Wednesday May 03, 2017

May 3, 2017 full episode transcript

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The Current Transcript for May 3, 2017

Host: Anna Maria Tremonti

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

VOICE 1: I didn’t do that.

VOICE 2: You tell me what you did.

VOICE 1: I swear to god I didn’t do that.

VOICE 2: [Inaudible yelling]

VOICE 3: Why did you do that?

ANNA MARIA TREMONTI: Was it an act, just a prank or an example of ongoing child abuse? That scene from the DaddyOFive YouTube channel shows a hysterical nine-year-old boy screaming his innocence while his father and stepmother berate him. The channel focuses ostensibly on a couple pranking their five kids for the enjoyment of the entire family and for their lucrative base of 700,000 subscribers. But the youngest appears to be distraught and upset in online clips and now the dad has lost custody of two children to their mother. As social media buzzes with both disgust and support of DaddyOFive, we're looking at the ethical issues around families who cash in on their kids online. Also today, when being a refugee means always having to say you’re grateful.

SOUNDCLIP

Gratitude quickly came to be expected and it came to be expected in individual interactions with people who really had very little to do with accepting us.

AMT: Dina Nayeri was a child when she fled Iran as a refugee. Three decades on, she hears attitudes of judgment and superiority in the voices of those who murmur just how grateful she must feel. In half an hour, we'll hear from several people who arrived as refugees as we explore the concept and the burden of gratitude. And people in Nova Scotia and BC have a lot in common these days with each province in an election campaign and hundreds of thousands of voters who cannot find a family doctor no matter how hard they try.

SOUNDCLIP

Some places laughed at me. Some places just said no and hung up. Most doctor’s offices said no, they are accepting patients.

AMT: We're starting there. I'm Anna Maria Tremonti. This is The Current.

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Government has to stop looking for cheap way to address doctor shortage, says GP

Guests: Danielle Martin, Chris Pengilly, Michael Rachlis

SOUNDCLIP

VOICE 1: You have one for so long and then they retire and then you can’t get another one. And when you're really sick, you need one.

VOICE 2: I'm going to do everything that I can to get my wife a doctor. They can send a doctor any time they want. But if they don't have one before Election Day, I wouldn't want to be a liberal on Election Day.

AMT: Well, those are the voices of Diane MacDonald and Reg Andrews, seniors whose hunt for a family doctor is making the news in Nova Scotia. Diane suffered a stroke a week after her doctor retired and her husband Reg has taken his fight to find her doctor public. The province’s doctor shortage—about 10 per cent of the population can't find a general practitioner. It's already a hot button issue in the Nova Scotia election campaign. That one kicked off Sunday. It's an issue with voters on the other side of the country as well in BC as they head to the polls next week. BC is facing a shortage of family doctors—about 700,000 people in the province do not have a family doctor. That's about 15 per cent of the BC population. Both the Liberal Party and the NDP in BC say addressing the shortage would be a priority if elected. Of course finding a GP can be hard in many communities across Canada. So we've convened a panel of doctors to talk about what is behind this reported shortage and the challenges family doctors and general practitioners face. Danielle Martin is a family physician and VP at Women's College Hospital. She's the author of Better Now: Six Big Ideas to Improve Health Care for All Canadians. Michael Rachlis is a public health physician and a health policy consultant and an adjunct professor at the University of Toronto in the Dalla Lana School of Public Health. They are both with me in our Toronto studio. Chris Pengilly is a semi-retired family physician in Victoria, BC. He is also the author of a manual for doctors called The Successful an Audit-Proof Medical Office and he's in our Victoria's studio. Hello everyone. Welcome.

MANY VOICES: Good morning.

AMT: First of all, I say GP and family practitioner together. Chris, there's a difference, right?

CHRIS PENGILLY: Not really, no. They're all primary care physicians which means they're the first ones to contact the patient. But that can involve a family physician, even I suppose to some extent a midwife.

AMT: Okay.

CHRIS PENGILLY: They're pretty well synonymous.

AMT: Okay. So how critical is the shortage of family doctors in BC right now?

CHRIS PENGILLY: It's bad. My office where I'm semi-retired, people keep wandering in every single day. Please, have you got a waiting list? Please, is it possible to be taken on? And you know it's really rather sad and the walk-in clinics are swimming up river to try and cope with this very urgent short problem. But the problem is accumulating and the larger problems are just not being attended to.

AMT: When you wanted to step away from your own family practice and you wanted to sell it, you couldn't sell it at first, could you?

CHRIS PENGILLY: I literally couldn't give it away. In fact if somebody said they would take it over and I’d give them $10,000, I would have done that. When I came in ‘78 to Victoria, I got the job, I paid $15,000 for the practice and just after my application, I signed it, 44 doctors wanted that practice—44. And when I wanted to retire, I looked for two years and couldn't find one.

AMT: What's behind the shortage?

CHRIS PENGILLY: Oh, so many things. One was the closing of medical school places back in the 1980s and there are more demands for family physicians. They are requested to do more. Victoria for example, we have 400 physicians, 400 GPs, what do you want to call them. But we have 66 hospitalists. Those are primary care physicians which I spoke about and they just work 40 hours a week in the hospital and that is it. And if we had even half of them, 33 available to be primary care physicians, family physicians, that would help.

AMT: Okay. Well, let’s stop there. Michael Rachlis, do you think there's a shortage of doctors in Canada?

MICHAEL RACHLIS: There absolutely are situations which Dr. Pengilly just described where people are not able to get a regular physician. But whether that translates into a shortage, we need to look at how they're currently being used. And also in Canada, we've been increasing the supply of physicians and there's about equal numbers of family physicians and specialists in Canada. We’ve been increasing the number of physicians at about three per cent per year for the last 10 years and the population is only going up at one per cent per year. So the number of doctors, the number of family doctors per capita in Canada has gone up very substantially and yet we're continuing to hear these stories. I think this goes back to what's been said for at least 40 years in various government reports and commissions. It's not necessarily the numbers of doctors. It's how we're using them or not using them up to their potential.

AMT: So Danielle Martin, so we're graduating more doctors than ever in Canada?

DANIELLE MARTIN: We are absolutely graduating more doctors and we're absolutely graduating more family doctors. In fact you know in some parts of the healthcare system, people are worried about a glut and you hear stories of people coming out and being unable to find a job. And so I think there is no question that we have a distribution problem. Is it truly a shortage problem? It feels like a shortage problem if you're in one of those places where the distribution is not kind to your community and the distribution problem is not just geographic. So of course we know that in many rural communities, it's difficult to recruit and retain primary care, not just doctors but nurse practitioners, nurses, other health care providers. And at the same time, there are also situations where people may be working in that community but we feel a distribution problem because they're not offering what we would think of as full service primary care.

AMT: What does that mean?

DANIELLE MARTIN: It means for example, they're working solely in the hospital or they're doing what we call a focused practice, so focusing on sports medicine or focusing on palliative care which may be meeting community needs in those areas, but they're not practicing what we would think of as full scope full service cradle to grave primary care, family medicine and that is what those people who are lining up at Dr. Pengilly’s clinic and asking. That's what they are looking for and of course that foundational relationship between each Canadian and their primary care provider—usually a family doctor but not always. When you don't have that foundational relationship, it's very distressing for people.

