“You're not allowed science any more”

http://www.nature.com/nature/journal/v489/n7414/full/489170a.html

by thisjepisje • 12 years ago

127 154 12 years ago

"You're not allowed sarcastic metaphors any more."

"Why not?" asked the scientist.

"Because you haven't learned to employ them in a way that doesn't alienate the very people you are trying to help. Now please send in Dawkins on the way out, we need to discuss internet memes with him."

sebular• 12 years ago

The sarcastic metaphor and the exasperation that motivates it comes after centuries of scientists being ridiculed, persecuted, and even killed by ignorant people.

cix• 12 years ago

That isn't limited to Scientists my friend.

jonnathanson• 12 years ago

Right, which is all the more reason to take the high road. To set a better example.

Also, because trading vitriol with religious fanatics and ignorants accomplishes nothing. Knowledge is the antidote to ignorance. Not smugness, defensiveness, or indignation (well-justified though all of those things might be).

lotsofmangos5• 12 years ago

I know where it comes from, with my scientists hat on, I completely agree with the piece. But from a literary perspective, it is like being repeatedly bashed round the head by a moron with a length of 2x4.

This conceit can be done well. Mitchell and Webb's little old lady job-justification hearings are a particularly good example. http://www.youtube.com/watch?v=UbXTBPN1HhA

VikingCoder3• 12 years ago

You're right, but you're wrong.

You're right - we shouldn't celebrate alienating people who need help.

You're wrong, because there is no argument that can convince someone who doesn't care about evidence.

So, please forgive us our gallows humor about this. After all, these people are content in risking the health of MY child on their Jenny McCarthy-inspired HUNCH that vaccines are bad.

If anti-vaccine folks were only risking the health of their own children, their anti-science stance (or selective-science stance) would be tolerable. As it is, they're a menace.

lotsofmangos5• 12 years ago

You're wrong, because there is no argument that can convince someone who doesn't care about evidence.

That sounds reasonably falsifiable, especially with some nice biscuits.

gloob• 12 years ago

So, please forgive us our gallows humor about this.

Apologies for my pedantry, but dreaming about harming people is actually pretty much the opposite of gallows humour. A more appropriate phrase might be "power fantasy."

DigitalJack• 12 years ago

My main issue with "science," which I put in quotes because there is the ideal of science and the reality of science which are unfortunately not the same. It is purported that science is objective, and that is the admirable goal, but it hasn't been successful.

For every study purporting one thing, one can find an equal an opposite study purporting the opposite (or nearly opposite). Now, that is hyperbole, as usually one of they studies is inferior in some way that is not obvious to the lay person, but it won't stop them from taking an overly strong stance based on an inferior study.

I believe a lot of the "vaccines are bad crowd" fall into a few categories:

1) the group that is very susceptible to confirmation bias

2) the group that has seen some studies that weren't conducted very well and were possibly informed by the first group.

3) those that fall victim to circular references in their proof (e.g. wikipedia article citing a magazine citing the wikipedia article, with possibly a few steps in between)

4) those who choose to believe something because the alternative is terrible for them. I see this one a lot. If you are discussing with someone of some modicum of intellect, you'll detect the situation when "slippery slope" starts being mentioned.

I'm sort of friends with a "vaccines are bad" person. I've cited numerous studies, which, while I'm no expert at interpreting studies, seemed to have rigor. Didn't phase her in the slightest, and we just don't talk about that subject anymore. Or at least I don't, and I don't take the bait. I believe she has an autistic grandson, and if she didn't have vaccines to blame, she'd have to believe that God caused the autism and that's too terrible for her.

jstanek• 12 years ago

If your child is vaccinated, they aren't really at significant risk of catching a preventable infection from an unvaccinated child, since that's the sort of thing vaccines are designed to prevent. This isn't to say that anti-vax is a rational position, but I don't think (disclaimer, I'm not a medical professional) it puts vaccinated children at additional risk.

spindritf• 12 years ago

I have spotted this totalitarian streak among some of my friends who went to med school. We should ban smoking, force everyone to do this or that. As bad as they can be, we're probably better off with lawyers in charge.

