Measles outbreak in Cheshire...
Dec 4 2008 14:54
#32
radicalgraffiti wrote:
Vaccination of young children and babies will never be voluntary, they don't have the ability to make a proper choice.
True, but then, who gives consent on their behalf? If their parents don't want them to have the vaccination then how are we supposed to force them to allow it without resorting to wildly out of proportion levels of compulsion? It's a thorny issue and one that can (IMO) only be resolved by demonstrating to the parents that vaccination is the best course of action.
Dec 4 2008 14:58
#33
Joseph K. wrote:
yes, and this is the ideal. probably impossible with capitalist eduction/media though. but you're employing a slippery slope fallacy here
I don't think that I am. I'm not saying that compulsorary vaccination innevitably leads to something terrible, I'm saying that compulsorary medical treatment (of any kind) is in itself a bad thing. As I've already said, how are we to force parents to let their kids have this vaccination? It's easy to talk about compulsorary vaccination, but you've yet to explain what the means of compulsion will be.
Dec 4 2008 15:09
#34
madashell wrote:
I'm saying that compulsorary medical treatment (of any kind) is in itself a bad thing.
even for smallpox vaccination? what about someone running down the street stabbing people? absolutism might offer you ethical comfort, but it doesn't help much in the actual world, where there are impossible choices to make.
madashell wrote:
It's easy to talk about compulsorary vaccination, but you've yet to explain what the means of compulsion will be.
well you hope it doesn't come to separating kids from their parents long enough for them to be vaccinated, because that could be traumatic etc. but then again, if say 80% of people decide to implement MMR vaccines, what right do minorities have to sabotage this to the detriment of their kids? so long as herd immunity is maintained, this isn't a problem, and if the evidence is in favour of it i'm sure people could largely be persuaded it's a good idea (with a decent education system equiping people with critical evaluation skills, and without a capitalist media peddling scares for market share). but just saying 'each to their own' is ridiculously individualistic. would you defend the right of climate change skeptics to pump out as much CO2 as they see fit?
i mean in any case it's not the kids making the decsions, and i see no reason why parents should have absolute title over their kids. of course parents think they know what's best for their kids, but this isn't always the case and this raises ethical dilemmas which can't be dodged by an absolutist 'each to their own' approach.
Dec 4 2008 15:14
#35
ah bollocks i did a big long post and it got fucking lost
fuck new libcom
Dec 4 2008 15:39
#36
Joseph K. wrote:
even for smallpox vaccination?
Yes, even for smallpox vaccination.
Quote:
what about someone running down the street stabbing people?
If somebody is running down the street stabbing people, medical treatment probably isn't what's needed in the short term, so much as a room with bouncy wallpaper and a jacket that buttons up at the back.
Quote:
well you hope it doesn't come to separating kids from their parents long enough for them to be vaccinated, because that could be traumatic etc. but then again, if say 80% of people decide to implement MMR vaccines, what right do minorities have to sabotage this to the detriment of their kids?
What "right" does anybody have to traumatise children in order to prevent their parents from slightly disrupting an attempt to manage a minor health risk? The idea that this could ever be considered a reasonable approach to a problem that could easily be solved with education (in a post-capitalist society, anyway) is truly mind boggling.
Quote:
so long as herd immunity is maintained, this isn't a problem, and if the evidence is in favour of it i'm sure people could largely be persuaded it's a good idea (with a decent education system equiping people with critical evaluation skills, and without a capitalist media peddling scares for market share). but just saying 'each to their own' is ridiculously individualistic.
Don't put fucking words in my mouth, I find it really irritating.
It'd make more sense (to me, at least) to actively try to persuade reluctant parents of the benefits of vaccination, rather than potentially causing serious problems (for both parent and child) down the line by taking their kids off of them for whatever period of time. This isn't a matter of silly individualists vs. clever collectivists, it's about weighing up the social consequences of compulsorary vacciation and making a decision as to whether it's worth it.
Quote:
would you defend the right of climate change skeptics to pump out as much CO2 as they see fit?
No, but I wouldn't suggest that we have a communist police force, going around forcing people at gun point to turn their heating down. I'm "ridiculously individualistic" that way.
Dec 4 2008 16:17
#37
madashell wrote:
If somebody is running down the street stabbing people, medical treatment probably isn't what's needed in the short term, so much as a room with bouncy wallpaper and a jacket that buttons up at the back.
i'm not following why you think it's ok to use compulsorary treatment for someone's own good, but suspend this if a parent vetos... afterall the side-effects of MMR are significantly more minor than locking someone up. what if street stabber's mum read something in the paper once about how padded cells cause autism?
madashell wrote:
What "right" does anybody have to traumatise children in order to prevent their parents from slightly disrupting an attempt to manage a minor health risk? The idea that this could ever be considered a reasonable approach to a problem that could easily be solved with education (in a post-capitalist society, anyway) is truly mind boggling.
since you're also talking about smallpox, and in fact each and every infectious disease, these aren't 'minor health risks' - you're making an absolutist point that compulsorary vacination is always wrong, not just MMR. while i'd like to believe education can avoid the dilemma, if enough people to subvert herd immunity for whatever reason decide to to their own thing they are putting their kids at risk - in the case of smallpox of death. sidestepping this ethical quandry with 'education' is like those who just say 'there won't be any crime' to dodge difficult questions about libertarian communist justice.
madashell wrote:
Don't put fucking words in my mouth, I find it really irritating.
we are not in libcommunity, be civil yeah?
madashell wrote:
It'd make more sense (to me, at least) to actively try to persuade reluctant parents of the benefits of vaccination, rather than potentially causing serious problems (for both parent and child) down the line by taking their kids off of them for whatever period of time. This isn't a matter of silly individualists vs. clever collectivists, it's about weighing up the social consequences of compulsorary vacciation and making a decision as to whether it's worth it.
right, and i completely agree, education is the ideal solution just as my ideal solution to crime is to make such a wonderful society no-one ever wrongs anyone else. but utopian absolutism doesn't get you out of the fact that in the real world these impossible ethical dilemmas do arise, and they demand a (necessarily imperfect) decision.
you're saying taking a kid away from their parents for 10 minutes not a price worth paying to prevent epidemics of fatal infectious diseases, if for whatever reason the parents don't want it - and this could include spite (and i don't think religious superstition will necessarily disappear in the act of revolution either). i think this absolutism is untenable, you're just sidestepping ethical dilemmas by denying their possibility.
madashell wrote:
No, but I wouldn't suggest that we have a communist police force, going around forcing people at gun point to turn their heating down. I'm "ridiculously individualistic" that way.
what was that you said about putting words in peoples mouths? for all your straw man you've just conceded the point here; there are circumstances where you think it's necessary to coerce people to prevent harm to others. of course vaccination isn't even coercing the child, cos it's not the child's choice either way.
now all this has been in the context of a future libertarian communist society. in the here and now i hope we can all agree that jumping on the baseless anti-MMR bandwagon is deeply irresponsible, given as there is literally nothing* to support the scare?