AMT: Let's talk about lineups. I want you to listen to Emily Baron-Cadloff. She's a young woman in Nova Scotia. She has Crohn's disease. She has been searching for a family doctor for six years with no success.

SOUNDCLIP

I was waking up at five in the morning so that I could get to the only walk-in clinic that was open. I would drive across the city to get to this clinic so that I could be there for an hour and a half before it opened so that I could get in the already long line up. I could wait for another several hours. Then this GP clinic doctor who saw hundreds of thousands of people a year who didn't keep detailed files on any of them could see me and take a stab at it. And after the second or third time that I came back and I said look, I've been here several times. These symptoms aren't going away. They're getting worse. Then he could refer me to a specialist. It took me about two years to get a Crohn's diagnosis from the time I first started having symptoms. I would attribute at least part of that delay to the fact that I didn't have anybody to act as my go-between, as my health care advocate.

AMT: Danielle Martin, what do you think when you hear that story?

DANIELLE MARTIN: There's no question that the most important thing for a person who is experiencing new symptoms or grappling with chronic disease, the most important thing is to have as she says that go-to person and go-to person doesn't always need to be a doctor. One of the ways that we can address this problem is by working more effectively in teams of healthcare providers. But it's absolutely true that it's the foundational relationship that not only is good for the health of the individual but also good for the health care system. It's not good for the health care system for people to use the emergency department when they do so out of desperation because they may even have a family doctor but can't get an appointment in a reasonable timeframe. It's not good for the health care system for people to be seen in walk-in clinics where there isn't a proper captain. There's no communication back to the person's regular provider. So all of these kind of work around solutions are bad for health and absolutely. We need to put in place that foundational relationship for each person. Whether the solution to that is just to train a zillion more family doctors, I would suggest probably not.

AMT: Chris Pengilly, so help me understand. You had a practice. You did everything. You weren't part of a clinic. You had your own practice.

CHRIS PENGILLY: I was in a group of four doctors.

AMT: Okay. And now the previous Liberal government in BC said it expanded entry level residencies for international graduates. It doubled the number of undergraduate medical school spaces. And yet that shortage persists. So what else?

CHRIS PENGILLY: Well, some of these primary care physicians, they can become full-time assistants in the operating room which when I was back in full service family practice, I would do between cases. We used to go to the hospital deal with patients in the morning before going to the office. We used to work five days a week—four and a half days in the office, half day house calls. But now you know these doctors, the hospitalists, they’re full time and that’s all that they do.

AMT: Is it more lucrative to be a hospitalist than a family doctor?

CHRIS PENGILLY: It is. It is.

AMT: Like how much more?

CHRIS PENGILLY: Well, if you really want the figures here in British Columbia.

AMT: I do.

CHRIS PENGILLY: They work for $150 an hour which 40 hours a week comes to $130,000 a year. No— $300,000 a year. Sorry, $300,000 a year which—

AMT: And no overhead, right? They’re in the hospital.

CHRIS PENGILLY: No overhead. So a family physician, the fee is that so the overheads are out of it. They would have to earn $400,000 in order to pay their overheads, their office staff, their rent to match that. So anybody coming out of medical school with a big student loan, which do you think they’re going to go for? A family physician have no time in hours a week or a hospitalist 40 hours a week and $300,000 with minimal expenses.

AMT: So you're saying, you've actually suggested that some doctors get help with their office expenses.

CHRIS PENGILLY: Oh, very much so. The fees system, it's time it was changed. It’s time it was rewritten completely. It's like an old car. It's got three new gearboxes, four new engines, new upholstery, new tires but you know it's time to eventually dump it and get a new one. And I think our fee schedule, the way it's organized at the moment is the fee includes professional help or professional part and for paying overheads. And I think what we need to do is to separate that because I see many, many practices where physicians are under staffing. They don't pay their staff well. I mean if a physician was to employ a registered nurse, a medical office assistant, if he was to employ a stenographer and anybody else, he would end up literally taking home nothing.

AMT: Okay. Michael Rachlis, you want to speak to this.

MICHAEL RACHLIS: I think that you're getting into the point that we really need to talk about which is that the funding of our system is 50 years old and I rush to add of course that it was 45 years ago when we brought in Medicare. A federal report by a University of Toronto public health professor John Hastings recommended a reorganization of practice as we brought in Medicare team-based practice, mainly non-fee-for-service payment. Similar reports in various provinces including Ontario, big report in ‘74 by Fraser Mustard recommended the same thing, dividing the province into regions with doctors being paid by the regional authority, working in groups with nurses and other professionals. So this model of care which is what young doctors are trading now, that's what they're looking for. Sometimes there's a tendency some of my older colleagues to say the younger doctors don't want to work. They don't want to work 80 hours a week. They don't want to be on call all the time. Well, I say good for them that they're looking to work in teams with other groups, with other physicians. They want to work in teams.

AMT: And with other medical professionals, right?

MICHAEL RACHLIS: With nurses and social workers and others.

AMT: Nurse practitioners.

MICHAEL RACHLIS: They don't want to fill out forms. They want somebody to do that for them. They recognize that other people—nurses and social workers, physiotherapists—can provide services not only as well but better than they can. They want to work in those models and they don't necessarily want to work on a fee for service arrangement. The legacy—

AMT: But we still think that we need to go to a doctor with that old-fashioned arrangement and that's what has to change.

MICHAEL RACHLIS: And that doesn't happen in arrangements where you provide the care that people need. Whether Nova Scotia for example, you mentioned, they've reorganized a lot of emergency rooms there and they have basically primary care centres now where they're able to see people the day they need to be seen. And what a surprise—people don't show up after hours. So providing good team-based primary health care which is what again we've been talking about for 45 years is where we need to go and we're a long ways away from that. But if you look at why we're not there, a lot of it has to do with the fact that as we brought in Medicare, most Canadians were looking for that new way of practising and the medical associations fought every step of the way.

AMT: Why?

MICHAEL RACHLIS: Well, medical associations in this country have maintained control over the allocation of the physician pot in Ontario. It is the OMA by and large that controls the distribution, the OHIP pot. In between agreements as we are now in Ontario, the provincial government has changed a few fees around the edges.

AMT: Okay. I just want to get some more points in. So Danielle Martin, do you agree with that? So the younger doctors are coming up, new doctors are coming up and they want to work under a different system than even the association wants them to.

DANIELLE MARTIN: They do and I have talked about this a lot. I work in a training centre where we train residents to become family physicians. There is no question. I mean first of all where we're seeing big changes in the medical profession. It's not uncommon for 70 per cent now of a medical school class to be made up of women. It's not uncommon for new graduates to have very different ideas as Michael says about work-life balance. All of which is terrific and to be respected, but if people are coming out into practice with that different set of expectations about how their work life is going to look, then someone has to take responsibility for organizing a system around them to ensure that the needs of communities are met. And I think that we are now in a moment of transition across the country actually, around what does it look like to be a medical professional moving away from the traditional model of the doctor as independent entrepreneur, fiercely separate from the rest of the health care system and moving towards models that acknowledge that we can't do this on our own anymore with the black bag going down the street in the evening to visit people. We need to work in a different kind of model and we need to be willing to be accountable to the folks who fund our health care system to our governments and to our communities for the way that we organize ourselves.

