HEALTH POLICY AND THE MEDIA
Ross D. Silverman, JD, MPH
Department of Medical Humanities
Southern Illinois University School of Medicine
PO Box 19603
Springfield, Illinois 62794-9603
217.545.4261
217.545.7902 (fax)
rsilverman@siumed.edu
SYLLABUS
WEEK ONE:
AND THE BAND PLAYED ON
READINGS (ALL AVAILABLE ON LINE OR IN THE LIBRARY)
1. M. Brodie, et al. "AIDS at 21: Media Coverage of the HIV Epidemic 19812002," published by the Kaiser Family Foundation
http://www.kff.org/kaiserpolls/upload/AIDS-at-21-Media-Coverage-of-theHIV-Epidemic-1981-2002-Supplement-to-the-March-April-2004-issue-ofCJR.pdf
2. K. Wright, "AIDS: Hiding In Plain Sight," Columbia Journalism Review,
March/April 2004
http://www.cjr.org/issues/2004/2/wright-aids.asp
3. Kaiser Family Foundation HIV Policy Program, Issue Brief: Trends in U.S.
Government Funding for HIV/AIDS--Fiscal Years 1981 to 2004. March 25,
2004. http://www.kff.org/hivaids/7032.cfm.
Optional readings:
a. Luc Montagnier, “A History of HIV Discovery”, Science 2002; 298(5599):
1727-28.
http://www.sciencemag.org/cgi/content/full/298/5599/1727?ijkey=JFZI1vF
OkeojA&keytype=ref&siteid=sci%20
b. Robert C. Gallo, “The Early Years of HIV/AIDS”, Science 2002; 298(5599):
1728-30.
http://www.sciencemag.org/cgi/content/full/298/5599/1728?ijkey=9SfD8syt
UvDXs&keytype=ref&siteid=sci
Health Policy and the Media
Ross D. Silverman, JD, MPH
HEALTH POLICY AND THE MEDIA
WEEK ONE:
AND THE BAND PLAYED ON
DISCUSSION QUESTIONS
1.
Overall impressions of the movie. Favorite moments, characters, least
favorite moments, characters?
2.
How did the personal interests of the various characters and entities affect
the way the early years of the AIDS crisis unfolded? (personally, politically,
scientifically, socially, economically, etc.)
3.
How did privacy serve as both a benefit and a detriment in the early years
of the AIDS crisis?
4.
What role did stigma play in the movie?
5.
How did the law impede containment of the spread of the disease?
6.
Describe the process of "Shoeleather Epidemiology" as it was portrayed in
the film.
7.
What role do you feel the opening sequence from Africa played in the
movie?
8.
Describe the political ramifications of the CDC's "what do we think, what
do we know, what can we prove" philosophy.
9.
In the 1988 prologue to his book, Randy Shilts wrote the following:
People died and nobody paid attention because the mass media
did not like covering stories about homosexuals and was especially
skittish about stories that involved gay sexuality. Newspapers and
television largely avoided discussion of the disease until the death
toll was too high to ignore and the casualties were no longer just
the outcasts. Without the media to fulfill its role as public guardian,
everyone else was left to deal – and not deal – with AIDS as they
saw fit.
Given our knowledge of the media's treatment of AIDS in the 15 years
since the book was written, how would you assess the media's
performance in its "role as public guardian"?
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Health Policy and the Media
Ross D. Silverman, JD, MPH
WEEK TWO:
THE INSIDER
READINGS
1. Richard A. Daynard, "Tobacco litigation: a mid-course review," Cancer
Causes Control 2001;12: 383-386.
2. Steven A. Schroeder, "Tobacco Control in the Wake of the 1998 Master
Settlement Agreement," N Engl J Med 2004; 350(3): 293-301.
3. Michelle M. Mello, Eric B. Rimm, and David M. Studdert, "The McLawsuit:
The Fast-Food Industry And Legal Accountability For Obesity," Health
Affairs, Nov/Dec 2003, vol. 22(6): 207-216.
