest of the fetus in reaching viability and delivery. One then declares his or her opinion that the interest of the fetus should be given priority - and that whether the act that led to conception was voluntary or not is irrelevant. Of course, reasonable people may disagree over how any ethical dilemma should be resolved, and that is what we are doing now, because just about half of Americans think abortion laws should be more restrictive than they currently are, and the other half disagree.]
Before the Akin incident started me thinking (yet again) about all of these nettlesome issues, I looked at his conduct rather simply: as I said at the beginning of this essay, surely no Member of Congress could be that stupid. My second thought: can it be legal for someone that stupid to be serving in Congress?
My third thought, and the one upon which I have settled as the answer to the whole mess, is this: I'm pretty sure the House of Representatives has no precedent for using astonishing, unconscionable, and reprehensible stupidity as a basis for censuring one of its members. It is time to set that precedent.
But ... no! Really? It couldn't be. No Member of Congress could possibly have said something that stupid! I assure you, coming from me, that is a very powerful exclamation, because I have many times quoted Mark Twain's old chestnut. ("Suppose you were an idiot. And suppose you were a Member of Congress. But I repeat myself.")
Representative Akin said when a woman is raped, her reproductive organs possess a sort of magic biological power that keeps the woman from getting pregnant. And he used the phrase "legitimate rape." Members of the viewing, listening, and reading audience immediately took that phrase out of context. Legitimate rape? What is that? How can a heinous violent crime be legitimate? What linguistic nonsense is this? And what kind of an absolute moron believes this old wives' tale about female biology that went out with the Dark Ages?
It is unfortunate that the phrase was taken out of context. Because placing it back in context is very revealing of the way some of the most misguided folks in the pro-life camp think.
To provide this context, I must ask you to imagine a nation without Roe v. Wade, the 1973 decision by the U.S. Supreme Court that invalidated many state abortion statutes as violating a woman's constitutional right to privacy. (I have very definite opinions about Roe v. Wade, as I do about many of the Court's most controversial cases, but I'll save those for another essay.) In the U.S. without Roe, the states are free to enact abortion laws that are very restrictive, as some of them did before 1973. A few on the pro-life side of the issue believe abortion is always wrong and should be illegal in every instance. More common, though still held by a small minority, is the view that it should be legal only when continuing the pregnancy threatens the life of the mother. Much more common is the inclusion of exceptions for rape or incest.
[As a sidebar, I should note that some who favor restrictive laws use the word "health" rather than "life" of the mother. The objection to that lies in the expectation that "health" will include mental health, and one could argue that an unwanted pregnancy has at least the potential for threatening the mental health of any woman who is sufficiently distressed by the unwanted pregnancy. Even were it restricted to physical health, there are plenty of obstetricians who specialize in high-risk pregnancies, and the risks they manage expertly are both maternal and fetal.]
So imagine that we did not have Roe, and states could enact laws restricting access to abortion to cases in which one (or more) of these three exceptions is present. Some in the pro-life camp worry that women would claim they had been raped in order to gain access to a procedure otherwise denied them.
You are now free to venture off into a thought experiment in which you imagine a woman claiming that her unwanted pregnancy was the result of a rape and think about how that would go. Would the system be set up simply to take her at her word? Would she have to have sought medical attention as the victim of a violent assault? Would she have to have filed a contemporaneous report with the police? Would she be required to help the police identify and prosecute her assailant? The way things are now, many women who are raped don't report the crime to the police because they've heard what a horrible ordeal may await them in the legal system. Some, but not all, seek medical attention even if they don't want an evidence collection exam, so they can be given the "morning after pill" to reduce the chance of pregnancy and antibiotics for common sexually transmitted infections. (Sadly, we don't have any way to keep them from coming down with HIV or hepatitis C.)
This notion of false reporting is what Akin was referring to when he spoke of "legitimate rape."
And that is where I found the most repulsive implication in what Akin said. It involves a certain circular reasoning that includes a false premise. If a woman was really raped (as opposed to just claiming she was raped because afterwards she had second thoughts and wanted to put her sexual partner through some legal torture, or because she had to say she was raped in order to get an abortion), she wouldn't get pregnant because of her body's automatic magical response (the false premise). And so a woman who says her unwanted pregnancy resulted from rape is lying.
