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The Ombudsman Column

Pumping the Heart

Being a senior citizen, as well as an ombudsman, I watched the just-concluded PBS three-hour, two-part series, "The Mysterious Human Heart," with an extra dose of interest. Even if you are feeling pretty good, these things always seem scary, triggering thoughts and mental images about what is going on in your arteries. When it was over, I felt somewhat reassured, not that I was healthy but that I had, even before watching the program, a general understanding about both the organ and the disease that afflicts and kills so many of us. So the series, for me, had a reaffirmation effect. But it went beyond that and struck me as an intelligent, informative and well-presented update on where things stand. The kind of thing that PBS does so well.

What I didn't do at the time, yet should have in my ombudsman's role, was pay much attention to the main sponsors of the series — Medtronic, a medical technology firm; AstraZeneca, a pharmaceutical company; and Mars, a leading snack food producer. But PBS has alert viewers and the day after the first two parts aired on Oct. 15, Bruce Halford of Stockton, N.J., wrote to say:

"Medtronic's role as a principal underwriter of 'The Mysterious Human Heart' seems to violate PBS' perception test for program funding. In Episode 2 of the series, viewers are told that the best treatment for certain potentially deadly heart arrhythmias is an implantable pacemaker. Who's the leading manufacturer of such devices? Medtronic, of course. But viewers are never told about potential problems with those devices, including the ironic and troubling story that broke the same day as this episode premiered: Medtronic reported a number of patient deaths among pacemaker recipients, deaths attributed to faulty wire leads. Just today, (10/16/07), the New York Times reports that patients with Medtronic pacemakers face a scary dilemma: replace the leads, which may or may not be faulty; or, do nothing, and wonder whether the leads will fail. In addition, viewers of the episode are not informed about possible financial ties between the series' on-camera experts and Medtronic, or with another major underwriter, AstraZeneca, which markets a full line of drugs for cardiovascular problems. No question, securing funding for this kind of series is a major challenge. But what's happened to PBS' pledge to prevent a blatant corporate tie-in from compromising the editorial content of such a high-profile project?"

There's a lot of he said/he said/she said/he said that follows in this column, but it's all interesting and important when thinking about PBS and where it gets the money to fund certain programs.

Now, Heeeere's Jeffrey

The next day, Jeffrey Chester, director of the Center for Digital Democracy, and an ever-vigilant observer of PBS funding arrangements, wrote to ask "how PBS (and presenting station Thirteen/WNET in New York) sought and publicly promoted the involvement of Medtronic and AstraZeneca as underwriters? As you know, both Medtronic and AstraZeneca have major commercial interests involving heart disease related medical issues, through technology and pharmaceuticals respectively. One of the episodes, called 'The Silent Killer,' describes how 'America is facing a deadly epidemic.' It then describes how 'treatment and prevention are critical.' This promotional video for the show highlights how various treatment approaches can 'modify your destiny.'

"The press release issued by Thirteen/WNET for the series, as well as the online 'Outreach Toolkit,' conveys [rather elaborately] the interest of these underwriters as 'driven by individual corporate missions of fostering heart-healthy goals.'

"But missing from the glowing approbation by PBS and WNET in the release, and what should be prominently featured as well in the series," Chester continued, "is any discussion of the serious health-related risks from Medtronic and AstraZeneca products . . . We believe that the involvement of these two heart-related commercial entities illustrates disturbing flaws in the PBS underwriting guidelines. PBS programming should not be supported by any concern that has a stake — either financially or politically — in the editorial content of the show or series. Whatever the positive merits of the series, and the well-intentioned goals of its producers, having two leading heart-related business concerns financially support the show helps transform it into a public media form of program-length commercial. I urge you to convey to PBS and its producing stations that seeking or securing underwriting support from commercially-interested parties should be prohibited."

Chester also requested "that you urge PBS to immediately revise its promotional materials for the series, including its 'toolkits,' in order to explicitly clarify that these underwriters have a financial stake in the matters covered. The series website and materials should also prominently discuss the recalls and controversies related to the two companies and their heart-related products. The program should also be re-edited for future broadcasts and video sales in order to ensure that viewers are well informed about these conflicts and product problems. PBS must always be an independent and honest provider of news and information. It should not issue press releases glossing over problems or ignoring conflicts of interest."