* well, there are some (2, i think) demonstrated false-positives from the guy who made the unjustified claims in the first place
Dec 4 2008 17:54
#38
People don't realise how dangerous these diseases are, my Mum gets agitated about this stuff because she's just about old enough to remember kids being blind or deaf as a result of infection.
Look at the bottom. estimated 30000 still births in three years and 20000 children disabled.
Fewer than 20000 people are disabled by traffic accidents but I assume you support wearing of seatbelts. Or rules against drink driving etc
In society sometimes there comes a point where refusing to do things that affect the rest of the community become a problem, not getting children immunised endangers the child and the wider community.
Out of interest Jason how do you feel about sex education in schools? It's a potential health risk if they don't but parents have a right to object and as a result they can choose for their kids to know nothing of contraception, STDs etc which has a negative impact on the individual and the wider community.
I'm not saying kids should be taken from parents but honestly I think parents shouldn't have the right to withdraw necessary treatment from their kids.
Measles
Quote:
Complications with measles are relatively common, ranging from relatively mild and less serious diarrhea, to pneumonia and encephalitis (subacute sclerosing panencephalitis), corneal ulceration leading to corneal scarring[4] Complications are usually more severe amongst adults who catch the virus.The fatality rate from measles for otherwise healthy people in developed countries is low: approximately 1 death per thousand cases.[citation needed] In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates of 10 percent are common.[citation needed] In immunocompromised patients, the fatality rate is approximately 30 percent.
Mumps
Quote:
* Infection of other organ systems
* Sterility in men (this is quite rare, and mostly occurs in older men)
* Mild forms of meningitis (rare, 40% of cases occur without parotid swelling)
* Encephalitis (very rare, rarely fatal)
* Profound (91 dB or more) but rare sensorineural hearing loss, uni- or bilateral
* Pancreatitis manifesting as abdominal pain and vomiting
* Oophoritis (inflammation of ovaries) but fertility is rarely affected.
Rubella
Quote:
Rubella can cause congenital rubella syndrome in the newly born. The syndrome (CRS) follows intrauterine infection by Rubella virus and comprises cardiac, cerebral, ophthalmic and auditory defects.[4] It may also cause prematurity, low birth weight, and neonatal thrombocytopenia, anaemia and hepatitis. The risk of major defects or organogenesis is highest for infection in the first trimester. CRS is the main reason a vaccine for rubella was developed. Many mothers who contract rubella within the first critical trimester either have a miscarriage or a still born baby. If the baby survives the infection, it can be born with severe heart disorders (PDA being the most common), blindness, deafness, or other life threatening organ disorders. The skin manifestations are called "blueberry muffin lesions." [5]
Quote:
During the epidemic in the US between 1962-1965, Rubella virus infections during pregnancy were estimated to have caused 30,000 still births and 20,000 children to be born impaired or disabled as a result of CRS.[19][20] Universal immunisation producing a high level of herd immunity is important in the control of epidemics of rubella.[21]
Dec 4 2008 18:46
#39
Joseph K. wrote:
i'm not following why you think it's ok to use compulsorary treatment for someone's own good, but suspend this if a parent vetos... afterall the side-effects of MMR are significantly more minor than locking someone up. what if street stabber's mum read something in the paper once about how padded cells cause autism?
And I'm the one being called an absolutist, Christ.
If you can't see the difference between a small increase in the chances that you or somebody you have been in contact with might contract an illness that sometimes has severe lasting effects and stabbing several people to death, there's not really much point in continuing this conversation.
Quote:
since you're also talking about smallpox, and in fact each and every infectious disease, these aren't 'minor health risks' - you're making an absolutist point that compulsorary vacination is always wrong, not just MMR.
Quote:
while i'd like to believe education can avoid the dilemma, if enough people to subvert herd immunity for whatever reason decide to to their own thing they are putting their kids at risk - in the case of smallpox of death. sidestepping this ethical quandry with 'education' is like those who just say 'there won't be any crime' to dodge difficult questions about libertarian communist justice.
In the absence of media scare stories, do you really think that enough rational adults are going to make stupid choices like denying their children access to vaccinations to undermine herd immunity in the way that you describe? Frankly, I think this shows a fairly worrying contempt for the vast majority of the population.
I don't think that compulsorary vaccination would be necessary in a communist society for the same reason that I don't think there'd need to be laws against smacking yourself in the face with a frying pan. Sure, one or two idiots might do it, but it's not exactly the end of the world, is it?
What's smallpox of death, by the way? Is it worse than the regular kind? 
Quote:
we are not in libcommunity, be civil yeah?
Then don't attribute things to me (in quotes, no less) that I never actually said. I wouldn't exactly call that "civil".
Quote:
for all your straw man you've just conceded the point here; there are circumstances where you think it's necessary to coerce people to prevent harm to others.
I never said otherwise. What I did say was that I don't think the benefits of every single child being vaccinated measure up to the harm that could be done by forcibly separating a parent and child in the way that you're talking about, which could be traumatic for the child.
