IS "THE INFINITE MIND" AN NPR SHOW?

UPDATE on May 20, 2008: The Infinite Mind has added an Underwriting page after the recent criticism and added fuller disclosure about a guest.

NPR is a complicated news entity.

It produces 59 hours of original news programming each week heard across the public radio system, the best-known of which are Morning Edition and All Things Considered. Then, it distributes 18 shows such as Car Talk, The Diane Rehm Show, and Fresh Air, which local public radio stations or independent producers create without any direct NPR editorial control.

And then there are other shows on NPR's three channels on Sirius: NPR, NPR Talk, and NPR Now. Some shows are produced by NPR, some are simply distributed by NPR and some are independently produced.

Got that?

But the average listener is pleasantly (and should be) oblivious to these business distinctions. If a listener hears a show on a public radio station, the assumption often is that NPR is responsible for the program. Sometimes that's accurate; sometimes not.

So it's no surprise that NPR was held responsible when Slate.com posted a piece on May 6 pointing out conflicts of interest and lack of balance in a March show, "Prozac Nation: Revisited" on The Infinite Mind. The Infinite Mind airs on one of NPR's Sirius channels.

Here is what was sent to me on May 8:

NPR show may stand in a class by itself for concealing bias
Slate: An episode of The Infinite Mind called "Prozac Nation: Revisited" featured four experts who have financial ties to the makers of antidepressants — something that public radio listeners weren't told. Also, they weren't informed that the show receives money from Prozac manufacturer Eli Lilly. Paging Alicia Shepard!
Posted at 11:17:57 AM

Was this the "Pentagon Pundits' Problem" all over again? (See my April 28, 2008 column 'NPR, The New York Times and Sourcing Military Experts')

Not specifically, but it is the latest tangle to arise concerning the undisclosed ties of "experts" on the air.

On March 26, The Infinite Mind ran "Prozac Nation: Revisited," an hour-long piece questioning the science behind high-profile news stories that reported a link between anti-depressants and suicide or violence. "There really is no science that we were able to find that if you take anti-depressants, you will be more violent," Bill Lichtenstein, who created the show 10 years ago, told me.

But Slate health writers, Shannon Brownlee and Jeanne Lenzer, disagreed. "The body of evidence on this issue is conflicting and there are huge battles in the medical arena on this," said Lenzer.

The Slate authors say the issue is more complex than the show indicated. There were four experts on "Prozac Nation," and all dismissed the idea that these medications could affect suicidal or violent behavior. "They only offered a singular viewpoint," said Lenzer. "They [the show] should have dug up different sources and independent sources."

Lichtenstein said that was because "there are no scientific, clinical or epidemiological research or studies that indicate a direct link." (For another take)

But more importantly, the show didn't disclose that the guests and host had some financial ties to makers of anti-depressants. "To me, it's not terribly relevant whether there's a clear scientific link between anti-depressants and suicide," said Gary Schwitzer, publisher of HealthNewsReview, an independent website that evaluates health coverage. "Bill Lichtenstein does good work. But he should have disclosed the financial ties."

One of the guests was Peter Pitts, a former Food and Drug Administration official. The show's host doesn't mention that Pitts is senior vice president for global health affairs at a public relations firm. That firm represents drug companies that make anti-depressants. Lichtenstein acknowledged that Pitts' business ties should have been mentioned. He said Pitts didn't disclose them while the Website Center for Medicine in the Public Interest, where Pitts is president, says he did.

"If we had known, and (full mea culpa here) we should have, we would have disclosed that connection," wrote Lichtenstein in a response on Slate's, The Fray. "Pitts apparently didn't disclose it elsewhere, either - he's appeared on NPR's Talk of the Nation as well as PBS' News Hour with Jim Lehrer, without either of those programs mentioning the PR company ties." (Slate responded to Lichtenstein on May 12.)

Lichtenstein is correct about Talk of the Nation. Pitts appeared on the show in June 2005, one year after joining the public relations firm Manning Selvage & Lee, according to the firm. The call-in show identified him only as with the Pacific Research Institute, which lists itself as a non-profit educational charity promoting free market policy solutions.

Another issue is The Infinite Mind's funding. According to Lichtenstein, he takes no more than 15 percent of the budget from any one sector. In 2006, he told me, the program got $100,000 from Eli Lily, which makes the anti-depressant, Prozac.

All that said: Is The Infinite Mind an NPR show?

Technically, it depends on what you mean by an NPR show. The Infinite Mind is distributed several ways. Show creator Lichtenstein independently produces and distributes the program to 300 public radio stations and also offers podcasts. In addition, NPR has a contractual relationship with Lichtenstein to run the program on Sirius' NPR Now.

"We acquire the show only for our satellite service," said Margaret Low Smith, vice president for programming who handles program acquisition for NPR. Acquired shows are programs that are not produced by NPR employees.