lazyant• 12 years ago

People die because some idiot parent didn't vaccinated their children, so I say yes, enforce it or don't live in society, go to some isolated island because you are causing harm, it's as totalitarian as allowing people to play Russian roulette with other people's children (actually you'd go to jail so I think we're too lenient with these parents).

autokad3• 12 years ago

your child has more chance of dying by going to the morning bus stop than their child does of dying from not being vaccinated. in fact, i'd bet your child has a better chance of dying by catching the flu from a vaccinated child than some other child not vaccinated by MMR.

i understand if someone doesn't want their child vaccinated and they can't go to public school, but forcing people is another thing, even if it is 'for their own good'.

gress• 12 years ago

Are you claiming that people never die because of bad law or bad science?

Rockdtben• 12 years ago

Your viewpoint is flawed and very anti-science.

gambiting• 12 years ago

On one hand - yes, absolutely, I agree. On the other hand, you remember the outbreak of the swine flu? And some countries wanted to force vaccinations on their citizens? Vaccinations that were later proven to not work at all, because they were prepared for the wrong virus, and some EU countries spent hundreds of millions of euros buying them? How about that - should the government have the power to force you to be vaccinated or not?

Infinitesimus• 12 years ago

Yes, but people also die because someone miscalculates something in science. A totalitarian world will never be the answer to either problem.

tormeh3• 12 years ago

We would be better off if nobody smoked, but let's not expand the war on drugs. I'm actually OK with a bit of this kind of totalitarianism, but not when it doesn't actually work.

dictum• 12 years ago

Well, keeping the trains running on time did work.

—

The nice thing about mentioning Mussolini is that there's no Godwin Police to immediately point at you.

natophonic• 12 years ago

I'm not sure if it's a culture encouraged at med school, but I certainly have met many a doctor with a mighty god complex. Not that that's exactly rare in the computer science / software engineering world either.

Also, I'm sure we could find people who'd gleefully re-imagine this fantasy story as one where a parent refuses to read the religious tracts being offered to them by a school principal, resulting in the kids being sent to mandatory bible study.

waffle_ss• 12 years ago

There are people who cannot be vaccinated (very young, very old, those with immune deficiencies) who rely purely on herd immunity to prevent getting certain illnesses. If all the healthy people who could suffer through the flu opted-out of the vaccine, most of them would get through it just fine, but the illness would pass through the population and kill off a lot of weaker people.

Smoking obviously causes lung cancer via secondhand smoke, but it also leaves a carcinogenic and heavy metal residue on walls and floors (thirdhand smoke). Kids, especially, get sick from this from crawling around the floor. They don't have the luxury of opting-out of smoking.

What are the solutions to these public health problems that aren't heavy-handed? I'm all for freedom and voluntarism but the libertarian solution of identifying the perpetrator and bringing them to civil court falls apart when the vector from perpetrator to victim is so diffuse that you can't trace it back.

Similar problem with people engorging themselves on unhealthy junk. I have no problem when it only affects themselves, but once their obesity-related maladies start costing other people via subsidized healthcare or extra-wide ambulances and whatnot, it's no longer just an individual choice.

dnautics• 12 years ago

There are studies that suggest voluntary vaccination programs are better at achieving a higher level of penetration than mandatory ones.

jeffbr13• 12 years ago

Doctors aren't really scientists, although some might think so -- they're taught the results of scientific research, and how to apply that to diagnose and treat patients. There's a reason that "evidence-based medicine" isn't just called "medicine". Most of it is pattern-matching on learned knowledge. The result is that some of this knowledge becomes outdated as the underlying body of scientific knowledge evolves, which may cause problems if the practitioner doesn't keep up with the latest changes in their field.

This probably applies to engineers, too because we use scientific (or logical) results imply certain solutions, and we don't always realise that validity of the underlying assumptions changes over time.

Unless you're actually formulating hypotheses and running experiments, you're probably not a scientist.