AMT: Chris Pengilly, this is an election issue in BC. Is this how the politicians are talking right now?

CHRIS PENGILLY: First of all I just want to compliment what was said and it's not only that physicians that are beginning to recognize the need for this change but patients are. They’re willing to accept a team. They're willing to see a pharmacist rather than a GP. Yes, I think the problem is—and Michael is saying why is this not happening—it’s because government are not looking for a better way. They’re looking for a cheaper way and it's not going to be cheaper. There is not a cheaper way.

AMT: Michael?

MICHAEL RACHLIS: I think that over the years, I've watched how governments tried in the early seventies, tried again in the nineties to make changes in the way that doctors are enumerated, have them work in teams, et cetera. I think that many physicians were always ready for that, now more than ever. But what we're locked into now is that provincial medical associations by and large control the allocation of dollars. So that means if you want doctors to practice in a different way, a non-fee-for- service method of payment, you need to come up with new money. Secondly, Danielle mentioned accountability. Within hospitals, most hospitals in Canada—depends by province or department sometimes—you've got measurements of doctors, you've got accountability, you've got improvement of performance. Within a community, you've got virtually nothing like that. And in Ontario, one of the major things that got the Ontario Medical Association angry the last couple of years was a suggestion and a major report that all doctors in a particular community would have to form a group if they wanted to bill OHIP. That's what one of the things that got doctors in Ontario most upset.

AMT: Okay. So the fight is going on at that level while the patients are. We have to end it there. Danielle Martin, the idea that it's a cheaper way—if people aren't getting to primary care physicians fast enough to be diagnosed, it's actually more expensive, is it not?

DANIELLE MARTIN: I think it becomes more expensive in the long term as people sort of float about unanchored in the health care system. And so there's no doubt that healthcare systems that are structured around high performing primary health care are less expensive and produce better health outcomes and that is what we should be seeking for every single Canadian.

AMT: We have to leave it there. Thank you all of you for your ideas. That is Danielle Martin, family physician and VP at Women's College Hospital, author of Better Now: Six Big Ideas to Improve Health Care for All Canadians. Michael Rachlis, public health physician and health policy consultant, adjunct professor at U of T in the Dalla Lana School of Public Health. And Chris Pengilly, semi-retired family physician in Victoria and author of The Successful and Audit-proof Medical Office. He's in Victoria. Let us know what you think. You can tweet us. We are @thecurrentCBC. Go to our website, www.cbc.ca/thecurrent. Stay with us. The news is next. This is CBC Radio One.

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Expecting gratitude from refugees can be toxic, says author

Guests: Dina Nayeri, Golsa Golestaneh, Lina Arafeh

AMT: Hello. I'm Anna Maria Tremonti and you're listening to The Current.

[Music: Theme]

AMT: Still to come—

SOUNDCLIP

I do agree that we put things on the Internet that should not be there. We did things that we should not do.

AMT: A father learns a hard legal lesson about parenting and pranking on the Internet. But first, great expectations—how expecting gratitude can turn thankfulness sour for refugees in a new homeland.

SOUNDCLIP

VOICE 1: The Alboush family busily prepares their supper. Majeed Alboush is grateful to be here with his wife and two young children.

VOICE 2: Thompson is thankful for the opportunity to pay it forward. Her mother was a Jewish refugee who fled Germany in the 1930s.

VOICE 3: We were very lucky and we are very grateful.

VOICE 4: While she's grateful to be here, she says the settlement agencies tasked with helping government sponsored refugees are overwhelmed, and she says, they feel that they've been left pretty much on their own.

VOICE 5: Taking off her glasses to wipe away tears, Asha Ahmed is grateful for the chance to build a new life.

AMT: Gratitude, grateful—words that come up a lot in stories about refugees. Many refugees want to express their gratitude to the country in which they've arrived and people in that country are often happy to bask in its glow. But novelist and essayist Dina Nayeri argues that despite the warm feelings, there can be a darker side to gratitude. Dina Nayeri was a refugee from Iran when she arrived in the US nearly three decades ago. She has also since lived in the United Kingdom, in Dubai and Rome. Over the years she has heard the word “gratitude” a lot and she's written about her reaction to it in The Guardian newspaper. Dina Nayeri’s new novel Refuge will be out in July. She joins us from London, England. Hello.

DINA NAYERI: Hi. Thank you for having me.

AMT: What were you thinking as you heard those news clips talking about gratitude in the context of refugees?

DINA NAYERI: It feels natural to me that those people would feel grateful for their circumstances and to the country that took them in. For me it feels a little bit cloying when it continues to be repeated and then there's this expectation of it that’s transferred to individual people or people who are natives of that country.

AMT: What is it that bothers you when you hear it put that way, when you hear talk of refugees being grateful?

DINA NAYERI: That's a really healthy emotion and it's a very natural one and one that I felt a lot in my first years and even beyond. But I think that in my own experience was that that gratitude quickly came to be expected and it came to be expected in individual interactions with people who really had very little to do with accepting us. It started to be the way refugees and immigrants were expected to interact with natives and that felt very problematic for me. So I think it's hard for me not to hear that in the repetition of the word in relation to these people who've been displaced and their lives have been turned upside down. And what they need is so much support and so much help and love and to be welcomed and to be thought of as a neighbour, not as someone who should be grateful.

AMT: When did you first start hearing the word gratitude in your own life in this way?

DINA NAYERI: My family has always been in one way or another religious. When were in Iran, they were Muslim then my mother converted to Christianity and gratitude is a big part of I think a lot of these religions. So when I was a child, I heard that I should be grateful to God. And that is easy to accept I think because it's a very, very personal thing. But the idea of gratitude to the Western person, the people around us who accepted us, it just started from day one when we arrived in the US We lived in Oklahoma and it was the early nineties and it was a tough time to be from the Middle East.

AMT: So what kinds of things did you hear? Were you hearing it from teachers?

DINA NAYERI: Yes. Well, I think some of it was very innocent and well-meaning. You know the teachers would say innocent little remarks like oh, you must be so grateful. Or when something horrible would happen to me like when my pinky, a big chunk of it was sliced off, the very next day I heard that I should be grateful that I was here, that those kids were playing with me, that I was okay.

DINA NAYERI: It felt like the wrong word.

AMT: Let's go back to the pinky because that had to do a lot with the fact that you were a little girl from Iran and the kids who you were playing with were bullying you essentially. Were they not?

DINA NAYERI: The thing I remember very vividly is that they didn't in the first couple of days and that's a child's instinct. Those children wanted to be my friend. I think that as soon as they went home and explained to their parents who I was and where I was from, this seed started to be sown that I was someone who maybe wasn't their friend and very soon a small group of them started to aggressively bully me. And that eventually escalated to that piece of my pinky being chopped off.

AMT: Somebody put your hand in the door and the other one slammed it. It was very deliberate.

DINA NAYERI: Yes. Yeah.