And where does that lead us? Directly to a rationale for not including the rape exception in a severely restrictive abortion law.
This is a fundamentally flawed rationale, first because of the false premise, and second because of the inherent assumption that any woman would accuse a man of a terrible crime he didn't commit so as to gain access to a restricted medical procedure.
[Another sidebar: there is a sound rationale for not allowing the rape exception. One simply declares the question of abortion to be what it is, namely an ethical dilemma. Like most ethical dilemmas, it is characterized by competing interests, in this instance the interest of the mother in controlling her own body versus the interest of the fetus in reaching viability and delivery. One then declares his or her opinion that the interest of the fetus should be given priority - and that whether the act that led to conception was voluntary or not is irrelevant. Of course, reasonable people may disagree over how any ethical dilemma should be resolved, and that is what we are doing now, because just about half of Americans think abortion laws should be more restrictive than they currently are, and the other half disagree.]
Before the Akin incident started me thinking (yet again) about all of these nettlesome issues, I looked at his conduct rather simply: as I said at the beginning of this essay, surely no Member of Congress could be that stupid. My second thought: can it be legal for someone that stupid to be serving in Congress?
My third thought, and the one upon which I have settled as the answer to the whole mess, is this: I'm pretty sure the House of Representatives has no precedent for using astonishing, unconscionable, and reprehensible stupidity as a basis for censuring one of its members. It is time to set that precedent.
Thursday, August 2, 2012
The "Faux News" Calumny
It isn't my usual approach to give away the conclusion in the title, because I like to keep readers in suspense, but ever since the derisive epithet "Faux News" was invented I have found it objectionable.
My first objection was that "faux" is a French word, and its correct pronunciation, even in English, is "f" followed by long "o" (rhymes with "doe"). Pronouncing "faux" so it sounds anything like "fox" is something people should do only when they are making fun of those who pronounce everything French in a way that I would describe as an illiterate Americanization. But I digress.
Regular readers know that I enjoy taking the news media to task for sloppy reporting, and I am sometimes harsh in my criticism. There are organizations that have set themselves up to be critics of the media, and I must say I find no small irony in their existence. From the left we have Media Matters, which criticizes news reporting perceived as having a right-wing bias. And from the right we have the Media Research Center, which criticizes news reporting perceived as having a left-wing bias.
We all have biases, unique perspectives, and opinions. Most of us recognize that we should try to separate opinion from fact. Sometimes this can be challenging. When I first heard lawyers speak of "true facts," I thought it an absurd redundancy, but then I realized it was an admission that the truth of claims set forth as facts is sometimes not straightforward. Daniel Patrick Moynihan, the late U.S. Senator from New York, is credited with having made the observation that we are all entitled to our own opinions, but we are not all entitled to our own facts.
On a clear day the sky is blue, and that appearance is caused by the way sunlight is scattered by water vapor in the air. Few people (I hope) would argue the factual nature of this statement. On the other hand, a statement to the effect that this summer in Pittsburgh, Pennsylvania has been unpleasantly hot should be regarded as a matter of opinion, regardless of what percentage of Pittsburghers surveyed might agree with it.
When it comes to public affairs, lines between opinion and fact are often not so clear. For many years Walter Cronkite concluded the evening newscast on CBS with the trademark line, "And that's the way it is..." (typically followed by the day's date, because the way it is today isn't necessarily the way ... well, you get the idea). Had I been a bit more inclined to question the authority of "the most trusted man in America," I might have said, "Oh, yeah? Says you." But I didn't.
As the years have gone by, Americans have been increasingly disposed to doubt the accuracy and objectivity of news reporting. In 1980 Ted Turner founded a cable news network with that as its name, abbreviated as CNN. Some to the right on the political spectrum thought the network lacked objectivity and editorialized (with a decidedly liberal slant) within its news reporting. There was a perception that CNN reflected the biases of its founder, as Turner was widely viewed as having leftist leanings. In the early 90s some Republicans began derisively referring to CNN as the Clinton News Network because it seemed to report the news in a way so favorable to the Administration. Many thought it was time for some competition, and Australian media mogul Rupert Murdoch's News Corporation obliged in 1996 by launching the Fox News Channel. Unlike CNN, News Corp said, FNC would report the news in a way that would be "fair and balanced." Further, on Fox News the reporting of "straight news" and the programs featuring analysis and opinion would be clearly separated. There would be no editorializing in the straight news reporting, and the analysis and opinion segments and shows would include voices from the right in proportions far exceeding the token conservative one might (infrequently) find on CNN. Finally, in reporting of straight news, FNC insisted that different people had different views of the facts, so Fox would tell its audience what those different views were and let them decide for themselves which were the "true facts," so to speak. "We report ... you decide" was the tagline.