<http://www.neatorama.com/2009/01/01/mad-scientists-are-actua...

vonklaus2• 12 years ago

I take your point. The semantics to me aren't really that important. Good doctors who have made a lot of observations and read the results of many medical experiments and research are probably pretty qualified people. In a sense when they do "pattern matching" they are performing micro-experiments. They take in synptoms as data, draw out a hypothesis and then treat as an experiment. If the treatment is a success it proves their illness hypothesis.

cossatot• 12 years ago

I think this is an under-appreciated point. Science is really concerned with inquiry into the world (broadly defined), while doctors and engineers are concerned with improving the world, typically by applying solutions that are based in science to specific problems that have been tasked to them. A lot of the difference isn't apparent even at the undergraduate level, where much of science is presented as true vs. false, rather than as this edifice built on bricks with wildly different levels of epistemic uncertainty that looks quite different to different observers.

The boundaries between these things are pretty fuzzy, though, (even though the cores are distinct) and many doctors and engineers engage in research, while most scientists spend a fair amount of energy on developing tools and techniques, which are often more engineering-type challenges (fortunately we don't practice medicine frequently). Nonetheless, there are often very large discrepancies between the mindsets and approaches of the typical scientist vs. doctor vs. engineer.

cowbell• 12 years ago

I feel this way about non-technical management calling the shots on software projects :)

lnanek2• 12 years ago

Pretty funny wish fulfillment where someone forces their own views on others. I fully support vaccination, but don't support this.

bnejad2• 12 years ago

Don't support what? Mandatory vaccination?

danielweber8• 12 years ago

I could see the case where I support vaccinating someone against their will. I couldn't see doing that because the person, once, made a bad argument in the doctor's office.

WorldWideWayne3• 12 years ago

I don't support mandatory vaccination for the same reason I don't support the drug war. No government has the right to tell me what I can or cannot put into my body. Simple as that.

ErikRogneby• 12 years ago

I wonder if the "producer at the BBC" reference was from the BBC not giving air time to climate change skeptics in debate anymore?

capnrefsmmat• 12 years ago

No. This article is from 2012.

kstenerud8• 12 years ago

This is so telling. The sheer arrogance is plainly visible, as is the doctor's complete lack of empathy. There are plenty of ways to motivate people, and this is most certainly not a good one. You don't get a mule to move by pushing it.

falcolas4• 12 years ago

Arrogance, which I'd call exasperance in this case, in the face of repeated ignorance of reality, is justified. You can only deal with willingly ignorant people for so long before giving up on the human race.

And the doctor in the tale did try and educate the mother before she was cut off. She just didn't want to listen.

kstenerud8• 12 years ago

It's fine to feel exasperated. It's not fine to treat people in such a condescending manner. People are rational, and want to understand, but unless you make the information properly accessible in the UX sense, your exasperation is due to your own fault.

The doctor did not try to educate the mother. He tried to lecture her. He offered her a bad user experience, which she naturally rejected. People are not machines. You don't just feed the same information format in and expect the same result from everyone.

slashdotaccount• 12 years ago

Just give up on the human race already, they aren't worth it.

aganders32• 12 years ago

I agree, but consider that it's on Nature.com and the expected audience. This was an entertaining read for those who have felt such frustration, but it's ultimately unhelpful as a published article.

I did appreciate the point about being proud to be bad at math. I think that attitude is damaging and probably deserves a (more reasoned) article of its own.

kstenerud8• 12 years ago

Except that those who are "proud to be bad at math" exude pride because they've given up, but don't want to feel like a failure. In other words, all attempts at math education have so far failed them, and they have succumbed to learned helplessness.

When people are consistently frustrated using your website, you'd normally look into the UX so that you can make a smoother experience. You then test to make sure your changes actually made your site better. Math and science education is no different, except that those in charge tend to treat it like the bad old UNIX days of "If it was hard to write, it should be hard to understand" and "RTFM".

danielweber8• 12 years ago

The odds are heavy that the doctors don't understand the math either https://www.mpib-berlin.mpg.de/en/media/2012/03/new-study-ph...

I used to think "if I could just punish/control other people the world would be so much better because I'm so smart." But then I went through puberty.

