Originally published by STAT, September 27, 2022.
The California State Legislature has sent a bill to Gov. Gavin Newsom that strengthens discipline for doctors who knowingly spread Covid-19 misinformation. Legislation like this is sorely needed across the country.
More than two years into the pandemic, Covid-19 misinformation still runs rampant. Some comes from doctors spreading lies about unproven — and actually harmful — “treatments” for Covid-19 and promoting anti-vaccine conspiracy theories. Physicians account for three of the 12 individuals thought to be responsible for up to 73% of anti-vaccine content on Facebook. These physicians have been highly influential in their claims that, for example, masks suppress the immune system and that, after getting the vaccine, “becoming sterile [is] almost a certainty.” These lies have real and potentially deadly consequences.
An effective response to misinformation and its effects requires a multilayered approach, including one that holds rogue physicians accountable for their pronouncements, helping to preserve integrity within the medical profession.
As a primary care physician, I see the effects of Covid-19 misinformation every day. Some of my patients continue to decline getting vaccinated against SARS-CoV-2, the virus that causes Covid-19, based on false theories about immunizations causing death or decreased fertility. A few have become severely ill from the virus just weeks after saying “no” to vaccination during their visit to my office.
They are not alone. Polls have shown that 78% of U.S. adults believe common false statements about Covid-19. Multiple reports document cases of individuals who have been harmed or died after trying harmful Covid “treatments” like drinking methanol and taking ivermectin. Nationwide, misinformation is responsible for up to 30% of people’s decisions to not get vaccinated and has contributed to the more than 300,000 Covid-19 deaths that could have been prevented by vaccines.
I find it shocking that some of the doctors peddling medical misinformation are still practicing medicine without accountability. These professionals, who swore an oath to protect the health of their patients, have been undermining trust and contributing to poor health outcomes.
The scientific and medical communities have taken modest steps to rein in this type of behavior. Last year, the Federation of State Medical Boards released a statement describing its intention to discipline and potentially revoke the licenses of physicians who participate in the dissemination of mis- or disinformation. Since then, at least 10 states have disciplined doctors accordingly, including revoking licenses for supporting anti-masking, spreading vaccine misinformation, and issuing inappropriate exemption letters.
Multiple physicians’ professional organizations and several nonprofit organizations have stepped up their support of the Federation of State Medical Boards’ efforts, including the health worker-run organization No License for Disinformation, which advocates on this issue.
Despite these efforts, the preponderance of misinformation, including that spread by physicians, remains a potent and very real threat to all Americans. Firstly, the disciplinary action being pursued by medical boards has been limited. Thus far, reported fines have been relatively low (one Houston doctor was fined $500 — a drop in the bucket compared to an average yearly salary of $200,000), and even physicians who lose their licenses may choose to continue promoting misinformation using their MD titles.
Furthermore, legislation in some states adds to the problem: The efforts of some state medical boards have been stymied by legislation that allows for off-label prescribing of medications like ivermectin, which is proven to be ineffective at treating Covid-19 and can be harmful. Other legislation under discussion would prohibit medical boards from disciplining physicians for Covid-19 “free speech.” So far, these types of laws have been passed in North Dakota, Tennessee, and Missouri, with additional legislation in process in more than half of U.S. states.
The political motives behind these efforts have dangerous implications: lawmakers with no medical knowledge or training are trying to dictate public health decisions and dominate the discourse. The country’s policy response to national health emergencies should be informed by experts who have knowledge and training in safeguarding health and human well-being and by the patients and communities most affected by those emergencies, not self-appointed experts committed to promulgating their own anti-science agendas.
Mistrust in medicine is a complicated topic. Even if all Covid-19 misinformation were eliminated tomorrow, there would still be issues with trusting medical professionals, given the sordid and ongoing history of racism, ableism, and other forms of discrimination within health care. Promoting truthful, helpful information requires multifaceted processes of truth-seeking, reconciliation, and accountability not only to prevent harm but to work to heal communities. Stopping the spread of ongoing Covid-19 misinformation is just one — though critical — piece of the puzzle.
As the U.S. takes further steps towards accountability, the core principles of health care ethics — autonomy (affirming that patients have the right to make their own decisions), beneficence (acting for the benefit of others), nonmaleficence (doing no harm), and justice — must all be in effect. Rooting out misinformation and fighting back against anti-science laws that embolden misinformation remain vital first steps toward ensuring physicians are held accountable to their professional ethics as well as to the patients and the communities they serve.
The California bill is a good first step on a long road to accountability and to reducing the toll of Covid-19.
Covid-19 medical misinformation must be tackled like any other type of professional negligence. Physicians must be required to tell the truth and be held accountable for not doing so. Safeguards like these improve public trust, help physicians like me to do our jobs, and help communities across the country access reliable information to combat the pandemic.
Juliana E. Morris is a primary care physician in Chelsea, Mass., an instructor in medicine at Harvard Medical School, and a member of the Physicians for Human Rights Asylum Network.