AMT: How do racism and gratitude connect?

DINA NAYERI: Well, wow. I think when you expect a group of people to be grateful to you then there's this assumption that you're somehow superior to them. So I found it really interesting to think that maybe this is not really about immigration and displacement as much as it is about race.

AMT: As much as it is about you should be grateful that that means that you are allowed to be here kind of thing, that you are allowed to exist next to the others.

DINA NAYERI: Right. Exactly. That's the case in America and in Europe when immigrants come in. I think the idea is oh well, you come into our neighborhoods and you don't necessarily make it better. We accept you out of our generosity and out of our goodwill. And so you should forever be kind of bowing your head a little bit. And I find that really, really awful and quite a burden that a lot of these people have to bear silently. This is the vast majority of the e-mails that I've gotten have been about this, like this is such a burden we had to bear silently.

AMT: Well, I think it's really important that we talk about this because you know in Canada a lot of new Canadians—new Canadians because they do have permanent resident status—already have arrived from Syria. And what you're suggesting is some of the way that someone who is already here might talk to someone who's just arrived is offensive. What did you want to hear that you didn't hear?

DINA NAYERI: The word I would use—although I do find it offensive—but it's hurtful more than that. You don't feel welcome and I think what I would have loved to hear is, I would have liked to get the feeling that they wanted to know about me and who I was. I would have liked them to want to know about the country that I left and to understand that I am displaced and homesick and frightened and that maybe grateful isn't the primary thing I'm feeling. Maybe the primary thing I'm feeling is fear and homesickness and a desire to be loved and accepted and to have friends again.

AMT: Because even a country that you flee because you must flee, it's the politics. It's not the country. It's not the people. It's not the culture.

DINA NAYERI: It's home. It's still your home. It still has all the beauties from your childhood and all the places that you grew up in. Even if it is absolutely horrible which some places are, it's not about how good that place is. It's about being asked. The native people who are welcoming these refugees and wanting to know about them as individual people, not just their horror stories so that they can feel good that they have saved someone.

AMT: And so all these years later, what conversations about refugees are you hearing that still make you uneasy?

DINA NAYERI: The conversations I'm hearing now are very, very different from the ones I used to hear. One because the world has changed but two because I surround myself with a different kind of people. I mean the people that I'm around now are not Midwestern conservatives. They’re liberals. They're from New York and London and places that I've chosen to live in my adulthood. But even then, there's a disturbing narrative of look, the immigrants are beneficial to us. Look at all the good that they do in terms of the economies and building great communities and providing diversity, mix of cultures and all of that is great. And it's true. But that is not the case for accepting refugees into a free country. The case is that they were in danger and that their lives were in danger. And these are people and children that were going to die. It doesn't matter if they then go on to add nothing to your community.

AMT: Do you think there was a pressure on you to be “successful”?

DINA NAYERI: Oh, are you kidding? Absolutely. I was obsessed with it from the first moment I had the feeling that I was taking up space that didn't belong to me. In Iran, I had been a little girl that was celebrated for me, just like all the other little girls were. And in Oklahoma, it was that I had kind of squeezed my way in and I didn't belong there. So immediately I felt the need to prove that I actually am an asset to the society. That I'm smart, I'm academic, I can be the best in school and so that's what I did. And then in my teenage years, it became such an obsession to succeed in the American way. I mean I did some crazy things. I practiced sports for six or seven hours a day. I started my own little mini non-profit. I did all of these things just so I could get into a fantastic university. I thought that if I didn't, my life would be over because I would have no value or worth. It took until my mid-twenties to realize actually everything that's special about me has nothing to do with any of those things.

AMT: And this came from the people around you from your new country.

DINA NAYERI: Not directly. I mean nobody around me was saying well, Dina, it's time to prove yourself. Absolutely not. I think it was more of the attitude, attitude of indifference. I was just taking up space. I wasn't special. Nobody asked about my life in Iran. Nobody treated my mother the way they used to treat her with respect and reverence in Iran and the kind of respect that most women get, not anything above that. Just being refugees and not just refugees, but Iranians, we were a tier lower and as a result, I felt the need to prove myself so nobody was asking me to have those accomplishments. It was something that I felt was the answer to it.

AMT: Right. And you make the point that your liberal friends will talk about that today. Sometimes people talk about the contribution that immigrants or refugees make as an argument to those who don't believe they should be allowed in.

DINA NAYERI: Right. Yeah. That's exactly what I'm talking about.

AMT: But you're saying you shouldn't have to argue that. You should argue compassion. You should argue humanity.

DINA NAYERI: Absolutely. I mean I think the basic argument should not be that or at least if you're going to make that secondary argument. you should always begin with “But wait, we need to understand that those lives are just as important as ours and that also we are here by an accident of birth.” People just keep overlooking that because it's such a simple argument. It's such a basic thing to say but I feel like people are forgetting it. Why should we have to prove our worth in order to argue that people's lives should be saved? You know this makes no sense to me. The contribution to society shouldn't matter when they're on the verge of death. People in the the western world are where we are by an accident of birth. Well, not me. I'm here because I'm a refugee.

AMT: Now if a refugee is genuinely expressing gratitude for living in a country where there is peace or living in a country where they can start again or raise their children in a way that they could not any longer at home, what is wrong with that?

DINA NAYERI: Oh, absolutely nothing. I think personal gratitude to a country, to you know some higher power, to the universe and to those communities is healthy and necessary to be happy and necessary to get along. I think it's the expectation of gratitude that is toxic.

AMT: As if they owe a debt of gratitude.

DINA NAYERI: Exactly and especially in just these day to day interactions, people are very, very good at picking up subtle hints. You know it's not very hard to read someone who actually believes very close to the surface that your being here is an inconvenience to them. Your being here is very, very lucky for you and it raises their taxes and it makes life hard. And so you know they're going to be nice to you, but you should just remember all that just throughout this entire interaction. That is something that can be communicated in an unspoken way very easily by anyone. So it's not really very hard to feel that from someone. And that's the thing that I think is toxic and wrong and we should try to root it out. When I wrote this essay, so many people e-mailed me on the other end of things saying how could you say that people shouldn't be grateful? Gratefulness is healthy. You are so ungrateful. And that's not the case. I think that gratefulness, it's a wonderful sentiment and it's one that I feel all the time in my life.

AMT: But it shouldn't have to define why you are somewhere.

DINA NAYERI: It shouldn't be kind of a basic level expectation as it relates to your interactions with other people. It shouldn't be the thing that separates you from natives, people who are born there. They should be just as grateful. We should all be grateful. We all are now in these safe countries however we got here.

AMT: It's important to hear what you have to say. Thank you.

DINA NAYERI: Thank you for having me.

AMT: Dina Nayeri, a novelist and essayist. Her new novel Refuge will be out in July. She joined us from London, England. Well, the news clips you heard earlier were from recent stories about new refugees to Canada and we have two people here to give us their thoughts on how gratitude fits into their stories as refugees. Golsa Golestaneh is originally from Iran and came to Canada with her family through government sponsorship in 2014. She's an activist for refugee rights and social justice. She's in Vancouver. Lina Arafeh came to Canada in 2016 and is from Syria. She has worked as an interpreter and translator. She's in Halifax. Hello to both of you.

