Sunday, November 23, 2014

An Advocacy of Dunces

CONCORD, MASSACHUSETTS – Imagine that a group of advocates tried to alert the public to a danger that they perceived, only the evidence showed that the danger was not real, and that by spreading their fears, this group was causing people to behave in ways that put the wider public – and you – at risk. What would you do? What should the government do?

The government of Australia has answered that question in a dramatic way. It has revoked the tax-exempt charity status of an anti-vaccination advocacy group, on the grounds that their fear-mongering misinformation about the danger of vaccines threatens public health, especially the health of children.

The government has also required the group to change its name, from the Australian Vaccination Network to the Australian Vaccination-Skeptics Network, in order to make the advocate’s perspective clear. “We will continue to ensure that they present themselves as an anti-vaccination advocacy,” said New South Wales Fair Trading Minister Stuart Ayres. “We want to make sure that they don’t ever promote misleading information.”

This is, of course, dangerous territory. Though the evidence is clear that vaccination does not cause the harms that its opponents stubbornly claim it does, any effort by a government to restrict speech is worrying. No free society should permit its government to decide which advocacy groups can say what, based on what those advocates believe.

But, in this case, the Australian officials’ action was an entirely appropriate, and essential, public service: protecting public health and safety, based on robust and consistent medical evidence.

That evidence conclusively disproves the claims of anti-vaccination advocates that childhood vaccination causes autism and other long-term neurodevelopmental damage. Yet a small but vocal group of alarmists and self-serving profiteers continues to spread fear-mongering distortions and outright lies claiming that vaccines do more harm than good.

As a result, vaccination rates are declining in some communities, especially those with high concentrations of anti-government libertarians or back-to-nature environmentalists. As a result, in some areas, community-wide “herd” immunity levels for diseases like measles and pertussis (whooping cough) have fallen below those necessary to keep them from spreading into the general population. Adults in whom the vaccine has worn off or is not 100% effective are increasingly getting sick. Infants too young to be vaccinated against pertussis are also falling ill, with some actually coughing and choking themselves to death.

So the Australian government’s decision is clearly justified. Protecting us from threats from which we cannot protect ourselves as individuals is, after all, a central part of what we empower government to do. When the evidence is as clear as it is with vaccines (and the consequences as grave), the government has the well-established authority – indeed, obligation – to act in the name of public safety.

But vaccination is only one example of how advocates sometimes put the public at risk by rejecting scientific evidence. The ideology-driven denial of human-induced global warming is impeding efforts to mitigate climate-altering emissions or prepare for the increasingly obvious – and dangerous – consequences of this enormous threat. Absolutist opposition to any regulation of gun ownership, particularly in the United States, is making it harder to keep deadly weapons out of the hands of those who pose a threat to society.

Resistance to biotechnology, especially genetically modified (GM) foods, is another example. Some applications could bring enormous net benefits to human health, but society is not enjoying those benefits – and people are suffering and dying as a result – because opponents reject all GM applications, owing to a fundamental dislike of large companies, commercial agriculture, or modern technologies generally.

Consider “golden rice,” a GM hybrid that carries the gene from carrots that makes vitamin A. A recent study found that, in India alone, had golden rice been approved when it was technically ready in 2002, it could have saved 1.4 million disability-adjusted life years for those who instead suffered blindness or death from vitamin A deficiency.

It is time to push back against advocates when their values-driven views deny clear scientific evidence and put you and me at risk. Scientists must speak out, as they did recently in England, where researchers testing a new strain of wheat challenged anti-GM advocates to a public debate. The advocates refused, but went ahead with planned attacks on the field trials, causing public support for those activists to diminish.

You and I and our fellow citizens must push back, by choosing which groups to join or to support financially. We need to push back at public hearings and in testimony about pending legislation, and not let the most passionate voices bully our politicians and policymakers into choices that placate the loudest few, but that deny the greater community the most good. And, when the evidence is clear and the risk imminent, governments must push back, as Australia’s has done.

Feelings and values must always have a voice in any democracy. We need the passion of advocates on all sides to move society forward. But when those passions fly in the face of the facts and put us at risk, it is entirely fair that in the name of public health and safety, you and I and our governments all say, “Enough is enough.”

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    1. CommentedErwin Alber

      I have long ago arrived at the conclusion that vaccination is an organised criminal enterprise dressed up as disease prevention by means of junk science and that the entire vaccine industry needs to be shut down for good to keep us and our children safe from this medical fraud and abuse.

      Repressive measures against those who are denouncing vaccination as the hoax it is will only hasten the backlash against this over 200-year-old medical superstition and gravy train for those who benefit from brutalising, traumatising and poisoning children for profit.

