Establishing a taxonomy of potential hazards associated with communicating medical science in the age of disinformation

Objectives Disinformation on medical matters has become an increasing public health concern. Public engagement by scientists, clinicians and patient advocates can contribute towards public understanding of medicine. However, depth of feeling on many issues (notably vaccination and cancer) can lead to adverse reactions for those communicating medical science, including vexatious interactions and targeted campaigns. Our objective in this work is to establish a taxonomy of common negative experiences encountered by those communicating medical science, and suggest guidelines so that they may be circumvented.

Design We establish a taxonomy of the common negative experiences reported by those communicating medical science, informed by surveying medical science communicators with public platforms.

Participants 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 a survey, with 101 responses.

Results 101 responses were analysed. Most participants experienced abusive behaviour (91.9%), including persistent harassment (69.3%) and physical violence and intimidation (5.9%). A substantial number (38.6%) received vexatious complaints to their employers, professional bodies or legal intimidation. The majority (62.4%) reported negative mental health sequelae due to public outreach, including depression, anxiety and stress. A significant minority (19.8%) were obligated to seek police advice or legal counsel due to actions associated with their outreach work. While the majority targeted with vexatious complaints felt supported by their employer/professional body, 32.4% reported neutral, poor or non-existent support.

Conclusions Those engaging in public outreach of medical science are vulnerable to negative repercussions, and we suggest guidelines for professional bodies and organisations to remedy some of these impacts on front-line members.

Suggested guidelines for professional bodies and employers

Educational/professional organisations must recognise a commitment to support evidence-based actions by their members. This may require oversight of such activities and investment in the governance/training resources to protect members willing to act as advocates.

Institutions and professional bodies should have robust measures in place to oversee communication activities associated with their members, and to make assessments as to whether individuals are communicating established facts in good faith or are contributing to undermining of facts with potential legal/reputational damage.

When institutions receive complaints regarding members, the subject must be afforded presumption of innocence rather than being served with reactionary and inflexible procedures, lest the institution might become an unwilling tool against science.

In case of disputes and complaints, competent and impartial individuals should be engaged to independently assess complaints, cognisant of vital background and context.

Coordination between press offices and those engaged in outreach would improve communication, pre-emptively identifying those likely to be targets for malicious tactics.

Support for those identified as being on engagement front lines should be maintained, with clear legal advice/institutional support for targeted members.

Organisations must be vocal in supporting public-facing members, willing to issue strong rebuttals of vexatious complaints against individuals.

Professional bodies and employers should strive to promote both scientific freedom of speech and to champion evidence-based advocacy.

When possible, those expected to engage in outreach should be trained in methods that reduce opportunities for personal and professional attacks.

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Looking over this list:

I’ve certainly experienced both racism directed at me, threats of law suits, vexatious complaints to my employer, and I’ve also had to seek legal advice.