It's this last aspect of the FNC approach that some find unacceptable. Facts are facts, and people who disagree with the facts should not have their opinions reported as being equally legitimate. Perhaps I should illustrate with an example.
Let's use climate change. There's a nice controversial subject for you. The CNN approach is to tell you that the vast majority of climate scientists say the earth is getting warmer, that it's getting warmer faster than ever before in our planet's history, and human activity is largely to blame. If you watch enough coverage of this issue on CNN you may catch mention of the fact that there is a vocal minority of scientists who differ, but you could easily miss that, and that perspective is presented as an outlier barely worth acknowledging. On FNC, on the other hand, both perspectives are presented, with equal weight (and time) given to presentation of the bases of these diverging opinions. You may even find a suggestion that climate scientists who disagree with the majority view are not quite as tiny a minority as we've been led to believe, because many are afraid of being shunned (loss of research grant funding, among other possible repercussions) if they declare themselves skeptics.
Viewers who prefer the CNN approach say there is a strong consensus of scientific opinion, and it is irresponsible journalism to be "fair and balanced" by giving equal weight to a kooky minority view. Those who like Fox say that's exactly what's wrong with CNN: that network decides what is "kooky" based on whether it does or does not serve the political purposes of the "liberal establishment," and they tell their audience that the kooks are not entitled to their own facts.
There are some who think CNN is well left of center in its reporting, while Fox is squarely middle of the road. I'm not one of them. First, FNC's analysis and opinion segments and shows are overwhelmingly conservative in their orientation. Second, their straight news coverage features reporters and anchors who ask more pointed and challenging questions of interviewees and guests who are Democrats or seem to have viewpoints from the left of center than they do of conservatives. Third, the commercial success of FNC has not been lost on those running the business that is CNN, and Fox has forced CNN notably to the right. Now, when CNN's reporters are interviewing guests whose perspective seems to be coming from the right, their hard questioning is more respectful, and the skepticism with which the answers are greeted is more subtle. And there is less blatant editorializing within the reporting of straight news. The analysis and opinion are still overwhelmingly liberal, but that's OK, because it's analysis and opinion.
If you want criticism from the left, go to the Web site of Media Matters, and for the opposite perspective the Media Research Center will suit you just fine. But is there anyone providing a critique that's right down the middle?
(Just in case you were hoping, based on the name of my blog, no, I'm not going to claim that I am the ultimate, objective arbiter of who is doing things right in news reporting and who isn't. You are free to reach that conclusion, however. Now give me a minute to extract tongue from cheek.)
Remember the 2010 election? It didn't go well for the national Democratic party. So some savvy folks at the University of Maryland decided to explore the possibility that the U.S. Supreme Court's decision in the Citizens United case, and any number of other influences, may have flooded the American electorate with "information" of doubtful quality. Note the way I introduced this study, connecting it with the outcome of the election rather than presenting it as a matter of pure intellectual inquiry, thereby suggesting that those conducting it may have had a political agenda. Not to worry: I shall find a yardstick and rap my own knuckles for doing that.
The study is called, "Misinformation and the 2010 Election: A Study of the U.S. Electorate." The purpose of the study was to examine where voters were getting their information, what the voters themselves thought about the quality of the information available to them, and whether some sources of information were associated more than others with creating a "misinformed" electorate.
If I were to scrutinize the methods, the results, and the conclusions (interpretation of the results) in detail, the way I would if we were reviewing a paper from a medical journal at my teaching hospital, this essay would go on so much longer that those of you who are still with me would soon not be. So let me summarize: conservatives are more misinformed than liberals, and those who watch Fox News are more misinformed than those who get their news from other sources. Further, the more they rely on Fox News and the less they sample other sources, the more misinformed they are.
