Final paper: health reporting in China

Chai Huiqun is involved in a lawsuit against the Chinese Medical Doctors’ Association (CMDA). The health journalist for the Southern Weekly based in Guangzhou claims to defend himself after CMDA named him in a complaint to All-China Journalists Association (ACJA) for allegedly false healthcare reporting. The case brought up by CMDA dates back to 2008 when Chai reported on alleged corruption in purchasing equipment at Mianyang Hospital after a local earthquake.

This is not the first time that Chai becomes the focus of his journalist peers and Chinese health and medical departments. In 2010, he reported about the case of a women’s anus allegedly sewn by a midwife after child delivery in Shenzhen. The case received wide media coverage nationwide. Among all the coverages, Chai became the most disputable journalist for his deep investigative story. Again, Chai was being questioned. CCTV’s Wang Zhian investigated into it and claimed that the story was biased and based on presumption and lack of information from the hospital side.

What can be seen beyond Chai’s cases is the challenge of health reporting in China. Like the journalists covering other beats, health journalists often find it hard to complete deep investigative stories. The resistance comes from both sides. Interested parties like hospitals may refuse to cooperate with investigation; even when a story is finished, it’s likely not going to be published because currently mass media in China is still under control by the government. The lack of transparency in administration sometimes results in the lack of transparency and truth in reporting where journalists could be bribed or produce biased stories.

And the health journalists in China lack proper guidance. The All-China Journalists Association is mentioned before, but it’s a dependent organization led by the Chinese Communist Party, and it mainly functions in the management of media outlet. There is no organizations in China like the Association of Health Care Journalists (AHCJ) that focuses specifically on healthcare and medical issues coverages. Chinese health journalists may know the fundamentals of ethical guidelines—journalists in China are required to take a theoretical exam every five years to stay in the legal working status as a journalist, and journalism ethics is one of the six sections of the textbook—but the guidelines are abstract and journalists may find it contradictory to follow all the guidelines at the same time. One of the challenges is how to stay relatively independent in a not independent environment.

Tinker Ready, a health and science journalists and the writer of Boston Health News, says in an e-mail how individual writers keep independent and stick to journalism instead of market promotion:

“Freelancing, content marketing and the growth of online advocacy reporting present ethical issues for health writers, mostly around bias and conflict of interest. For example, a lot of health freelancers write for university or hospital websites or publications that are edited to avoid anything that might put the institution is a negative light. Or they write for advocacy groups, like the National <Name the Disease> Association… I don’t consider any of these websites or publication to be journalism… Journalism is independent; the goal it to serve the reader, not an institution or company or cause. The best way to handle conflicts is to avoid them. The other option is to clearly disclose them. When I wrote a story about that involved a hospital union, I included a tagline that noted I was a member of a different local (chapter) of the same union, which is also organizing adjunct faculty members. The goal is to alert the reader to the possibility of bias.”

The independent health site, Connecticut Health Investigative Team (C-HIT), also stress how they stay independent. C-HIT “may consider donations to support the coverage of particular topics, but…maintains editorial control of the coverage.” Its board of directors, varying from journalists to employees in the medical and health care fields, “…provides expertise, guidance and operational support to C-HIT, but has no control or input into editorial decision-making.”

And here’s how the Association of Health Care Journalist states in terms of independence:

“We should strive to be independent from the agendas and timetables of journals, advocates, industry and government agencies… Health journalists have a responsibility to be selective so that significant news is not overwhelmed by a blizzard of trivial reports. We are the eyes and ears of our audiences/readers; we must not be mere mouthpieces for industry, government agencies, researchers or health care providers.”

The Association of Health Care Journalist states that all the SPJ codes of ethics—seek the truth, minimize harm, act independently and be accountable—apply to health and medical reporting as well. In the latest version of the China News Workers’ Code of Professional Ethics (2009), seek the truth (真实性) is listed as one of the major codes. Being accountable and minimizing harm is not written in black and white, but it can be paraphrased from the code of serving the people (服务). Independence is mentioned as media outlets cannot make illegal profits (经营) out of reporting and should strictly distinguish news reporting from advertising. But the first two codes states that media outlets should be loyal to the Chinese Communist Party (忠于党) and should focus reporting on positive side (正面宣传).

