Conditional transparency: Differentiated news framings of COVID-19 severity in the pre-crisis stage in China.

Transparency of Chinese media coverage became an international controversy when the COVID-19 outbreak initially emerged in Wuhan, the eventual crisis epicenter in China. Unlike studies characterizing mass media in authoritarian contexts as government mouthpieces during a crisis, this study aims to disaggregate Chinese media practices to uncover differences in when, where, and how the severity of COVID-19 was reported. We examine differences in how media institutions reported the severity of the COVID-19 epidemic in China during the pre-crisis period from 1 January 2020 to 20 January 2020 in terms of both the "vertical" or hierarchical positions of media institutions in the Chinese media ecosystem and the "horizontal" positions of media institutions' social proximity to Wuhan in terms of geographical human traffic flows. We find that the coverage of crisis severity is negatively associated with the media's social proximity to Wuhan, but the effect varies depending on the positional prominence of a news article and situation severity. Implications of the institutions' differentiated reporting strategies on future public health reporting in an authoritarian context are also discussed.

Informed consent, duty of disclosure and chiropractic: where are we?

BACKGROUND: The COVID-19 pandemic has seen the emergence of unsubstantiated claims by vertebral subluxation-based chiropractors that spinal manipulative therapy has a role to play in prevention by enhancing the body's immune function. We contend that these claims are unprofessional and demonstrate a disturbing lack of insight into the doctrine of informed consent. As such it is timely to review how informed consent has evolved and continues to do so and also to discuss the attendant implications for contemporary health practitioner practice. We review the origins of informed consent and trace the duty of disclosure and materiality through landmark medical consent cases in four common law (case law) jurisdictions. The duty of disclosure has evolved from a patriarchal exercise to one in which patient autonomy in clinical decision making is paramount. Passing time has seen the duty of disclosure evolve to include non-medical aspects that may influence the delivery of care. We argue that a patient cannot provide valid informed consent for the removal of vertebral subluxation. Further, vertebral subluxation care cannot meet code of conduct standards because it lacks an evidence base and is practitioner-centered. The uptake of the expanded duty of disclosure has been slow and incomplete by practitioners and regulators. The expanded duty of disclosure has implications, both educative and punitive for regulators, chiropractic educators and professional associations. We discuss how practitioners and regulators can be informed by other sources such as consumer law. For regulators, reviewing and updating informed consent requirements is required. For practitioners it may necessitate disclosure of health status, conflict of interest when recommending "inhouse" products, recency of training after attending continuing professional development, practice patterns, personal interests and disciplinary findings. CONCLUSION: Ultimately such matters are informed by the deliberations of the courts. It is our opinion that the duty of a mature profession to critically self-evaluate and respond in the best interests of the patient before these matters arrive in court.