Dec 4 2008 19:42
#40
madashell wrote:
If you can't see the difference between a small increase in the chances that you or somebody you have been in contact with might contract an illness that sometimes has severe lasting effects and stabbing several people to death, there's not really much point in continuing this conversation.
you're the one saying this holds for all vaccinations, including smallpox. smallpox is estimated to have killed 300-500 million people in the 20th century alone. I don't have the figures, but i'd imagine that's significantly more than people killed by nutters with knives, even if you include Rwanda. MMR may not be this serious, but you've made the point "that compulsorary medical treatment (of any kind) is in itself a bad thing (...) even for smallpox vaccination."
madashell wrote:
In the absence of media scare stories, do you really think that enough rational adults are going to make stupid choices like denying their children access to vaccinations to undermine herd immunity in the way that you describe? Frankly, I think this shows a fairly worrying contempt for the vast majority of the population.
there's no contempt. the majority of the world believe in fairy tales (allah, christ...), i don't have contempt for those people, but for those ideas. i have a materialist understanding of religion, but also recognise that people are capable of holding contradictory beliefs at once, revolution won't automatically aboilsh all irrational beliefs and that while i expect it to vastly reduce such scares communism is no guarantee there won't be religious or cult-like groups who could undermine herd immunity, at least locally. whether the rest of us let them do that to their kids is an ethical dilemma.
i obviously hope it won't be necessary, just like i hope a communist society will have no crime. but i have the nagging feeling such utopianism is a sidestep to difficult ethical questions to which there aren't really any satisfactory answers, only lesser evils.
madashell wrote:
Then don't attribute things to me (in quotes, no less) that I never actually said. I wouldn't exactly call that "civil".
inverted commas (') are not quotes ("), they generally signify a paraphrase, such as "the 'hang em all' Daily Mail mob" doesn't imply the Daily Mail actually said "hang em all." sorry for any confusion.
madashell wrote:
I don't think that compulsorary vaccination would be necessary in a communist society for the same reason that I don't think there'd need to be laws against smacking yourself in the face with a frying pan. Sure, one or two idiots might do it, but it's not exactly the end of the world, is it?
the difference is the former is something which harms others, the latter only harms the perpetrator. this adds a dimension of ethical complexity. you've accepted that in the case of mass-polluting climate change skeptics, action may be necessary. so the question is, where do we draw the line? My argument is the solace offered by absolutism ('no compulsory medication ever') is illusory, that we have to weigh up these things on a case by case basis, considering both our principles and all the available evidence.
Of course all this pontificating on a communist future - interesting though it may be - somewhat takes us away from the present reality; widespread scientific illiteracy and compulsorary vaccinations by the state. should anarchist be opposing these in principle? i would hope nobody thinks so. should anarchist be opposing MMR jabs? again, i would hope nobody thinks so, since the evidence-base for the scare is basically nil. there may be specific vaccines where the risks outweigh the benefits, but this does not appear to be the case with MMR, one of the most researched vaccines whose known side effects are rather tame in comparison to the consequences of endemic infection.
furthermore, most people here aren't really attempting to argue from evidence, but from emotive appeals (you want to take away peoples kids!!). this is precisely the psychological capacity that underlines vaccine scares and other irrational panics. we're all capable of it, myself included, which is why i'm not so convinced communist revolution will produce 6 billion rational subjects and a world without ethical dilemmas.
madashell wrote:
What I did say was that I don't think the benefits of every single child being vaccinated measure up to the harm that could be done by forcibly separating a parent and child in the way that you're talking about, which could be traumatic for the child.
even for smallpox? if a mother insists on raising an infant on soya milk or someother unsuitable substitute, intervention may be traumatic. it's certainly fraught with ethical and logistical difficulties. but the dilemma doesn't go away by refusing to think about it. now for something like MMR, i'm not convinced physically separating kids from parents would be a great idea (of course in the real world it's just done by the state while the kids are at school, sans the trauma). for something as deadly as smallpox there's a much more compelling case that ignorance shouldn't be allowed to kill kids. of course it's best to eradicate ignorance, and we're not implementing the state's vaccination policies. but as i've said, a) i don't think you can make blanket, absolutist ethical judgements here and b) in the particular case of MMR i certainly don't think we should be opposing it even if we'd rather it is voluntary (afaik it is, and the single jabs are available by choice, despite some evidence they're less effective/more harmful. seems like spurious consumer choice to me.)
Dec 4 2008 21:19
#41
My daughter had the MMR vaccine (and no signs of autism so far), but I think this discussion is getting pretty silly.
One of the features of the scare story was people pointing out that the MMR vaccine is cheaper than separate vaccines - which makes it look like government cost-cutting in the face of a health crisis. Which wouldn't be the first time that's actually happened either.
If a couple of people aren't vaccinated, then it doesn't make much odds - it's when large numbers aren't - and it's precisely the distortion in this case which makes it the exception here, that distortion would be unlikely in other situations.
Those talking about compulsory medication would do well to remember Thalidomide and other medications that have caused serious damage in the past. Just because MMR was a false scare, doesn't mean there haven't been genuine ones in the past.
And while the man running down the street stabbing himself is an extreme example, compulsory psychiatric care is about the only place (at least in the UK) you can be locked up indefinitely without trial - I worked in it for a while and the stuff needed to lock people up for a couple of weeks, even a couple of years isn't all that much.
Dec 4 2008 22:05
#42
catch wrote:
One of the features of the scare story was people pointing out that the MMR vaccine is cheaper than separate vaccines - which makes it look like government cost-cutting in the face of a health crisis. Which wouldn't be the first time that's actually happened either.
tbh this was just turning a healthy skepticism for the government into a very unhealthy knee-jerk panic over nothing, or rather over some unsuported claims by one guy (who was also being paid in relation to a lawsuit claiming MMR caused autism, iirc, although this conflict of interest is much less important than the evidence base for his claims).
catch wrote:
Those talking about compulsory medication would do well to remember Thalidomide and other medications that have caused serious damage in the past. Just because MMR was a false scare, doesn't mean there haven't been genuine ones in the past.
yes this is true, and i haven't seen compulsorary vaccination as an ideal by any stretch of the imagination, more a potential lesser evil in hopefully hypothetical situations.
the point is that medical interventions should be evidence-based, and people should be educated with the tools of critical evaluation to understand evidence and statistics etc and make informed choices. i don't think this is likely to happen under capitalism, so i won't be campaigning in principle against compulsory vaccines (if there was one with significant adverse evidence that the government kept pushing i might though). i mean the evidence at any one time may prove to be wrong, even tragically so, but it's all we have to go on.
fwiw there is a suggestion for a database of all medical interventions on the NHS and reported symptoms (there's already a limited version of this where you can submit symptoms online) to help spot thalidomide-like side effects as early as possible.
catch wrote:
And while the man running down the street stabbing himself is an extreme example, compulsory psychiatric care is about the only place (at least in the UK) you can be locked up indefinitely without trial - I worked in it for a while and the stuff needed to lock people up for a couple of weeks, even a couple of years isn't all that much.
yes, there's a lot wrong with psychiatric detention. it might not even be the best example. but the point is to illustrate there are times when we think it right to intervene in someones life for their own good or for the good of their kids. where to draw the line in any given case is an ethical quagmire that can't really be avoided, imho.