Zigurd• 12 years ago

At no point in this very long parable did the patient actually get information about the nature of risk, the odds of bad reactions, the nature and severity of bad reactions, treatments for reactions, etc. If an MD is actually going to talk that much to a patient, the information content could be a lot higher.

jebus989• 12 years ago

A more computational crowd might enjoy "You're not allowed bioinformatics anymore": http://biomickwatson.wordpress.com/2014/07/21/youre-not-allo...

vonklaus2• 12 years ago

If only there was a way to outsource all decision making to an over-arching centralized authority to make all decisions for us. That entity would have all our best interests at heart and make the tough decisions for us. It would be auch a weight off my shoulders of I didn't have to think anymore. I would even be willing to pay 20-30 percent of my paycheck to it, just so it could help me stay safe. What would we call such authority?

darkstar999• 12 years ago

Big Brother

0xdeadbeefbabe3• 12 years ago

A bad religion?

Terr_3• 12 years ago

Cue Deus Ex quotes:

"The human being created civilization not because of a willingness but because of a need to be assimilated into higher orders of structure and meaning. God was a dream of good government."

nemo• 12 years ago

You can give a medically informed body that understands the issues much more deeply some authority over public health policy, while still being able to think about those issues if you're interested. They wouldn't make all decisions for you, just those that have such a broad and important impact to society as a whole that irresponsible individuals wouldn't make choices that could have a net effect of significantly harming others like skipping vaccinations does.

Perhaps we could call that authority "civilization."

WorldWideWayne3• 12 years ago

Personal freedom, to me, is worth the price of possible death or illness due to large swaths of the population not being vaccinated.

ddalex• 12 years ago

This is beyond stupid. You can't explain something, so you ban the person from having a say so. I'm terrible afraid of people thinking that this is the way to go.

As a doctor, which I am not, I would've said: the danger of your children dying or being crippled by a preventable disease is about 1000 times the risk of having an adverse reaction to the vaccine. Furthermore, I can guarantee that the vaccine will not cause autism.

This is what I tell my "anti vac" acquittance, because I can't say I'm friends with morons. But being a moron doesn't preclude the right to understand what's actually happening and what the risks are when making a decision, even if you refrained in the past to educate yourself.

But it's hard to educate, so the author would just ban the discussion altogether. You, the author, are no better than the ones to which you would ban explanations and discussion.

avmich• 12 years ago

I think you didn't get the story.

mpweiher4• 12 years ago

You didn't get the point at all.

"You can't explain something,"

That's exactly not it. The doctor wanted to explain the facts, with the leaflet. Sacha wanted a simplistic assurance that wasn't possible, and refused point blank to have it explained to her.

danielweber8• 12 years ago

Those were the words she used, which could be entirely different from her actual reasoning that she didn't feel like talking about. And if this were any kind of world where doctors overrule you because "your argument is invalid" then she will of course not be forthcoming with her doctor ever. She will instead learn the magic words "oh, Johnny had a bad reaction to a vaccine at his previous doctor in Canada."

The doctor's office is not a courtroom or an arrest where everything you say can and should be used against you.

I'm reminded of people who think it would be awesome to bug lawyer's offices or doctor's offices or confessionals to ferret out crime. It will work the first time, but after that you have totally destroyed trust so you haven't gained yourself anything and the public has lost a place to sensitive discuss issues with people they trust.

shurcooL• 12 years ago

As a doctor, which I am not, I would've said: the danger of your children dying or being crippled by a preventable disease is about...

Did you read the part where the doctor tried the same thing and she cut him off?

“As I said, there is always a small risk, but if you look, you will see that this is less than the probability of...”
Sacha held up her hand.
“Please, Doctor. Don't try and confuse the issue.”

Spooky232• 12 years ago

The question to respond back to such a person is: "Can you assure me that you will get little Willow home safely after this appointment?"

Demanding a yes/no answer to a question that isn't yes/no doesn't make a point, except that you already made an opinion and are paying a copay so that you can ask a doctor rhetorical questions. The fact is, likelihood that the parent in this story smashes the minivan into something on the way home is probably higher than the chances of any ill effect from the vaccine.

