Medical response to Trump requires truth seeking and respect for patients

As a medical anthropologist, my area of expertise is in the power relationships between patient and health professional, and in the forming and maintenance of the dominant discourse.

My first observation is that vaccine safety has become a ‘hot button’ topic, and that a culture war is raging between two extremes, on one side the “all vaccines are inherently safe, and effective, by definition” argument, and on the other the people arguing the exact opposite. With extremists on both sides engaging in highly emotional name-calling and hysteria, it has become almost impossible for a rational voice to be heard, and so, thank-you for publishing this call for rationality.

I have noticed that, for a significant number of people in the ‘pro-vaccine’ camp, the status of vaccines appears to have been raised to the level of what anthropology would call a ‘sacred icon’. Something that must never be criticised, or critiqued, but rather given the status of a ‘sacred cow’, to be treated with reverence. Similarly, to many in the ‘anti’ camp, the exact opposite applies. To them all vaccines are ‘evil’, to be avoided at all costs, and every piece of news of anything that could be construed to be in any way critical of a vaccine is seized on with delight, and offered up as ‘proof’ of their thesis.

In this climate of warfare, it has become very difficult to be a voice of rationality, and many people who do not wish to join either extreme camp tend to avoid the topic altogether.

This is not the forum to go deeply into the social science theories that could be applied to this. However, there is a large body of theory that could be applied, which would shed a lot of light on this heated topic. For example, the pro-v zealots could be said to be acting as enforcers of the ‘ideological state apparatus’, as per the work of the French scholar Louis Allthusser (Google it for a definition of the term). They are determined to maintain a ‘hegemony of orthodoxy’. The anti-v side could be said to be the ‘resistance’ to the dominant discourse, as per the work of Michel Foucault. Antonio Gramsci’s work on hegemony could also be used to analyse the roles of each side, as also could Foucult’s theory of ‘pastoral power’, which is a form of power that purports to ‘protect’ the citizens from some harm, and also Pierre Bourdieu’s theory of ‘symbolic power’, where the citizens surrender their own power to an ‘authority’, often the state, even when there is a cost to them in doing so. There is a quite complex interplay between all these forces and powers, which I have never seen examined, in any published forum, in relation to the vaccine wars.

To adequately examine all of this, would fill a book, a book that needs to be written, ideally in a non-partisan and unemotional manner. Certainly, there is a definite need for the tools of social science to be deployed to inject some rationality into the debate, rather than the present culture wars, between people with no knowledge of the social science, and often with little skills in critical thinking.

Discussing medical journalists, Peter Doshi argues “journalists must also ensure that patients come first, which means a fresh approach to covering vaccines. It’s time to listen – seriously and respectfully – to patients’ concerns, not demonize them”.

Certainly we must move beyond the crude ‘pro’ and ‘anti’ vaccine dichotomy that currently dominates in the science community and the mainstream media.

The antagonistic attitudes of many in the medical/scientific establishment are astonishing, with their dogmatic stance that seems to forbid questioning of any vaccine product, and denial of adverse experiences after vaccination.

Citizens in our liberal democracies are entitled to question medical interventions being instigated by governments, particularly when these interventions, i.e. vaccinations, are mandated, as is occurring in the United States and Australia.

Vaccination schedules are growing at an alarming rate, with novel vaccine products and revaccinations being added for diseases which do not pose a threat for the majority of the population, e.g. meningococcal and HPV. The processes that result in such vaccine products being added to the schedule must be open to scrutiny and challenge by the community.

Vaccination policy is a matter which impacts on all citizens and we are entitled to be consulted about the imposition of vaccine products. Instead, government vaccination bureaucracies conflicted by associations with the pharmaceutical industry are adding more and more vaccine products to the schedule, without objective and independent oversight.

So yes, it’s time for a fresh approach to covering vaccines, one that is open and transparent and which respects the right of informed citizens to question and challenge vaccination policy.