Over the coming year a batch of programmes featuring human experiments will hit television screens across the UK. Best described as a rendezvous between reality television and scientific experimentation, they are set to follow in the footsteps of such controversial programmes as Cheating in Athens (review BMJ 2004;329: 207) and Torture:The Guantanamo Handbook (review BMJ 2005;330: 543).
Science programmes, just like all other television genres, follow trends. The new formats have come a long way since the highbrow traditional documentaries featuring “talking heads” that, judging by BBC Horizon's message board (www.bbc.co.uk/sn/tvradio/programmes/horizon/index.shtml), many scientists remember nostalgically.
While informative, the older formats often had limited appeal and failed to generate a major debate outside a select audience. Hamish Mykura, head of history, science, and religion at the UK's Channel 4, says that the ultimate aim of broadcasting is to reach a broad audience. “What you set out to do is bring people to a programme, who wouldn't normally be interested in that area. It's important to deliver what is often a detailed, complex scientific topic in an interesting way and when television works best, that's exactly what it does. To say that programmes that are entertaining and informative can't communicate credible science is to completely misunderstand the way that television works,” he says.
A prime example is Jamie's School Dinners (review BMJ 2005;330: 678). Lobbyists and scientists featured on health programmes had been advocating that junk food was rather unhealthy for years, yet chemical and fat laden food continued to be served up to the UK's schoolchildren. But when reality empirical television was coupled with a well known celebrity, the chef Jamie Oliver, public health became accessible and touched a national nerve. The phone lines on radio chat shows were jammed with disgruntled callers demanding for heads to roll. Politicians and policy makers sat up and listened.
Edward Briffa, a former executive producer at the BBC's specialist factual science unit, who now runs his own production company, says: “Putting things to the test, what you might call experimentation, has become a major technique for a lot of television programmes.”
He pins the move towards empirical television on to a seminal World in Action programme in the 1980s. The programme makers pitched Times columnist and former Conservative MP Matthew Parris to live for a week in a deprived part of Newcastle on unemployment benefit—the then princely sum of £26.80 (€38.97; $49.24). Parris had been an ardent defender of the low levels of benefits for unemployed people, but in practice found it impossible to live on. Issues surrounding poverty in the UK had long been debated on television, but had not really scored many political points.
Figure 1.
Jamie's School Dinners: extraordinary impact
Credit: CHANNEL 4
Television is a medium that thrives on human stories. Mr Mykura says, “It's much easier to show people experiencing something than it is just having a talking head talking about what it's like to experience that. It's about getting closer to somebody's own reaction to something. That's why these programmes seem a lot more vivid and, in many ways, are a lot more attractive to audiences than traditional documentaries.”
While the empirical genre looks set to continue and turns to televising human experiments for the next big trend, it is worth noting, before scientific purists start heckling from the sidelines, that these programmes are not necessarily intended to represent a gold standard study or a publishable study.
“I think they are borrowing the clothes of science—ie, we have a hypothesis and we'll put it to the test,” says Mr Briffa. “You can see this in Wife Swap. But it would be extremely rare that anyone would be rash enough to claim that the outcome is designed to do the same as a scientific experiment. The outcome of these kinds of programmes, depending if they're factual or purely entertainment, is to make the subject more engaging. They're a concrete way of providing a natural cliff hanger. This is intrinsic to drama and it's intrinsic to a test—that's why they're so popular.”
There are a number of reasons why human experimentation on television can't observe many of the conventions of a proper scientific test and these limitations run throughout the whole production process.
Firstly, the selection procedure cannot be randomised and introduces selection bias. It's impossible to get a random sample of people—television researchers don't want a participant to clam up in front of the camera or have a personality that fails to grab the audience. They've got to be interesting, and researchers will select them accordingly.
Moreover, it is hard to see how any experiment involving or modifying human behaviour can be extrapolated to draw conclusions about society in general when, during filming, a television camera and boom microphone are looming overhead. While people may become accustomed to being followed around by a cameraman or observed by a static camera, it is only really possible to say that this person acted in this way in this particular set of conditions.
There are other ways in which the programmes fall down scientifically. There is rarely a control group, the trials are certainly not double blind, and the sample size barely makes double figures. Nor do the researchers put their work through a peer review process, or have to gain approval from the research ethics committee. But the programmes are subjected to tight ethical controls and guidelines. Mr Mykura says, “The guidelines that control programmes are pretty stringent when they're undertaking these kinds of projects. The producers' guidelines issued by different broadcasters and those of Ofcom are all fairly specific.” Although one of the participants in Torture: The Guantanamo Guide-book commented to the Sunday Telegraph that he “realised just how meaningless the term `informed consent' can be.”
However, Mr Briffa doesn't think that this type of programme that uses the scientific tradition sees the communication of science as its first objective. “I think they're principally factual entertainment—entertainment that happens to dip into factual stuff when they feel inclined. A good example is Plastic Surgery Live. Its first purpose is not to communicate a balanced account of the pros and cons of plastic surgery.”
But he urges caution about simply disregarding this type of programme. “It's all very well and good to say, `Bah humbug' about these sorts of programmes, but look at Jamie's School Dinners. That has done, or looks like it will do, such a lot of good for the nutritional diet in England, that I don't think traditional or orthodox documentaries would have done.”
Mr Mykura agrees: “By using this format, you can really bring in a wider audience who are intrigued by the proposition and then deliver a very serious message. That's why these programmes are so powerful and important. When they're done well they can have an extraordinary impact.”