There is a line that can be crossed where you take away people's ability to make decisions. This happens via court order for folks with religious convictions against blood transfusions, for example. Anti-vaxing is certainly reckless and IMO ignorant, but I don't know if it crosses that line.

danielweber8• 12 years ago

There is a line that can be crossed where you take away people's ability to make decisions. This happens via court order

Yes, most disturbing in the story was how the woman took her children into a place she thought was trustworthy and she could talk openly, but instead her words were used against her to rob her of agency.

Antivaxxers can be pretty horrible, but there can always be something worse.

OrwellianChild• 12 years ago

Despite being adamantly pro-vaccine myself, I had a very similar reaction... "Making decisions for people" doesn't strike me as an acceptable solution unless the harm you are doing has pretty serious externalities. The "science ban" is nothing more than excessive and fanciful retribution to was was most assuredly a frustrating conversation.

"You are more likely to crash your car on the way home from this office than experience harm from this vaccine." is a pretty succinct explanation invoking relative risk.

I understand the frustrations that lead to doctor wanting to write this sort of fan fiction... I just wish they'd try harder to make the "hero" doctor from the story a more sympathetic character by trying much, much harder to sway the mother's point of view.

suprgeek• 12 years ago

I think we should be making a financial/societal incentive to do the right thing if the science is settled enough.

The trouble with the view presented here is that sure the children get the vaccine due to this hypothetical rule. what happens when later the children get a severe cold (say) and the mom who remembers the previous visit thinks - bloody doctors I will just keep my kid home and pray for him to get better?

Much better approach: "Ok Sacha since you declined the vaccination now I have to report it to all medical insurers. Your family insurance just doubled."

At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated."

Apartment: "Ok Sacha your kids are not vaccinated (per this website where we can query); we will need to charge you a fee that is contributed to our residents' medical fund to cover the risk of housing you."

If you really truly start to hurt in the pocketbook, I bet there will be much more incentive to really read up on the Science.

JumpCrisscross• 12 years ago

At school: "Sacha your kids are not vaccinated and we do not admit any students not vaccinated."

I thought this would perpetuate social stratification. But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect. The National Network for Immunisation Information finds that "compared to fully immunized children, unvaccinated children were more likely to be non-Hispanic white and live in larger households. Educational levels, family income and other factors did not differ" [1].

Removing the philosophical exemption, at the federal level, seems a prudent first step. "States that allowed philosophical exemptions to immunization laws in schools had many more unvaccinated children than states that do not have philosophical exemptions."

[1] http://www.immunizationinfo.org/science/demographics-unvacci...

Terr_3• 12 years ago

Alternate theory: "Poor families" are more likely to be aware (either directly or "institutionally") of the impact of the various preventable diseases or conditions.

Reminds of of a Bujold quote. The character is referring to how over time people forget how hard things were:

"They like to play dress-up and pretend being [noble-class] ladies of old, rescued from menace by romantic [noble-class] youths. For some reason they never play 'dying in childbirth', or 'vomiting your guts out from the red dysentery', or 'weaving till you go blind and crippled from arthritis and dye poisoning', or 'infanticide'."
"Well, they do die romantically of disease sometimes, but somehow it's always an illness that makes you interestingly pale and everyone sorry and doesn't involve losing bowel control."

tzs• 12 years ago

But my hypothesis, that poor families are less likely to vaccinate their children than rich families, was incorrect

Indeed. The Waldorf School of the Peninsula, an expensive private school ($20k/year tuition for kindergarten and elementary school, $21k/year for middle school, and $28k/year for high school), full of the children of very well off people from top Silicon Valley companies, had a 23% immunization rate a few years ago (I haven't seen what the current rate is). Compare to 90% for the public schools in the same city, and 94% for the public schools in the county.

DanBC2• 12 years ago

I would love it if schools and nurseries started to disallow children who were not vaccinated.

Unfortunately there are enough parents to make "no vaccinated children allowed" (you are not allowed in if you've been vaccinated) schools viable. See "Measles parties" and the sending of items infected with chicken pox through the post for examples.

JonnieCache2• 12 years ago

There are really measels parties? I've heard of chicken pox parties, which makes sense because there's no vaccine and the adult form is vastly worse than the infant form. But measels parties, that's just medieval.

