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Censorship or social responsibility? Amazon removes some books peddling vaccine misinformation.

A new Amazon Books store in Washington in March 2018. (Matt McClain/The Washington Post)

YouTube said it was banning anti-vaccination channels from running online advertisements.

Facebook announced it was hiding certain content and turning away ads that contain misinformation about vaccines, and Pinterest said it was blocking “polluted” search terms, memes and pins from particular sites prompting anti-vaccine propaganda, according to news reports.

Amazon has now joined other companies navigating the line between doing business and censoring it, in an age when, experts say, misleading claims about health and science have a real impact on public health.

NBC News recently reported that Amazon was pulling books touting false information about autism “cures” and vaccines. The e-commerce giant confirmed Monday to The Washington Post that several books are no longer available, but it would not release more specific information.

Experts say these companies are being tasked with new and challenging responsibilities.

Art Caplan, a professor of bioethics and head of the division of medical ethics at New York University School of Medicine, said companies cannot allow themselves to be “vehicles for misinformation contagion.”

“You can certainly post things that oppose vaccination — individuals can speak their minds. But when you have websites that are presenting false information, debunked information or, similarly, books that tout phony cures, I think there is a role for somebody in censorship,” said Caplan, who co-authored a 2017 paper on “The overlooked dangers of anti-vaccination groups’ social media presence.” Caplan said that it is important for companies to exclude such misinformation “because the power of social media, particularly in the vaccine space, is so strong that it’s leading to fear of vaccines, which is leading to epidemics, which is putting people at risk.”

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The anti-vaccine movement has been sustained, in part, by fraudulent research from 1998 that purported to show a link between autism and a preservative used in vaccines — despite numerous studies that have provided conclusive evidence that vaccinations do not cause autism.

False anti-vaccine claims continue to sweep the Internet, prompting concern from public health experts, lawmakers and from parents who are not able to get their children vaccinated because of medical conditions and rely on others to do so.

In fact, the World Health Organization has named “vaccine hesitancy” as one of the “Ten threats to global health in 2019”:

The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines.

Joe Holt, a business ethics professor at the University of Notre Dame, said the problem with businesses being forced to play a censorship role is that most of them, if not all of them, probably never intended to do that. But now, he said, “there’s more and more external pressure for them to do more censoring.”

Over the past couple of months, Rep. Adam B. Schiff (D-Calif.) has been calling on companies such as Google, Facebook and Amazon to address anti-vaccine claims on their platforms.

Schiff announced March 1 that he had sent a letter to Jeffrey P. Bezos, Amazon’s chief executive and owner of The Post, to express concern that the company “is surfacing and recommending products and content that discourage parents from vaccinating their children, a direct threat to public health, and reversing progress made in tackling vaccine-preventable diseases.”

“As the largest online marketplace in the world, Amazon is in a unique position to shape consumption,” he said he wrote to Bezos. “The algorithms which power social media platforms and Amazon’s recommendations are not designed to distinguish quality information from misinformation or misleading information and, as a result, harmful anti-vaccine messages have been able to thrive and spread. The consequences are particularly troubling for public health issues.”

“I’m pleased that all three companies are taking this issue seriously and acknowledged their responsibility to provide quality health information to their users,” Schiff said in a statement March 7. “The responses from Google and Facebook describe the steps they are taking to address the issue of harmful public health misinformation on their platforms. Amazon has informed me they will also be responding to my letter in the coming days.

“The crucial test will be whether the steps outlined by Google and Facebook do in fact reduce the spread of anti-vaccine content on their platforms, thereby making it less likely to reach users who are simply seeking quality, fact-based health information for their children and families. I plan to continue working with the companies on the issue of misinformation on their platforms and monitoring the effectiveness of the changes they are making because our health, and particularly the health of our children, is at stake.”

It’s unclear whether the companies’ recent actions are connected to the congressman’s call to action.

Holt, of the University of Notre Dame, said the idea that companies should assume that censorship role prompts several interesting questions, including what is driving the decision.

“When a company like Amazon does this, does it do it because it thinks it’s the right thing to do, or does it do it because it has to has to do it as a result of external pressure?” he said. “In the vast majority of cases, it seems to me it’s the latter and, morally speaking, that’s an important difference.”

But, Holt added, perhaps the toughest question is: Where does a company’s responsibility to do so end?

“The challenge, to me, is to determine how far your responsibility extends your bottom line and then to have a clear set of values and principles that guide your decisions to meet that responsibility,” he said.

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