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Saturday, September 1, 2018

Antivax and Mistrust of Experts

In The Politics of Autism, I look at the discredited notion that vaccines cause autism.

At the 2018 APSA annual meeting, Naomi Scheinerman has a paper titled "Anti-Vaccination in the Trump Era: Mistrust of Experts and the Promise of Democracy."  The abstract:
The case of vaccination policy offers us a perspective of democratic ills that were previously characterized as stemming from epistemic droughts as a problem of science communication, the solution to which is increased democratic deliberation that aligns personal interest with community welfare while instilling greater trust in expert authority.
Today’s political moment is often diagnosed as the spread of disparate information, that our democracy’s ills stem from the condition of two groups of people who consume two divergent diets of facts. Perhaps even more pernicious is the growing sentiment that due to this confluence of seemingly contradictory information that the truth is unknowable. However, closer examination reveals that some ordinarily divisive topics are not so clearly a case of clashing knowledge, but rather a breakdown of communication and interpretation regarding that information. Indeed, the case of vaccination shows that individuals align themselves with groups based on a valued risk assessment and social coherence rather than scientific ineptitude. Better understanding the science of communication can bolster democratic efforts to counteract the rhetoric of “alternative facts” and interpretation of risk that threaten the scientific foundations of good social policy.

Early in 2017, two polarized political camps unearthed common ground when President-elect Donald Trump requested that Robert F. Kennedy Jr. head a commission on vaccine safety and “scientific integrity.” The concurrence of the liberal anti-vaccination movement and the conservative Trump base revealed that no aspect of the political life is immune from the Romantic Era’s successor, what Jean-François Lyotard dubbed the “postmodern condition”: distrust of expert authority in deference to grand narratives cultivated through personal experiences. Whereas the anti-vaccination movement has fought for personal freedoms through attaining “philosophical” (non-medical and non-religious) exemptions from vaccination mandates, the Trump strategy has been to overhaul or even eliminate the regulatory agencies whose legitimacy is based on expertise. Vaccination skepticism emerges in part due to science communication failings and the perennial human need to find meaning in group membership and validation. Anti-vaccination group membership demands both an epistemic alignment with certain facts as well as a moral evaluation of acceptable levels of risk: even as many anti-vaxxers acknowledge the health benefits of vaccines, they perceive the risk of autism and injury to outweigh them.

Perhaps the great irony of democracy as seen through the history of science is that the liberal ideals of freedom of expression, freedom to believe otherwise, and freedom to dispute the status quo, have heralded both benefits to and detrimental attacks on democratic and medical institutions. Further, philosophies of science both advance the imperative of scientific neutrality alongside the need for epistemic communities to inform medical practitioners of their lived and subjective accountings that come from a robust social epistemology. Consider that much of scientific progress comes from recognizing the fallibility of even the most widely held of views. Progress can be both born and killed in moments of skepticism.
Ultimately, progress also requires democratic trust through robust institutions that recognize dissenting views formed from personal accounting alongside an ability to effectively communicate science and educate. Today’s political moment features a JSMillian political tension between desiring epistemic guidance of experts alongside experiential contribution of the average individual whose skepticism may provoke debate and progress. Deliberative politics must embrace this challenge of modulating the right amount of healthy debate. Mistrust of experts and government emerges from the feeling that one has been abandoned and lived experiences denied, and thus both society and the individual could benefit from renewal of the integrity and significance of democratic processes that re-inform epistemic identities in ways that are deeply meaningful and healthy.