Talk About Timing!

I'll come to PBS's response, and then mine, in a moment. But first, there is no denying that the timing of this series turned out to be pretty bad, at least for those who were paying attention.

As both Chester, whose letter included additional material, and the New Jersey viewer pointed out, on the day after the series began, Dow Jones, the New York Times and the Associated Press reported that Medtronic Inc. "decided to pull the 'Sprint Fidelis' brand of leads for defibrillators . . . because they are prone to fracturing and potentially causing major problems. The issue may have contributed to five deaths, Medtronic said," according to the Dow Jones report. And the AP reported that "hundreds of injuries linked to a brand of heart defibrillator wires were reported to the government by last winter," and quoted a consumer advocate who asked why the wires weren't recalled until last week.

As for AstraZeneca, Chester reminds us about a Food and Drug Administration warning in 2005 about the cholesterol drug Crestor that the firm produces.

PBS, Thirteen/WNET and the Producer Respond

I first asked PBS and the presenting station, New York's Thirteen/WNET, about Chester's criticisms and got the following response from William Grant, director of science, natural history and features programs at WNET:

"David Grubin Productions (the producer of the series) and Thirteen/WNET were able to secure three funders to cover the cost of production, publicity, outreach and web site for the Mysterious Human Heart. The three — AstraZeneca, Medtronic and Mars — produce a wide variety of products including pharmaceuticals, medical devices and confections. While all three of them produce products designed to promote a healthy heart or to treat heart disease, none of their products were highlighted in the series and none of the companies had any editorial involvement in the series whatsoever.

"At Thirteen/WNET we carefully adhere to the established PBS funding guidelines and are careful to preserve the firewall between program production and funding. But it is important to note that the final say on who is permitted to fund a PBS program is PBS itself. In this case the three funders were approved by Marcia Diamond at PBS, and you may also want to talk with her."

I took Grant's advice and asked Diamond, who is a senior director for program underwriting policy, about Chester's critique. And I also asked, "Was PBS aware of the long-standing problems and, if so, what was the reasoning to accept funding from Medtronics? One has to be aware of Crestor and its history, so how was that rationalized as okay for funding? Should any references to these problems, or explanations about why these are still suitable funders, have been mentioned or included somewhere in the film or back-up material? What are the guidelines that would allow firms with a clear product stake in a subject to be funders?"

Diamond's response follows: "This program has been in the works for about 5 years. AstraZeneca and then the Medtronic Foundation made their underwriting commitments to this project in 2002 and 2003. Two more funders were secured after that, The Fannie E. Rippel Foundation [focused on health care], and Mars in 2006. PBS set the schedule for 'Heart' five months ago. Neither WNET nor the funder had any part in setting the air date."

She also sent along Producer "David Grubin's direct response to your questions."

"The Mysterious Human Heart," Grubin wrote, "was never meant to be an investigation of the pharmaceutical or medical device industry. Put simply, it is an effort to dramatize for our viewers how the heart works and how best to take care of it according to the most current medical standards and practices. Nowhere do we advocate medical devices or drugs or procedures that are not in accord with the most stringent medical guidelines. And, of course, nowhere, do we even mention, let alone trumpet the virtues of any corporate brand. Certainly, none of our funders had any input whatsoever into the making of our series.

"Pacemakers, heart assist devices, anti-statin drugs are all indeed part of the best contemporary medicine. But our emphasis, especially in 'The Silent Killer,' is on prevention: diet, exercise, stress reduction — a 'healthy life style.' If there is any 'treatment' that today's cardiologists advocate above all others, it's 'lifestyle,' and that's the main point of our series . . . According to our research, there is indeed a world wide epidemic of heart disease. The goal of our series was to explore what modern medicine is doing to prevent its spread, and what each of us can do to keep our own hearts healthy."

My View, from the Heart (Gut)

Grubin is a respected, Emmy Award-winning producer and I think he and Grant provide some key assurances for viewers, namely that the films do not "trumpet" any corporate brand and that "none of our funders had any input whatsoever into the making of our series," as Grubin put it.

But the responses, especially from PBS, do not address the real conflict, criticism and questions at issue here.