BOTH VOICES: Hello.

AMT: Golsa Golestaneh, let's start with you. What do you think of what Dina Nayeri has been talking about? Does it resonate with you?

GOLSA GOLESTANEH: Oh, absolutely. It was just a lot of things that we as refugees in my community and immigrants in my community talk all the time about. We get really frustrated on these issues and it’s just always with us why are we looked up on like that, that we are a different sort of individual that has to have different feelings about living in a space just because of their background. So I felt like someone finally spoke up. Someone finally put an end to all these introductions saying she is very grateful because like I have been a victim of those introductions myself, whether by the media, by regular people. So I felt really relieved that someone took this heaviness from our backs.

AMT: Give me an example of how you've felt that pressure.

GOLSA GOLESTANEH: Ah, there are tons. But the most recent one, it was just the headline of this interview with me and a bunch of other refugees from seven banned countries that are not allowed to go to the US anymore. The headline was just saying “not banned here.” It just had nothing to do with what I had said. My purpose of that interview, I want to spread the word about this rally that is going to happen soon by the border and I am organizing it. I wasn't intending to advertise for this country and this government.

AMT: So in other words the headline said “we're better than them” essentially.

GOLSA GOLESTANEH: Yeah. Exactly.

AMT: That was the undercurrent. Okay. Lina Arafeh, what were you thinking with what Dina Nayeri had to say? How do you react to it?

LINA ARAFEH: Well, before I listened to Dina actually, I have always sworn by the word “gratefulness”, “gratitude”. It was always you know a part of my life. I have always been grateful for very little things in my life. But after listening to her, you kind of feel that she has some right, you know. Gratefulness should not be begged from someone or imposed on someone. It's something you either feel or you don’t feel and if you feel you need to show it. But I'm really grateful for one thing. I'm really grateful for being so lucky that I have only been exposed to some fantastic people in Canada. When my kids went to school, I'm very grateful to the teachers and the students. Everybody has been helping them, showing them the way, suggesting things that they didn't know, introduce them to events that they have not heard about. All of this makes me grateful. I was really grateful when I woke up one day and the snow had filled my driveway and I found my neighbour shoveling it for me without me asking. He knew somehow that I don't know how to do it. I was very, very grateful. But if I'm walking in the street just because you know a Canadian happened to be my neighbour for example and they expect me to be very grateful for nothing that they had done, I don't know. I wouldn't be upset like I wouldn't resent that fact. I would say yes, thank you of course. I would say it. But maybe they don't have that right. The country, Canada as a government, I am very grateful to the country, very, very grateful. The people who have helped me, the teachers, the neighbours. Where I'm working at the moment, my boss is trying to be patient with me and very grateful for that, I’m sure.

AMT: But do you feel you need to show an extra level of gratitude to Canadians, Lina?

LINA ARAFEH: Of course. Absolutely. Yes. I mean as a mother when I put food on the table, I do expect my kids to say “thank you.” Otherwise I wouldn't make an effort.

AMT: No, but I mean do you feel that because you have come from Syria that there's an expectation that you'll be thanking everybody else in the country a lot?

LINA ARAFEH: Everybody in the country, no. But there are people who have gone the extra mile. There are those who have sponsored families, paid a lot of money for families. They have done all they can do to help. I know for example they are having sessions, welcome ambassador sessions to teach Canadians how to be sensitive to the emotions of refugees. How can I not be thankful and grateful? But to other people who have done nothing, who have lost nothing, who have not suffered anything, I mean I would still say thank you. But I’m not obliged to.

AMT: Golsa, what do you think Canadians are willing to hear from people like you? I mean people like you meaning somebody who is a refugee who wants to talk about this. They're only willing to hear certain things?

GOLSA GOLESTANEH: From my personal experience, what I can say is that as long as I talk about how miserable I was back home, how miserable I was as a refugee claimant in Turkey, as long as I talk about how happy I am that I am in Canada, that I'm saved finally by the saviour of this, they are always willing to listen. But it was after I started to actually stop talking about my past because I realize nothing is going to change in those countries. It's only spreading what we call Iranophobia. And that was when they stopped wanting me to talk. In my first year in here I was invited to maybe like four different events to speak as a keynote speaker, an 18 year old. But after a few months that I stopped actually talking about my past and then started talking about my struggles in here, my parents’ struggles in here, that was when I was not invited anymore. I heard even from one of these settlement workers that he said I wanted you to be a speaker in this panel. But they said she's too loud and I just didn't understand what that means.

AMT: When you say too loud, so they didn't want you to criticize.

GOLSA GOLESTANEH: Exactly.

AMT: Do you feel free to criticize Canada? Do you criticize anything in Canada?

GOLSA GOLESTANEH: I criticize a lot of things. I feel free to actually do it. But the thing is my criticism never reaches anyone's ears. I always say everything whether it is to the media, whatever it is, how I struggle, how it's important for me to solve those issues. But the only thing that is important is that I came here from Iran, my parents escaping persecution are the only thing that I always read about myself. They stick to what they want to hear.

AMT: What do you want to say about life in Canada as a refugee that people don't want to hear?

GOLSA GOLESTANEH: There are a lot of stigmas around being a refugee in Canada and it's really not the heaven that a lot of people think. I experienced racism every day every time I have difficulties understanding one sentence in English or like I just need it to be repeated. I get eye rolls. Whenever I’m on the train and I feel scared because of my skin colour to be attacked, that is not the safety that I claimed for. That is not why I fled my country for. So I'm basically just going back to my country to see if I actually feel safer in there rather than here. I want people to know that I don't know why everyone attacks me whenever I say I expect that something better than what I'm going through every day.

AMT: Okay. So let me just clarify. You are going to visit Iran to see if you want to live there again?

GOLSA GOLESTANEH: Yeah. I'm going to visit for two months. I think I really need it mentally and emotionally. I left when I was 15. I never experienced Iranian society, Iranian life.

AMT: Let me just ask you a practical question. If your parents were persecuted politically, can you go back to Iran? Are they just going to let you in?

GOLSA GOLESTANEH: It's kind of 50-50, but most probably yes because from what I've seen, a lot of people can.

AMT: Lina, I want your reaction to what Golsa is saying because you've come here with your children and the idea that maybe they might want to go back to Syria because she’s expressing it's not as good here as she would have expected. It's difficult. What do you take from what she's saying?

LINA ARAFEH: I have spoken to many of my Syrian refugee friends here and they are saying the same thing. In fact, you know that as soon as Syria recovers, they’re going back. I don't want to say that this is ungrateful because not all of them speak English. Some of them feel stranded. Some of them were deployed to Canada, others to Germany, others to England. So they don't go where they wanted to go. So I would understand. I think if you have children, being in Canada is the best thing that you can do for your children. This is one of the reasons why I also believe that some Canadians should also feel grateful to refugees. Because we feel that we are treading on everyone else's toes, we have to prove our best. This in itself is something. It’s an asset to Canada, I would say. Every single day, I send my kids to school saying, “You have to prove yourself. You cannot waste your time. You have to show them that you are doing well. You want to contribute something to Canada in the future so that they don't regret it.” I have learned that if you want a certain outcome, the outcome I want is to be happy. There is this event and that is the reaction. The event is for example people asking you to be grateful and the action is you either feel offended or upset or you just smile and say “Of course I am grateful.” So the way you react will affect the outcome. Honestly it's not that I don't feel it. I feel it. But if it makes people happier to hear it, then I will make it heard. It’s not enough to feel appreciation and not say it.