For example Fresh Air, On the Media and Car Talk are "acquired" from outside producers exclusively for NPR to distribute to its member stations. Those programs carry the NPR brand. The Infinite Mind is in another class because NPR does not distribute it to member stations so the show doesn't carry the NPR brand.

"Nonetheless," said Smith, "if we are going to put a show up on our Sirius service, our expectation is it will live up to NPR standards and if it doesn't, it can become an issue."

When NPR distributes a show produced by non-NPR employees —whether it comes from a member station or an independent producer — the contractual agreement says that each show must follow NPR standards and practices. "We are very careful about the shows we select for Sirius and it matters a lot to us that those shows live up to the highest journalistic standards," said Smith.

Smith said NPR is reviewing this particular episode of The Infinite Mind.

No matter what NPR finds, a few things should happen. On NPR's website listing "popular public radio shows," NPR should make it clear which are distinctly NPR-produced shows and which ones are not. For instance, the site lists Prairie Home Companion and provides a link, even though the popular show is produced and distributed by American Public Media, a competing public radio service.

The Infinite Mind, particularly since it deals in the controversial world of science and medicine, should include information on its website about how it is funded. It should also add Peter Pitts' public relations job to the link for the "Prozac Nation" episode and to any related transcripts.

Being upfront about real or potential financial conflicts of interest is key to establishing credibility. Financial associations don't mean that experts should necessarily be disqualified as commentators, but the public must be told about them.

With the Internet, it is much easier for news operations to be transparent, and they should take advantage of the ability to be more transparent if they ever want to win back the public's respect and trust.
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Comments

 

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Just to confuse thing even more, "Day to Day" has a regular "Marketplace" segment, even though "Marketplace" is neither produced nor distributed by NPR. And recently "All Things Considered" had a piece produced with "This American Life," also a totally non-NPR show.

Sent by Neal Rauch | 1:04 PM | 5-13-2008

I posted this comment on the Slate site and I sent it to the editors of the show. So far no one has responded:

Dear Mr Lichtenstein,

In all this discussion about conflicts of interest I think everyone is glosssing over the innaccuracies of the show. Below are some comments from the guests and hosts that are at odds with the scientific literature.

Andrew Leuchter: "In those studies where this increase[d] thoughts about suicide and agitation were noted, actually, there were no suicides - that people thought about it but they didn't act on it."

This is a problematic statement. For instance in 1991 Glaxo submitted an analysis and reported that there were five suicides in the drug group. People might argue about the statistical significance compared to the placebo group but at least according to the FDA and Glaxo he has misspoken. What he most likely meant to say was that there were no reported suicides in the studies looking at the use of antidepressants in children. However even this is problematic as the case of Traci Johnson shows.

Goodwin: "There is no credible scientific evidence linking antidepressants to suicide or violence."

This is a rather flippant statement about a large body of data, and again at odds with the FDA, as presumably the FDA believes that their decision to place a box warning on the SSRIs was based on an analysis of the scientific evidence. Goodwin not might agree with the data, but according to Healy (Lines of Evidence, 2003) there were more suicides and more thoughts about suicide in the trials for every single antidepressant studied. In the Zoloft group there were two suicides and in the Paxil group there were five, and the list goes on.

I think someone from your show needs to comment on these factual errors. If you need supporting documents I would be happy to send them to you.

It would have also been nice if an expert had pointed out to the show's host that the study they were relying on to support the use of the SSRIs was not a placebo controlled study.

It is unclear to me how you decided to have a show made up of experts who disagree with the FDA and you never considered having someone from the other side. How did this happen?

It is also odd that in your letter about Jeanne Lenzer and the BMJ having to retract their report that Lilly hid documents you provide a link to an article that shows Lilly knew about problems with Prozac. (The retraction was not about whether or not Lilly had internal documents suggesting that there was a problem with Prozac but whether or not they made the documents available to lawyers in a specific case. They did not make the documents available to the general public)According to the very article which you cite,

"The London-based BMJ, formerly called the British Medical Journal, did not retract its contention that the documents show the antidepressant is linked to increased risk of suicide or violence. All we have retracted is the statement that these documents went missing," wrote acting editor Kamram Abbasi, in an e-mail to CNN.

If you could please go to this link,

http://www.healyprozac.com/EditorsDilemma/Psychotherapy_Psychosomatics.pdf

and open up the paper, go to table one, and please tell me how someone can say there were no suicides in the trials.

-Jon Leo

Sent by Jonathan Leo | 1:25 PM | 5-13-2008

Why is NPR distributing its programs (and others, like Infinite Mind) only on Sirius?

That exclusive deal must be trashed.

I am an XM subscriber and I am ripped off. I subscribe to 2 NPR affiliates but live in an area with no FM coverage - this the satellite radio.

I find it incredible that NPR - which I support with my money - makes an exclusive deal with one company.

Imagine if PBS affiliates only allowed their programming on DISH Network and not DirecTV.

This was a 5-year deal that should have expired 2 years ago - and we deserve an answer.

