A Shot of Confusion

The complainant, the media co-ordinator for the Canadian Consumers Centre for Homeopathy Karen Wehrstein thought a Marketplace episode on vaccinations and the alternatives offered by some homeopaths was biased and twisted the facts. It is critical but is a solid piece of journalism

COMPLAINT

You are the media co-ordinator for the Canadian Consumers Centre for Homeopathy. You wrote because you were concerned about an episode of Marketplace, entitled “A Shot of Confusion.” It originally aired on November 28, 2014. You said “that Marketplace’s clear intention to discredit homeopathy” caused it to “cut corners and journalistic ethics and sometimes outright break them.”

You outlined a number of things that illustrated your concerns:

The first point you raised was your belief that in researching the program, the producer who approached various homeopathic organizations for interviews included “false statements” in the questions she asked. You said you were “surprise and alarmed” to receive an email from Tayana Grundig, the segment producer, dated Sept 5, 2014 asking you to comment on this statement:

Marketplace has documented homeopaths in Vancouver and Toronto selling homeopathic nosodes without the required disclaimer.

You dispute this was ever the case and you noted that Marketplace had also filed complaints with Health Canada against two homeopaths and the complaints had been dismissed. You found it suspect that none of this was mentioned in the show. You added that homeopaths are careful to adhere to Health Canada regulations, and that the homeopaths in question were “coating blank pellets with a medicating potency” which is a standard homeopathic procedure and not in violation of Health Canada regulations.

Your second area of concern was the use of hidden cameras to record the discussion and interaction between mothers with babies and homeopaths. Your reading of CBC Journalistic policy led you to conclude that their use of a hidden camera was based on an apprehension of illegality because “Marketplace staff was so certain that homeopaths were selling nosodes illegally when they weren’t.” You were aware from the policy that producers and reporters have to seek permission to broadcast material obtained with a hidden camera, and you thought that the Marketplace crew had presented a case based on the criterion of possible illegal activity. Because there was nothing illegal going on you feel this violates the CBC policy. You urged me to review the request made to senior management for permission to use hidden cameras. You are skeptical that another criterion, that of abuse of trust, was the reason cited. You believe homeopaths are reluctant to agree to on camera interview because Marketplace has a demonstrated bias against them. You thought hidden cameras were not necessary because homeopaths had information on their websites so there was no need to obtain the information in another way.

You also said that the program rejected “valid science” thereby violating the CBC’s own policy on science reporting. You had sent the segment producer research material, “some on the efficacy of homeopathy and others on the nature and property of homeopathic medicines:”

I asserted to her that sufficient comparisons of the properties of homeopathic medicine solutions with plain water have been made that it is not valid to say that there is no difference, even if the reason for the difference is not yet agreed upon, and I shared many of those comparisons.

For this reason, you said the representation in the programme that showed how homeopathic medicine works is false.

You were also concerned that the Marketplace episode put the blame for incomplete vaccination of young children on homeopaths. You said the program stated that non-compliance across the country averaged about 40%. You said it was not possible that homeopaths were responsible because their prevalence is limited. You also pointed out that the programme failed to mention that not all homeopaths even practice preventive medicine. The majority of them, you said “do not offer homeopathy as vaccine alternative” because they believe that you do not use homeopathic medicine until there is already a condition to treat. You criticized the interview request you got because it did not ask you about the position of homeopaths vis a vis vaccination. You thought this was further evidence of a bias and inability to present anything related to homeopathy fairly.

MANAGEMENT RESPONSE

The Executive Producer of Marketplace, Marie Caloz replied to your concerns. She explained the impetus behind the story and provided some of the context. She told you that there had been significant news coverage about increased outbreaks of whooping cough and measles. Part of the discussion around it dealt with the resistance to childhood vaccination, and the fact that some young children are only partly vaccinated. She told you that there were many factors that contributed to this and one of them was the advice parents received from alternative health care providers:

When Marketplace began to investigate vaccine trends and falling vaccination rates, we discovered that many parents who visit alternative health care providers are being discouraged from immunizing their children. We learned one group of practitioners – homeopaths – was going further, offering parents vaccine alternatives they advertise as over 90 percent effective, despite the absence of credible evidence.