AMT: We're going to have to leave it there, but thank you both for your thoughts today.

LINA ARAFEH: You’re welcome.

AMT: Bye-bye.

GOLSA GOLESTANEH: Bye.

AMT: That is Golsa Golestaneh who came to Canada from Iran in 2014. She joined us from Vancouver. Lina Arafeh came to Canada in 2016 from Syria. She joined us from Halifax. We will continue on this issue in a moment with Vinh Nguyen. He studies refugee stories at the University of Waterloo and he argues that countries taking in refugees use their gratitude to build the image of their own nation and sometimes countries even use it to justify war. So Vinh Nguyen will give us his thoughts on all of this in about 90 seconds. And as well in our next half hour, we're talking about DaddyOFive, the YouTube family channel and the ethics of making your fame and fortune by using your kids. And in this particular case in using the kids, are they being pranked? Is it just a prank? Is it child abuse? Lots of questions about that now. I'm Anna Maria Tremonti. This is The Current.

[Music: Sting]

AMT: I'm Anna Maria Tremonti. This is The Current. We are going to continue our discussion about refugees and gratitude. If you're just joining us, I spoke in our last half hour with author Dina Nayeri. She arrived in the US as a refugee from Iran as a child. She says from day one, she began hearing comments about how grateful she must be to be in America. And Dina Nayeri argues that while being thankful is a healthy emotion, gratitude can be toxic if it becomes an expectation from those in the country which accepted the refugees. We also heard the perspective of two recent refugees to Canada on the meaning and limits of gratitude. And if you missed those conversations, you can hear them on our website, www.cbc.ca/thecurrent, or go to the CBC Radio app or download the podcast. Now as we've heard, questions of gratitude form a central part of the refugee story and these stories are something our next guest has studied. Vinh Nguyen is an assistant professor of English at the University of Waterloo. He researches refugee culture and literature. He came to Canada as a child as a refugee from Vietnam and he is with me in our Toronto studio. Hello.

VINH NGUYEN: Hi. Thank you for having me.

AMT: Why is gratitude so central to the refugee story?

VINH NGUYEN: Gratitude, it has something to do with the ways in which we conceptualize and conceive a refuge. And so I think we understand refuge not as a moral obligation, as something that on principle we should extend to all human beings. Right. But we understand refuge as a gift, a kind of benefit that is bestowed upon the “lucky ones”. And so in some ways this understanding of political refuge creates this relationship of debt and repayment that then becomes I think both an internal expectation for a lot of refugees but something that the host nation, the receiving nation also comes to impose upon and expect of these people who have been given this gift.

AMT: Right. Okay. So let's break it apart a little more. What positive elements does gratitude offer to refugees?

VINH NGUYEN: Gratitude is an incredibly healthy emotion, an incredibly healthy feeling and it functions in a variety of different ways. But I think one of the things that it can do for refugees is that it can really provide them with a kind of public platform, in that stories of refugee gratitude and refugee success are incredibly palatable and digestible to the mainstream public. And these stories can really give refugees a voice, a kind of public visibility within the national community.

AMT: But that has downsides built right into it, right, because if it gives them a voice as a refugee, it might give them only the voice of the refugee as opposed to a person living and thriving next to everyone else.

VINH NGUYEN: Right. So the danger is that it becomes a very restricted voice, right, that that voice can only have one kind of expression which is the expression of gratitude. But in my study, what I've found as well is that gratitude can also be a way of criticizing the nation. That expression of gratitude, the public visibility that refugees have can be a way of asking the nation to live up to its ideals of compassion and generosity and humanitarianism. So I think it does have a critical edge, that it can have a critical edge.

AMT: Well, that's interesting. So for example, when the debate over the bringing in of Syrian refugees was under way, a lot of us looked at the 40-year history of Canada bringing in the Vietnamese, the so-called boat people. And that was used almost as a reminder that Canada had stepped up and should step up again.

VINH NGUYEN: Absolutely. It's a reminder that look, we are capable of compassion, that we are capable of being generous to refugees and we've done it before. And what it does is that it kind of puts into sharp relief how we're not doing it in the present moment. Right. The lack of compassion, the lack of generosity, the kinds of restrictive policies that are actually in place.

AMT: Is there a danger though that countries who take in refugees use gratitude to their own ends?

VINH NGUYEN: Absolutely. That gratitude can be co-opted by sort of nationalistic narratives. So for example just a few months ago, Prime Minister Justin Trudeau tweeted, he writes here: “To those fleeing persecution, terror and war, Canadians will welcome you” and this was in response to Trump's Muslim travel ban. So that kind of public display is really useful for the Canadian nation in projects of nation building. This creates this image of Canada as being this haven of refuge, as having an open door. Stories of refugee gratitude can function in some ways as supporting evidence for this narrative so we can say look, Canada is welcoming and tolerant and here are the really good successful refugees who are grateful and they are the evidence of that. But what that actually does is it obscures the kinds of restrictive policies that are actually place. So in fact, Canada doesn't welcome all and there are policies that are in place that bar a lot of people from claiming refuge.

AMT: How can the gratitude of refugees be used at times to even justify a war?

VINH NGUYEN: A lot of American scholars have talked about how these good, successful, grateful refugees are used by the American media and the American government to turn the war into a successful war. So we know that the US lost the war in Vietnam, but their use of the successful refugees to say that they've rescued and liberated these refugees as a way of saying look, we went to war. We intervened militarily. This is why we were there in the first place. And it becomes a way of also justifying further war, right, wars in Afghanistan and Iraq.

AMT: Used as a propaganda tool almost.

VINH NGUYEN: Yes. Absolutely.

AMT: What was the moment for you personally when you felt this conflict over the meaning of gratitude for refugees?

VINH NGUYEN: I'm a refugee so of course I feel grateful.

AMT: Well, you don’t have to.

VINH NGUYEN: [Laughs] Of course I feel grateful. But I think what's interesting and I think what Dina’s article has really brought up for us is this idea of how do we find a different way of relating to refugees beyond this relationship of gratitude. How can we be very thankful to the variety of different people and groups that have helped them make this new life? But also point out that this life isn't perfect, that there are conditions such as racism.

AMT: Then that becomes a question of what do we need to think about if we want to welcome refugees, if we want to speak to people about the past that might have been a struggle to get here but we don't want to pigeonhole them, how should that conversation go? Give us some ideas.

VINH NGUYEN: I think that conversation needs to number one be based upon this idea that these refugees come from very complex lives. Right. That they're not sort of one dimensional people who are fearful, who are persecuted, who experience misery. So it's either that or these are people who are grateful and are successful. One of the things too is that we tend to think of refugees in a way that is very stereotypical as all one sort of group that has these—

AMT: The same experience, yeah. Maybe we should just be asking what they miss about the country they left behind so they can tell us something that isn't stereotypical.