4. Kim Severson, "S.F. lawyer plans to drop Oreo suit," San Francisco
Chronicle, Thursday, May 15, 2003
5. Ross D. Silverman, “Foreward: The Mass Media’s Influence on Health
Law and Policy”, Houston Journal of Health Law & Policy, 2005; 5:175185.
Optional reading:
Marie Brenner, "The Man Who Knew Too Much," Vanity Fair, May 1996.
Available at http://www.jeffreywigand.com/insider/vanityfair.html
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Health Policy and the Media
Ross D. Silverman, JD, MPH
Health Policy and the Media
WEEK TWO:
THE INSIDER
DISCUSSION QUESTIONS
1.
Overall impressions of the movie. Favorite moments, characters, least
favorite moments, characters?
2.
In what ways do personal financial interests influence the various
characters and entities in the film?
3.
What would you have done in Jeffrey Wigand's position?
4.
Describe the tobacco industry's litigation defense strategy.
5.
Describe the motivations behind state litigation against the tobacco
companies.
6.
What is "tortious interference"?
7.
Describe the various ways the media influenced the main characters in the
film. How does the media impact society's knowledge about health
issues? How can physicians play an increased role in how the media
addresses health issues?
8.
Are smokers victims? Are the obese? Why are they the same/different?
9.
What has happened to the tobacco industry and tobacco's impact on
society since these proceedings?
10.
Jeffrey Wigand stated in his interview and testimony during the movie that
he believed cigarettes, as a "nicotine delivery device," are a drug. Should
they be regulated as a drug?
11.
Your thoughts on litigation as a public policy/public health tool.
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Health Policy and the Media
Ross D. Silverman, JD, MPH
WEEK 3:
PANIC IN THE STREETS
READINGS
1. David P. Fidler, "Legal Issues Surrounding Public Health Emergencies,"
Public Health Rep (Suppl 2) 2001; 116:79-86.
2. Jay C. Butler, Mitchell L. Cohen, Cindy R. Friedman, Robert M. Scripp,
and Craig G. Watz, "Collaboration between Public Health and Law
Enforcement: New Paradigms and Partnerships for Bioterrorism Planning
and Response," Emerg Infect Dis 2002; 8:1152-1156.
3. Laurie Garrett, "Understanding Media's Response to Epidemics," Public
Health Rep (Suppl 2) 2001; 116: 87-91.
4. Lawrence O. Gostin, Ronald Bayer, Amy L. Fairchild, "Ethical and Legal
Challenges Posed by Severe Acute Respiratory Syndrome: Implications
for the Control of Severe Infectious Disease Threats," JAMA. 2003;
290:3229-3237.
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Health Policy and the Media
Ross D. Silverman, JD, MPH
HEALTH POLICY AND THE MEDIA
WEEK THREE:
PANIC IN THE STREETS
DISCUSSION QUESTIONS
1.
Overall impressions of the movie. Favorite scenes? Favorite/least favorite
characters?
2.
In addition to being a movie about a plague outbreak in New Orleans, this
1950 film was interpreted by some as an allegory on the Communist
Scare in the United States. What aspects of the movie support such an
interpretation? Do you see any parallels which could be drawn between
this movie and post-9/11 America?
3.
How were patients' rights issues like informed consent/autonomy handled
in the film? How do you think these issues would/should be addressed
today?
4.
The media's role in a public health crisis was hotly debated at several
points in the movie by a number of different characters (the Public Health
department, the police department, the mayor's office). Describe
similarities and differences between the media's role in that crisis versus a
current public health crisis. What role do you feel the media should play in
such circumstances?
5.
Describe the relationship between the police, the mayor's office and the
public health service then and now. In the face of a public health crisis,
who should be in charge?
6.
Describe the "shoeleather epidemiology" which took place in this film.
7.
How was quarantine used by the public health service in this film? What
concerns would be raised with its use today that may not have been an
issue in 1950?
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Health Policy and the Media
Ross D. Silverman, JD, MPH
WEEK 4:
RASHOMON
READINGS
1. David Medine, “Law and Kurosawa’s Rashomon,” Literature/ Film
Quarterly, 1992; 20(1): 55-60.
