Fear + vaccines + autism = ?

Dear friends,

I was taking a break from some preliminary dissertation reading (that’s right – done with term papers and on to dissertation work!) via Tumblr and came across this post:

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There’s a nearly obscene amount of sass in this post, and I would personally refrain from expressing any thoughts on this matter in such an accusatory way. However, I think this post does point towards a few deeper issues that we need to confront.

I’m really interested in value judgments that humans give to medical treatments (or just value judgments in general, but that discussion is for another time), especially when potential death is involved. Specifically thinking about vaccinations, we might see value in vaccinations only for making us physically healthier, or for allowing us to avoid death caused by a little molecular entity having a field day with our bodies. However, the recent phenomenon of parents (not just mothers, as the post refrains to regard (we don’t want to gender the politics of decision-making for children’s health)) choosing to not vaccinate their children raises peculiar issues regarding value judgements regarding vaccination. With this phenomenon, we see a parent choosing that their child face the risk of losing their life, or having their life physically threatened, solely for the sake of avoiding what is perceived as a disability by contemporary society.

I (regrettably) don’t know enough about autism to make informed comments on this condition, but I want to raise a point that may let us circumvent having to know too deeply about autism.

What is the fear of a child having autism saying about our value judgments when it comes to disease risk versus risk for a ‘disability’ that (is said to, and might not actually) come from getting a vaccine? One of these outcomes will, quite objectively, kill you. The other is what I believe to be the simple consequence of a different neural network, one that causes ‘issues’ only due to the difference’s relation to what is perceived as ‘normal’ in our society. Additionally, having autism will not kill you. (That’s to say autism will not physically kill you. The stresses caused by having to conform to mainstream society might lead to more stress and premature death, but again, we must save that conversation for another time.) Must we assume, then, that the fear of a child having autism (what can be seen as a socially contrived condition) is greater than their child potentially dying (not to mention the potential risk of causing other friends’ and family members’ children the same demise)?

Moving along and assuming that this assumption is true, is it right to blame the parents who choose to not vaccinate their kids for acting irrationally? If they are acting irrationally, then are they acting out of impulse or emotion? Is this impulse born out of their own research (regarding the post’s mention of “access to the internet”), or born out of the larger societal notion that autism is a bad thing to have in our society, bad enough that we are willing to risk death by infectious disease to avoid autism?

Contrast this phenomenon with the idea of putting a loved one on life support to extend their living but possibly vegetative state. In this instance, we are putting objective physical health (staying ‘alive’ in a biological sense) over socially valued health (being able to interact with others in an unhindered way, or living comfortably without being connected to medical equipment 24/7). In essence, our value judgments have flip-flopped.

At the bottom line, we can see here that value judgments are by no means concrete or unchanging. Just because we might swing one way when it comes to vaccinating a child, does not mean that we are bound to swinging that same way when we might make a decision for our less-than-autonomous parent who is approaching a (dignified) end. What does this say about where our value judgments are based? If we see that value judgments are not coming from objective moral reasoning, and rather from impulse and emotion born out of highly external factors, then I fear that we cannot put sole responsibility on the non-vaccinating parents for making that decision.

We might instead see that we have a duty as a whole to work toward a re-conceptualisation on what is socially valued, especially with notions of what is deemed ‘good’ and ‘bad’ regarding action in the social setting (that which is affected greatly by autism). Hence, instead of blaming those who make these decisions to not vaccinate their children, I might think that we have a shared responsibility in resisting a (what I see as detrimental) shift in the perception of value in vaccines.

Furthermore, I might call attention to the fact that this vaccination issue is a manifestation of a larger social problem of how we create (yes, create) disabilities that result in unjust stigmatisation. Regarding the word ‘create’, I mean only that much of what we may see as a difference (in social interaction, or mental processes) is deemed a disability when, in reality, this difference is only a difference and nothing more. If we don’t address this detrimental social wrong that takes place all too often, then fighting the vaccine issue (by any means, including blaming parents who probably shouldn’t be fully blamed) will not fix the problem, and we will come out of this situation with two ‘bads’ (namely, sick children with antiquated diseases and further social stigmatisation). Certainly, we might (rationally, emotionally, however you like) fear this outcome.

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RIP, Keith.

Dear friends,

On my way home today, I passed this set of flowers and messages on the wall outside of a Sainsbury’s (a UK grocery store chain).