VINH NGUYEN: Or maybe asking what refugees need is I think probably a better question. What do they need to be comfortable? What do they need to build a new life here? Do they want to go back? Do they want to stay? What are their desires? Frame it in that way perhaps.

AMT: And even the labeling of a refugee. I introduced you as a refugee as a child.

VINH NGUYEN: Right.

AMT: Should I have done that?

VINH NGUYEN: For me, yeah. For me it's a complex question, right, in that being a refugee and having gone through that experience, that has shaped my professional life. It's shaped the people that I'm attracted to, the communities that I have built. It has shaped my politics. Even though I'm a Canadian citizen now, but that experience of refugee has stayed with me. There are people though who want to forget and want to leave that history and that past and that experience behind and I think that's also really important. I'm in a position where I can talk about these things, but other people don't want to be identified as refugees. And I think that should also be respected.

AMT: Thanks for sharing your thoughts.

VINH NGUYEN: Thank you.

AMT: Vinh Nguyen, assistant professor of English at the University of Waterloo. He studies refugee culture and literature. He joined us in our Toronto studio.

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Where's the line when it comes to prank videos and children?

Guests: Brittany Britto, Bob Thompson

AMT: You're listening to The Current on CBC Radio One, Sirius XM, online on www.cbc.ca/thecurrent and on your radio app. I'm Anna Maria Tremonti. And now we're going to talk about the point when pranks stop being funny and a warning: you may find this next clip a little difficult to listen to.

SOUNDCLIP

VOICE 1: I bought this here invisible ink and I'm going to squirt it all over his carpet.

VOICE 2: I didn’t do that.

VOICE 3: What the hell is that? What the hell is that?

VOICE 2: What is this?

VOICE 3: Cody.

VOICE 1: You tell me.

VOICE 2: I didn’t do that.

VOICE 1: You tell me what you did.

VOICE 2: I swear to god I didn’t do that.

VOICE 3: Cody.

VOICE 1: You coloured your carpet.

VOICE 2: I didn’t do that. I don’t have anything to colour with it.

VOICE 3: Why did you do that?

AMT: Well, that was a scene from the DaddyOFive YouTube channel. It is a so-called family channel and it's at the centre of a growing controversy over what's being called the dark side of the so-called prank video. Mike and Heather Martin—the adult voices you heard—have over 760,000 subscribers. It's all come to a stop. Last week a growing online backlash concerned for the welfare of the children in those videos culminated in a tearful apology issued by the Martins.

SOUNDCLIP

VOICE 1: I am ashamed. It started out as family fun. It started with me and my kids. With them it was just about making a video.

VOICE 2: They would get excited when they would get a lot of views and you know it was more for shock value. It's a character. It was a show—a bad show—but it was a show. We did do pranks, but most of the time the kids knew about them. They were planned. Some stuff is real. Some stuff was acted out, scripted.

AMT: Well, you can hear more of that show behind that apology. This week it was confirmed the two youngest kids—who are nine and 12—were taken out of the home that Mike Martin shares with their stepmother, Heather. Their mother has been given temporary emergency custody. The Martins are far from the only family to have capitalized on YouTube's pay model by exposing some real or fake version of their family to the world. Today we're asking where to draw the line when it comes to prank videos and or making money off children with those videos. Brittany Britto is a features blogger and reporter at The Baltimore Sun. She's written about the controversy swirling around DaddyOFive. She is in Baltimore, Maryland. Hello.

BRITTANY BRITTO: Hi. Thanks for having me.

AMT: Well, we'll get to the Martins in a second, but what are family prank videos generally like?

BRITTANY BRITTO: So a prank is a practical joke, something that you play on usually a friend or a family member and you're looking for a reaction and it's something that's supposed to be kind of funny. So there have been simple pranks like using water and splashing it on someone and kind of filming the reaction to more extreme examples. There was an example that I saw a couple of months ago where a father was playing with his son and pretended to throw a doll that looked like his son over a railing which obviously really upset the mother who he was pranking. So you've got a range of different types of pranks that happen.

AMT: How popular are they?

BRITTANY BRITTO: So I know on YouTube, there is a whole genre of pranks and people tag them as “pranks”, “funny”. If they involve children they'll tag the word “kids”. It's pretty popular. You've seen them on different television shows, America's Funniest Home Videos and things like that.

AMT: How lucrative are these videos on YouTube?

BRITTANY BRITTO: Well, from what I know, the Martins mentioned in some interviews that they were able to give their children things that they couldn't afford before. All of their videos were at one point monetized, so they were making money off of those as well as getting fan mail and gifts sent to them by viewers.

AMT: So tell us more about the Martin family. There are five kids?

BRITTANY BRITTO: Yes. Five kids. Three of them are Heather's biological children from a previous relationship and then the two youngest and then Cody are Michael Martin's children with the biological mother, Rose Hall.

AMT: And so it is the two youngest children who have now been given—Rose Hall has taken custody of them?

BRITTANY BRITTO: Yes. And there is supposed to be a hearing this Friday. And from what I'm told from Rose Hall's lawyer, a decision regarding custody or investigations could be made as early as next Friday.

AMT: So we heard a little bit of that where Cody is the little boy who's sounding hysterical and saying he didn't do that. What kind of videos do they usually post?

BRITTANY BRITTO: So there's a range. Most of them do include a lot of that yelling that you hear in that video. I've haven't watched all of them. There were nearly 300 videos that existed on this YouTube channel. But some of the most disturbing that I saw, there was one where Michael Martin pushed Cody. It appears he pushes him into a bookcase and it seems as though his nose starts bleeding and you can even see him go to a pillow and kind of wipe his face and there's red on the pillow. So a lot of the public was really disturbed by that. There were several videos of Michael Martin smashing some of their toys, namely Xboxes and it seemed as though he did separate parts. So there was like smashing the Xbox Part One, Part Two. And in the other videos, people were pretty upset when they saw that a lot of the kids were fighting, some of the time Michael Martin was instructing one of his sons to slap his daughter as if it was a game.

AMT: I watched one last night where Cody is in the bathtub and he's just hysterical. He's telling his father to go away and get the camera away and it just goes on and on and on.

BRITTANY BRITTO: Yeah. There's a lot of instances where these children are asking not to be filmed especially when they're upset. In one video I remember Michael saying I have to film my life, you know that.

AMT: But we don't know if it's real or if the kids are acting? What do we know?

BRITTANY BRITTO: That's what Heather and Michael Martin have said in their apology video and also when I spoke to Heather Martin, she mentioned that you know the children got excited about these views and wanted to film these videos. And they’ve mentioned that it started off as family fun and the pranks were real. But over time they became scripted and character acting apparently.

AMT: So this was raised because another YouTube person actually raised the issue. Am I right?

BRITTANY BRITTO: Yes. So it seemed as though around April 17th, the invisible ink video, invisible ink prank got a lot of attention and a YouTuber named Philip DeFranco brought some attention on his YouTube talk show. And I think his video has gotten more than like three million views. People were very outraged by his clip which kind of showed a montage of some of the videos.