Dec 4 2008 22:55
#43
Joseph K. wrote:
tbh this was just turning a healthy skepticism for the government into a very unhealthy knee-jerk panic over nothing, or rather over some unsuported claims by one guy (who was also being paid in relation to a lawsuit claiming MMR caused autism, iirc, although this conflict of interest is much less important than the evidence base for his claims).
Yes of course - but in the 'post-revolutionary' examples we're talking about, the government skepticism wouldn't be much of a factor, and most likely selling newspapers too. While there can always be some irrational behaviour, money goes a long way towards supporting it in a lot of cases.
Quote:
i don't think this is likely to happen under capitalism, so i won't be campaigning in principle against compulsory vaccines(if there was one with significant adverse evidence that the government kept pushing i might though).
Same here. I wouldn't be campaigning for them either mind.
catch wrote:
yes, there's a lot wrong with psychiatric detention. it might not even be the best example. but the point is to illustrate there are times when we think it right to intervene in someones life for their own good or for the good of their kids.
Well I think this view conflates 'we' and 'the state' a bit. While some people in psychiatric hospital really are a danger to themselves and/or others, a lot aren't - including some in the 'medium secure forensic psychiatric' ward where I worked for 9 months - which had child killers and rapists living alongside teenagers with schizophrenia - who'd literally been running down the street stabbing people but were on their way out to hostels and pretty stable, couped up with real nasty pieces of work.
Quote:
where to draw the line in any given case is an ethical quagmire that can't really be avoided, imho.
Except in current psychiatric care, that line is held by one social worker and two psychiatrists, even for a section 3 iirc. And reviewing it is mainly down to some retired old volunteers who are there to stop the hospital getting sued, and then an external review board of three people once a year (and I think you have to ask for that). Much less than for detention on criminal charges.
Dec 4 2008 23:14
#44
catch wrote:
While there can always be some irrational behaviour, money goes a long way towards supporting it in a lot of cases.
yes i don't doubt this, i've argued a lot of the blame lies at the door of capitalist education and media throughout. i'd like to think compulsorary vaccinations will be unneccessary, but don't think they should be a priori ruled out in all cases.
catch wrote:
Well I think this view conflates 'we' and 'the state' a bit.
only insomuch as they are necessarily conflated under capitalism. i was arguning more generally, trans-historically even about conflicts between society and the individual, which i don't think are resolved by all the poetic rhetorical dialectics about communism being the final resolution of this problem (not from you personally, it's a general commie cop out i've probably been guilty of myself). it will obviously fucking help though. there are cases where social intervention is justified, like parents malnourishing their kids or outright abuse. it's not easy though, and the solutions carry problems of their own.
catch wrote:
Except in current psychiatric care, that line is held by one social worker and two psychiatrists, even for a section 3 iirc. And reviewing it is mainly down to some retired old volunteers who are there to stop the hospital getting sued, and then an external review board of three people once a year (and I think you have to ask for that). Much less than for detention on criminal charges.
yes, i don't doubt there's a hell of a lot wrong with psychiatric detention at present. but the fact capital draws a shitty line doesn't mean there isn't going to be a line to be drawn. and it's a fucking ethical minefield of paternalism vs autonomy etc. getting rid of capital will certainly help focus things on human needs though, i'd hope.
Dec 4 2008 23:57
#45
Joseph K. wrote:
yes i don't doubt this, i've argued a lot of the blame lies at the door of capitalist education and media throughout. i'd like to think compulsorary vaccinations will be unneccessary, but don't think they should be a priori ruled out in all cases.
It's just MMR is the only vaccination I can think of which has been controversial for a very long time, so I don't think it's much of a practical discussion to be having. Maybe if I'd been watching survivor it might feel a bit more topical, but 'what ifs' don't interest me much.
Having said that, sometimes it feels like 'we shouldn't rule out x' on here is too much of a reaction to individualist idiots, and there aren't actually any on this thread - so coming into it a bit late, it looks like 'libertarian communists in forced vaccinations shock'. If a large minority of the population was going to reject vaccinations it'd be unenforceable anyway. If it's a tiny minority then that's enough for general levels of immunity to be maintained.
Quote:
only insomuch as they are necessarily conflated under capitalism. i was arguning more generally, trans-historically even about conflicts between society and the individual, which i don't think are resolved by all the poetic rhetorical dialectics about communism being the final resolution of this problem
Yeah fair enough.
Quote:
but the fact capital draws a shitty line doesn't mean there isn't going to be a line to be drawn. and it's a fucking ethical minefield of paternalism vs autonomy etc.
Like you said though, each case is so unique that I don't think standardised lines can be drawn at a societal level - the man running down the street stabbing himself doesn't leave much time to negotiate the minefield.
Dec 5 2008 00:10
#46
catch wrote:
the man running down the street stabbing himself doesn't leave much time to negotiate the minefield.
isn't he in the ICC?
(Sorry)
I broadly agree with catch's position here. This type of "controversy" is very rare nowadays and I'm sure that that around the MMR will be a distant memory by the time the revolution comes
Dec 5 2008 00:12
#47
As catch said, what increased the resistance of parents MMR a lot was the insistence of government that they would not provide the choice to have the 3 vaccinations separately. This was sheer bloody-minded authoritarianism on the part of New Labour and also based on saving money.
What also adds to the general distrust of 'reassurance' by govt., medical authorities and the pharmaceutical industry is the fact they've regularly been shown to lie or manipulate facts in the interests of profits over public safety. The recognition that capitalist industry will act like this seems often to be suspended when it's a matter of scientific matters, as if science is somehow more neutral. Nothing is more arrogant than the way scientific authority often deals with the concerns and risk factors of the 'lay person'.