Voters were asked questions about economic stimulus and its effects on jobs; health care reform; the state of the economy; climate change; the Troubled Assets Relief Program (TARP, also known as the bank bailout); the bailout of GM and Chrysler; whether the income tax burden on the middle class is getting better or worse; the war in Afghanistan; and the "birther" controversy over the president's origins.
The investigators tried to tease apart voters' own personal views from what they understood to be generally accepted facts. But this is challenging at best. Let us take, as an example, the question of whether the Obama Administration's economic stimulus package "saved or created millions of jobs." If voters thought otherwise, they were misinformed. So how was that question phrased?
"Is it your impression that most economists who have studied it estimate that the stimulus legislation ... (a) saved or created several million jobs; (b) saved or created a few jobs; or (c) caused job losses?"
I consider myself to be a well-informed voter, and that's more than a matter of intellectual egotism. I read a lot and seek out a wide variety of news sources. I remember reading that the Congressional Budget Office issued a sanguine estimate of the effect of the American Recovery and Reinvestment Act on job creation. But I also remember thinking the phrase "saved or created" was itself created to facilitate optimistic claims, and I certainly never assumed that the CBO's estimate was based on the carefully considered opinions of "most economists who have studied" the question.
So, assuming I do not wish to answer the question by saying "I don't know," I might choose (a) because I think that's the answer they're looking for even though I am deeply skeptical. Or I might choose (b) because I think economists tend to be realists or even pessimists (remember, they call economics "the dismal science"). Or I might choose (c) because I think little the government does has the intended salutary effect, and economists are surely smart enough to figure this out.
How do you think I will answer the question if I am a conservative or a Fox News viewer (two subsets of respondents to the survey with, I would guess, substantial overlap)? Right. I'm misinformed.
This is just one example. But most (not all) of the questions on the survey, subjected to close analysis, would tend to lead to a similar result and conclusion.
Fox News has its detractors, and some of the points they make are legitimate. We should get our news about public affairs from a variety of sources. If we gravitate toward sources that are full of opinions that mostly agree with our own, we may stay in a comfort zone, but we are less likely to be well informed - and much less likely to understand divergent views.
The study from the University of Maryland has been cited by many who dislike Fox and believe (1) conservatives are dimwitted; (2) conservatives watch Fox News, which keeps them misinformed; (3) conservatives won't watch anything else, because they do not wish to be enlightened. Some of FNC's detractors believe most or all of what Fox News does is an unconscionable breach of journalistic ethics, and FNC should be forced off the cable systems. At least until they remember the meaning of the First Amendment.
Here's what I believe. Fox News is reactionary. It is a reaction to the perception that for decades the news media have been populated chiefly by people whose political ideology is clearly left of center and who have been a good deal less than successful in keeping their ideological biases from affecting the way they report the news. Sit with me at home as I watch CNN or read the news on CNN.com, in my car as I listen to NPR, or anywhere as I read the articles linked from my daily e-mails from the New York Times. I will be happy to point out countless examples. Well, not countless. We can count them. The number will be large.
And that is why Fox News exists.
My first objection was that "faux" is a French word, and its correct pronunciation, even in English, is "f" followed by long "o" (rhymes with "doe"). Pronouncing "faux" so it sounds anything like "fox" is something people should do only when they are making fun of those who pronounce everything French in a way that I would describe as an illiterate Americanization. But I digress.
Regular readers know that I enjoy taking the news media to task for sloppy reporting, and I am sometimes harsh in my criticism. There are organizations that have set themselves up to be critics of the media, and I must say I find no small irony in their existence. From the left we have Media Matters, which criticizes news reporting perceived as having a right-wing bias. And from the right we have the Media Research Center, which criticizes news reporting perceived as having a left-wing bias.
We all have biases, unique perspectives, and opinions. Most of us recognize that we should try to separate opinion from fact. Sometimes this can be challenging. When I first heard lawyers speak of "true facts," I thought it an absurd redundancy, but then I realized it was an admission that the truth of claims set forth as facts is sometimes not straightforward. Daniel Patrick Moynihan, the late U.S. Senator from New York, is credited with having made the observation that we are all entitled to our own opinions, but we are not all entitled to our own facts.
On a clear day the sky is blue, and that appearance is caused by the way sunlight is scattered by water vapor in the air. Few people (I hope) would argue the factual nature of this statement. On the other hand, a statement to the effect that this summer in Pittsburgh, Pennsylvania has been unpleasantly hot should be regarded as a matter of opinion, regardless of what percentage of Pittsburghers surveyed might agree with it.