NPR: When will you supply NPR programming via satellite to XM customers?

Sent by Hans Laetz | 12:50 PM | 5-14-2008

I have Sirius and there are two (not three) NPR stations, "NPR Talk" and "NPR NOW." I don't have a third simply called "NPR."

I'm glad to hear that NPR wishes to hold the programs it only distributes to the same editorial standards as NPR produced shows.

Sent by Ed Boyte | 1:28 PM | 5-14-2008

It seems strange of you to say that you are not responsible for shows because NPR did not create/produce them. NPR controls what NPR selects to distribute. It also chooses what not to distribute. Saying you are not responsible is like a drug dealer saying he is not responsible since he did not create the drug he sells. There is some truth to all sides of it, no?

Why use your blog to tell us what you take no responsibility for? Maybe you could tell us how NPR selects authors for its shows. We here the same voices over and over. Certain authors get to make the rounds on all of your shows, and other voices we do not hear at all.

Sent by Andrew Hennessy | 6:56 PM | 5-14-2008

Thanks for the almost-complete essay. I think it's important to note that, per full disclosure, I was never asked. I would like to assume that when I am called for interviews that the producers have done their due diligence. When you go to www.cmpi.org, one click on my name tells you everything. I also want to be clear that on the other programs mentioned, I was asked by the producers about my various affiliations. I answered fully and honestly -- and the decision was made not to mention it on the air.

Most interesting is the fact that nobody seems to want to talk about what I said.

Sent by Peter J. Pitts | 9:49 PM | 5-14-2008

SHEPARD RESPONSE: There are actually three NPR channels on Sirius. Two appear on the radio -- one is accessed over the Internet and available to Sirius subscribers. www.sirius.com/npr It's a way of listening to Sirius without a radio.

Sent by Ed Boyte | 1:28 PM ET | 05-14-2008
I have Sirius and there are two (not three) NPR stations, "NPR Talk" and "NPR NOW." I don't have a third simply called "NPR."

I'm glad to hear that NPR wishes to hold the programs it only distributes to the same editorial standards as NPR produced shows.

Sent by Alicia Shepard | 4:01 PM | 5-15-2008

Peter, I've talked about what you said on my site. Although I respect where you are coming from and you are welcome to your opinions, I think your views on the black box warning are naive. I'm pretty certain from listening to the show that you don't even know what suicidal ideation is.

I'm a bit confused that NPR's ombudsman feels yours are the only guest conflicts that should've been revealed in connection with this program. The host and the other two guests have similar conflicts.

Sent by Philip Dawdy | 1:07 AM | 5-16-2008

Let's review, NPR broadcasts without identifying:

-Paid shills for big Pharma.

-Paid shills from the Pentagon.

-Paid shills from Fox News (its own reporters picking up Rupert's checks).

It's all part of the NPR's style book since W moved into the White House.

Makes me happy after more than twenty years, I stopped pledging.

I thought the ombudsman's job was to represent the listeners' interest, not be defend NPR?

Sent by Ron Gordon | 12:58 PM | 5-16-2008

A Challenge to NPR!
How is this for a suggestion that should appease everyone. Just redo the show with the same original guests but include: David Healy, Irving Kirsh, David Cohen, and Philip Dawdy. How could anyone argue with this proposal? At the very least you would probably get pretty good ratings.

Sent by Jonathan Leo | 3:48 PM | 5-16-2008

This is a great suggestion. The Infinite Mind can prove it is not biased by discussing those same issues again...with David Cohen, Irving Kirsch, and David Healy, three highly respected academics who write on this topic. Phillip Dawdy represents both the voice of 'clients' and someone who thinks critically about the issues.

I would love to hear such a show!

Sent by Jeffrey Lacasse | 6:02 PM | 5-16-2008

http://kska.org/2008/05/19/off-mic-justice-talking-and-the-infinite-mind-sign-off-this-summer/

Off Mic: Justice Talking and The Infinite Mind sign off this summer

Mon, May 19, 2008
Posted in Off Mic

Two programs will sign off the air this summer, NPR's Justice Talking and Lichtenstein Productions, The Infinite Mind. Reasons given by their producers are changes in funding and staff. Both shows have been favorites of KSKA listeners for years. It's public radio's loss, but it's also an opportunity. Radio programming is fluid. When a program ends, another program takes its place. When Justice Talking wraps this summer, Fresh Air with Terry Gross will available for you Monday - Friday at 9:06a.m. repeating at 3:00p.m. We will have more info on Off Mic on what will air on KSKA when The Infinite Mind finishes this summer.

Sent by Jack Imholfe | 12:36 AM | 6-22-2008

If you stopped pledging, then you shouldn't complain about the content on NPR. Simple as that.

Sent by Stacey Hanrahan | 7:29 AM | 6-28-2008

Here is a link to an article about the Infinite Mind and Prozac:

http://chemicalimbalance.org/?p=113

Sent by Jonathan Leo | 6:20 AM | 7-31-2008