This program, and the criticisms of Chester and Halford, once again put the spotlight on what has been a continuing source of viewer questioning and complaint about several PBS-supported and promoted programs — the seeming inappropriateness of funders for a number of programs and the residue of doubt that leaves in the mind of some viewers even though one may not see or sense any hint of influence.

In my almost two years here it has come up repeatedly — in documentaries about child abuse cases and about Las Vegas, in films about the Armenian Genocide and the U.S. Marine Corps — and been mentioned in numerous ombudsman's columns.

It may be that this problem is never going to be resolved until some different funding scheme for public television is arrived at that can truly isolate it from even the appearance of influence from some of those who put up the money, meaning those others out there beyond the proverbial "viewers like you," some government funding and some of the less advocacy-oriented foundations and donors. There is no doubt, as Halford said in his letter, that "securing funding for this kind of series is a major challenge." Indeed, I accept the fact that raising money, period, for a whole raft of programs is exceedingly difficult and at times involves close calls between presenting programs on important subjects and sponsor associations. And, as Chester says, there are these issues whatever the "positive merits to the series" and "well-intentioned goals of its producers." Here, too, one can also accept that the companies involved have good intentions.

Nevertheless, even though I watched this series and felt it was within the spirit of good and informative public television, without any sense of commercialism, I agree with the central points raised by Chester and Halford. It is hard to imagine what goes through the minds of officials when the history of problems encountered by two of the main funders of this series goes back two years. As PBS points out, this program has been in the works for five years and the funding commitments go back to 2002 and 2003. Yet there are ways to update and inform about subsequent events, especially with ancillary press releases and Web material that could address some of these developments. But there was not a whiff of this.

The 'Perception Test'

In looking over PBS's own guidelines for "Funding Standards and Practices," the section labeled "Perception Test" pretty well nails this issue down.

Here's what it says, in part:

"Therefore, even if the public television professionals know that programs have not been inappropriately influenced by program funders and therefore would be acceptable under the editorial control principles set forth above, steps must also be taken to avoid the public perception that program funders have influenced professional judgments. Should a significant number of reasonable viewers conclude that public television has sold its professionalism and independence to its program funders, whether or not their conclusions are justified, then the entire program service of public television will be suspect and the goal of serving the public will be unachievable . . .

"In general, the perception test will be applied most vigorously to current affairs programs and programs that address controversial issues. In these cases, when there exists a clear and direct connection between the interests or products or services of a proposed funder and the subject matter of the program, the proposed funding will be deemed unacceptable regardless of the funder's actual compliance with the editorial control provisions of this policy."

And here is an example offered in the PBS guidelines that also comes eerily close to this actual situation:

"Similarly, a nonprofit organization whose mission is to eradicate heart disease or to raise money for leukemia research could not fund a program designed to educate the public about these respective illnesses. Again, even though the program may not contain controversial subject matter, and even though there might be few who would criticize the goals of these organizations, a reasonable segment of the public might readily conclude that the program was created solely to promote the interests of the funder."

One of the frustrations ombudsmen face is that there is often no way to know whether there are "a significant number of reasonable viewers" reaching the conclusions that observers like Chester and Halford reached in this case. Sometimes lots of people write. At other times, just one or two or a handful does so. But the issue is the same and, although the real numbers are unknown, the risk factor for PBS credibility — whether fair or not — is almost certainly real.

Letters on Other Topics

The biggest surprise in the letters both pro and con re Cheney's Law is the commentary on media bias and applause for same. Viewers don't seem to recognize the fundamental behavior that accounts for all these remarks. We are all prisoners of our learning history, our predispositions, based on the social-psychological demographic variables that influence us all, i.e., peers, church, school, parents, location, socio-economic status, etc. We all come to the media setting with built-in biases, a set of goggles through which we interpret events. Conclusion: The audience is more slanted than the media! No wonder folks can see the identical presentation and arrive at dramatically different conclusions. It's much easier to point the finger elsewhere. I have no question re your journalistic integrity. I question those who question yours.