When it comes to public affairs, lines between opinion and fact are often not so clear. For many years Walter Cronkite concluded the evening newscast on CBS with the trademark line, "And that's the way it is..." (typically followed by the day's date, because the way it is today isn't necessarily the way ... well, you get the idea). Had I been a bit more inclined to question the authority of "the most trusted man in America," I might have said, "Oh, yeah? Says you." But I didn't.
As the years have gone by, Americans have been increasingly disposed to doubt the accuracy and objectivity of news reporting. In 1980 Ted Turner founded a cable news network with that as its name, abbreviated as CNN. Some to the right on the political spectrum thought the network lacked objectivity and editorialized (with a decidedly liberal slant) within its news reporting. There was a perception that CNN reflected the biases of its founder, as Turner was widely viewed as having leftist leanings. In the early 90s some Republicans began derisively referring to CNN as the Clinton News Network because it seemed to report the news in a way so favorable to the Administration. Many thought it was time for some competition, and Australian media mogul Rupert Murdoch's News Corporation obliged in 1996 by launching the Fox News Channel. Unlike CNN, News Corp said, FNC would report the news in a way that would be "fair and balanced." Further, on Fox News the reporting of "straight news" and the programs featuring analysis and opinion would be clearly separated. There would be no editorializing in the straight news reporting, and the analysis and opinion segments and shows would include voices from the right in proportions far exceeding the token conservative one might (infrequently) find on CNN. Finally, in reporting of straight news, FNC insisted that different people had different views of the facts, so Fox would tell its audience what those different views were and let them decide for themselves which were the "true facts," so to speak. "We report ... you decide" was the tagline.
It's this last aspect of the FNC approach that some find unacceptable. Facts are facts, and people who disagree with the facts should not have their opinions reported as being equally legitimate. Perhaps I should illustrate with an example.
Let's use climate change. There's a nice controversial subject for you. The CNN approach is to tell you that the vast majority of climate scientists say the earth is getting warmer, that it's getting warmer faster than ever before in our planet's history, and human activity is largely to blame. If you watch enough coverage of this issue on CNN you may catch mention of the fact that there is a vocal minority of scientists who differ, but you could easily miss that, and that perspective is presented as an outlier barely worth acknowledging. On FNC, on the other hand, both perspectives are presented, with equal weight (and time) given to presentation of the bases of these diverging opinions. You may even find a suggestion that climate scientists who disagree with the majority view are not quite as tiny a minority as we've been led to believe, because many are afraid of being shunned (loss of research grant funding, among other possible repercussions) if they declare themselves skeptics.
Viewers who prefer the CNN approach say there is a strong consensus of scientific opinion, and it is irresponsible journalism to be "fair and balanced" by giving equal weight to a kooky minority view. Those who like Fox say that's exactly what's wrong with CNN: that network decides what is "kooky" based on whether it does or does not serve the political purposes of the "liberal establishment," and they tell their audience that the kooks are not entitled to their own facts.
There are some who think CNN is well left of center in its reporting, while Fox is squarely middle of the road. I'm not one of them. First, FNC's analysis and opinion segments and shows are overwhelmingly conservative in their orientation. Second, their straight news coverage features reporters and anchors who ask more pointed and challenging questions of interviewees and guests who are Democrats or seem to have viewpoints from the left of center than they do of conservatives. Third, the commercial success of FNC has not been lost on those running the business that is CNN, and Fox has forced CNN notably to the right. Now, when CNN's reporters are interviewing guests whose perspective seems to be coming from the right, their hard questioning is more respectful, and the skepticism with which the answers are greeted is more subtle. And there is less blatant editorializing within the reporting of straight news. The analysis and opinion are still overwhelmingly liberal, but that's OK, because it's analysis and opinion.
If you want criticism from the left, go to the Web site of Media Matters, and for the opposite perspective the Media Research Center will suit you just fine. But is there anyone providing a critique that's right down the middle?
(Just in case you were hoping, based on the name of my blog, no, I'm not going to claim that I am the ultimate, objective arbiter of who is doing things right in news reporting and who isn't. You are free to reach that conclusion, however. Now give me a minute to extract tongue from cheek.)
