Those of us lucky enough to live in a modern, free society often forget how fragile civilization is. We take for granted that our institutions work (all the while complaining of how poorly they function), and assume that a rational society will always remain a rational society. Our founders, perhaps because life in the 1700s was so much less insulated from reality, appreciated the historical tendency of societies to drift toward the irrational and created structures that they hoped would protect us from our own worst natures; so far, so good. Yet, even in the most sophisticated society, the all too human predisposition to believe in magic as opposed to the far more difficult project of relying on science and data, persists.
Last week Glenn Reynolds linked to a story about once nearly vanquished diseases making a comeback:
WHOOPING COUGH, MEASLES, POLIO: Diseases making a comeback because of anti-vaccine hysteria.
In the Megan McArdle's post Glenn linked, she pointed out that:
Pertussis is now killing, as best we can determine, something like a dozen infants a year. Polio is still not gone from the world, and seems to be making something of a comeback this year. The list goes on--American parents who have never seen an epidemic, because their parents vaccinated them, are putting everyone's children, and not a few adults, at risk.
I assume this is self limiting--if anti-vaccination goes far enough, a bunch of unvaccinated kids will die, and then their parents will be more scared of the disease than the vaccine. But it would be really nice if we could convince them in some other way than leaving them with a bunch of dead kids.
And it would really help if our politicians would take the first step by not encouraging their beliefs.
Today, Glenn has another link to a related story, Freeman Hunt discussing how there are:
For many people, the issue is purely emotional. It doesn't matter that there is no solid science behind the vaccinations can cause autism hysteria. It doesn't matter that a resurgence of measles or polio or some other major disease would be an epic tragedy. The reasoning seems to go something like this: "I just can't risk my child getting autism." "But there's no evidence that vaccines cause autism." "Yes, but what if they do? If I had my child vaccinated, and she was later diagnosed with autism, I could never forgive myself."
The numbers are not too large yet and this is still a small story, but it illustrates as clearly as possible how when our emotionality contradicts our rationality, reason has no chance.
One of the great successes of medicine has been the control and near eradication of many of the childhood illnesses that were the most significant contributors to historical child survival rates (to age 5) hovering around 50%. Today, in large part because of vaccinations, the vast majority of newborns have every expectation of living into adulthood. The triumph of vaccines represents the best that science has to offer. Courageous pioneers, like Ignaz Semmelweis, and Walter Reed, risked their careers and lives to work out the rudiments of the germ theory of disease. Others, like Louis Pasteur and Jonas Salk, dedicated themselves to finding ways to use the bodies own defenses to defeat diseases that were horrific and deadly. With such success, often new problems appear.
Autism is to childhood what Alzheimer's Disease is to old age. A typical medical history of a child with autism involves a seemingly healthy 18-24 month old infant who slowly turns into a stranger, with minimal or no language, an inability to relate in a human way, and extremely limited abilities to take care of themselves or live independently. Like most syndromes, there are people with very mild variants (Asperger's Syndrome) who can grow up to be successful, independent, though often quirky, adults but the parent's nightmare of severe autism is a familial disaster that affects everyone in the immediate vicinity.
Psychiatry, and Psychoanalysis, in the flush of excitement of the 1950s, when the "talking cure" was thought of as, finally, the definitive treatment for mental illnesses (before multiplying failures to adequately treat many types of severe mental illness and character pathology brought some needed humility to the field) imagined that poor mothering was the cause of most mental illness, including autism. This did a terrible disservice to the parents of autistic children and reinforced their already unconscious and preconscious guilt over having a "damaged" child. The Mental Health professions were not helpful in dealing with what for most parents was a catastrophe.
Fast forward 50 years, having cycled past the period when medication was going to solve all mental problems, to the present. Now, with the etiology and treatment of autism still uncertain, we have too many parents, politicians, radio personalities, lawyers, celebrities, and some scientists, pushing the idea that vaccines are causative. This would be unfortunate even if it did not have real world consequences. It is also understandable: Parents who have a child with very early problems (birth defects, genetic disorders diagnosed early in life such as Tay-Sachs disease) not only have to deal with the very real consequences of such a diagnosis but almost always struggle with self-recriminations. Blaming oneself, and sometimes blaming the other parent, whether conscious or (more often) unconscious, is a reason that so many marriages stressed by childhood illnesses fail at a higher rate than those who do not face such adversity. Thus, finding an externality to blame for the disaster that has befallen them is tempting. If something as simple as vaccines were the cause of autism, the parents would be able to stop blaming themselves, future parents and children could be spared simply by avoiding the vaccines, and the risk of such decisions would be borne by the community at large. Unfortunatelyfor the proponents, there is no scientific study that supports the contention that vaccines cause autism.
Avoiding vaccines is not without risk, as we have seen in various countries where radical Imams have counseled people to avoid vaccines as an infidel plot; there are areas in Nigeria where polio, once thought vanquished, is now making a comeback.
When pandering Politicians (are there any other kind) reinforce the irrational emotionality of their constituents, it distorts our politics. Money spent on the vaccine-autism connection does not fund research that might be better suited to delineating the complex pathways and etiologies that comprise autism, delaying greater understanding and more effective treatments. When pandering politicians reinforce irrationalities, and there is no adequate counterbalance, our system can become dangerously unbalanced.
In one of my earliest posts, I described how democracy works at its best:
I would posit that when either extreme of left or right takes a prominent place in our polity, it presents serious dangers. Democracy works essentially by summing the irrationalities of its citizenry in ways which tend to cancel out the most extreme manifestations. When it works well, both parties move to the center and try to appeal to the broad, more rational middle. [Emphasis added-SW]
It is very easy, in these days when news is synonymous with entertainment and most people confuse feelings with facts, for our political system to become unbalanced in the face of passionate advocates of the pseudo-science of the day. All too often, the real world consequences are ignored until too late.
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