These codes restricts the independence of media in another way. In Chai’s case, he obviously didn’t “follow the codes.” I believe what he chases for is full independence. It can be hard to apply SPJ codes to health reporting in China, but I believe even when facing with restrictions, health journalists should keep the spirit of independence and revealing the truth—health reporting is about the public, not the Party.

Below is some proposed ethics guidelines for health journalists in China that I think would be somewhat practical:

  • Pledge loyalty to the public and readers. Ask yourself before writing a story: What’s the journalistic purpose in the story? What parties should you interview to ensure the accuracy to the greatest extent? If a story raises controversy, find out what makes it controversial, review feedbacks from all parties involved and do follow-up reporting.
  • But keep independent. While comments from all angles should be considered, this is your story. Stick to what you believe is right to report on. Never, ever interview someone whom you knows well. I’ve stated in my personal ethics guidelines that I won’t consult with my acquaintances in their expertise. If you happens to have a friend who works in a hospital that will appear in your story, don’t try to get information from your friend. Ask somebody else.
  • Be sympathetic to patients and medical personnel, but stay objective. Nowadays in China, there’s a point of view that covering the darker side of hospitals intensifies the conflicts between doctors and patients and causes “yinao,” a form of medical disputes involving act of violence. Medical personnel blames the media for digging out too much the perpetrators’ stories and relatively ignoring the act of crime. Don’t take sides. Include both in your story. What you should dig out is what causes the tragedies from both parties’ perspective and how to prevent potential cases in the future.
  • Weigh the possible harm you will cause and then make decision. Revealing the dark sides of a local hospital may lead to temporary lack of medical support in the area and unemployment for many medical personnel, but if it can result in for a greater good, do it.
  • Be patient. Obtain sufficient information before you write a story. If you meet with obstacles when trying to obtain official information, try it again. Meanwhile, search for equivalent information. State clearly in the story that these information are only for reference and official departments turn down your request. Don’t create bias by leaving out any relevant parties even that all you can write about them is “no comment.”
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The issue of transparency and trust

Over the past week I’ve been following the coverage of the Tianjin explosion. Sadly, although I’ve read numerous stories on it, I find it hard to trust any news agency–even for the number of the dead. I would think, yeah, Xinhua says 112 dead. Since that’s the only number that domestic and international news agencies can refer to, I’ll take it as the fact.

My cousin and I had a rather weird conversation. She knows I study journalism and one day she asked me, “Sis, what did the foreign news guys say on the figure of the dead? They said foreign media reported far more people were killed.” This was a few days ago and by then the official number was like less than 30. I said, “I don’t know. Don’t count on me. Foreign news guys know exactly what you know. And who are ‘they?'” I told her to ignore the “according to foreign media…” unless the news linked to a specific story, and then I thought, it’s so, so sad. My cousin doubted the domestic media credibility and she couldn’t get further information on foreign media. We know nothing but the official report.

It’s not the first time that the public question authorities’ report on accidents. I feel like it all started with the high-speed train crash in 2011. It was a remarkable period when almost every mainstream news media conducted deep and responsible coverage, but soon the authorities interfered. Since then, I feel it’s harder and harder to tell the truth. I think that interference severely damages the public’s trust to mass media and provides opportunities for rumors. Even if the official number of dead is exactly correct, people will have doubts–they don’t trust the government, and they don’t trust the media. Many of the people I know turn to online news without identified sources and they would rather trust the words from “a relative of my mother’s colleague in Tianjin.”

Set aside the number issue, it’s also becoming harder to report on what’s happening there. Poynter concludes the challenges that foreign journalists meet with in Tianjin, but honestly, Chinese journalists face with the same interference. What are they trying to hide? If they worry that foreign journalists would distort the facts because of communication (which happened before), why not let Chinese media in? If they still worry that Chinese media would do fake reporting (which also happened before), why not confront with the media with plain facts?

Compared with journalists’ obstacles caused by the non-transparency, I’m more concerned about the damage of the trust building between the public and the media. Indeed it’s a time when everyone can be a “journalist,” but without several reliable news sources–only one is apparently not going to work because it can control all speeches–the public will be in a far more challenging situation where they don’t know which are rumors, which are facts, and which should be further investigated to alarm the people.

Operation correct that error

So it’s been a month since I started the operation correct that error, and so far I’ve got no response from both sites.