2. Troyen A. Brennan, Michelle M. Mello, “Patient Safety and Medical
Malpractice: A Case Study,” Ann. Intern. Med. 2003; 139(4): 267-273.
3. William J. Donnelly, “Righting the medical record. Transforming chronicle
into story,” JAMA 1988; 260:823-25.
4. M. Louis-Courvoisier, A. Mauron. “'He found me very well; for me, I was
still feeling sick': the strange worlds of physicians and patients in the 18th
and 21st centuries,” Med Humanit. 2002 Jun; 28(1):9-13.
5. Ronald Loewe, John Schwartzman, Joshua Freeman, Laurie Quinn and
Steve Zuckerman, “Doctor talk and diabetes: towards an analysis of the
clinical construction of chronic illness.” Soc Sci Med 1998; 47(9): 1267-76.
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Health Policy and the Media
Ross D. Silverman, JD, MPH
WEEK 4:
RASHOMON
“The reality of all this is that medical histories are created, not found.
Furthermore, whatever we physicians compose and record as history
is not “reality” in any global sense, but one version of reality, one that
we choose to construct.”
William J. Donnelly, “Righting the medical record.
Transforming chronicle into story,” JAMA 1988; 260:823-25.
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Health Policy and the Media
Ross D. Silverman, JD, MPH
WEEK 5:
GATTACA
READINGS/VIDEOS
1. Fost NC. “Conception for donation.” JAMA. 2004 May 5;291(17):2125-6.
2. Cooper RS, Psaty BM. “Genomics and medicine: distraction, incremental
progress, or the dawn of a new age?” Ann Intern Med. 2003 Apr
1;138(7):576-80.
3. Caplan A. “Is biomedical research too dangerous to pursue?” Science.
2004 Feb 20;303(5661):1142
4. Gregory Stock, “From regenerative medicine to human design: what are
we really afraid of?” DNA and Cell Biology, 2003;22(11): 679-83.
5. Francis Fukuyama, “Life, but not as we know it,” New Scientist, 20 April
2002, pp. 42-45.
6. Katharine Mieszkowski, “Clone Free (Interview with Francis Fukuyama),”
Salon Magazine, May 21, 2002. Available at
http://www.salon.com/tech/feature/2002/05/21/fukuyama/.
7. Norman Fost, “America’s Gulag Archipelago,” N Engl J Med.
2004;351:2369-70.
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Health Policy and the Media
Ross D. Silverman, JD, MPH
HEALTH POLICY AND THE MEDIA
WEEK FIVE:
GATTACA
DISCUSSION QUESTIONS
1.
Overall impressions of the movie. Favorite scenes? Favorite/least favorite
characters?
2.
Describe the type of genetic modification portrayed in Gattaca. How,
morally, technologically, etc., does this type of intervention differ from the
types of modifications raised in the readings?
3.
In what ways do individuals adjust – psychologically, socially – to the
ready dissemination of their genetic makeup, as portrayed in the film?
4.
What types of sociological and economic changes are depicted as
resulting from availability of this information?
5.
What is "perfection" in the eyes of Gattaca's society? What types of
pressures does that place on the characters? What is not
measured/valued in that society's hierarchy that we find of value today?
6.
If society can screen for genetic diseases in newborns, should they?
Would you want to know your genetic limitations and flaws (e.g. higher
propensity toward a particular disease), even if nothing medically could be
done to address that concern?
7.
As in the movie, a large share of genetic medicine today focuses around
fertilization. In addition to screening for certain diseases (e.g.,
thalassemia or Down syndrome), a few recent examples of childbirthrelated genetic medicine include gender selection in babies and screening
embryos for tissue-type, in order to create children who are compatible
stem cell donors for ailing siblings (Verlinsky Y, Rechitsky S, et al.
Preimplantation HLA testing. JAMA. 2004 May 5;291(17):2079-85; Fost
NC. Conception for donation. JAMA. 2004 May 5;291(17):2125-6.)
Should society place limits on genetic research or therapies/interventions
arising out of such advances? If so, how? If not, why?
8.
How should insurance (life, health, etc.) address genetic information about
individuals? What about individualized medications, created based on
one's personal genetic code?
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