A Fight Between Facebook And The British Medical Journal Highlights The Difficulty Of Moderating 'Medical Misinformation'

from the what-a-disaster dept

There are multiple efforts under way in the US to pass laws that require social media sites to take down "medical misinformation." As we've described repeatedly, these are really dangerous ideas. Bills like those from Senators Amy Klobuchar and Ben Ray Lujan seek to force social media to remove medical misinformation as declared by the Ministry of Truth... er... Secretary of Health & Human Services. Of course, it was not all that long ago that we had an administration that was actively anti-science, and wanted to declare anything that made the president look bad as "fake news."

Also, in the midst of a pandemic, when the data and the science are rapidly evolving, what might seem reasonable at one point, may later turn out to be misinformation -- and vice versa. Forcing down misinformation leads to all sorts of dangerous consequences. Hell, we saw this in China, where such a law was used to silence a doctor who tried to raise the alarm about COVID-19, and was forced to apologize for spreading "untruthful information online."

But there's another aspect of this which people rarely try to deal with: content moderation involves a lot of very gray areas and an awful lot of context, much of which may not be immediately obvious. An ongoing war of words between the former British Medical Journal (now just "The BMJ") and Meta/Facebook demonstrates nicely just how impossible it is to claim that "medical misinformation" must be taken offline. There's a bit of background here, and it's a, well, touchy subject, so try to go through the whole thing before you react.

First off, the BMJ is not, in any way, anti-vaccine. Somewhat famously, the BMJ was a key player in exposing the fraudulent behavior of Dr. Andrew Wakefield, whose fraudulent study created the modern anti-vax movement. That said, in November, The BMJ published an investigative journalism piece, based on a supposed "whistleblower" suggesting that there was some data integrity issues with the way Pfizer's vaccine was tested, specifically involving a research partner of Pfizer, Ventavia Research Group.

Ventavia responded to the allegations by noting that the supposed whistleblower in question had raised the issues a year earlier, and they were investigated and found to be unsubstantiated. That said, many reasonable people noted that this should be further investigated and worried that it might lead to further damaging the public's trust in science.

But, of course, you can fully predict what happened next. It didn't just "damage the public's trust in science," the BMJ article instead was instantly championed by all of the big anti-vax voices all over social media as "proof" that the COVID vaccine was dangerous and rushed into approval -- key talking points among that crowd, repeated despite tons of evidence that the vaccine is both incredibly effective and incredibly safe.

This resulted in Lead Stories, a fact checking organization, to fact check the article, and slap it with a "missing context" label, and calling into question the way that people were interpreting the article:

Did the British Medical Association's news blog reveal flaws that disqualify the results of a contractor's field testing of Pfizer's COVID-19 vaccine, and were the problems ignored by the Food & Drug Administration and by Pfizer? No, that's not true: Pfizer and the FDA were made aware of the allegations about the contractor in 2020. Medical experts say the claims aren't serious enough to discredit data from the clinical trials, which is also what Pfizer and the FDA say they concluded. The FDA says its position is unchanged: The benefits of the Pfizer vaccine far outweigh rare side effects and the clinical trial data are solid.

Because of this fact check and because of the way the article was being used in a misleading way by thousands of anti-vaxxers, users who tried to share The BMJ article were flagged with fact check warnings saying: "Missing context ... Independent fact-checkers say this information could mislead people," which is accurate, but incomplete, and very dependent on the context of who was sharing it and for what purpose.

The BMJ kinda flipped out about this and published an angry open letter to Mark Zuckerberg (who, I assure you, had nothing to do with the decision on the fact check and flagging). To be honest, I find the BMJ's anger here completely disingenuous. They act like they don't understand at all why Lead Stories highlighted the "missing context" point on their story, when -- of anyone -- the BMJ should be willing to acknowledge how their own article was being weaponized by ignorant anti-vaxxers.

But from November 10, readers began reporting a variety of problems when trying to share our article. Some reported being unable to share it. Many others reported having their posts flagged with a warning about “Missing context ... Independent fact-checkers say this information could mislead people.” Those trying to post the article were informed by Facebook that people who repeatedly share “false information” might have their posts moved lower in Facebook’s News Feed. Group administrators where the article was shared received messages from Facebook informing them that such posts were “partly false.”

Readers were directed to a “fact check” performed by a Facebook contractor named Lead Stories.[2]

We find the “fact check” performed by Lead Stories to be inaccurate, incompetent and irresponsible.

-- It fails to provide any assertions of fact that The BMJ article got wrong

-- It has a nonsensical title: “Fact Check: The British Medical Journal Did NOT Reveal Disqualifying And Ignored Reports Of Flaws In Pfizer COVID-19 Vaccine Trials”

-- The first paragraph inaccurately labels The BMJ a “news blog”

-- It contains a screenshot of our article with a stamp over it stating “Flaws Reviewed,” despite the Lead Stories article not identifying anything false or untrue in The BMJ article

-- It published the story on its website under a URL that contains the phrase “hoax-alert”

We have contacted Lead Stories, but they refuse to change anything about their article or actions that have led to Facebook flagging our article.