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I tend to use this Sainsbury’s fairly often, mostly because it’s close to Uni and close to the tube stops that I use. I may have seen Keith outside, perhaps made eye contact with him a few times, but did not engage with him further than that. As a disclaimer, I want to fully respect the death of this man. I think his death (which I would not have known about had I not passed this memorial) brings about a few thoughts worth sharing. (I’m also not claiming moral high ground on talking about others’ actions – for all intents and purposes, I, too, belong to the ‘other’ that I write of in this post.)

Here’s what went through my head upon walking past this memorial:

  1. This is out of the ordinary – why are there all of these flowers outside of Sains?
  2. There’s a message posted on the wall – ah, it seems as it someone who used to sit out here has died. Perhaps a homeless man? – yes, confirmed by what’s pasted to the wall.
  3. It’s good that people are remembering his death with flowers – he must have been well-known by those who frequent this area.
  4. What were people doing during the time when Keith was alive?
  5. Were they spending the money that they spent on flowers to give food or other necessities to Keith?
  6. What makes one’s death worth drawing attention to, when the suffering it took to reach that death was probably an objectively worse thing than the death itself?

This article was pasted on the wall above the flowers – it gives a short overview of who Keith was, why he was on the street, and how he may have died that night. I want to expand upon a thought regarding death versus suffering, and why we notice death more than whatever suffering leads up to that death. Also, why would we feel a moral imperative to act on that death and not on the suffering that precedes the death?

It seems that these flowers may be a signal that others have chosen to show their sadness and lamentations over Keith’s death at this moment, only after he has died. Upon first examination, this seems a bit counter-intuitive to me. Quite bluntly, this man’s death might have been a form of respite from his life up until that moment. That’s not to say that it was okay that he died, but it may be safe to say that he isn’t suffering as much as he was (not to open up the debate on what ‘suffering after death’ actually means). What is it about death that makes us realise so suddenly the ‘badness’ of any lost human life? Think about that cliché moment in a film, when the antagonist’s family member or loved one dies – even the protagonist and their posse manage to find compassion for the antagonist’s loss. However, they can’t seem to find that compassion until death is involved.

One idea that may help explain this is Daniel Kahneman’s ‘peak-end thesis’. This topic is best explained using the experiment that Kahneman and his fellow researchers used, involving colonoscopies. In this experiment, the researchers had the whoever was conducting the colonoscopy leave the probe in the patient a little longer for some patients (which led to the patients getting a bit more used to the pain by the end of the test), as compared to leaving the probe in for a normal amount of time (this was the control trial). Patients then rated their overall pain experience as they remembered it, and it showed that the patients who had the probe in for longer (which might have caused a larger ‘total’ (think integrals here, calculus people) amount of pain) remembered less pain than did the patients who had a normal-length colonoscopy (who would have experienced less ‘total’ amount of pain).

This basically shows that people will remember the ‘badness’ of experiences by two things: the amount of pain at the worst moment (the peak) and the amount of pain at the end of the process (the end). Taking this idea to Kevin’s death (or anyone’s death, who is also suffering prior to that death), we might think that the ‘end’ of someone’s life ending has a great determining factor in how we actually remember that person’s life – i.e. death plays a large part in our perception of the ‘badness’ of the suffering in one’s life, and the length of that suffering plays less of a role in how we recognise the ‘badness’ in someone’s life.

This may be able to provide us with an explanation of why humans act more often (and perhaps why they feel more compassion) for someone when they die (as opposed to when we see a living person suffering).

If this is true, the implications of this sort of thinking are drastic, especially in explaining why homelessness (and more generally inequality that leads to human suffering) persists despite our clear knowledge of the sort of suffering that is caused by homelessness. If our reaction towards this sort of suffering is explainable using contemporary behaviour theory, then we can’t necessarily fault those who participate in that way. However, once we become aware of our implicit assumptions and actions, we may at the same time generate a duty to address these actions and not merely leave them up to the whim of nature. After all, we are rational beings (not meaning that we always act rationally, but have the ability to think about our actions and not merely ‘do’).

If we now can recognise why it may not be natural to go out of our way to recognise our compassion for the living homeless only until they die, our duty to do something about human suffering (and homelessness, surely) may be grow stronger with each passing day.