A Lake Tahoe skiing accident changed Brian Jacobson’s life forever. The award-winning graphic designer from Marin County, Calif., and father of two lost his balance off a jump in March and landed head-first in the snow. He survived, but he is a quadriplegic.
Jacobson, 42, San Rafael, needs wheelchair-accessible modifications to his home, continuous physical therapy and home care help. His medical expenses have run upward of $1 million.
Jacobson’s friends came to his rescue, setting up two bank accounts to receive donations and organizing a community fund-raiser. A client of Jacobson’s, who works in public relations, pitched Jacobson’s story to local media. Both the Marin Independent Journal and the San Francisco Chronicle took an interest, writing stories about Jacobson’s “Engage the Human Spirit” fund-raiser, held Nov. 6 in San Rafael. Included in both articles was detailed information on attending his benefit dinner and silent auction and on making financial contributions to the Jacobson family.
After the fund-raiser, the Marin Independent Journal wrote a follow-up story on the success of the event, which raised $30,000. In the weeks that followed, checks poured into the Jacobson household by mail.
“We got so many donations from people we didn’t know,” says Brian Jacobson’s wife, Therese Jacobson.
Therese Jacobson estimates that of the $40,000 her family has received, at least $10,000 came from people who do not know her husband – in other words, from people who read the newspaper articles.
The media coverage benefited the Jacobsons financially, but not every Marin County resident with a similar story is as fortunate. Selecting a story such as Jacobson’s is arbitrary, says Doug Bunnell, managing editor for news at the Marin Independent Journal. The Journal sometimes receives several requests each week for media coverage of critically ill and injured people, making it impossible to cover every individual’s story.
“A lot of it depends on how busy we are,” Bunnell says.
The selective media coverage of Brian Jacobson’s plight was “totally unethical,” says Dr. David Goldstein, co-director of the USC-based Pacific Center for Health Policy and Ethics.
“It’s getting this man a gift solely because his story is presented before the media,” says Goldstein, a USC associate professor of medicine. “I’m not begrudging the people who raised the money, but ethically for society, that’s not the way things should be done.”
Goldstein says all such coverage is unethical, regardless of whether individuals are soliciting money, medical services, organ donations or other scarce commodities such as a rare blood type. Just as patients ought not to receive preferential treatment because of the color of their skin or their celebrity status, Goldstein says, media coverage should not impact the distribution of scarce medical resources.
“Why should we have people lining up to find out if their blood type matches someone with an article in the paper?” he says.
Author Raanan Gillon, in the book Philosophical Medical Ethics, explores the question of how to fairly distribute scarce medical resources. He concludes that the sole criterion should be medical need, not factors such as merit or social worth.
But pleas to end selective media coverage of the sick and dying often fall on deaf ears. Bernadette Fay, who wrote the San Francisco Chronicle article on Jacobson’s fund-raiser, says she would have “no response” to someone who thought her coverage was unfair.
“I don’t think I was doing any promotion,” says Fay, North Bay editor for the Chronicle. “I was putting out some news that was happening in the community.”
Yet Jacobson family friend Jerry O’Connell, who manages the “Brian Jacobson Fund,” does not deny the media-driven phenomenon and its potentially powerful impact on readers.
“There are people that have good contacts,” he says of a person’s ability to get media coverage. “It works very well if you know how to work your contact list.”
Sergio Arellano: Another case study
In February, Daily Breeze reporter Doug Irving wrote a story about Sergio Arellano, a 5-year-old boy from Lomita, Calif., undergoing an expensive medical procedure to fix a rare genetic disorder that was slowly killing him. Arellano’s disease, known as adrenoleukodystrophy, prevented his body from making the enzyme he needed to break down a fatty acid that was gradually destroying his brain tissue.
Irving says Arellano’s story, which evolved into a three-part series, touches on broader, more universal issues – far beyond the boy’s medical condition or the family’s struggle to cope.
“These types of stories remind people that there are critically ill children,” he says. “To some degree, I think Sergio stands in for all sick children, for (all) people who need something.”
Soliciting donations was not a prominent part of Irving’s series. A separate box, however, accompanied each of the three stories, explaining how to give to the Rigoberto Arellano Family Charity Trust, named for Sergio’s father. Irving says the bank account – set up specifically to provide Daily Breeze readers with a way to donate – raised enough money for Rigoberto Arellano, the sole source of income for his family, to stop working during his son’s intensive, three-month-long hospital stay.
If the story had focused less on Sergio Arellano and more on the family’s desperate pleas for financial assistance, Irving says, the family probably would not have received the same response from Daily Breeze readers.