    2. CommentedVivek Shroff

      This article advocates 'good information practices' i.e. ethics to be followed while disseminating information. I appreciate that.
      However, I would like to point out two things.
      One, the Australian government has been very nuanced in restricting the advocacy of the anti-vaccination group. It has effectively allowed them to carry on their anti-vaccination propaganda provided it is not financed by tax-payer funded tax-breaks and provided they do not try to misrepresent their stand.
      Secondly, though the article starts with the author, an 'intellectual', advocating the high road to honest information dissemination practices, we soon find him degenerating into the same disingenuous practices. Why else, do we not find him take a stand on whether foods which are genetically modified should be clearly labelled so, or not? This, that the GMO companies clearly lobby against. Preparing the emotional ground in his readers by giving the examples of vaccination and climate-change, the author presents his shill for the GM foods industry.

    3. CommentedKate Arnold

      Mr. Ropeik,

      Your evaluation of the Australian government’s actions regarding the Australian Vaccination Network and their implications for free speech was intriguing to me, and I concur that the officials are indeed performing an essential duty by “protecting public health and safety, based on […] medical evidence.” The data support the efficacy and safety of vaccination, with most significant adverse effects attributable to co-occurrence rather than causation. And because community-wide immunization is crucial to protecting the public from devastating diseases, vaccine skeptics who promote untruthful information must be held accountable for their actions. Our constitution does not protect speech if it creates "a clear and present danger” to others, as Justice Holmes wrote in his opinion on Schenck v. United States. When anti-vaccination materials dissuade parents from immunizing their children, the effects of herd immunity wane and we witness the resurgence of diseases that were previously almost eradicated, such as the recent measles outbreak. If the government does not regulate these vocal opponents, who will ensure the public has access to evidence-based and unbiased information? It is clear to me that the right to life and security supersedes the right to free speech in this instance, because others in the community can be harmed by an individual's decision not to vaccinate.

      However, I find your dismissal of vaccine critics as “alarmists and self-serving profiteers” concerning, for not all can be so narrowly categorized. There have been a number of legitimate health concerns surrounding immunization, particularly the oral polio vaccine, which was linked to several cases of poliomyelitis and is no longer used in the U.S. These dissenting voices should not be silenced because they play a vital role in accountability, driving investigations of vaccine safety and pressuring pharmaceutical companies to continually improve upon their products. The distinction to be made here is that the Australian government did not censor the materials of the AVN; it mandated a change in name to ensure the group's platform and biases were readily apparent to the public. In keeping with this precedent, my proposal is that vaccination critics not be prevented from sharing their views, but that national governments follow the example of the World Health Organization, which set forth recommendations for identifying websites "providing information on vaccine safety that comply with good information practices." If the government mandated that similar comprehensive guidelines be displayed on both pro- and anti-immunization sites, readers would have immediate access to materials to help them evaluate the legitimacy of web-based sources. Additionally, while the messages of interest groups are influential in forming public perceptions of vaccines, we cannot deny the importance of a trusted healthcare provider, whose responsibility is to inform parents about the risks of not immunizing their child and to reassure them of the safety of the vaccine itself. Through counseling by specialists and utilization of tools that allow people to evaluate online sources, it seems certain to me that immunization will again become a respected cornerstone of this nation's health.

    4. CommentedDavid Donovan

      Dangerous territory, indeed. This article unsettles me. Freedom to express an opinion and follow personal beliefs allows for a just and free society.

    5. CommentedStamatis Kavvadias

      "...And, when the evidence is clear and the risk imminent, governments must push back, as Australia’s has done."

      Here is the real problem with government suppressing freedom of speech. Advocates of "imminent risk" appear left and right, and start saying things like "in the name of public health and safety," referring to metrics like Disability-Adjusted Life Years....

      This metric, has been modified recently in an IHME study, as the author-provided link explains, which clearly indicates immaturity of the specific metric. Not only that, but with a double definition, we do not really know what anyone is measuring.

      Most of all, when someone starts with government suppression of free speech, continues with genetically modified food, and finishes with "imminent risk," the next thing to expect is to pose sanctions to not complying countries! This is not about health risks; it's about money.

    6. CommentedClyde Israel

      Dangerous territory, indeed. This article unsettles me. Freedom to express an opinion and follow personal beliefs allows for a just and free society. Convince those that do not agree, do not legislate change in the face of uncertainty.

    7. CommentedDouglas Costello

      The anti vaccination advocacy group and others of their ilk actively follow and use the process of doubt creation, obfuscation of scientific evidence to justify their fears. The same process Big Tobacco used to hide the fact that smoking leads to higher rates of lung cancer which they knew but wanted those profits so much that they were prepared to sacrifice the rest of us to gain them. are these groups any different.

      GMO's well there is an issue of forcibly merging (purist say splicing but it is forcibly done otherwise it doesn't happen) genetic material from one species or variety to another and typically those who advocate it as a solution cry out that it is perfectly safe and many lives will be saved. This is a reversal of the approach taken by the Merchants of Doubt and present it as those who question our product as Luddites and the causes of unnecessary deaths. Likewise both sides have no real proof of the benefits or the negative consequences but the risk is high for a later adverse finding.