Let’s just review how this started. When I wrote down the first piece, it was only three days after the 2015 San Diego Comic Con. I couldn’t remember the original post I saw, but one of them linked to this source on the US Weekly, in which Jesse Eisenberg’s character in the upcoming Batman v Superman: Dawn of Justice, Lex Luthor, is misspelled as Lex Luther.

I realized it could be a common mistake—Warner Bros. even jokes about it in its Lego DC Comics Super Heroes: Justice League: Attack of the Legion of Doom! (One man asks another, “is it Lu-the-r or Lu-tho-r?”) So I Googled “Lex Luther” and so many results pumped out. Most of the sites are small news feed sites, and their stories seems highly similar. That’s not really surprising; I assume their source to be this AP piece. Breitbart even attaches the original AP piece right below its own. However, the AP attachment has the correct spelling and the site’s own post has it spelled wrong!

I was not able to find any way on the website to contact the writer/editor Daniel Nussbaum of Breitbart, so I used used the “send us a tip” function to send a note, and I’ve got no response.

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I sent a note to Sierra Marquina of the US Weekly via Twitter—at least she can be easily found on social media—but still got no reply.

Again, I don’t think either website provide a convenient way for readers to report such mistakes except for the comments. And this is also a problem of the digital age. Not every editor or writer will refer to trustworthy news sites as sources. Information is shared at an amazing speed. If one site makes a mistake, it’s very likely that many other sites will make the same mistake. In fact, this is how rumors spread as well.

Another point is that professional news sites (The New York Times, The Boston Globe) provide writer/editor’s contact information. It’s much easier for readers to report an error and for the news organizations to fix it. But many these smaller sites don’t act this way. As such, how could they correct the errors? I begin to wonder, if the error raises serious issues, will these sites ignore the errors or will they just delete the post?

But I want to share a positive feedback. There’s a Chinese SNS app called WeChat (Weixin). It’s similar to WhatsApp but it gradually develops more functions than live chatting. Users can subscribe to specific “public accounts” and receive news and information notification. Many mainstream Chinese media have develop their own WeChat account. It also allows you to send messages to the account coordinator using its original live chatting function. Some coordinators may reply to you.

When I was reading a story recalling the author’s life in Boston published by the account “Travellers’ Stories (LvRenShuo)”, I noticed the author wrote that Celtics is the ice hockey team in Boston.

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I sent a note to the account coordinator—I deleted the records so I couldn’t provide a snapshot here—and received a response soon. The coordinator said they already found out the mistake, but they could do nothing to change the published contents, but still thanked me for pointing out the error. I’ve heard similar complaints before so I knew it was the app system’s problem. But later the team sent a post in which they correct several errors.

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I was impressed. This shows the team’s attitude. And I think such public accounts are a good method to send the news because the app provides a way of communication, but the app has this shortcoming of not allowing to change published contents. I can only wish as the technology moves forward, it would perfect itself in the future.

How C-HIT covers health care news

When I was searching resources that could possibly help with my final paper on health and medical reporting ethics in China, I remembered that I once talked with Lynne DeLucia of the Connecticut Health Investigative Team on an assignment for News England Newspaper and Press Association last year. I checked its website again. It seems there is no specific ethical guidelines stated, but the contents on the “about” page can tell me a little bit about what they choose to report and how they operate the team. One of the team’s mission is as follows:

To fill a void in health, safety and medical coverage by producing a steady stream of news stories, many of them investigative, that focus on systemic problems within the healthcare system that affect real people – ie, the quality of care in hospitals, nursing homes, schools and other facilities; regulatory actions by government agencies; mental health treatment issues involving children and adults; and healthcare reform, including coverage of the insurance industry, the impact on consumers and the elderly.

The team’s policy on independence states C-HIT maintains editorial control of their contents. As an independent non-profit news organization, C-HIT’s board of directors vary from journalists to employees in the medical and health care fields. And the ethics policy says:

The Board of Directors provides expertise, guidance and operational support to C-HIT, but has no control or input into editorial decision-making.