Experts agree. Triggering readers’ emotions plays an important role in getting people to take action, say Gary L. Kreps and Barbara C. Thornton in their book, Health Communication: Theory and Practice.
“People respond to certain words and ideas (through emotion),” the authors write. “You can appeal to the emotions of the audience by knowing the audience’s attitudes.”
Irving says that detailing the pain and suffering of Sergio Arellano and his family indeed may have compelled readers to open their checkbooks, but he does not view his series as a conduit for the family to solicit donations.
“For me, I’m not sure that the idea of us as fund-raisers came up,” Irving says. “I don’t see myself as a fund-raiser.”
But readers do, argues USC law professor Michael H. Shapiro. Writing for the University of Pittsburgh Law Review, Shapiro builds a case against the practice of covering individuals who appeal to the media for coverage. Leaving the fate of a patient in readers’ or viewers’ hands, Shapiro points out, could compromise the notion that life is unique and invaluable.
“The aura of the Roman Circus is unmistakable: Audience whimsy is a major basis for lifesaving,” Shapiro writes. “… No one need be saved, and if someone is saved, it is based on his having certain personal traits, on entrepreneurial skills, on wealth, etc.”
Media insiders disagree with this assessment. Paul Skolnick, managing editor of KCBS2 and KCAL9 news, does not see media as part of the problem – he views them as part of the solution. Skolnick says he chooses stories not to help a selected few but rather to speak to the problems many viewers will find themselves in at some point in their lives. Although there may be some inequities, Skolnick argues, they are not of the media’s creation. He believes that lawmakers, bureaucrats and the medical establishment create the disparities.
“These are stories not about enriching one person at the expense of another, or about granting one person life at the expense of another, but rather raising reasonable questions that the institutions of our society need to grapple with to equitably divide the available resources,” Skolnick says by e-mail.
Skolnick also believes the media have a responsibility to explore life-and-death issues on a case-by-case basis and to explain to viewers how individuals react in extreme situations – instances, he points out, that “may befall any one of us on almost any day.”
Searching for solutions
While reporters have no intention of ending their coverage of critically ill and injured individuals, the ethical ramifications of doing these stories are on reporters’ minds. Susan Jacobs, health editor at the Orange County Register, receives about one request each week from sick and dying individuals who want the newspaper to write a story about them. She says the requests trouble her.
“Who am I to say whose plight is more worthy?” Jacobs says. “When do you draw the line trying to help people? It’s a slippery slope.”
Jacobs solves her dilemma by almost always turning them down, though the reason is primarily practical – she has no reporters to cover the stories. However, she says, the Register is owned by a company that runs a number of smaller, weekly community newspapers – papers that do have the ability to cover the stories. Jacobs often directs the requester to the appropriate community newspaper.
William Diepenbrock, North County team leader for the Register, is one such person who receives the story pitches.
“I don’t know that we’ve turned anyone down,” says Diepenbrock, explaining that because of the narrower focus of community newspapers, his reporters have more freedom and time to cover the stories.
Other media organizations have different approaches to dealing with these stories. At least one newspaper, the Atlanta Journal-Constitution, has an unwritten policy against doing stories about medically needy individuals unless the article speaks to broader themes and emphasizes the bigger picture.
“We look for a way to tie that person’s story into the larger issue,” says Mike King, a six-year veteran of the science and medicine section of the Journal-Constitution. “It’s a tough, very subjective decision, but it’s a legitimate one to make.”
Blame beyond the media
With reporters justifying the ethics of their decision-making, medical experts concede that fighting with the media to end coverage of individual medical cases may be a lost cause.
“I’m spitting in the wind if I expect the media to stop doing these stories,” says Goldstein of the Pacific Center for Health Policy and Ethics. “It’s the media’s responsibility, but I don’t expect it to change.”
Other medical ethicists view individual stories about the sick and dying as a manifestation of a far more significant and pressing issue: the overarching problem of how to distribute scarce medical funding and resources.
“If there is not going to be automatic government support, is it appropriate to have a system in which people go around begging for help?” says law professor Shapiro.
The problem, then, may involve a subject that transcends the media’s responsibility – what to do about America’s growing health care crisis. Dr. Robert E. Tranquada, a USC emeritus professor of medicine and public policy, has a solution: universal health care.
With equal health care opportunities for everyone, no one would need to make desperate and often fruitless appeals to the media for coverage, says Tranquada, an advisory board member for the Pacific Center for Health Policy and Ethics.
But until that happens, the public will continue to turn to local newscasts and newspapers for help.
“Now that I can see what it can do, I think everyone should contact their media,” says Therese Jacobson, the wife of quadriplegic Brian Jacobson. “I think (readers) are touched because they don’t get to read about the true goodness of people very often. It just compels people to want to help.”
