The U.S. surgeon general and other federal officials charged with protecting public health bear an obligation to ensure that people receive medical information that is supported by scientific evidence. With this responsibility comes the imperative to actively counter those voices deliberately spreading disinformation—or unintentional misinformation—about vaccines and other health issues to preserve public health and save lives.
The need to balance this imperative with First Amendment rights is at the heart of a case now pending before the U.S. Supreme Court. In Murthy et al. v. Missouri et al., multiple plaintiffs, including the attorneys general of Missouri and Louisiana, contend that several federal agencies as well as the Biden administration engaged in censorship by asking private social media platforms to remove medical falsehoods. The lawsuit was filed in May 2022 and oral arguments were held March 18.
In an amicus brief (PDF) filed with our nation’s highest court, the AMA and four other medical associations (the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, and the American Geriatrics Society) focus on a single legal question: Does the government have a compelling interest in combating vaccine misinformation? We believe it clearly does.
Efforts to strip away outright falsehoods about vaccines in favor of documented scientific evidence of their safety and efficacy are nothing new for the AMA and our partners. Well more than a century ago, the AMA helped lead the fight to end the harm patients were suffering from falsified medical products, snake oil elixirs and other miraculous “cures.” We have always strived to stand with science and evidence, wherever it leads. Deliberately spreading false health information that harms public health can be compared to falsely shouting “Fire!” in a crowded theater.
However, the political polarization that grew in tandem with the COVID-19 pandemic exacerbated the misinformation problem by fueling vaccine hesitancy and stiffening resistance to public health measures proven to slow the spread of infectious disease.
Vaccines have long been one of our safest and most powerful tools in protecting public health, a main reason why the AMA offers vast resources promoting vaccine uptake. Vaccines save lives not only by protecting vaccinated individuals against severe health outcomes such as hospitalization or death, but also by preventing the spread of vaccine-preventable disease among both the vaccinated and unvaccinated. Food and Drug Administration-approved and Centers for Disease Control and Prevention-recommended vaccines are safe and effective, with multiple systems in place to help scientists monitor their safety over time. Widespread vaccine uptake also reduces the overall burden placed on our health care system.
Some of the misinformation spread by anti-vaccine groups and individuals (for example, that some people receiving the COVID-19 vaccine became “magnetized”) was not based founded scientific evidence, however many chose not only to believe these baseless claims but to further propagate them as well.
Meanwhile, a recently published study estimates that nearly 17,000 hydroxychloroquine-related deaths occurred across six nations during the initial wave of the COVID-19 pandemic after people took that an antimalaria agent that was wrongly promoted to treat COVID-19. Additional clinical research quickly demonstrated that hydroxychloroquine was not only ineffective against treating COVID-19 but heightened the risk of death in those who took it.
YouTube bans medical misinformation
Officials at YouTube landed a solid punch in the fight against medical misinformation last August by banning content that contradicts health authority guidance on treating or preventing health conditions, as well as content that promotes harmful substances or practices and content that denies or disputes the existence of specific medical guidance and facts.
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“Our goal is to ensure that when it comes to areas of well-studied scientific consensus, YouTube is not a platform for distributing information that could harm people,” according to a blog post co-written by Garth Graham, MD, a former U.S. deputy assistant secretary for health who now leads YouTube Health. This policy update by YouTube—the popular video-sharing website that specializes in user-generated content—is a welcome example of development that other platforms, particularly social media sites, would do well to implement.
While we continue to hope that the worst of the COVID-19 pandemic is behind us, the need to share accurate health information rooted firmly in evidence-based medical science is greater than ever. The huge amount of misinformation we experienced during the COVID-19 pandemic played a role in the vaccine-preventable death toll in the U.S. while sowing distrust in science, organized medicine and public health institutions that persists to this day.
Going forward, this lack of trust will impede our ability to mount an effective response to the next health crisis. Countering those voices who spread easily disproven and blatantly false information online is the first step in regaining trust in medical science and public health. We will continue to urge technology companies and social media organizations to evaluate and refine existing policies against medical misinformation to ensure those policies are as comprehensive and effective as possible.
Physician responsibility
Sadly, I must acknowledge that a very small number of licensed physicians played a role in spreading disinformation before, during and after the pandemic, which is a blatant violation of the ethics of our profession. Their actions are particularly damaging in that they undermine the trust that exists at the heart of the patient-physician relationship, and also serve to diminish the public confidence in medical institutions and public health agencies.
Physicians and other health professionals are trusted messengers that patients rightfully rely upon for accurate, timely, evidence-based medical guidance; the spread of disinformation by a few has negative implications for us all. The AMA seeks to ensure that licensing boards have the authority to take disciplinary action against health professionals for spreading health-related disinformation.
Stopping the spread of medical misinformation and disinformation online is an enormous task, and we cannot expect any single entity to accomplish this challenge. Those of us who have taken an oath to protect the health and well-being of patients share the responsibility to help them separate fact from fiction. Abdicating that responsibility puts the health of our communities—and our nation—at risk.
We must work together to create a common understanding of medical science and shared facts that empowers our patients to make informed decisions about their own health and the health of those they love.
Editor’s note: Dr. Ehrenfeld also co-wrote, with American Academy of Pediatrics President Benjamin D. Hoffman, MD, a MedPage Today “Second Opinions” column on this topic, published March 25.
