Public Health and Private Populism

| February 2, 2011

Some interesting things going on these days regarding the matter of vaccination.  Between concerns over possible links between vaccination and autism and disgust over the unprecedented rates of profit enjoyed by the pharmaceutical industry, the cognitive dissonance experienced by many people in the face of public heath initiatives supporting mandatory vaccinations seems to reach a kind of breaking point characteristic of our age.  Faced with the sheer complexity of the issues involved in politics, science, and the law, many attempt to dissociate themselves from the chaos by seizing on simple rules of thumb to guide their behaviors and opinions.  This raises the issue of private versus public decision-making; it seems that what works at the local scale doesn’t at the global, and vice-versa.  While attempts to force localities to submit to a global rule certainly produced many modern atrocities, less well studied are the examples of attempts to impose locally-appropriate measures of order onto global contexts.  The latter characterizes what I’ll whimsically call a ‘schizo-utopian’ trend in contemporary culture; a trend characterized by a volatile mix of negative sentiments about corporations, globalization, civilization, and science -social, economic, and cultural institutions in general!- on the one hand, and a strangely disaffected advocacy of unrealistically simple extensions of locally-applicable solutions to global scales -a tacit admission of the classic “i’ve got mine” mentality- on the other.  In either case, opportunities for critical thought are lost.

So while Bill Gates launches a well-publicized initiative to ‘end Polio’ by providing free vaccinations to people in Africa, India, and the Middle East (wherever Polio remains endemic), and Paul Offit, appealing to relatively-uncontroversial scientific data, tries to combat some of the popular misconceptions about the risks of vaccines, self-styled ‘health ranger’ Mike Adams, editor of naturalnews.com, issues an exclusive “myth-busting report” supposedly from an “International Medical Council on Vaccination,” claiming to “refute vaccine propaganda.”  Displaying a lack of regard for scientific standards of evidence or historical perspective, Adams promotes a general condemnation of vaccination as a public health initiative, claiming that “there is no real science backing the ‘vaccine mythology’ that vaccines are somehow good for kids.”  Also invoked are the obligatory shadowy corporate conspiracies.

Perhaps time spent critiquing such a position might seem like time wasted.  This is probably how most people with some training in the history and/or scientific basis of vaccination would probably think (excepting, apparently, the 80 or so signatories on the ‘International Council’ document).  This reticence helps to explain the lack of informed debate on this topic.  The critics of vaccination and its defenders do not speak the same language.  Vaccines are one of the most uncontroversial successes of medical science, but the nature of scientific thought and practice is poorly understood, even by some scientists.  This is because the probabilistic nature of scientific reasoning is extremely counter-intuitive when compared to everyday logic.  In my view, this whole controversy provides us with an excellent example of the increasingly acute disjuncture between scientific and anecdotal modes of communication and logic.  What’s good for the population is not necessarily good for all of the individual members of that population, and vaccination is an excellent example of a public policy intervention that asks us to tolerate a small but statistically definite set of unacceptable consequences in order to avert a much larger, equally unacceptable set of effects.  We instinctively find this logic reprehensible, but it is precisely the kind of logic that public policy needs to observe and practice if it is to perform its task of keeping us all alive here together on this planet, all 8 or so billion of us (and still growing).  The lack of public appreciation for this crucial difference -between the kinds of evidence required for policy formation and that required for personal decision-making- can perhaps best be conceived as a serious educational problem, and would thus seem to indicate a huge failure on the part of public education conceived as a public service.  But how can we educate people to observe a rational relation between such incommensurable realms (the local-anecdotal and the global-scientific)?

Paul Offit has written a couple of books about this specific matter, ‘debunking’ (I’ll register here my misgivings about this term’s egregious overuse in public discourse) many of the popular claims against vaccination, i.e. that it causes autism (which is not true).  Offit recently appeared on The Colbert Report, ostensibly in support of the programs launched by Gates and others (as well as his recent, scarily-titled book about vaccination).

But these problems of communication breakdown are not just going to go away because the occasional scientist descends into public discourse to ‘debunk’ them.  Perhaps the only thing that the article in the otherwise insipid naturalnews article that’s worth repeating is the call for more public participation from educated health professionals.  Of course, for any kind of legitimate debate to proceed along these lines though, respect would need to be present on both sides.  While scientists can perhaps be faulted for arrogance and uncriticality, not many are going to want to attempt to cross the ideological divide between science and popular culture if those who do, like Offit, continue to receive death threats (ironically) from radical (read: overconfident) natural health nuts.

Overall, this matter reveals a troubling inconsistency that defines schizo-utopian discourse: self-congradulating ‘critical thinkers’ seize ironically on facile controversies framed by dubious authorities, insofar as these support their local observations and personal experiences.  When confronted with the failure of such tactics to provide any real grasp of the complexities collectively at stake, reactions range from interest, through a return to inarticulate disaffectation, to irrational anger.  This is not meant to be a trite personal observation, but rather an identification of a serious collective condition.  The irresponsible, dissociative, pseudo-radical sentiments of a disengaged middle class without any historical sense of their biologically-unprecedented good fortunes is no laughing matter; it could easily turn into a dangerous mass movement.  Indeed, the recent increase of ethno-religious violence and all manner of political extremisms seems to bode ill for our political situation in this country, if efforts to stem the growth of such movements are unsuccessful.  The movement I’m referring to as schizo-utopianism is motivated by the tacit belief that our feelings of despair and anomie in the face of seemingly uncontrollable economic globalization and seemingly impossible socio-cultural hypercomplexity can be remedied by recourse to simplistic, antagonistic rhetorics of blame and hysteria.  A better solution, if perhaps, sadly, an even more far-fetched one, would be an effective system of public education.  As always, a shot of knowledge would be the most effective inoculation.