EDIT: apparently there is a chicken pox vaccine, but it isn't administered to the general population in the UK, only NHS workers. Interesting.

bane3• 12 years ago

I generally agree, but some people really are allergic to some vaccinations. They present the same exposure risk as somebody who chooses not to be vaccinated for stupid reasons. Should they also not be allowed in?

ISL3• 12 years ago

Do you want people to read up on the science, or to accept what's "settled"?

As a professional scientist, there are few things more anathema than the idea that a scientific theory is "settled". Experiments can only falsify theories; they can never be proven to be correct. The best a theory can hope for is to remain consistent with observation.

Once upon a time, it was well-settled in large communities that the universe spun about the Earth.

jbooth• 12 years ago

Yeah, but we're talking about not vaccinating your kids, here. It might be that we're all living in a computer simulation and none of this matters but we should still act on what we observe.

IanCal• 12 years ago

Do you want people to read up on the science, or to accept what's "settled"?

You're assuming that both of these things are possible / likely. I want people to stop killing each other but that's not necessarily realistic.

It's an interesting problem, trying to achieve the theoretical best situation (everyone understanding and accepting science) vs 'tricking' people (just getting them to accept what you say).

eridius• 12 years ago

People who are inclined to actually study the issue, form an informed opinion, and be willing to change that opinion in the face new evidence, they absolutely should read up on science.

But everyone else, no, they should just accept the opinions of the experts if the issue is reasonably settled. They're not going to engage in the scientific process anyway, so their uninformed opinion really doesn't matter.

GhotiFish• 12 years ago

I bet there will be much more incentive to really read up on the Science.

You mean capitulate to a forced perspective?

If she learned fundamental statistic, pored through paper after paper, found errors and miscalculations, would she get her money back? No, so ignorant or not is irrelevant.

Your utopia is terrifying.

mhb• 12 years ago

Roald Dahl: Vaccines, Measles and his Daughter

https://news.ycombinator.com/edit?id=8080516

micro_cam2• 12 years ago

Things like this makes me ashamed to have my name on papers in Nature.

First, lets set aside the hypocrisy of a non open access journal publishing this[1]. (What happens if Sacha wants to inform her self by reading a few old nature papers?)

I am pro vaccine but far too many doctors have this fantasy that they should have unlimited control and articles like this just serve to validate that view point.

Medicine is an inexact and continually evolving science and a good doctor should always be willing to talk over the options with you and engage with you on a level beyond just parroting the current recommendations. As someone who is one of the people contributing to the body of often-vague statistics we call medicine it is continuously annoying to have to get doctors to explain their (often subjective) judgment calls they are making and actually present their reasoning analytically.

Additionally, many doctors choose to forgo recommended treatments themselves due to side effects [2].

[1] In fact you can pay extra to make your nature paper open access but it is by no means fully open access. [2] http://www.nytimes.com/2013/11/20/your-money/how-doctors-die...

ISL3• 12 years ago

This is a Nature Future, the story printed at the back of the magazine as food for thought. Perhaps only twenty percent of them present a future in which we'd like to live.

If the Future has driven HN to active discussion of an ethical topic, then it has succeeded in its purpose.

Unlike most of Nature, the Futures are free to read (and ~10% of them are compelling enough to make reading them all worthwhile).

(just scroll down to see the complete archive) http://www.nature.com/nature/focus/arts/futures/

lotsofmangos5• 12 years ago

I posted this Mitchell and Webb sketch further down, as an example of how to do this well - http://www.youtube.com/watch?v=UbXTBPN1HhA

Now reflect on your reaction to that piece. Even when on the side of the trader, it is still funny. You can be a trader and find that funny.

This is because of how the characters are treated in the piece. Essentially, it is ridiculing ideas while remaining sympathetic to the character that holds them, which is difficult to do well, but makes for a much more persuasive piece of satire that will be appreciated by a wider range of people.

The piece in Nature however is just preaching to the converted, and doing it in a way that will just entrench the views of anyone who identifies with the mother. Frankly, if they want to publish satirical sci-fi, they should pay someone who can do it well rather than embarrassing themselves like this. It reads like a teenage first attempt at short-story writing.

api• 12 years ago

https://en.wikipedia.org/wiki/Polio_vaccine#Contamination_co...