And the real risk of vaccination may be elsewhere; a book, Robert Kirby's 'Evidence of Harm' documents the long struggle of thousands of parents in the US to be given access to suppressed govt. evidence, compensation and care provision for autistic children. These parents include doctors, paediatricians and many other health professionals. Their claim is that the use of increasing levels of mercury preservative (Thimerosal) at toxic levels in vaccinations contributed correspondingly to the great increase in autism. As multiple jabs were given, without relative child body-weight being taken into account, the levels of mercury absorbed were sometimes up to 138 times the official 'safe level' - at as young as 2 yrs old. (In fact US babies apparently now receive their 1st vaccine 12hrs after birth.) There was also pre-natal exposure via mothers' flu jabs. To aid the cover up/protection of business interests, the US govt. even went to the extent of trying to hide immunity clauses for the drug company Eli Lilly in the 2002 Homeland Security Bill. So state and industry attempts to defend their interests means the truth is obscured further. There is still mercury and aluminium (and some other potential neuro-toxins) in some vaccines.
Research in the US also suggests a possible corellation between environmental pollution by heavy metals and solvents and a 50% higher levels of autism in affected areas.
Whatever the truth of the matter, (and leaving aside Wakefield's MMR claims) at the least I'd say it's not at all a totally crackpot idea to be rejected out of hand that vaccines containing mercury and other potential neuro-toxins may be linked to damaging a quite large minority of (probably genetically susceptible) children. There is a video of a long public debate on the complexities of the issue here with Kirby and an opposing journalist in front of an audience;
http://anon.autismri.com.edgesuite.net/anon.autismri/Kirby_Allen_debate/ArthurAllen-DavidKirbyDebate-highband.mov
Dec 5 2008 00:13
#48
Steven. wrote:
I broadly agree with catch's position here. This type of "controversy" is very rare nowadays and I'm sure that that around the MMR will be a distant memory by the time the revolution comes
i certainly hope so to. in terms of the present, does anyone actually oppose MMR jabs, or was the reaction more to Jack/Jenni's *ahem* tactful endorsement of compulsory vaccination?
Dec 5 2008 00:32
#49
Ret Marut wrote:
As catch said, what increased the resistance of parents MMR a lot was the insistence of government that they would not provide the choice to have the 3 vaccinations separately. This was sheer bloody-minded authoritarianism on the part of New Labour and also based on saving money.
while i don't doubt that cost may have been a factor for the government, there is evidence that MMR jabs are more effective than single ones (i can't scan the charts, but infection rates drop dramatically on the introduction of single jabs, but then noticably again on the introduction of the MMR), so i'm not sure why there should be a 'choice.' if anything it fits with the new labour 'choice' agenda for the NHS, when we don't want a bloody choice we want the best possible care.
Ret Marut wrote:
What also adds to the general distrust of 'reassurance' by govt., medical authorities and the pharmaceutical industry is the fact they've regularly been shown to lie or manipulate facts in the interests of profits over public safety. The recognition that capitalist industry will act like this seems often to be suspended when it's a matter of scientific matters, as if science is somehow more neutral. Nothing is more arrogant than the way scientific authority often deals with the concerns and risk factors of the 'lay person'.
i really would recommend Goldacre's book (read critically of course, like everything). he's a liberal, but he's in no way soft on the government, big pharma or 'alternative' quacks. he doesn't explcitly say the scientific ideals he espouses are incompatible with capitalism (because he's not afaik a communist), but he does argue about how commodification distorts evidence-based medicine (suppression of adverse results, proliferation of spuriously patented 'me too' and 'me again' drugs etc). the problem is 'scientific authority' is largely a media caricature, which they then proceed to knock down.
i mean there's definitely hubristic GPs and scientists, but science is not about authority at all; in principle everything we think we know can be undermined by a single contradictory result (although in practice it should first be independently replicated, and vested interests of various shades may conspire to suppress it, since science doesn't take place in a social vacuum).
Ret Marut wrote:
I'd say it's not at all a totally crackpot idea to be rejected out of hand that vaccines containing mercury and other potential neuro-toxins may be linked to damaging a quite large minority of (probably genetically susceptible) children...There is a video of a long public debate on the complexities of the issue here with Kirby and an opposing journalist in front of an audience
it shouldn't be about debate between arbitrary authority figures, journalists, scientists, politicians, emotive parents or whoever. if there's a thesis, some appropriate RCTs should be designed to try to falsify it. publish in a peer reviewed journal. others should try to replicate the results, and publish their findings and methods. meta-analyses or systematic reviews like the Cochrane Collaboration can look for patterns in the overall data set accumulated that may have been missed at the single-trial level, or identify false positives. our knowledge is advanced by testing and evidence. none of this requires a suspension of critical faculties with regard to capital's effect on science, au contraire, it's a practical application of critical faculties to advance our knowledge and enhance the evidence-base for medical practice.
Dec 6 2008 11:56
#50
JK wrote:
if anything it fits with the new labour 'choice' agenda for the NHS, when we don't want a bloody choice we want the best possible care.
Well other "we's" do/did want that choice and there would've been higher take-up if it was offered.
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i mean there's definitely hubristic GPs and scientists, but science is not about authority at all;
Not if it only exists as an admirable abstract ideal - but as it actually exists at present it is part of the hierarchy of class society.
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it shouldn't be about debate between arbitrary authority figures, journalists, scientists, politicians, emotive parents or whoever.
I linked to that debate as a convenient means of grasping the issues involved - not to imply that it's an ideal form of discourse. But the debate has been going on for years - it certainly should include "emotive parents" as it's their kids getting harmed (for whatever reason) and they want answers. Part of what is interesting about the history of the debate is that parents in the early days had to teach themselves the complexities of the issues, to the point where some became as knowledgeable as many 'scientific experts'. But, yes, the media circus and its distortion is still inevitable in this society when dealing with an 'emotive' issue.