She responded to your complaint that the interview request sent to you and some other homeopathic organizations was deliberately misleading. She told you that the information in the interview request emails was based on the information and understanding they had at the time. In further discussion with Health Canada, they learned that while the agency requires a warning that states that it has not licensed any homeopathic medicines for prevention of a communicable disease and that they are not to be used as an alternative to vaccines, if the practitioner prepared the nosodes his or herself, the warning is not required. She added that the correct information was conveyed in the broadcast itself.

She also told you that your concern that the use of hidden cameras to record the interaction between homeopaths and parents was not in violation of CBC policy. She told you “the legality of the practitioners using warning labels was not a factor in the decision to use a hidden camera.” The interest was in the information that practitioners would give to parents. She added there were other criteria that pertained in this case, including antisocial activity or an abuse of trust:

Our research suggested that about a third of the time alternative health practitioners swayed parents from vaccinating their children. We found some homeopaths were going further by offering a homeopathic vaccine alternative, one with no credible scientific backing. To dissuade parents from choosing to vaccinate their children which would protect them and others in the community from serious, even life threatening disease, is open to being seen as unethical and irresponsible. Parents who consult with alternative health practitioners trust they are acting in the best interests of their children. For these alternative health practitioners to discourage vaccinations or offer scientifically unproven alternatives is to abuse that trust.

She explained that the mothers were sent with hidden cameras to five practitioners who offered vaccination consultations on their web sites. After the appointments, all of the homeopaths were made aware of the interviews and offered the opportunity to appear on camera to present their positions.

She addressed your concern that the program researchers and producers had rejected “valid science.” She said the focus of the program was on the use of homeopathic vaccines, and the information homeopaths were providing patients, and that is what they sought comment on. She said the material you sent to the producer did not “pertain to homeopathic vaccines.” She also said that the broadcast featured an interview with Dr. Isaac Golden about his research and the efficacy of homeopathic vaccinations.

She explained that the program did not state that 40% of children are not vaccinated nor did it lay the blame on homeopaths for this level of non-compliance. She informed you that what Erica Johnson had said was that with general confusion about vaccines, there is a growing concern about rates of vaccination and that in “some communities more than 40% don’t have all their shots.”

She said the programme illustrated a number of causes for the confusion parents have about the efficacy and and safety of childhood immunization. She said that there may be a minority of homeopaths who provide alternative vaccinations, but in the course of their research, they were able to find five of them in Vancouver and Montreal. “Whether they are a majority or minority of homeopaths, they are readily accessible to the public.”

REVIEW

I too will review each of your areas of concern, based on Journalistic Standards and Practices. The underpinning values of the entire code are accuracy, fairness and balance and impartiality. Those values on the face of it, are pretty obvious. Aside from committing to getting it right and to presenting information clearly so citizens can form their own conclusions, it also introduces concepts of professional judgment and expertise. For example, under accuracy, it states:

We seek out the truth in all matters of public interest. We invest our time and our skills to learn, understand and clearly explain the facts to our audience. The production techniques we use serve to present the content in a clear and accessible manner.

And under impartiality, it states:

We provide professional judgment based on facts and expertise. We do not promote any particular point of view on matters of public debate.

The programme provided balance by presenting Isaac Golden and his assertion that homeopathic treatments work. He cites his research as evidence that it does so. He is given an opportunity to explain himself. This is part of the exchange with programme host Erica Johnson:

Dr. Isaac Golden: So all I’m asking is to put aside that barrier in your mind and not be stuck on whether you can understand how it works, but look at the evidence of whether it does work.

Erica Johnson: Evidence he says there is plenty of. No clinical trials but other research and his own.

Dr. Isaac Golden: My job as I see it is to share the data with the world, so that people who are really genuinely concerned about this topic can see what evidence there is.