The BMJ open letter also gets unnecessarily snarky (which also seems out of character for a prestigious medical journal):

Rather than investing a proportion of Meta’s substantial profits to help ensure the accuracy of medical information shared through social media, you have apparently delegated responsibility to people incompetent in carrying out this crucial task.

That's ridiculous. Clearly this is a difficult situation. Even if the reporting was accurate -- there is crucial context here. Did the revelations support the claims of anti-vaxxers who were using it as evidence that the Pfizer vaccine was not safe? The answer is no, it did not. And there's a strong argument that The BMJ could have and should have made that point a lot clearer in their own reporting, recognizing how the article would be weaponized by grifters and fed to the ignorant.

Lead Stories then responded to the BMJ, in fairly great detail, more or less saying "you can't honestly be that naïve."

It is ironic to read that BMJ.com objects to the headline on Lead Stories' fact check of a BMJ.com article when the original BMJ piece carries a scare headline that oversells the whistleblower and overstates the jeopardy. Their November 2, 2021, headline "Covid-19: Researcher blows the whistle on data integrity issues in Pfizer's vaccine trial" is the reason BMJ.com's article has appeared in hundreds of Facebook posts and tweets, many by anti-vaccine activists using it as "proof" the entire clinical trial was fraudulent and the vaccine unsafe.

Lead Stories also points out that The BMJ's headline to its article is extremely misleading, as it can be read to say that there were data integrity issues with the entirety of the Pfizer vaccine test, rather than 3 sites out of 153, and then also highlights that the whistleblower in question is not a scientist who is an expert on this. It also notes that the whistleblower appears to have some... questionable beliefs and associations regarding vaccines:

The BMJ.com article eventually gets around to saying she worked at the lab for just two weeks. But BMJ's open letter fails to mention important context: The Brook Jackson Twitter account agreed with leading COVID misinformation-spreader Robert F. Kennedy Jr.'s criticism of the "Sesame Street" episode in which Big Bird encourages kids to get a COVID-19 vaccine. "Shocking, actually." she wrote in a November 9, 2021, response to a Kennedy tweet blasting Sesame Street (archived here). Elsewhere on Twitter, the Brook Jackson account wrote to a vaccine-hesitant person that vaccination makes sense if a person is in a high-risk category. When the U.S. 5th Circuit Court of Appeals ruled against a federal employee vaccine mandate, she tweeted "HUGE!" and not with a frowny emoji.

Lead Stories talked to Jackson, looked at available documents (after BMJ refused to permit us to see their basis for the story and did not make the documents available on a transparency site). Unlike BMJ.com, Lead Stories then tested Jackson's assertions with Pfizer, with the lab contractor in question and with the FDA and then published their responses. It's not at all clear yet whether there are data integrity issues if you ask the other stakeholders, and that's the crucial missing context. We also talked to experienced medical researchers for perspective, one of whose credentials BMJ editorial staff demeaned for reasons we can only imagine.

By talking to Ventavia, we contributed context BMJ.com missed: Ventavia said the whistleblower had not worked on the Pfizer trial, but Lead Stories set that straight by embedding in its story a copy of a letter, provided by Jackson in which she was expressly welcomed to the Pfizer trial team. That's what we mean by context.

The BMJ has thus far failed to document what is "inaccurate" in the Lead Stories fact check, but again oversells by using that and other name-calling to vent frustration at our documentation of obvious missing context

All of this involves an awful lot of judgment calls, understanding of context, and a lot more. But under a law that requires the pulling down of medical misinformation, how the hell would anyone handle this kind of scenario? The BMJ story isn't wrong per se, but there is a lot of important context that seems like it's missing (which Lead Stories highlighted above). On top of that, there's all the important context around how people are using the article and stretching an already weaker-than-it-seems story to pretend to be a lot more damning on the overall vaccine.

In other words, how the article is being represented and used is an important piece of context as well. And this is frequently the case with medical misinformation. People will take something that is factual or accurate, and present it out of context or in a misleading light, in order to make an argument that doesn't support it. So which part is the "misinformation" and how do you police that?

In an ideal world, we'd be able to see all the details and the back and forth, and figure it all out. Frankly, when I first heard about this -- via The BMJ's open letter -- I initially thought that the details would support The BMJ, and that Facebook mislabeled something (which, of course, happens all the time because of the old Masnick Impossibility Theorem). It was only after reading multiple articles on both sides of this, and going through the details of Lead Stories' process, that I realized that they had (to me) a much stronger argument, that there's an awful lot of important context that is missing from The BMJ piece that you would hope a journal like that would have considered before publishing the article the way in which it did.

But to expect every social media platform to be able to determine this on every piece of medical sharing out there is next to impossible -- and putting legal liability on top of it, as Senators Klobuchar and Lujan want to do -- would be dangerously impossible.

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Filed Under: content moderation, context, covid, fact checking, health, health misinformation, journalism, misinformation, reporting, vaccines
Companies: facebook, lead stories, meta, pfizer, the bmj