It's not as simple as 'do some tests, peer reviews etc' - the interpretation of available scientific info is primarily what is contested, as is the design of research etc. (Btw, scientific research for a long time now has shown that there can be status and gender bias present within the peer review system itself, eg, it was found the same papers submitted to the same journals were assessed differently depending on the author's gender and status of their unversity etc - so it's not necessarily the absolute 'objective' last word.) Epidemiological evidence seems to be the primary refutation of those opposing mercury toxin theory - while the other side use more of a mix of biological and epidemiological evidence. (Not surprising perhaps that they should give more credence to biological evidence - their empirical observations of their children's symptoms (despite often later being verified) often being dismissed as worthless, as the mere bias/hysteria of "emotive parents". Sure, sometimes emotion does cloud judgement - but that's a quite patronising term typical of language 'experts' use to dismiss the opinions/observations of 'laypersons' as always worthless.) But it seems to be generally agreed there is a problem, whatever the cause.
Dec 6 2008 12:46
#51
Ret Marut wrote:
Well other "we's" do/did want that choice and there would've been higher take-up if it was offered.
but why should there be some spurious choice of inferior treatment (based on all available evidence) on account of a baseless scare? it's not like there's two treatments each with their own pros and cons to be weighed up, but one that's superior to the other. should you get the choice of homeopathy or witchcraft, since some people honestly believe that's best for their kid?
Ret Marut wrote:
Not if it only exists as an admirable abstract ideal - but as it actually exists at present it is part of the hierarchy of class society.
right, so do you think the MMR jab is an apparatus of class rule or do you think one - hubristic and arrogant - doctor made unsubstantiated claims which were taken up by large part of the establishment to bash the government?
Ret Marut wrote:
It's not as simple as 'do some tests, peer reviews etc' - the interpretation of available scientific info is primarily what is contested, as is the design of research etc.
yes, but none of this is outside of normal scientific practice. criticism of interpretation of results, study design etc is scientific bread and butter. often (perhaps inevitably) studies are flawed in some way, or unmerited conclusions are drawn from banal data. of course ideally studies and their datasets should be openly published for review, and meta-analyses or systematic reviews can to some extent attenuate such problems too. as it happens Wakefield's MMR 'study' (small collection of clinical anecdotes) and subsequent research papers were both significantly methodologically flawed and/or drew conclusions not supported by the data.
Ret Marut wrote:
(Btw, scientific research for a long time now has shown that there can be status and gender bias present within the peer review system itself, eg, it was found the same papers submitted to the same journals were assessed differently depending on the author's gender and status of their unversity etc - so it's not necessarily the absolute 'objective' last word.)
i don't doubt this. systematic reviews and meta-analyses can help attenuate such biases, but i'm sure they exist. whether they skew the data in any meanungful way i'm not sure (would women scientists make different findings to their male collegues?). none of this means 'science' is part of class rule, only that capital exerts its pressures there like on all terrains of social life. it certainly doesn't invalidate an evidence-based approach.
Ret Marut wrote:
Sure, sometimes emotion does cloud judgement - but that's a quite patronising term typical of language 'experts' use to dismiss the opinions/observations of 'laypersons' as always worthless.
i know little to nothing of the specifics of the mercury stuff, but the point isn't that individual testimonies and experiences, emotive or otherwise are worthless, but that the plural of anecdote is not data. of course anecdotes may flag up necessary areas of research, and that research may be suppressed by vested interests if the findings are unfavourable. but this doesn't mean anecdotes should supplant an evidence base, only that in class society you sometimes have to fight to establish an evidence base.
Dec 6 2008 17:20
#52
JK wrote:
but why should there be some spurious choice of inferior treatment (based on all available evidence) on account of a baseless scare? it's not like there's two treatments each with their own pros and cons to be weighed up, but one that's superior to the other.
I wouldn't pretend to be expert on these matters so I don't know if there is much difference between 3 separate or 3-in-1 jabs in their effectiveness. But my point stands that in practice there would've been higher take up with a different approach, at a time when the whole issue was very controversial and uncertain in many people's minds.
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right, so do you think the MMR jab is an apparatus of class rule
I didn't suggest anything like that. But - it's administering does take place within class relations. (Unless we're back to 2-class 'theory' and it's claimed there's no class relation within medical practice.)
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none of this is outside of normal scientific practice. criticism of interpretation of results, study design etc is scientific bread and butter. often (perhaps inevitably) studies are flawed in some way, or unmerited conclusions are drawn from banal data. of course ideally studies and their datasets should be openly published for review, and meta-analyses or systematic reviews can to some extent attenuate such problems too. as it happens Wakefield's MMR 'study' (small collection of clinical anecdotes) and subsequent research papers were both significantly methodologically flawed and drew conclusions not supported by the data.
As I said, the Thimerosal mercury toxicity debate has been going on for years, with accumulation and re-assessing of evidence etc in various ways and no agreement reached - maybe the evidence so far really is inconclusive - so should the state then still deny any choice to parents (and be supported by 'libertarians')? Certainly many well-informed parents (some of whom are health professionals, including paediatricians) still believe the Thimoseral thesis, others are unsure, and certainly vested interests have tried to suppress evidence. And certainly there is still mercury, unnecessarily so, (and other neuro-toxins) in some vaccines. (But I'm not sure why you refer to Wakefield's MMR theory here - I haven't defended it.) As you say, the possibility of vested business interests (including some scientists), supported by the state, suppressing evidence harmful to their profits and dominance and distorting conclusions is a constant factor that one has to take into account when evaluating this stuff. Even what is researched and what is deliberately not - ie, what we can even begin to have an opinion about - is skewed by this. So we are sometimes forced to try and make informed decisions despite our limited information being somewhat loaded by other forces. This is played out on various levels, from personal dealings with patronising arrogant doctors and bureaucrats to national healthcare policies.
Dec 6 2008 18:28
#53
Ret Marut wrote:
I wouldn't pretend to be expert on these matters so I don't know if there is much difference between 3 separate or 3-in-1 jabs in their effectiveness. But my point stands that in practice there would've been higher take up with a different approach, at a time when the whole issue was very controversial and uncertain in many people's minds.
my understanding is the MMR is significantly more effective. but as far as i'm aware there is now a choice to have the triple jab (not sure if this came about because of the controversy?), and availability may have boosted take-up. however we don't make state policy, but certainly in a communist society i'd be arguing we produce the best known medications (on the evidence) and only offer choice in cases where it is medically advantageous (i.e. because of different indications/contra-indications being more appropriate for an individual patient). like i say i think the argument for 'choice' in this case is not a libertarian one but one in line with New Labour's 'choice' agenda for marketising the NHS.
