Engineering Ethics Blog: Ignoring the Experts: Autism and Vaccinations


By necessity, engineers are
experts in their professional field compared to the public at large.  And as we’ve discussed many times before,
expertise confers both privileges and responsibilities.  Most of the time, engineers and other experts
who inform the general public about questions of interest find that the public
at least listens to them, and usually takes what they say seriously.  But not always.  And when expert advice and information is
ignored, we have to go beyond strict logic and rational thought and deal with a
wider range of human behavior.

All that is to preface an
issue that on the surface, seems to fly in the face of logic and even common
sense:  the question of whether autism is
caused by the routine measles-mumps-rubella (MMR) vaccine that, until recently,
was a non-controversial part of every baby’s medical care in industrialized
countries. 

Then in 1998, one Dr. Andrew
Wakefield published an article claiming that he’d found a link between the
unexplained rise in incidence of autism and something about the MMR vaccine,
possibly the tiny amount of mercury present in it used as a preservative. 

To parents of autistic
children searching for a reason why their son or daughter has such a debilitating
disease, Dr. Wakefield seemed like a godsend. 
Here at last was something to blame. 
At the time, his report made huge headlines and spawned parents’ groups
who took up the cause of delaying or abstaining altogether from MMR
vaccines. 

Trouble was, according to
the vast majority of medical experts, Dr. Wakefield’s paper was deeply flawed.  Of course, other labs and researchers got onto
the bandwagon and started investigating the alleged link.  From what I have read and from a recent
report in the Annals of Internal Medicine on a Danish study of over 600,000
children for eleven years, there is no statistical link between MMR vaccine and
autism.  None.  It just doesn’t happen, according to the best
and most judicious scientific knowledge we have today.  And this is not new news.  In 2010, Wakefield was found by the British
General Medical Council to be guilty of dishonesty in connection with his
paper, which was retracted by Lancet,
the journal that published it.  Wakefield
is as discredited as a professional can get. 

But none of this seems to
matter to a persistent group of people who keep sharing and encouraging the
idea that vaccines cause autism.  In the
latest attempt to stifle this misinformation, the president of the American
Academy of Pediatrics, Dr. Kyle Yasuda, wrote letters to Google, Facebook, and
Pinterest, asking them to do more about the vaccine misinformation that is
spread through YouTube, Instagram, and Google’s search engine. 

Dr. Yasuda cites the danger
of increased measles outbreaks, such as the one that occurred in connection
with Disneyland in the winter of 2014-2015. 
Over a hundred cases were identified in this outbreak, and four out of
five of the victims were either unvaccinated or could not show proof that they
had been vaccinated for measles.  One out
of five of the victims had to be hospitalized.

While in my long-ago youth,
measles was just part of growing up, it wasn’t a necessary rite of
passage.  It can lead to complications
involving many bodily systems and can even kill you.  A world without measles is unquestionably a
better world than one with the disease. 
And until Dr. Wakefield started meddling with his fraudulent paper, we
were well on the way to eradicating measles much as smallpox has been
eradicated—through systematic vaccinations and the hunting down of outbreaks
with treatment, isolation, and more vaccinations.

But something has changed in
the way U. S. society (and societies in many other Western countries) view
experts and their opinions.  Maybe it
started in the general 1960s rebellion against authority.  Granted, the 1950s were a little too conformist
for many peoples’ taste.  But most of
what everybody knows is known by authority. 
If we all had to learn our physics, chemistry, and mathematics from
experience, most of us would never finish and we would be continually
reinventing the wheel.  In case you hadn’t
noticed, one of the big differences between what G. K. Chesterton called “civilization
versus savagery” is that civilization accumulates knowledge (and sometimes
even wisdom), thus saving succeeding generations from the trouble and expense
of figuring the world out all over again. 

With the advent of the
Internet, this process became much easier. 
Instead of shipping piles of paper around, we ship bits, which are much
lighter.  So light, in fact, that any
yahoo with a computer and Internet connection can set himself up as an
authority and, once he finds the key phrases that trigger fears or anxieties
enough to get his message to go viral, he can get more attention than those who
have dedicated their lives to the pursuit of expertise and truly know what they
are talking about. 

I am sure that some of the
parents of autistic children are entirely sincere in their belief that autism
is caused by vaccinations.  But sincerity
of belief on the part of individuals makes absolutely no difference to
objective truth, which is true for everybody all the time.  That’s what objective truth means.  Part of the problem is that for many people
in advanced countries, the worst thing that’s happened to them is not that bad
compared to routine life occurrences that were common fifty or a hundred years
ago.  I am old enough to recall the fear
that every summer brought when a few kids in town would come down with
polio.  That was banished with the polio
vaccine, at least in the U. S.  But
people who grow up protected by things that ward off terrible diseases, sometimes
do not appreciate what the protection is doing for them, and are liable to
throw it away if persuaded that along with the great but invisible good it
does, the protection (e. g. MMR vaccines) is even suspected of doing some
harm—especially if it is mysterious harm such as having a baby born with
autism.

Engineers tend to think that
logic reigns supreme, and if you just explain a thing to someone and make them
see the logic in it, they’ll automatically agree with you.  The ongoing controversy about autism and vaccines
shows that this assumption is a bad one. 
And wise engineers should be prepared to deal with the emotionality and,
yes, even irrationality, of the public whenever their activities get into
controversial areas.



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