Abstract
This paper, reporting on the quality of information available on the Web in relation to assisted dying, offers an interesting and reflective account of the power of the digital media to influence public understanding of healthcare issues. Not withstanding the fact that the study demonstrates the breadth and variable quality of information available, it also highlights how the academic view of balanced scholarly evidence, once considered the sine qua non for publication has been displaced by polarised opinion pieces, blogs and wikis, which are more readily understood and accessible to the general public (even if the material is perhaps factually incorrect). The commendable application of a series of measures of quality in this study shows that healthcare communication is no longer a two-way process between practitioner and patient, but a multi-layered, complex and somewhat confusing trawl through a variety of perspectives on a topic to see which one fits the scenario best.
The issue of assisted dying is clearly contentious and the assertion made by UK professional bodies that such topics should not be discussed for fear of prosecution, is disturbing. Add to this a recent call from the BMJ for medical bodies to take a ‘neutral’ stance in relation to assisted dying (BMJ, 2012) and a picture emerges of an ineffectual leadership response to this important and very public issue. One might argue that as healthcare professionals and certainly the bodies who uphold professional standing, there is a responsibility to provide balanced scholarly evidence to refute misleading and inaccurate information that the researchers identified in their study. In effect, a voice of reason, in an otherwise unreasonable and imbalanced media portrayal of issues, which pertain to living and dying.
The internet is not all bad. There are some excellent examples of where the public can gain reasoned and helpful information to enable them to make decisions relative to their own health. Websites such as Macmillan Cancer Support provide such essential services. Nor is there suggestion of censorship or paternalism here regarding what the public read. People should, and will, read whatever they choose. Rather, engagement in these key debates encourages discernment and may enable the public to make informed decisions which are not swayed by emotive and possibly unsubstantiated opinion. In effect, this is the closing argument of the paper – healthcare professionals need to become confident in identifying and working with the materials produced on websites to ensure a better outcome for their patients and their families. Assisted dying is one of the most challenging debates to engage with, not least because it asks us to reflect on issues of unbearable suffering, hopelessness and perceived futility in treatment. The British Medical Association overwhelmingly rejected the BMJ call at their AGM shortly after the original call was made. Arguably, medicine can never be neutral in this debate because the outcome of any change in legislation would have a profound impact on their practice. As this study identifies, the World Wide Web will continue to propagate information, which needs careful and consistent review for accuracy, content and wherever it may be possible, the truth.