Ret Marut wrote:
I didn't suggest anything like that. But - it's administering does take place within class relations. (Unless we're back to 2-class 'theory' and it's claimed there's no class relation within medical practice.)
well doctors aren't at the proliest end of the spectrum but i don't think doctor-patient relations are class relations. i'm really not sure how MMR is a class issue, any more than satsumas or any other commodity. i mean, what exactly is the objection to MMR here? i'm really not sure and it would help if you stated it.
Ret Marut wrote:
As I said, the Thimerosal mercury toxicity debate has been going on for years, with accumulation and re-assessing of evidence etc in various ways and no agreement reached - maybe the evidence so far really is inconclusive - so should the state then still deny any choice to parents (and be supported by 'libertarians')?
sounds like a systematic review could help matters. there's certainly a strong case for demanding the precautionary principle be upheld if there's unexplained adverse effects and a plausible risk. if the evidence is inconclusive on systematic review, that suggests there is no causalilty since you'd expect to see correlations if there were. of course with something like this the studies may be too short-term to catch the effects, and so the precautionary principle should still apply.
in the case MMR there was no 'controversy' or 'inconculsive evidence,' except in the minds of journalists, and consequently many parents and politicians. Wakefield was styled as a peoples champion against an uncaring establishment, when in reality he was simply a charlatan without the evidence to back up his claims. i really don't blame parents for being confused here, any reasonable person could have thought there were doubts about the safety of MMR due to a massive media campaign over nothing. this reflects badly on education and media in capitalist society, not understandably worried parents with a healthy skepticism for politicians (we all remember the BSE burger MP).
Ret Marut wrote:
(But I'm not sure why you refer to Wakefield's MMR theory here - I haven't defended it.)
sorry, i thought it was at issue given the topic of the thread. if we're talking more generally my view is that medical interventions should be evidence-based and if there's any doubt (e.g. from insufficient data, or conflicting data not obviously explained by methodological flaws/chance) the precautionary principle should apply.
Ret Marut wrote:
As you say, the possibility of vested business interests (including some scientists), supported by the state, suppressing evidence harmful to their profits and dominance and distorting conclusions is a constant factor that one has to take into account when evaluating this stuff.
yes, and this does happen, with numerous high profile examples (cigarettes/cancer being the obvious one), and lots of lesser known ones. interestingly, there is a statistical method (a form of meta-analysis) for spotting publication bias known as a funnel plot. if you plot reliablity (sample size etc) vs reported effect on a chart, you would expect to see a triangle/funnel shape scatter plot, with more reliable studies clustering around the true effect, and less reliable ones randomly distributed around it; i.e. the plot should be symmetrical. if it isn't, that's a good indiction of publication bias.*
one of the things that Goldacre advocates is a register of all trials before they commence to make it easier to spot the burying of unfavourble results. as reforms under capitalism go, it seems fairly sensible. i mean i'm not hurrying to the barricades to demand it, but vaccine campaigners might consider adopting it, assuming their fight is not against evidence-based medicine but against the distortion of the evidence base by capital.
Ret Marut wrote:
Even what is researched and what is deliberately not - ie, what we can even begin to have an opinion about - is skewed by this.
this is doubtless true to an extent, but it is often exaggerated, particularly by those whose claims have been extensively tested, and falsified (like homeopaths). apparently the three most popular articles on PubMed (database of medical journal publications) are all articles critical of big pharma, so it's not that this stuff doesn't get researched. in general you would expect research to be skewed towards commodifiable solutions, and thus to ignore wider social or political factors (like the 'serotonin hypothesis' for depression, medicalising and atomising what may be perfectly healthy responses to the stresses of life under capitalism).
of course a demand for suitably independent research and in the meantime the application of the precautionary principle could be made if the resources/expertise to conduct a trial were not forthcoming ('the scientific community' and funding sources are fairly diverse, so the obstacles to doing trials of things aren't necessarily that great - of course they should be designed to try and falisfy your hypothesis not confirm it, otherwise the authorities will - rightly - ignore you on methodological grounds. a cheaper alternative would be a collection of clinical anecdotes to flag the need for studies, just don't make overblown extrapolations from the results).
Ret Marut wrote:
So we are sometimes forced to try and make informed decisions despite our limited information being somewhat loaded by other forces. This is played out on various levels, from personal dealings with patronising arrogant doctors and bureaucrats to national healthcare policies.
my argument is it has to be an evidence-based decision, or a demand for the precautionary principle and independent studies in the case of inadequate evidence (and observed unexplained adverse effects, prima facie plausible mechanism). you can't just base it on an 'informed' hunch cos your doctor's a bit of a prick or politicians usually lie (or more accurately, subjugate truth to expediency).
* there was apparenlty a study like this done of studies on publication bias - it produced an asymmetric plot. i'm told this chart is circulated amongst statisticians and passes for humour. strange lot.
Dec 6 2008 18:50
#54
madashell wrote:
The key here is education, not compulsion. You simply cannot go around forcing people to undergo medical treatment, that way madness lies.
In madness it is our duty to force medical care on those who don't want it!
A little strong, but you get the point.
Measles not only kills but can lead to measles encephalitis (brain damage, deafness) and orchitis (infertility).
I understand where Jason is coming from, but there are problems here with lay people's inability to properly apportion, perceive and rationalise risk. As others have pointed out, thi8s is not just an individualist decision, choosing to opt out compromises the collective immunity painstakingly built up over the last few decades, and also is a decision that negatively effects the child.
Medical practice is always orientated towards consent and persuasion, and compulsion is a last resort for good reason. So far there has not been any need to shift to the latter when ti comes to immunisations- but if collective herd immunity became seriously compromised then I would support it, along with a serious and sustained publicity campaign and fucking strong sanctions on the irresponsible press organisations that fuel and sustain these antiscientific scares.
Dec 6 2008 18:54
#55
pingtiao wrote:
choosing to opt out compromises the collective immunity painstakingly built up over the last few decades, and also is a decision that negatively effects the child.
someone also reminded me that immunosuppressed kids who can't have the jab rely on herd immunity and so they too are put at risk by opt-out parents, not just the kids of other opt-outers.