Health Canada has recently strengthened its warning that nosodes, or homeopathic preparations used in the treatment of infectious diseases (“homeoprophylaxis”). It reinforces the fact that there are no alternatives to vaccines. Based on research and professional judgement, and the opinion of every major medical and scientific organization in the world, the producers of this program chose to provide further information to help individuals assess what they heard on this programme. They asked three specialists in medical research methodology and immunology to assess Isaac Golden’s work. They found it deficient. I have read one of those reports, and it questions almost every aspect of that study. Balance is not about weighting every view with the same value.

It is worth pointing out that your organization and others were invited to participate in the programme about vaccination. Since you distrusted the motives, you declined to do so. And that is a reasonable choice and yours to make. I can only observe that some of the context you provide in your complaint, that most homeopaths do not practice “preventive homeopathy” could have been on the record in an interview.

I understand that you and the producer had some exchanges about what you were willing to discuss and what she wanted to talk about, and you were not able to come to an agreement. There is no violation of policy if the journalists did not get answers to the questions they were asking and chose not to substitute it with what you were willing to discuss. Nor was there a violation of the policy on reporting science. It states:

We take care to understand properly and reflect the true implications of medical or scientific study results that we obtain, especially those involving statistical data.

We will exercise caution with regard to results disclosed at a conference but not yet published in a peer-reviewed scientific journal.

In matters of human health we will take particular care to avoid arousing unfounded hopes or fears in persons living with or close to those living with serious illnesses. We will also avoid suggesting unproven benefits or risks to health related to changes in habits of consumption of food or pharmaceutical products.

It is my assessment that they lived up to it, particularly around suggesting unproven benefits of a pharmaceutical product which health Canada states is not a substitute for vaccine.

You were also concerned with the hidden camera use. The fact that Marketplace chose to use a hidden camera technique is reasonable. They had seen that various homeopaths offered vaccination consultation on their websites. Given that the focus of the story was finding out what parents were being told about alternatives to vaccine, the reasonable way to capture the most accurate picture was to send a real mother with a real child to hear what would be said. Within the context of the public policy debate and the clear Health Canada position that there are no alternatives to childhood vaccines, that is not unreasonable. Your assertion that there was a claim of illegality to get permission to use a hidden camera is without basis. Here is the email request sent to David Studer, Director of Journalism Standards and Practices.

As part of our investigation into homeopathic remedies for children Marketplace is researching the sale of homeopathic vaccines or nosodes. It is accepted in the scientific and medical community that there is no validity to homeopathic remedies and vaccines. For that reason the licensing, marketing and sale of homeopathic vaccines is of particular concern since they promise to protect individuals from serious preventable diseases like whooping Cough, Polio, Meningococcal Disease, Measles, Mumps and Rubella among others. This is particularly problematic in today’s climate where vaccination rates across Canada are declining and the country is experiencing a resurgence of measles and whooping cough.

In response to these concerns, Health Canada released a statement requiring homeopathic nosodes to state on the packaging "This product is not intended to be an alternative to vaccination." The Canadian Homeopathic pharmaceutical Association was asked to post a position statement on their website stating that they “cannot recommend the use of any homeopathic medication, in lieu of conventional medical vaccinations.”

But do these measures go far enough? Since it is most often homeopaths that promote and dispense homeopathic nosodes, consumers are more reliant on the information given by practitioners than on the small print on product packaging.

To find out, Marketplace would like to request permission to use hidden camera to test what consumers are told by homeopathic practitioners when it comes to homeopathic nosodes and their ability to offer protection. We are requesting to do this using hidden camera as we believe we would not get a true representation of what practitioners would advise if they knew they were speaking to the media. Our research has revealed that when talking to parents, practitioners sometimes make promises the science doesn’t back up. For example, in an email to a parent, one homeopath stated that the “homeopathic childhood immunizations given at our clinic are proven effective” and that “a child is fully immunized against 6 diseases a year after starting homeopathic vaccines.”

As you can see, there is no mention of illegal activity, and the request is made based on research already done. You might also be encouraged to know that in granting the request, Mr. Studer reminded Ms. Caloz that in airing the results, “we have to reflect reality as we find it.”

