Fruit, Veg and a Lot of Drink: Disseminating Research Findings Correctly and Ethically

by Dr. Nileema Conlon Vaswani in

Medical research is intended to contribute to our knowledge and understanding of medical conditions and thereby be of benefit to the public. Are there times, however, when the findings of such research, although of academic interest, are either not beneficial or indeed harmful in practical settings? This question is important in light of recent findings by researchers at Oxford University in the UK. They have found, in their evaluation of many studies on the issue, that there is no consistent evidence that occasional binge drinking during pregnancy harms the foetus.

At a first glance, this research seems to have no more than academic value. It is not immediately clear why one ought to know the findings of such research especially when only binge drinking and not alcohol consumption over the course of one's pregnancy is what has been studied here. Further, there is the fear that women who might be prone to drinking might have a ready excuse if they are unable to stop or cut down their alcohol intake during pregnancy.

Sometimes research is controversial because it is not clear whether what is being researched is good or bad for the individual. If the current research were of this type, it would be asking whether alcohol is good or bad for the foetus. However, the research asks a different question, i.e., whether alcohol consumed via binge drinking is bad or simply not bad for the foetus. One could argue that such research has limited value because it is only prudent for pregnant women to avoid alcohol. Alcohol has no known benefits for the foetus so to debate the permissiveness of the occasional session of binge drinking is of no medical value per se.

This research is, however, beneficial to one specific group of women, i.e., those who binge drink before they discover that they are pregnant. Currently, a number of women who do not realise that they are pregnant and have been binge drinking, request abortions for fear that they may have unknowingly harmed their babies. This research can be reassuring to them and they might, with the knowledge that their babies are probably healthy, not wish to undergo abortions.

The fact that the research is beneficial to a very specific group of women is important but the fact that its findings can easily be misinterpreted ought not to be undermined either. Most people are unlikely to read the original paper in the Journal of Epidemiology and Community Health but will instead obtain their information through newspapers, many of whom have not made the benefits of the research clear but have focussed solely on the findings when printing their headlines. If one reads headlines and gains an impression of a news report through its headlines, as most of us do, one might seriously misunderstand the purpose of the research findings. Instead of interpreting the research as providing reassurance for women who were binge drinking before they knew that they were pregnant, some women may misinterpret the research as giving them permission to drink. Headlines such as "Occasional binge drinking by mother does baby little harm" (Times Online, UK, 14 Nov 2007), "Little Evidence That Binge Drinking While Pregnant Seriously Harms ..." (Science Daily (press release),13 Nov 2007), "Risk to unborn babies from binge drinking 'minimal', claim scientists" (Scotsman, United Kingdom, 13 Nov 2007) and "Binge drinking mums don't harm foetus" (Pulse, UK, 15 Nov 2007) could easily lead someone who already has a tendency to drink to glance at these headlines and view the research as a green light to binge drink while pregnant. The fact that the research has concentrated on binge drinking only and not heavy, sustained drinking throughout pregnancy may not be clear if one were to read some of these headlines only. People may, therefore, misunderstand the findings as pertaining to the consumption of any amount of alcohol at any time during pregnancy. In an attempt to reassure a specific group of women that they have not harmed their babies, we may in fact have inadvertently allowed many other women to do just that.

Consider the case of a woman who believes that she needs an abortion because she was binge drinking before she knew that she was pregnant. She visits her GP and requests an abortion. According to the current abortion laws, abortions can only be carried out if not performing one can compromise the mental or physical health of the mother or if the health of the foetus is at stake. A woman who genuinely wants to keep her baby but who requests an abortion because she believes that she has harmed the baby can, at this stage, be assured by her GP that her binge drinking is unlikely to have compromised the health of the baby. Unfortunately, however, for the woman who misinterprets the research and drinks more than she should during her pregnancy, there is little that her doctor can do for her. She can only be asked to stop or her misinterpretation of the research can be clarified only if she seeks help with regard to her drinking.

For research to have benefits, the benefits must be implemented and not merely exist. For this reason, the release of research findings that are easily open to misinterpretation ought to be regulated so that the public is not misled into making decisions that are detrimental to their health. Public health is and ought to be of paramount importance to the Government. It seems ironic that just as the Government has announced its proposal to provide pregnant women with money for fresh fruit and vegetables to help improve the health of their babies, research has been published on binge drinking and pregnancy which, if misinterpreted, will harm the very babies we are trying to help. If research exists, it would be wrong to withhold it from the public. The public has the right to know what Science and Medicine discover and then choose how best to use that information. But this is exactly the problem: in informing the public about binge drinking during pregnancy in the way that they have been informed, they are being misinformed rather than informed.