Manny Lucoff, Gainesville, FL

I watched the Frontline program about Iran and again I was not surprised at the propaganda. John Bolton was identified as a "conservative"! Bolton is part of the Institute for National Security Affairs, the Project for the New American Century and is a vice-president at the American Enterprise Institute. That hardly qualifies him as a "conservative". He is a hard-core neocon. With Rumsfeld, Wolfowitz, Khalilzad, Bennet, Woolsey, Perle and Kristol, Bolton co-signed a letter in 1998 urging President Bill Clinton to take military action in Iraq. After watching the program, I was left with the distinct impression that the filmmaker thought bombing Iran would be a rational thing to do, and would entail only minimal risk! Bombing Iran would be insane and might provoke World War Three. The film also implied Iran was actively working on developing nuclear weapons! I recall that PBS made the same allegations about Iraq before it was invaded and those allegations turned out to be false.

H.H., Chicago, IL

I just watched the Wired Science episode on meteorite hunters online. I'm not sure, if this is the full version of what will be on air tonight, but I think it's really too bad that this is going to be aired not on any other station, but on PBS!!! I wasn't aware that "meteorite hunting" is actually a science, I would rather see it as a business. The scientific value of this show I would say equals zero. I am a Ph.D. student in the Department of Earth and Planetary Science and I am studying meteorites. It makes me sad to see that PBS is supporting meteorite hunters who become millionaires by selling the valuable rocks they find, rocks that could be essential for our research.

I must say that some meteorite hunters work fairly closely with the scientific community, they let us classify the meteorites they find, give us a little piece for our collection and our research and we give them a certificate that they can give their customers together with the rock basically saying that it is a real meteorite. I think that with this documentary you are not only supporting people to go out there and dig, but to keep the findings for themselves or even worse to make money with them! This documentary is clearly not about professional science.

If you watch or watched the show: How much did you actually learn about meteorites? Can you answer these questions: Where do meteorites come from? Why are they different from terrestrial rocks? How can we tell that they are that old? How do we determine their age? How do we know that pallasites probably come from a core-mantle boundary and that iron meteorites come from the core of an asteroid?

Also, there was no mention about meteorites that don't contain iron-metal (e.g. Martian meteorites) or meteorites that have not experienced melting and differentiation. And just for the sake of it: An iron meteorite should not be called a "siderite". Siderite is a mineral — an iron-carbonate with the formula FeCO3: In that half hour or so, people could have learned so much more about meteorites! Seriously!

Jana Berlin, Albuquerque, NM

Yes, we all know it's (solar energy) wonderful and expensive, but all the on-screen stuff was how great it is. Fine, but when you get to the gritty part, it, in the present state, at least in our area, isn't nice. I contacted three plumbing contractors about a solar HWH system, and all said that they'd removed more systems than they'd installed. The reason is quite pedestrian: roof leaks. Umm, the devil's in the details.

John Leach, Sarasota, FL

Your latest NOVA program on Solar Energy was terribly biased. I don't want to discuss every misstatement on the program. Suffice it to say that while Germany wants to have 30% of its energy needs from solar source by 2030, France has 70 to 80% of its energy from nuclear source. Not one word was said about it. One wonders who is (or are) sponsoring this program.

Zoltan Benedek, Bronx, NY

Am watching "Saved by the Sun" NOVA. Its content is outstanding and I am learning a great deal. But I am totally repelled by the grating music superimposed. It is counterproductive to good learning. It even goes on when people are talking. Your audio people need to consult people who know how to set an atmosphere for good.

Anne F. Jones, Shawnee, KS

Simple: Weijun Chen's "Please Vote for Me". . . cinematic and documentary delight questioning the nature of power in a political system. Far better and more valuable than a rehash of WWII.

David Petersen, Kansas City, MO

Having now completed viewing "The War" by Ken Burns, I would have to say that this is one of the most informative films on WWII I have witnessed to date. Ken Burns is a master. My only complaint would be the glossing over of how minority combatants were treated on their return to the US. Maybe this was done by design as not to cause shame and embarrassment to the Caucasian majority in this country. This should have been a very important segment of the film in understanding how the contributions of those minorities were so easily overlooked for so very long after the war. With that being said, I still thought the film was important. Bravo to Mr. Burns and his crew.

Edward Bibb, Greenwood, LA

The WAR was a great piece of work. I can watch it over and over again. I would like to correct a statement made. The comment was a soldier was being sent to Camp Shanks in New Jersey for training, Camp Shanks was in Rockland County, NY.

Howard Estreich, New York, NY