You thought there was a violation of accuracy because false information was sent to you and others in an email dated September 5, 2014. Of particular concern to you was the statement that “Marketplace has documented homeopaths in Vancouver and Toronto selling homeopathic nosodes without the required disclaimer”. You said that wasn’t possible and mentioned that a complaint filed by the programme about two homeopaths had been dismissed.

At this stage in the production of the episode, the crew had already recorded the appointments with the moms and babies with five practitioners. Some had provided product without the warning mandated by Health Canada. Concerned about this and seeking accountability from Health Canada for its monitoring practices, the producer called the agency for a response. She was told the only way it could be looked into is if a complaint was filed. So the decision was taken to do so. The information received from Health Canada was that the warning label was not required when a practitioner prepared the compound his or herself, which is why the complaints went no further. That information was what was reflected on air:

Erica Johnson: We contact Health Canada about our findings, but they say nothing is amiss. If a homeopath mixes their own vaccine alternatives, they don't require a warning label. Go figure. As for the fear mongering and misinformation, we contact all of the homeopaths we visit and several associations, no one will talk on camera. And the homeopaths say they just provide parents with information.

The emails sent in September were based on the understanding, which seems logical, of the Health Canada policy. They were sent in order to gather more research and seek input from homeopaths. It would have been a violation of policy if the statement in the email had gone to air, but in fact the episode reflects the new information.

You also were concerned that the programme left the impression that homeopaths were responsible for declining rates of childhood vaccination or incomplete vaccination. Ms. Caloz provided you with the script which clears up the misunderstanding around the reference to 40% of seven-year olds not having received all their shots. It was a statistic describing one community. The framing of the entire episode is the concern about falling vaccination rates and the outbreak of some infectious diseases. The opening segment points out the conflicting information parents receive and illustrates it with a sampling of conversations with parents and comments from celebrities:

Erica Johnson: We head to Granville Island, in Vancouver, a popular kids’ hangout, and ask parents to give it a shot. (On scene): Hi, there! Do you want to make a Marketplace test? How old is your little one.

Streeter (woman):7 months.

Erica Johnson: And talk to us about a health decision they have all had to make. To vaccinate or not. (On scene): Is it a hard thing to grapple with?

Streeter (woman): I think so. For sure.

Streeter (woman): Absolutely.

Erica Johnson: Parents here say it's a tough choice.

Steeter (man): I think a lot of parents are influenced with the latest magazine covers.

Erica Johnson: Made tougher when it's not clear who to believe.

Jenny McCarthy: (CNN): Without a doubt in my mind, I believe vaccinations triggered Evan's autism.

Erica Johson: Even celebrities are battling it out.

Ron Schneider: One of the most vulnerable things you can do with a child who doesn't have an immune system is give them a shot.

Amanda Pete: Vaccines are very safe.

Ms. Johnson goes on to add that “about a third of the time alternative health practitioners swayed parents from vaccinating.” Then she goes on to explain why, of the various alternative practitioners out there, the programme focused on homeopaths. It is because some homeopaths provide alternative treatments to vaccination.

Erica Johnson: About a third of the time alternative health practitioners swayed parents from vaccinating. Other research has found that too. So, we start to dig, and sure enough, we easily find alternative health websites slamming vaccines. But one group goes further. Homeopaths. They offer an alternative treatment to vaccination.

You dismiss this by asserting a level of bias and say that Marketplace would find the one homeopath in Canada who did so. The evidence presented in the programme suggests otherwise, although it does not ever suggest what proportion. The issues raised and covered were not only the prescribing of alternate vaccine, but the misinformation, like a link between vaccine and autism, provided by some of the homeopaths featured in the program.

Where you see a systematic attack on homeopathy by the use of selective facts or misinformation, I see a thoroughly researched piece of work. It is true that it is strongly critical of the practices shown; that is no violation of policy. It is based on facts, evidence and expertise. The program in no way violated CBC policy.

Esther Enkin
CBC Ombudsman