This provides basic background information to my knowledge to medical coverage. It’s important to ensure the independence of reporting. What is of the interest to most people? When journalists cover events, maybe it’s also useful to think about what else should be paid attention to. C-HIT “may consider donations to support the coverage of particular topics, but…maintains editorial control of the coverage.” Mainstream news organizations are not bounded by donors, and it provides the opportunity to journalists to dig out more stories. For instance, I’ve read stories about doctors of urban hospitals regularly travel to rural areas to offer free medical diagnose and educate colleagues. As I read such stories, I wonder: what’s the condition of medical resources allocated to those areas? How can it be improved and what has been done or will be done to improve it? To me, these stories are of greater value than the ones telling the same event again and again, and they are more useful to the public.

C-HIT’s ethics policy on the organization structure is also very interesting. I assume most journalists are not experts in medical or health care fields. Journalists should consult professionals for their stories, but should also be cautious and avoid possible affiliation. Some may say only the professionals can provide accurate reporting because they know what they are reporting on, but even the related professionals can make mistake. Remember CNN’s Sanjay Gupta? For journalists without expertise in medical area, it’s impossible to avoid all mistakes, but they do have the responsibility to conduct researches and contact reliable sources.

Personal ethics guidelines (final)

It’s been a week since I wrote my personal ethics guidelines draft. I’ve read some interesting cases and had some meaningful–if not pleasant–discussion on Chinese social media. My thoughts hadn’t changed much. The ethics guidelines I follow in life come from all these years’ personal experience and what I learn from the media, and most of the journalism ethics guidelines I will follow are the same ones. Some codes like how independent I should be are different in the two conditions, though.

When knowing which four classic theories of ethics are, I almost discard Rule-Based and Ends-Based Thinking without hesitation. The reason is simple. I tend not to be too absolute, though I must admit thinking nothing but the result is quite tempting. As for the Golden Rule, I think it’s just too ideal to realize. (Shame on me—I didn’t recall any of Confucius’ theories when Bill first mentioned him. But to be fair, the word “Zhong Yong” has nothing to do with “golden,” so blame the translation.) When I first knew this way of thinking in middle school, I view it as my moral standard. But when I entered college, I found it as unrealistic as Newton’s Laws in an imperfect condition. Still, I will keep it in mind and wish that some day it’s more than just a theory.

I will basically follow Aristotle’s Golden Mean when I make ethical decisions, whether in journalism or in life. It is, by far, the most applicable theory in my point of view. I believe journalists often face dilemmas, and an alternative is important. I wrote a story and more people would know about the woman’s miserable life. But the authorities added pressure to my boss and threatened us. What should I do? When facing such situation, maybe I could write a fictional story for the metro page to alarm the readers. Sadly this is not true journalism. (I’m not sure if any US newspaper has these columns, but in China, some fictional stories will appear with things like crosswords and sudoku.) Lu Xun, the great Chinese modern writer, was an expert in this. I don’t see Confucius can provide much help in this case, and I would choose to keep the news organization running in order to do more reporting in the future. Yet, sometimes Aristotle doesn’t work, either. When you happened to see a bullet hitting someone in their heads, just shoot the picture, and may them rest in peace.

Here’s some codes I choose to follow as a journalist. They are from SPJ Code of Ethics and NPR Ethics Handbook. I’ll explain if some of them are different from the ones I follow in daily life.

1. Tell the truth and be responsible to the readers.

I would say this is the keystone to a news story. Otherwise there’s no difference between a news story and a fictional story. A journalist should be the witness and teller of the facts. Sometimes the truth may be cruel, but I can find alternate ways to show the facts. And I will ask myself to be responsible to the readers by showing the truth from various voices. If I’m going to tell the truth, I’m going to tell all the truth. I would  write the potential benefit to the society if a nuclear power station were to be built, but I would also include the potential harm it would do to the environment, and vise versa.

2. Respect people and minimize harm.

Before I’m a journalist, I am a human. But apparently journalist is not an occupation to make friends. I will try to respect all the stakeholders during interviews and when writing a story. As I said above, I’ll follow the Golden Mean and try to find a third way to minimize harm. Sometimes I doubt how much harm can be minimized if truth shall be guaranteed, but I’ll try anyway.

3. Act independently and be accountable.

In my personal life, I can be not that independent. I’m educated to help others as much as I can, and I’m not shy on relying on interpersonal relationships. But when I act as a journalist, I will try to build my source network but always keep a distance from them. Even I have a friend who’s an expert in computer science, I won’t consult with him/her for a story assignment. I won’t use other news stories as primary sources. I’ll never fabricate or plagiarize. Once I figured out one of my ex-friend plagiarized when writing a fiction, and I felt deeply betrayed. Always remember why I choose journalism in the beginning.

