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Rage over Saudi TV show draws attention to problem of medical misinformation

JEDDAH: Public health misinformation has been a major concern during the COVID-19 pandemic, when issues such as lockdown policies, mask-wearing and vaccines have proven deeply polarizing, with many questioning their scientific basis.

Policing what doctors and other healthcare professionals say in the public domain is not an easy task, in part because the boards and regulators created to investigate alleged malpractice were created long before the advent of social media.

As individuals become more interested in their health and well-being, demand for expert medical advice on television and social media has increased, providing them with influential platforms from which to assess the official guidelines.

Illustration of the Hippocratic Oath by Shutterstock

A recent incident on Saudi television has brought this phenomenon to the fore, prompting renewed calls for tighter controls on the dissemination of personal opinions and theories in the media and on digital platforms, and perhaps even new guidelines on medical ethics.

Is it time for a Hippocratic oath for the digital age?

A few weeks ago, Dr. Saud Al-Shehri, a renowned family doctor and frequent guest on Saudi Arabia’s official news channel, Al-Ekhbariya, caused a stir when he appeared on the network’s Al-Rased show. in which he addressed the health consequences of consuming large amounts of water.

Dr. Saud Al-Shehri. (Provided)

Discussing food issues related to fasting during the holy month of Ramadan, Dr Al-Shehri said that people who consume five bottles of water or more than 200ml in an hour could suffer from a disease which he later developed. termed water intoxication or water poisoning. .

The claim might not have raised many eyebrows had it been made by someone without medical training. But given that the source was a respected medical professional with a sizable Twitter and YouTube account, the comments understandably attracted considerable attention online.

Many in the Saudi medical community downplayed or disputed Dr. Al-Shehri’s warning. Although water poisoning is a real condition, known as hyponatremia, it is not caused by the rapid consumption of a single liter.

Extra glasses of water are recommended by many for those who are fasting, especially during the summer months. (Photo Shutterstock)

Muslims who break their fast are encouraged to drink plenty of water to avoid the far more dangerous consequences of dehydration. Yet scientists believe that the effects of abstinence from water during Ramadan fasting are negligible.

A 2012 study titled “Hydration and Performance During Ramadan,” published in the Journal of Sports Sciences, found that water loss during fasting can amount to as little as 1-2% of body mass.

According to a 2012 study, water loss during fasting can amount to as little as 1-2% of body mass. (File photo)

The Medico-Legal Commission of the Saudi Ministry of Health is the designated legal body to oversee complaints of medical malpractice and medical error filed by the Ministry of Health or ordinary citizens.

Speaking to Arab News, Rayan Mufti, a lawyer and legal adviser, said the council should take an active role not only in monitoring the words of doctors, but also in holding accountable those who provide medical advice on public platforms for potentially harmful consequences.

“In this case, the doctor gave his personal opinion which is not based on medical research or general medical rule,” Mufti said.

“This is the supposed medical error, and the Ministry of Health is the main authorized legal body that should follow up such cases because it is considered medical error on the part of the doctor given that he provided advice that was not part of his medical specialty.”

Tackling the spread of misinformation requires a multi-pronged approach, countering misinformation with credible and shareable content, says lawyer Rayan Mufti. (Provided)

Dr Al-Shehri could not be reached by Arab News for comment.

The controversy is emblematic of an issue that crosses national and cultural boundaries, where medical opinions are often aired unchallenged on prominent media platforms, potentially distorting public health messages and, as in the case of COVID-19 , undermining the response.

A 2014 study published in the British Medical Journal looked at 40 randomly selected episodes of “The Dr. Oz Show,” one of America’s most-watched medical talk shows, hosted by the eponymous celebrity doctor, Mehmet Oz.

The results showed that the information broadcast in these episodes was based on evidence only 46% of the time.

In his programs aired by MBC4, a channel owned by the Middle East Broadcasting Center, Dr. Oz advocates alternative therapies, fad diets, detoxifications and cleanses.

French infectious disease specialist Didier Raoult testifies before the National Assembly on the use of hydrochloroquine as a treatment for COVID-19 on June 24, 2020. (AFP file)

Although the medical community routinely dismisses his health recommendations as baseless and unproven, Dr. Oz has built up a substantial following.

“Recommendations made on medical talk shows often lack adequate information about the specific benefits or the magnitude of the effects of those benefits,” the University of Alberta research team originally said. of the British Medical Journal study.

“About half of the recommendations have no evidence or are contradicted by the best available evidence. Potential conflicts of interest are rarely addressed. The public should be skeptical of recommendations made on medical talk shows.

The danger of medical misinformation was evident to authorities around the world from the onset of the COVID-19 pandemic in early 2020.

Brazilian leader Jair Bolsonaro says he was “perfectly fine” after testing positive for coronavirus. (AFP)

Without consistent messages about the benefits of social distancing, personal hygiene, and vaccine safety and effectiveness, entire cities risked having lockdowns ignored and their health systems overwhelmed.

From the outset, Saudi Arabia issued explicit guidelines to the media, public and private entities and the medical community advising them of the potential repercussions of spreading incorrect information about the pandemic.

The Kingdom’s Public Prosecutor’s Office has made it an offense to produce “rumors or false news that would harm public order or public security or to send or forward them via social media or any other technical means “.

Violators could face imprisonment of up to five years and a fine of SR3 million ($800,000).

“Evidence-based science was not a priority because there were many drivers of misinformation. It was something that was prevalent at the start of the pandemic,” Mufti said.

“There have been many instances where doctors (in Saudi Arabia) have appeared in the media, giving their opinions that were not in their areas of expertise.

“This led to many contradictions at the level where the Ministry of Health warned against listening to doctors unless (their statements were) published by the main source (the Ministry of Health).”

Nursing staff are seen at a COVID-19 vaccination center in Riyadh on December 17, 2020. (AFP file)

According to the American Federation of State Medical Boards, health authorities around the world are under increasing pressure to act against doctors who spread false or misleading information.

In the United States, physicians can already be subject to disciplinary action for failing to provide advice or treatment consistent with evidence-based medicine and standards of care. The question for authorities now is whether this should extend to statements made in the media and on digital platforms.

Britain’s General Medical Council is currently updating its guide to good medical practice for the first time in nearly a decade. Doctors who allegedly shared “misleading” information on social media could soon face regulatory action, according to the Guardian newspaper.

For Mufti, a possible antidote is for health authorities themselves to engage more closely with media and digital platforms by sharing medical advice based on hard science.

“Combating the spread of misinformation requires a multi-pronged approach, including the deployment of credible and shareable content,” he said.

“It will also prevent regulated healthcare professionals, especially doctors, from spreading nonsense without evidence.”