Remember the 2010 election? It didn't go well for the national Democratic party. So some savvy folks at the University of Maryland decided to explore the possibility that the U.S. Supreme Court's decision in the Citizens United case, and any number of other influences, may have flooded the American electorate with "information" of doubtful quality. Note the way I introduced this study, connecting it with the outcome of the election rather than presenting it as a matter of pure intellectual inquiry, thereby suggesting that those conducting it may have had a political agenda. Not to worry: I shall find a yardstick and rap my own knuckles for doing that.
The study is called, "Misinformation and the 2010 Election: A Study of the U.S. Electorate." The purpose of the study was to examine where voters were getting their information, what the voters themselves thought about the quality of the information available to them, and whether some sources of information were associated more than others with creating a "misinformed" electorate.
If I were to scrutinize the methods, the results, and the conclusions (interpretation of the results) in detail, the way I would if we were reviewing a paper from a medical journal at my teaching hospital, this essay would go on so much longer that those of you who are still with me would soon not be. So let me summarize: conservatives are more misinformed than liberals, and those who watch Fox News are more misinformed than those who get their news from other sources. Further, the more they rely on Fox News and the less they sample other sources, the more misinformed they are.
Voters were asked questions about economic stimulus and its effects on jobs; health care reform; the state of the economy; climate change; the Troubled Assets Relief Program (TARP, also known as the bank bailout); the bailout of GM and Chrysler; whether the income tax burden on the middle class is getting better or worse; the war in Afghanistan; and the "birther" controversy over the president's origins.
The investigators tried to tease apart voters' own personal views from what they understood to be generally accepted facts. But this is challenging at best. Let us take, as an example, the question of whether the Obama Administration's economic stimulus package "saved or created millions of jobs." If voters thought otherwise, they were misinformed. So how was that question phrased?
"Is it your impression that most economists who have studied it estimate that the stimulus legislation ... (a) saved or created several million jobs; (b) saved or created a few jobs; or (c) caused job losses?"
I consider myself to be a well-informed voter, and that's more than a matter of intellectual egotism. I read a lot and seek out a wide variety of news sources. I remember reading that the Congressional Budget Office issued a sanguine estimate of the effect of the American Recovery and Reinvestment Act on job creation. But I also remember thinking the phrase "saved or created" was itself created to facilitate optimistic claims, and I certainly never assumed that the CBO's estimate was based on the carefully considered opinions of "most economists who have studied" the question.
So, assuming I do not wish to answer the question by saying "I don't know," I might choose (a) because I think that's the answer they're looking for even though I am deeply skeptical. Or I might choose (b) because I think economists tend to be realists or even pessimists (remember, they call economics "the dismal science"). Or I might choose (c) because I think little the government does has the intended salutary effect, and economists are surely smart enough to figure this out.
How do you think I will answer the question if I am a conservative or a Fox News viewer (two subsets of respondents to the survey with, I would guess, substantial overlap)? Right. I'm misinformed.
This is just one example. But most (not all) of the questions on the survey, subjected to close analysis, would tend to lead to a similar result and conclusion.
Fox News has its detractors, and some of the points they make are legitimate. We should get our news about public affairs from a variety of sources. If we gravitate toward sources that are full of opinions that mostly agree with our own, we may stay in a comfort zone, but we are less likely to be well informed - and much less likely to understand divergent views.
The study from the University of Maryland has been cited by many who dislike Fox and believe (1) conservatives are dimwitted; (2) conservatives watch Fox News, which keeps them misinformed; (3) conservatives won't watch anything else, because they do not wish to be enlightened. Some of FNC's detractors believe most or all of what Fox News does is an unconscionable breach of journalistic ethics, and FNC should be forced off the cable systems. At least until they remember the meaning of the First Amendment.
Here's what I believe. Fox News is reactionary. It is a reaction to the perception that for decades the news media have been populated chiefly by people whose political ideology is clearly left of center and who have been a good deal less than successful in keeping their ideological biases from affecting the way they report the news. Sit with me at home as I watch CNN or read the news on CNN.com, in my car as I listen to NPR, or anywhere as I read the articles linked from my daily e-mails from the New York Times. I will be happy to point out countless examples. Well, not countless. We can count them. The number will be large.
And that is why Fox News exists.
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