Why full disclosure is healthy

(Image: Andrzej Krauze)

Do British people know enough about the financial interests of those writing health articles? Time to toughen editorial codes

LAST year, the BBC News website published an article that questioned if psychological therapies were enough to tackle the rise of depression in the UK. "Is it time," asked the author, "to question our seeming obsession with talking treatments? I want to stand up for the very important role medication can play in the treatment of mental illness."

What stood out for me was not just the pro-pill stance, but an endnote that its author, Richard Gray, a professor in nursing research at the University of East Anglia, Norwich, had "given lectures on behalf of a number of pharmaceutical companies". It did not state he had been paid for them, or that he had received fees and honoraria from antidepressant manufacturers, including AstraZeneca and Eli Lilly, for consultancy work.

This kind of omission happens all the time, so why single out this case? Primarily because the site is run by the BBC, a global media corporation. And the thousands reading the article could not judge its impartiality because they did not know about the payments.

After trying to get a comment for some time, the BBC agreed to amend the endnote. But at medical journals such as The Lancet failure to disclose payments would have breached editorial codes. In the UK, we rely on codes, in the US, media outlets are legally obliged to declare potential vested interests.

Sophie Corlett of Mind, a UK mental health charity, thinks we should take this seriously. "People experiencing mental health problems look to professionals... for many, this includes information that filters through the media. The responsibility to inform readers of issues which may affect the impartiality of a published piece lies with... news outlets and contributing authors. Mind has long campaigned for medical information to be conveyed in an open and balanced manner... we encourage... disclosure of interests."

This is happening at a time when concern is mounting over industry influence on psychiatric research and practice, and on public opinion. Trials of antidepressants are mostly funded, and often analysed and directed, by pharmaceutical companies. Some 60 per cent of the task force behind DSM-IV (the psychiatrists' diagnostics handbook) received money from pharma, as have most research centres and many heads of psychiatry schools. Of the 29 experts writing DSM-5, 21 received honoraria, consultancy fees or funding from pharma.

The BBC defends its coverage: "It's common for the BBC to speak to people with expertise in a particular subject. We do so under clear editorial guidelines that contributors associated with a particular viewpoint or with a commercial interest in a subject should be clearly signposted... Nothing has been put to us which suggests that there has been any conflict of interest."

So the BBC aims to ensure articles are signposted. In this case one slipped through the net and was duly amended. But it must be more alert to contentious topics and conflicts of interest. Perhaps its code needs tightening - or we should consider a law.

James Davies is a senior lecturer in social anthropology and psychotherapy at the University of Roehampton, London

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