AMT: So again, the parents are saying that the videos were fake or scripted and they actually said the increased attention is what's hurting their children.

BRITTANY BRITTO: Yeah. They came out with a video before the most recent apology video released on April 22nd and that video was called “Blocking all the haters”. That video has since been deleted. But in that video they did say that the viewers who are taking issue with their videos and making comments were the ones that were bringing drama to their children, not the actual pranks. I think over time they have apologized for their actions, but they've still have said we're seeking counseling—not only to get over the media stuff—but also to show what we did wrong as parents. So there is kind of this element where they're sort of placing some of the blame on the public for what's happening.

AMT: Okay, Brittany. Thanks for bringing us up to speed on this.

BRITTANY BRITTO: Absolutely. Thank you for having me.

AMT: Brittany Britto, features blogger and reporter at The Baltimore Sun. She is in Baltimore. The Current requested an interview with Michael and Heather Martin. They live in Maryland. They declined. Well, whether they are real or scripted, the Martin family videos raise ethical questions about the use of children in videos on social media platforms. Bob Thompson is the director of the Bleier Center for Television and Popular Culture at Syracuse University. We've reached him in Syracuse, New York. Hello.

BOB THOMPSON: Hello, how are you?

AMT: I'm well. I'm interested to know what you think of this. When you took a look at some of these prank videos, what did you think?

BOB THOMPSON: Well, the first thing when anyone looks at kids being screamed at and then the kid's crying and convulsing and all the rest of it, it's very, very disturbing. And it is the kind of thing that is so disturbing it's hard to stop watching because you can't believe that it's happening. However, it's really hard to rationally discuss this particular case because we know so little about what is exactly happening, including this idea of how scripted it is. A lot of people say those kids couldn't possibly be acting or they'd be getting Oscars. But I've looked at what videos are still available and I could see that this could be acting. So there's all kinds of issues. How is this family treating their kids? Are they treating their kids in horrible ways so they can get more views? How much are the kids a part of the whole thing? And even if the kids are part of it, should you be doing that kind of thing with your kids and putting it up for the world to see?

AMT: Well, I guess that that gets us to the ethical concerns about some exploitation of families. I mean YouTube pays for the content, am I right?

BOB THOMPSON: Right. There's a formula where they get paid depending on how many views and that whole pay mechanism. But you know this isn't just social media. We've had 18 and Counting, Jon and Kate Plus 8. We've had a lot of these family reality shows on big cable channels and I think there are ethical issues there. I think the idea of kids before the age of consent who are suddenly put into these positions where they're getting a lot of attention and people are looking at their family life. These kids have very little say in whether they're on these shows, whether they're reality shows on cable or these YouTube videos.

AMT: And there really has been an explosion over the last decade or so. I'm wondering if anybody is following what they're like as they become adults, like when they turn 35 or something.

BOB THOMPSON: Well yeah, I mean that would make an interesting study because some of them are becoming adults. What becomes of Honey Boo-Boo? Well, we know with the Duggar family that there was all kinds of bad, bad stories that circulated around that. But with this particular Martin case, we do need to keep in perspective—I think one of the questions people ask is—are we complicit by watching this stuff and why is this kind of thing so popular? And they did get impressive numbers. As your last guest has reported, there were about 300 videos up there before they took them down and they were getting oftentimes more than 100,000 views. But DaddyOFive had 765,000 subscribers. That sounds like a lot. It's just a raw number. But let's remember: that's a tiny, tiny percentage of people who go on social media. Down here alone there's over 300 million in the population. If you had all the people who have access to this, not a whole lot of them are watching.

AMT: And who is watching? Any idea?

BOB THOMPSON: Well, no. I don't think we have any demographics of who's clicked specifically on this. There are fans of prank videos. As it was pointed out earlier, these things get tagged as such. And you know there is a certain appeal to pranks. Candid Camera was one of the first reality shows ever and it was based on the idea of pranks. We've seen it in America's most embarrassing moments and America's Funniest Home Videos and all that kind of thing. For that matter, we have a holiday celebrating pranks—April Fool’s Day. It's just that on social media which has virtually no standards, some of this stuff is getting really mean spirited and scary and creepy.

AMT: Well and it's involving children.

BOB THOMPSON: I think that’s the big issue here. And children who are not old enough to give consent to the people who give consent for children are their parents, and it's the parents themselves who are making the video.

AMT: So this particular story, you make the point that it's probably getting even more attention to an audience that didn't know they existed now. But this particular story, do you think it will cause any change?

BOB THOMPSON: Well no. I think some people will have raised consciousness with regards to it. But I think there are other people who are wanting to break through the infinity of material that is YouTube, will look at this as an opportunity that oh, this outrageous video is getting all this attention for being so outrageous. And that's really the mechanism that a lot of people operate on. You’re right. I hadn't heard about DaddyOFive until the controversy started. So all of that I've seen about it has come from that guy who put together a collection of the complaints. So the video that complained about these people that got three million hits, got a lot more hits than the videos did before the complaint came.

AMT: Where’s YouTube’s responsibility in this though?

BOB THOMPSON: Well, that's difficult. I mean they just carry this stuff. They can respond to complaints and I think they need to do that as does Facebook and all the rest of it. But it's kind of like if you're a cab driver and somebody gets into a cab and you take them to a destination where they're going to do really bad things, that's a tough sort of responsibility thing to figure out.

AMT: Except you're the virtual cab driver and you're making a lot of money off somebody exploiting their kid.

BOB THOMPSON: These are all of these ethical issues that we have really not had time or bothered to figure out in all their complexity. When you had a few cable channels, a few broadcast channels and those were operated by people with long traditions of standards and everything, these were not issues that came up.

AMT: Okay, Bob Thompson. We have to leave it there but thanks for your thoughts on this.

BOB THOMPSON: Pleasure is mine. Thank you.

AMT: Bob Thompson, director of the Bleier Center for Television and Popular Culture at Syracuse University. He is in Syracuse, New York. We want to hear from you on this. What are your thoughts on prank videos on YouTube, on parents of using their children on YouTube family channels? Good idea? Not so good? Tweet us @thecurrentCBC, find us on Facebook, e-mail us from our site: www.cbc.ca/thecurrent. That's our program for today. Stay with Radio One for q and Tom Power. We were talking about gratitude earlier. People feel grateful for many things in their lives and in 2000 the film American Beauty won Academy Award for Best Picture, something for which those people no doubt felt grateful. We're going to leave you with the final moments of that movie, American Beauty. Here is Lester Burnham played by Kevin Spacey—who won the Oscar for best actor that year—reflecting on gratitude. I'm Anna Maria Tremonti. Thank you for listening to The Current.

SOUNDCLIP

I guess I could be pretty pissed off about what happened to me. But it's hard to stay mad when there's so much beauty in the world. Sometimes I feel like I'm seeing it all at once and it's too much. My heart fills up like a balloon that's about to burst. And then I remember to relax. And stop trying to hold on to it. And then it flows through me like rain and I can't feel anything but gratitude for every single moment of my stupid little life. You have no idea what I'm talking about, I'm sure. But don't worry. You will someday.

[Music: Ending theme]

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