Balance and Controversial Issues

The complainant, Patricia Maloney, thought an interview with a doctor critical of the rules for dispensing the abortion drug RU-486 was one-sided and failed to acknowledge the dangers of the drug or the controversy around abortion. Even with hot button issues like abortion, balance and a range of perspectives and aspects of the controversy are achieved over time. There was no violation of policy.

COMPLAINT

You thought an interview regarding the issue of accessibility of Mifepristone (RU-486) for Canadian women, a medication legalized in Canada this past July for medically induced abortions, was biased. You said that only one person was interviewed, Dr. Wendy Norman, whom you described as “the abortion doctor/researcher.” Dr. Norman was critical of the rules Health Canada put in place for the dispensing of the drug.

You said she called it “bizarre” but that it was no different from the protocol in the United States.

In fact, there are actually a truckload of dangers associated with RU-486, especially in remote areas. But when Hiscox asks Dr. Norman why these dispensing precautions, Dr. Norman has no idea. I am not kidding. She basically she says she doesn't know why, that this is "very strange".

You added that there was no discussion of the dangers of the drug or the reasons why the rules were in place. You pointed out that abortion is a “politically and emotionally charged subject” and it should not be discussed without providing alternative perspectives. Anything less, you added, is bias and the segment should have included a discussion of the dangers of the drug which would explain the Health Canada rule that it must be dispensed by physicians, and not pharmacists.

When Dr. Norman stated that the restrictions are unusual and bizarre (and CBC reiterated these adjectives in their tweet on the show when they stated: "It's very strange." reproductive health expert reacts to "bizarre" restrictions on #RU486 home abortion pill @cbchh), it seems clear to me that the CBC should have asked someone else to please explain this "strange bizarre unusual" behaviour, since Dr. Norman in the seven minute interview couldn't explain it.

MANAGEMENT RESPONSE

The Managing Editor for CBC News Network, Jennifer Harwood, replied to your complaint. She stated that the interview was not a debate about the safety of the drug. Rather it was about the issue of accessibility. She said that in “that context, it is my view that the coverage was fair and balanced.”

Ms. Harwood cited that additional coverage of the issue on cbcnews.ca included criticism of the Health Canada decision from other medical bodies.

The Federation of Medical Regulatory Authorities of Canada wrote to Health Canada to express concerns about the rules and accessibility of RU-486 writing, "dispensing by physicians is not normal practice (and could be a conflict of interest) and has the potential to create additional barriers for patient access."

She told you that Dr. Norman did explain why she used the words “unusual and bizarre.”

[Dr. Norman said] “in Canada for many years the safety mechanisms for drugs have required pharmacists to dispense them" and she went on to use the example of methadone being dispensed by pharmacists rather than by physicians.

REVIEW

CBC Journalistic Standards and Practices provide policy on balance:

We contribute to informed debate on issues that matter to Canadians by reflecting a diversity of opinion. Our content on all platforms presents a wide range of subject matter and views.

On issues of controversy, we ensure that divergent views are reflected respectfully, taking into account their relevance to the debate and how widely held these views are. We also ensure that they are represented over a reasonable period of time.

The part of the policy to be considered in this instance is the need to take into account the relevance of a particular perspective, and the concept that a range of views is expressed over a reasonable period of time. You believe that there was bias because the safety of RU-486 was not addressed, nor was the controversy around abortion and abortion rights. Context does matter, and framing a particular segment to address only one aspect of an ongoing story is acceptable. That is what happened in this case. The host of CBC News Morning Live introduced the interview with Wendy Norman in this way:

Canadian doctors say Health Canada’s strict guidelines will limit access to the abortion drug RU-486. Doctors can now write prescriptions for the drug but they say special rules around distribution will stop many people from getting it. That is the headline – let’s get more detail on the story from a special guest, this morning a long time family physician, who has an expertise in sexual and reproductive health, she is the Chair of Family Planning, Public Health, in fact, at the University of British Columbia but also speaks on behalf of the Society of Obstetricians and Gynecologists for Canada. She is normally based in B.C. but we find her in Ireland today, Dr. Wendy Norman.

The interview is clearly addressing the issue of accessibility of the drug. It is acceptable to limit its focus partly because of the scope of this issue. It is impossible to address all aspects of the abortion debate in a meaningful fashion in one interview, especially within the format of an all-news television channel. The segment was produced because the drug had just come on the market in Canada and Dr. Norman was explaining the nature of the concern of some professionals in the field. You describe her as an “abortion doctor”. As Ms. Hiscox mentioned in her introduction her qualifications are extensive in the field of public health as well as family planning. According to the Canadian Institutes of Health Research (the federal funding agency for health research) website, she is also the Applied Public Health Chair of that organization.

Your other concern was that she could not provide any explanation for why she described the Health Canada decision to require physicians to both prescribe and dispense the drug as “bizarre and very strange”. Ms. Hiscox actually asked her about that description, and Dr. Norman does supply an explanation. She commented that it was very unusual, that in some provinces physicians are prohibited from dispensing, and that it is based on old practices in the early days of the drug’s introduction in other countries:

HEATHER HISCOX

You’ve used a couple of interesting words – you called this very unusual regime around this, you said “have bizarrely put in place”. Why do you think they’ve put this extra layer or these extra additional requirements around this particular drug?

WENDY NORMAN

Well, this is a gray question, Heather, and I think it is a little bit inexplicable, a little bit hard to explain. In Canada, for many years, the safety mechanisms for drugs have required pharmacists to dispense them and even some of our most concerning drugs, for example, methadone, pharmacists are able to dispense this drug, so for all of a sudden out of the blue to have a normal woman’s health medication such as Mifepristone, the RU-486, requiring this very unusual mechanism, is strange. Now, decades ago when this was first approved in France and in the U.S., it’s been around for many, many years, we know a lot about the safety, but they didn’t know back then. And the systems in France are different, of course, and for doctors to sell things or charge patients in the U.S. is perhaps easier than within the Canadian system, so in those places, at that time, many, many years ago, a quarter century, they put these regulations in place. But for Canada to do that now and we know so much more about safety and about how to engage different professionals for different aspects of care with patients and families so that patients benefits most, it’s, it’s very strange.

In this answer, she also supplied the rationale Health Canada used for their regulation, although she did not agree with it. That is the balance that is required in the context of this segment. I agree it might have been clearer and would have benefited from a more explicit explanation of Health Canada’s position on the use of the drug.

CBC News covered the introduction of Mifepristone into Canada over a period of time and on multiple platforms and programmes. Many of those did adequately represent the position of Health Canada and its reasons for the regime required for use of the drug in Canada. There was no violation of CBC policy.

Finally, I apologize for the long delay in conducting the review. The error was mine.

Sincerely,

Esther Enkin
CBC Ombudsman