Dec 7 2008 13:10
#56
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Ret Marut wrote:(But I'm not sure why you refer to Wakefield's MMR theory here - I haven't defended it.)
sorry, i thought it was at issue given the topic of the thread. if we're talking more generally my view is that medical interventions should be evidence-based and if there's any doubt (e.g. from insufficient data, or conflicting data not obviously explained by methodological flaws/chance) the precautionary principle should apply.
I'm glad we got that sorted . I began by saying 'the real danger of vaccination may lie elsewhere' and going on to mention the mercury toxin issue. I speak with no great authority on this, but was referring to the possibility that if there is any link between vaccination and autism its cause might be found in the mercury preservative rather than Wakefield's claims.
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my argument is it has to be an evidence-based decision, or a demand for the precautionary principle and independent studies in the case of inadequate evidence (and observed unexplained adverse effects, prima facie plausible mechanism). you can't just base it on an 'informed' hunch cos your doctor's a bit of a prick or politicians usually lie (or more accurately, subjugate truth to expediency).
Agreed, we can neither totally use as justification nor discount the factor of some doctors being pricks or politicians lying. (Nor can we discount the fact that laypersons can sometimes become just as informed on particular topics as professionals, as has happened with some parents in the US Thimerosal case.) But nor can we posit/appeal to some perfect ideal(ist) notion of scientific 'evidence based' rationality when its not available/existent in the real world, any more than ideal notions of law or democracy - all being not as objective or impartial as their ideology claims. (Of course, that doesn't mean - having taken those limits into account - we should never use them. I also recognise it's not an exact analogy insofar as in a classless society we might have more use for scientific investigation than, eg, the compulsion of 'law'.)
But if the options are the policy of a proven to be untrustworthy state (backed up by an often less than impartial scientific/business establishment) or parents' own informed assessment, thru gathering knowledge via years of involvement in struggles of parents campaigns, there's no reason to always support the official state view. Another mercury-related topic; dental fillings. Based on disputed or inconclusive evidence some countries dismiss the claim of any health risk - other states accept there is a risk or err on the side of caution (iirc, they've been banned in some parts of Scandinavia for decades, while non-mercury is only available here if you pay). Some states also insist on their removal from bodies before cremation as it has been estimated that significant levels of arsenic are released into the environment via cremation. Other do not consider this a risk. It doesn't have quite the same implications as the vaccination issue, but does show that scientific opinion is not always able to resolve itself. We also know that certain products that become associated with safety issues here (including vaccines now deemed to have problematic mercury levels for Western consumption) are routinely dumped on the 3rd World markets without any info being provided on the known risk factors.
It's an interesting topic, I will at some point check out the Goldacre book.
Dec 7 2008 13:54
#57
Ret Marut wrote:
Nor can we discount the fact that laypersons can sometimes become just as informed on particular topics as professionals
no, it can happen, and is a good thing. i mean i'm sounding off about vaccines and scatter plots and i haven't studied science formally since i was 18, and i don't think i'm talking shit. the problem is there's a lot of nonsense on the internet too, so people need the skills to critically evaluate evidence. in general i don't think we're very well equipped to, as we're not really taught it. therefore we often have to defer, although it's then a bit of a bakunin's bootmaker situation. of course science ≠ professionals/experts either.
Ret Marut wrote:
nor can we posit/appeal to some perfect ideal(ist) notion of scientific 'evidence based' rationality when its not available/existent in the real world... Of course, that doesn't mean - having taken those limits into account - we should never use them.
exactly, the fact that evidence is necessarily imperfect isn't an argument against evidence-based medicine. i'm not postiting some pure method outside of social relations, in fact i think a critical awareness of the wider social context as well as the methodological shortcomings of studies is crucial to an evidence-based approach.
Ret Marut wrote:
But if the options are the policy of a proven to be untrustworthy state (backed up by an often less than impartial scientific/business establishment) or parents' own informed assessment, thru gathering knowledge via years of involvement in struggles of parents campaigns, there's no reason to always support the official state view.
nobody is saying we should "always support the official state view." what i'm saying is we should base an assessment on all the available evidence - what else? sometimes the state/business is being untrustworthy, like supressing evidence of cigarrettes/cancer, sometimes it isn't, like MMR. however well motivated, an automatic siding with the little guy is just slave morality. it's not a case of believing the opposite of politicians say, but critically assessing the available evidence (including publication bias) and coming to your own view.
Ret Marut wrote:
It doesn't have quite the same implications as the vaccination issue, but does show that scientific opinion is not always able to resolve itself.
of course, evidence requires interpretation, risk factors need to be weighed up against judgements of acceptable risk (and if politicians or company bosses are judging what's an acceptable risk to us, obviously that's problematic). science isn't about pristine truth statements, but about probabilities, risk factors and the gathering and critical evaluation of evidence. the fact scientists do all disagree on stuff strikes against the view of 'science' as an institution of authority, and underlines the usefulness of tools like meta-analyses and systematic reviews.
Ret Marut wrote:
routinely dumped on the 3rd World markets without any info being provided on the known risk factors.
yes, this shit happens. but it says more about capitalist social relations than it does about an evidence-based approach.
Ret Marut wrote:
It's an interesting topic, I will at some point check out the Goldacre book.
it certainly is. considering he's a guardian columnist, his book's closer to a libertarian communist critique of (the public understanding of) science/medicine under capitalism than anything i've seen from actual communists. he takes a materialist approach, looks at how commercial pressures distort scientific practice and the commodity form is a barrier to medical development (as complex socio-political problems are medicalised into patentable pills), and he takes aim at 'alternative' treatment entrepreneurs, big pharma and the media. of course he's a liberal lefty and so doesn't say 'and it's going to be like this until we smash the state and communise the means of production', but i think there's a lot of use to libertarian communists in it, and he writes clearly for a lay audience (he doesn't really touch on things like the doctor-patient relationship since that's outside the 'bad science' scope).
As a sampler, an extract from his book is in the library - The medicalisation of everyday life.
You haven't, but that's the logical conclusion of arguing parents should have final say. It's fine if they're sensible and making a decision based on a logical following of the facts, but I've got friends who are quite capable of doing themselves tremendous harm because of silly conclusions and stupid biases, and if they had kids they would do them a lot of harm as well. Part of having a collectivist view of the world is acknowledging that it's not just the parents who bring up kids, it's the society/community they live in too.