Whose community is being benefitted?

Citation

Birnbaum, D. and Decker, M. (2019), "Whose community is being benefitted?", International Journal of Health Governance, Vol. 24 No. 4, pp. 241-243. https://doi.org/10.1108/IJHG-12-2019-080

Whose community is being benefitted?

Engagement and accountability with your community is the theme in this issue, and there is no denying that virtual communities are and will remain a significant political reality. Drawn together by common interests and philosophies, members of virtual communities share information and messages of support on web sites provided by companies that report tens of billions of dollars in annual profit. Since it has become evident that corporations like Facebook earn their profit from third parties, not from virtual community members themselves; have been unable or unwilling to prevent the spread of damaging deliberate misinformation content on their platforms; and in expanding their corporate value to third parties they have on several occasions violated the privacy of millions of their virtual community members; regulatory agencies in the European Union and the USA have started taking action through fines and proposed regulation. It is crucial to ask whose community is being benefitted by social media, and to what extent are communities being harmed. Case in point: vaccination advice.

Leading policy and law makers in the UK (Lomas, 2019; Pym, 2019), USA (Najera, 2019) and elsewhere are applying pressure to social media corporations so that false and misleading anti-vaccination information should not continue to receive prominence on these virtual community distribution channels. Good governance often requires making difficult and sometimes unpopular decisions in order to maintain a community’s health when the best available scientific evidence contradicts popular viewpoints. However, one consequence of the populist political movement has been a backlash against political leaders who oppose the anti-vaccination movement on scientific grounds (e.g. in Italy; Broder, 2019). In the USA, following widespread criticism by scientists, public health and medical professionals against President Trump’s proposal to form a commission on vaccine safety and scientific integrity chaired by a vaccine skeptic (Anon, 2017), then apparent lack of action to form that commission (Smith, 2018), anti-vaccine advocates launched an effort on Facebook to “Inundate the CDC ACIP Meetings” (Wadman, 2019). Accounts of the meeting exchanges are disheartening (https://respectfulinsolence.com/2019/02/28/antivaxers-inundate-the-advisory-committee-on-immunization-practices/). Andrew Wakefield, the disgraced former UK gastroenterologist who left the UK after his falsified research against vaccination was discredited, is quoted as stating while attending one of President Trump’s inaugural balls “What we need now is a huge shakeup at the Centers for Disease Control and Prevention (CDC) – a huge shakeup. We need that to change dramatically” (Boseley, 2018).

The World Health Organization has identified vaccination hesitancy as one of today’s top ten threats to global health (WHO, 2019). In this journal’s 2017 theme issue on “Vaccine-preventable diseases: organizational issues and challenges,” one of the articles (Attwell and Smith, 2017) made the case that members of a social identity group will selectively accept or reject information based upon whether that evidence is consistent with their identity-group beliefs or not. In short, those members value tribal identity to the extent that simply providing factual education to counter misinformation will not cause all of their vaccine-hesitant community members to change. Given the ease and effectiveness of reinforcing such communities through social media platforms, this raises the question of whose community is being benefitted by the platform products of the for-profit corporations. Several countries have experienced a decrease in immunization rates followed by an increase in outbreaks of vaccine-preventable diseases such as measles that threaten the well-being of many who cannot be vaccinated due to infant age or medical contraindication. Unable to stop the promotion of misleading anti-vaccine information readily found on the internet, several jurisdictions subsequently introduced legislation to require either disclosure of mumps-measles-rubella vaccination status for school entry or initiated mandatory vaccination programs, measures that come with political costs. Understanding the levels and drivers of public support for these and other policy options in specific communities is beneficial (Bettinger et al., 2019).

Shareholders in the social media corporations, executives of the corporations, members of virtual communities, and affected societies as a whole all are stakeholders in the question of whose community is being benefitted. An ethical construct should guide the governance of social media platforms and their corporate providers, and there is little in the broad categories of ethical theory (deontology, utilitarianism, rights and virtues) that would seem to support a minority holding any privileges to sow misinformation that harms many others. While foundational documents like the American Constitution and Bill of Rights protect freedom of speech, deliberate false statement of fact is not necessarily constitutionally protected free speech. A series of US Supreme Court cases establish that “False statements that are on matters of public concern and that defame public figures are unprotected if either the speaker has knowledge that his statements are false, there is a negligence in the statement, or there is ‘actual malice’ to inflict harm” (https://en.wikipedia.org/wiki/False_statements_of_fact). Thus, there may be a legal framework (slander, libel, fraud and criminal liability) to enforce an ethical construct in this matter. Those who espouse or distribute an injurious false statement of fact should not be the community benefitted by social media platforms, and governance of the corporations providing those platforms clearly has not been adequate.