4. To be as fair as I can, and keep it transparent.

This is somewhat similar to the debate of the Golden Rule and the Golden Mean. And again, absolute fairness is almost impossible, but I’ll be as fair as I can. I will make sure all the documents in the stories can be traced, and use people’s full names when I quote them. The exception may be when exposing the sources’ names may result in threats to them. Otherwise I tend not to use anonymous sources, and I’ll explain briefly whenever I quote someone anonymously.

5. Be accurate.

I can’t promise I will spell every word correct in my stories, but I’ll do my best, especially when I spell someone’s name. It’s good if I’m familiar with what I’m reporting on, but human’s memory can’t be trusted forever. I’ll check the facts with reliable sources in a specific area. Nowadays it seems everything can be Googled, but I’ll keep away from online information, especially Wikipedia. I may read a Wiki but when I want to refer to something, I always drag to the bottom and find the original reference.

Final paper snapshot

For the final paper I plan to take a look into the medical and health reporting in China from an ethical perspective. The major case discussed in the paper will be a report of the Southern Weekly by Chai Huiqun. In Shenzhen 2010, a women’s anus was allegedly sewn by a midwife after the child delivery. The midwife denied it. The truth is still unclear. The case received wide media coverage in Shenzhen and Guangdong Province. Among all the coverage, Chai became the most disputable journalist for his deep investigative story for the Southern Weekly. CCTV’s Wang Zhian investigated into it and concluded that the story was biased and based on presumption and lack of information from the hospital side.

Chai has also done several pieces of health coverage, including exposing the corruption of a hospital in Mianyang, Sichuan. Recently he is involved in a lawsuit against the Chinese China Medical Doctor’s Association. Meanwhile, the public’s attitude was divided into supporting and questioning. Chai’s supporters believe that he expose what needs to be known. The opponents question Chai’s credit after the 2010 case.

Here comes the interesting question: What should be taken care of when doing a medical and health coverage? Whose voice should a journalist listen to? What are the relevant ethical strategies?

The voices from both the patient and the hospital are no doubt necessary. However, what kind of information is allowed to be released by the hospital? If the hospital doesn’t follow the rule of transparency and refuse to provide non-confidential information, what could a journalist do to pursue the truth? When a journalist fail to obtain information from the hospital side, is it a lack of fairness to write a story? And to what extent should a journalist rely on official statement to ensure not losing the independence of reporting? If a journalist tries to follow the code of minimizing harm, who are the stakeholders? What should the journalists pay attention to and avoid intensifying the patient-doctor relationship?

I plan to read relevant media reports and discussion for the final paper. I will also try to contact Michael Woodhead, the writer of the independent site China Medical News. If possible, I will try to reach to a medical staff member for the opinions from another side.

Not a model, but a victim

One of the hottest topics on Chinese social media these days is about a woman named Gao Yanmin. She’s a victim of human trafficking. She was abducted in 1994 and was human trafficked to a rural village in Hebei Province. But recently, “many netizens believe that it is not appropriate for certain media to focus on Gao’s contribution as a teacher in rural areas, but the first matter to be questioned should be her status as an abducted woman.

It’s not difficult to understand why the public—at least most of them—are irritated. Gao tried to escape and commit suicide but failed. Later she became a teacher in the village and was nominated for a “Touching Hebei” award. Her story was widely reported and made into a movie in honor of her sacrifice. All these happened years ago when social media was not a popular media for news reading and discussion. Somehow one of the articles and the movie was brought up about a week ago—they literally appeared from nowhere—and raised the public’s rage towards the media, the villagers, local government and law enforcement authorities.

I feel ashamed for the news organization. Everything in the article is truth. It could have been another ordinary event coverage story if not for the facts accidentally or on purpose excluded. To tell the real truth and to be fair, a news organization should have at least included as much contents of the abduction as those of the award nomination. Even so, the story have lost its core value.

But I also feel sorry for the news organization. The key to the case is that the organization had no media independence. And it’s not a problem of a single organization. In China, there have always been some invisible rules that what can be reported and what cannot. When news organizations and the whole journalism field are not independent from other authorities, how could the media report the truth and how could they win readers’ trust?