Minimise Harm

The media can cause significant harm. Established ethics call for harm to be minimised — not avoided completely, since some kinds are unavoidable or even justifiable.

The concept of "public interest" is a key one in the ethics of journalism. It is defined in the SA Press Code of Professional Practice:

"The public interest is the only test that justifies departure from the highest standards of journalism and includes:
  • detecting or exposing crime or serious misdemeanour;
  • detecting or exposing serious anti-social conduct;
  • protecting public health and safety;
  • preventing the public from being misled by some statement or action of an individual or organisation;
  • detecting or exposing hypocrisy, falsehoods or double standards or behaviour on the part of public figures or institutions and in public institutions."
 

In considering many situations, we use the test of public interest, asking whether it outweighs the harm that may be caused? Neither the public's right to know nor the harm to individuals have an automatic priority, and deciding which weighs more heavily is often very difficult. Certainly, the public's claim to information needs to be taken very seriously. Journalists' first loyalty should be to the public, and more particularly to the section that constitutes their audience. In the context of HIV and AIDS, we should not lose sight of the public need and desire to be informed properly.

There is a second general consideration that should be introduced here. Most of the harm issues that arise need to be understood in the context of the "triangle of stigma, denial and discrimination." 3

The stigma is very real. It hurts people, even kills, as the example of Gugu Dlamini shows. She was stoned to death in KwaZulu / Natal after disclosing her status. As journalists, we need to take the stigma very seriously.

There are three main areas of potential harm that can be identified:

 

Privacy

Also see: Living with HIV/AIDS: Right to Privacy, Living with HIV/AIDS: Stigma and Discrimination

This right is enshrined in many constitutions, it is a legal right and an ethical duty.

In concrete terms, it means taking great care when it comes to reporting on people's status. Their story, the way their family deals with the situation, medical details, photographs — all of this belongs to their private sphere, over which they have control.

The issue has a particular slant where, as is so often the case, journalists are dealing with people who are poor and disadvantaged. They need to take particular care not to bulldoze people, pushing them into doing something they may not really want to do.

A very useful code of conduct 4 developed by the Journ-AIDS website talks about informed consent, which means journalists should make sure that people they want to write about know and have thought through the implications of putting their lives on public display. This means journalists identifying themselves, explaining clearly and honestly what is intended and speaking in their language, avoiding promises that can't be kept and so on.

There are particular complexities here around children. What constitutes informed consent if a journalist wants to talk to a 14-year-old who is heading a household? The Journ-AIDS code says: "Where possible informed consent should be obtained with the knowledge and consent of the children involved from a responsible adult, guardian or carer." It is a useful approach, since it asks for the children themselves to be consulted — they often know quite well what is in their best interests. It also recognises the fact that circumstances may not allow for an adult to be asked, and that adults — even a guardian — may not always be acting in the child's best interests. These complexities underline the need to be particularly careful in dealing with children.

As indicated above, public interest can trump the right to privacy, if there is a strong public interest. This is recognised in various codes.

But journalists need to be very sure of the public interest before they decide to disclose somebody's status against their will. Undoubtedly, openness is an important principle, but that doesn't mean people can be dragged into the trenches of this battle if they don't want to be there.

 

Wild Claims

WARNING SIGNS OF AN HIV FRAUD

(Source: AIDSinfonet.org)  
  • The product prevents or cures HIV or AIDS. Researchers have been working hard for over 10 years, but there is not yet any known cure for HIV or AIDS
  • The product is a quick cure for a wide range of ailments . Most products are effective only against a specific illness or a few closely related medical problems
  • Personal success stories are the only evidence that the treatment works. Look for results of research studies or other evidence
  • The treatment is only available privately, for a short time, or from only one source; or if it requires payment in advance . If a product really works, why isn't it advertised and available publicly? This may be a way to get around government regulations
  • You can only get the treatment by paying to take part in testing an experimental treatment. When most experimental treatments are tested, people receive them free of charge

Journalists can cause a different kind of harm through their reporting of claims around cures.

In the Southern African context, though, these issues are overlaid with questions of culture and politics. In South Africa, a dissident view of the pandemic was given weight for a while because former President Thabo Mbeki seemed to be supporting it. Such views can't be ignored, no matter how crazy the journalist thinks they are. But they should be reported in such a way that it is clear they are fringe.

Traditional healers sometimes come forward with claims of being able to cure AIDS. Does a respect for traditional culture mean one should take these claims seriously or should one assume that only Western medicine can find solutions?

Perhaps a distinction can be made between limited claims and those that are actively harmful. Circumcision can be carried out in ways that minimise the risk of infection. And the use of the African potato does little harm. But one should not be squeamish in hammering myths like the one that sleeping with a virgin can cure AIDS.

With regard to claims of cures, Foreman says: "(A)ll claims of effective treatment, from whatever source, (should be) subject to scrutiny and not reported uncritically."5 He sets out a series of questions that should be asked, including how the claimed treatment is meant to work, what its side effects may be, what kind of trials were undertaken and others.

 

Fighting Stigma and Stereotypes

Also see: Living with HIV/AIDS: Stigma and Discrimination

Reporting — along with other forms of media representation — may perpetuate harmful social attitudes. If we always illustrate stories about HIV and AIDS with pictures of poor black women, we are perpetuating a stereotype about the disease that is both inaccurate and harmful. If we focus unnecessarily on how people were infected, we may reinforce an attitude that seeks to blame those with HIV or AIDS for being infected.

What is required is a balanced representation. This means taking care with generic images — where a general, non-specific picture is used to illustrate a report. These should, over time, reflect the different kinds of people who may be affected.

Reporting should also not reinforce a "them / us" mentality, where people with HIV and AIDS are seen as a separate species, a problem to be dealt with. Society needs to understand that we are all affected in one way or another.

Even though it is generally wrong to force people to disclose their status, there's nothing wrong with encouraging openness. Where prominent people have disclosed their status, they have generally received a lot of positive publicity. In doing so, the media (and they, of course) supported the principle of openness.

In this context, the question of language comes up. Various documents provide lists of problem words and expressions, but there's little unanimity about which ones should be avoided. Click here for some examples from the African Women's Media Centre.

Care should be taken with the use of language, but it should seen in the context of the general tone of reporting. A useful formulation comes from a 2001 UNAIDS document, which refers to the need to report in a "non-stigmatising and non-judgmental manner". 6

 
Wits Journalism Anova Health

The project is jointly managed by the Anova Health Institute and the Journalism and Media Studies Programme at the University of the Witwatersrand. The project is funded by by the Health Communication Partnership based at the Johns Hopkins Bloomberg School of Public Health Centre for Communication Programmes and the President’s Emergency Plan for AIDS relief through the United States Agency for International Development under terms of Award No. JH/HESA-02-05 and through the Anova Health Institute through PEPFAR via USAID under Award No. AID-674-A-12-00015.

USAID