When asked whether they shape public opinion or reflect it, journalists working for national news media tend to affect wide-eyed innocence, insisting that they simply report the facts and that it is for their readers, listeners and viewers to reach their own conclusions. The dimmest of them may believe such nonsense; when the brighter amongst them reiterate it, they know perfectly well that they are being less than candid.

Over the past year, three stories have demonstrated the realities of this all too clearly. They have also shown what can happen when the media climb aboard a bandwagon for a journey of indeterminate duration with no obvious destination and from which they are then unable to disembark.

The first concerned the H1N1 Influenza A virus, which surfaced in Mexico in April 2009, spread rapidly and was declared a “pandemic” by the WHO two months later. It is a pity that it was given the emotive name “swine flu”, not least for Egyptian pigs, which were immediately slaughtered en masse in a knee-jerk response to the implied connection. So melodramatic a name provided the media with a running story which they milked for all it was worth. Every new case was pinpointed and reported on breathlessly by a journalist standing in front of the school or hospital in question. Each of the very few deaths associated with the condition became front-page news, albeit usually with the grudging caveat that the victim had already had an underlying medical condition. Only when the public began to realize that the disease was no more serious than annual, seasonal influenza was the story quietly dropped, becoming yesterday’s news.

Despite such frustrating distractions, the government did well. They missed no opportunity to state the facts, were consistent in their messages and implemented a coherent and properly-developed contingency plan. So measured a response did much to reassure people and to prevent media-induced panic.

The second story, about parliamentarians’ expenses, was far more damaging. Few people can doubt that the rules governing them were too lax, that a few MPs and Peers may have defrauded the system, or that rather more were careless in their accounting or injudicious and extravagant in their claims. All that could have been exposed by front page features about the worst examples spread over, perhaps, two or three days. There can be no doubt that this would have triggered an urgent inquiry, rapid re-jigging of the rules and prosecution of those who appeared to have broken the law. Instead, The Daily Telegraph chose to spin the story out – day after day, week after week, for what seemed like an eternity. Not to be left out, the rest of the media clambered onto the bandwagon.

The result was a massive loss of public confidence in those who represent our interests in Parliament, probably to the benefit of extremist minority parties like the British National Party. Just as damaging, it led to the development of a mass persecution complex amongst parliamentarians who, guilty or not, were subjected to gross public opprobrium and never knew whether they would see their names splattered across the next day’s front pages. It is scarcely surprising that so many MPs have decided to stand down rather than face the electorate in the forthcoming general election; the price we shall pay is the loss of a great deal of very valuable experience and expertise.

The third example concerns the reporting of casualties in Afghanistan. It has become de rigueur to report each individual death, to name the serviceman concerned and to show film and photographs of the repatriation through RAF Brize Norton and Wootton Bassett.

As an ex-regular soldier myself, I have nothing but admiration and respect for the work our servicemen and women are doing in very difficult circumstances – fighting a ferocious war against a capable and committed local enemy. Nor do I have anything but the deepest sympathy for the families and friends of those killed in that war. But I wonder if we should not get all this into perspective.

Especially since the invasion of Iraq and the beginning of the war in Afghanistan, everyone joining the armed forces has done so in the expectation that they will see active service and that they will risk life and limb in doing so. That goes with the job. Unpleasant a reality as it may be, war always involves injury and loss of life.

The Falklands War, which lasted for two and a half months, from 2 April to 14 June 1982, resulted in the deaths of 255 British servicemen. So far, the war in Afghanistan, which began on 7 October 2001 and has therefore been running for just over eight years, has claimed the lives of just about the same number. That is not to suggest that the Afghan war is any less ferocious than the Falklands War. There are significant differences between the two conflicts. The Falklands War was brief, intense and was fought by a total British force of 28,000 at the head of a very long, thin, fragile supply line. The Afghan one, in which no more than 10,000 troops have been involved at any one time, is a more protracted war of attrition with more robust logistic support. But the comparison is interesting nonetheless.

The media’s evident determination to report every British death in Afghanistan in detail is self-perpetuating. Having reported on each one so far, how can any of them turn away and ignore the rest? But it is having a number of unfortunate unintended consequences.

Opinion polls show that it is sapping public support for the war itself, rather than for the armed forces. That trend is often accelerated by journalists repeatedly asking bereaved parents – the most understandably biased of all members of the public – whether they still believe the objectives to be worth the cost, in the reasonable expectation that at least some of them will say, “no”. And it has been exacerbated also, by the government’s failure to explain clearly enough to a public, many of whom are less geographically and politically aware than they might be, the Afghan campaign’s objectives and the essential differences between the invasion of Iraq and the war in Afghanistan.

Less damaging, perhaps, but no less regrettable is the threat by Islamic extremists to hijack the town of Wootton Bassett for their own political purposes, to organize a rally by 500 of their supporters and to carry empty coffins along the route taken by the British military cortèges. On the Today Programme on 4 January this year, a spokesman for the group concerned said there would be no point in holding an event of this sort elsewhere, because it would not attract the media attention they expect it to receive in Wootton Bassett. It may be, however, that such a demonstration would provide an opportunity for the media to reflect public opinion by ignoring it completely – and, perhaps, to clamber down from the bandwagon upon which they appear to be stuck. It may be, also, that the good people of Wootton Bassett would welcome being left to undertake their dignified demonstration of respect for the fallen in peace, away from the media circus that has come to surround it.

Peter Lapsley is patient editor, BMJ

Competing interests: None declared