Thursday, February 19, 2009


I ran across this rant written by Kev from Left Brain Right Brain today talking about authority and who has it. And more importantly, who wants it. I suggest you go read the entire post, but here are the highlights.

You have to understand. This is not about scientific truth – or even truth at all – to these people. Its about winning and its about pushing their antivaccine beliefs as fast and far as they can.


To these people science has no authority. Doctors have no authority. The Special Masters have no authority. The only people who have authority – real authority – can probably be counted on the fingers of one hand.


But more than that, scientists and doctors need to get online and blog, get on Twitter and use them. Talk to people in their own language. Screw decorum. Ask people who’ve been using their blogs to support vaccines for years what to do and how to do it.


This needs to happen because we’ve already lost one generation of kids to their loony parents. The loony parents who only recognise the authority of celebs, authors and each other in nests of email lists and blogs.

The first thought I had after reading all this was that it is just another anti-anti-vaccine rant. But then I thought about it some more and came to the conclusion that that there was some truth in what he was saying. The question I was left with is who is believed and why are they believed?

Kev from LBRB will have you believe that anyone who doubts vaccines and their safety is anti-vaccine and anti-science. This is obviously not true. These are no longer the Bush years were you are with us or against us - you should be able to question something without instantly being put in the against camp.

The obvious retort here is the "asked and answered" line. The problem is that science does not work that way. When anyone starts talking about "scientific truth" you know that they are trying to sell you something - there is no such thing as "truth" in science. If think you know the "scientific truth" of something, I can guarantee you two things. First, you are wrong. Second, you have closed your mind to new ideas.

But why do some people have authority and others not? I think the answer is simple.


So why have people lost their trust of the medical establishment?

There was a time when it was thought that doctors had all of the answers and were far wiser than the average person. And for a while that was true. But I believe the reason for that was the information they had. As long as that information was restricted and difficult to obtain this system worked; doctors really did know a lot more than the average person could hope to.

Then came the information revolution and tools like the internet. Now, anyone can do a google search and learn reliable facts about most health topics. Now, when you go talk to your doctor you can have an idea what it is that you are talking about.

The mystery of arcane knowledge is gone. What you are left with is a person like anyone else, someone who perhaps has a better understanding of medicine in general but not necessarily of the area that you are interested in.

So the implicit trust that was once there is gone. Doctors now have to earn their trust and reputation just like anyone else.

So how can the trust be reestablished?

Kev would have you think that scientists and doctors should launch what is in essence a PR campaign using new media to get the word out. What he wants it for there to be many copies Dr Paul Offit.

I think that is the worst idea possible.

I think the way to regain the authority and the trust is to actually listen to what people have to say and stop assuming that you have all of the answers. If you are a doctor and a parent is telling you about problems that they think were caused by vaccinations, take their concerns seriously and listen to what they say. Don't instantly start telling them about how that can't happen or how all of the evidence says that it can't. Don't treat it as an opportunity to "educate" them about the "scientific truth" of the matter.

Listen to what parents have to say and address them as equals. Because more and more the knowledge level of the average parent is going up.

Whatever you do, don't say (as Dr Offit does) "studies show that in theory, healthy infants could safely get up to 10,000 vaccines at once" because that is such a line of BS that it isn't even funny. If one shot has the potential to do enough damage that (in some rare cases) it can kill a child, what would 10 or even 100 do?

On some level Offit might be right with that a normal, health child's immune system can handle a large amount at a time but I seriously doubt that you could safely administer even 10 different shots at once. It took less than that to cause Hannah Polling to develop autism. So lines like that do nothing but insult the people you are talking to and make them not want to trust you.

So how to restore the trust and authority.

If you really want to go the way of new media, how about using the model of Dr Sears instead of the awful Offit method. On his blog Dr Sears takes the time to intelligently write about all sides of the issue before giving what his opinion is. If you don't happen to agree, he suggests alternatives that could be tried to get to a mutually desirable end. If you post comments to his blog, he will even give you an honest answer. At no time does he pretend that he has all of the answers or that a question should not even be considered.

Maybe Dr "PR" Offit could learn from his example.

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