I'm not at all anti-vaccination, but I am anti-authoritarian and anti-closed-science. People have a right to know what they're putting in their bodies. The SV40 contamination turned out to not be that serious, but it was a close call. Had SV40 been potently carcinogenic, we would have had a medieval plague of cancer.

In the end it reduces to the problem of freedom and open society: freedom means tolerating people being idiots. Freedom means it's okay for the Ku Klux Klan to mail me literature. It means it's okay for people to question vaccination because some stupid celebrity told them it caused their son's autism. It means it's okay for people to put pink plastic flamingos on their lawns. The alternative is a closed, authoritarian society.

mpweiher4• 12 years ago

"People have a right to know what they're putting in their bodies."

Right, and the doctor was trying to give her that knowledge, and she refused.

cstross• 12 years ago

Viral pandemics do not respect your personal boundaries: your "right to be an idiot" over vaccination may not be intended to result in deaths, but that's what will happen if we indulge such beliefs until herd immunity is lost.

We need to draw a distinction between idiotic behavior with no externalities -- side-effects for others -- and idiotic behavior that can damage third parties. Upshot: there's no simple dichotomy between an open society and an authoritarian one.

Taek• 12 years ago

I'm not sure why you've been downvoted because I believe you have made a non-harmful contribution to the discussion. Freedom is important, because once we've given up the right to refuse vaccination, we're a step closer to giving up other rights as well. Further down this path we could see criminals without the right to refuse sterilization or mood treatment.

This article of course is not about vaccinations specifically. It's about a woman with a black and white view of protecting her children. She ends up choosing the less safe option out of ignorance and stubbornness but she's ultimately trying to do what is best for her children.

This article assumes that her ignorance on the vaccination issue indicates ignorance about all things scientific, which is a fallacy. Likely, she only needs the right person (someone she trusts) to approach her with a proper explanation.

Yes, the vaccination issue is absurd but we will not resolve it by removing parents from the freedom to do what they think is healthiest for their child. That will not make them more open to logical discussion and more likely to trust the decisions of their doctors.

tanglisha• 12 years ago

Public health issues like vaccination aren't like other issues. Vaccination decisions aren't made in a bubble where only you suffer if you get sick or become a carrier.

There will always be a certain portion of the populace that cannot receive a specific vaccination because of allergies or a weakened immune system that cannot handle it.

The whooping cough epidemics that have been sweeping through anti-vaccination areas in recent years are an example of how a decision that you make for your kids can result in other people dying.

kordless2• 12 years ago

It's called a parable. The universe allows them, and evidently so does Nature. Why would you be ashamed of publishing a paper you worked hard on anywhere? Are you implying you believe others would be judgemental of you because the magazine ran a parable that taught a lesson about dismissal of a concept without consideration?

0xdeadbeefbabe3• 12 years ago

It makes Nature look overzealous, while failing to teach the lesson. You can find less heavy handed parables in the bible. The dystopia isn't that exciting either.

micro_cam2• 12 years ago

I said I was setting aside open access issues but I guess they do play into my reasoning. I want anyone with interest to have access to scientific results be they a garage biohacker, a stay-at-home mom trying to make sense of a 23 and me result or an MD PHD.

Nature already has an image problem [1] and the idea that they would use such a high profile venue to publish this seems silly even if it wasn't so alienating to people we need to be reaching out too. It just contributes to the distorted view of science and scientists that high profile journals are creating.

[1]http://www.theguardian.com/science/2013/dec/09/nobel-winner-...

mpweiher4• 12 years ago

"Medicine is an inexact and continually evolving science and a good doctor should always be willing to talk over the options with you and engage with you on a level beyond just parroting the current recommendations."

Exactly. The doctor tried to have that discussion, and tried to explain the pros and cons. Using a leaflet is a good starter and basis for discussion, because it contains those facts and pros/cons. Much better than just making things up as you go.

Sacha refused to engage, refused to be informed, refused to inform herself, instead wanting a simplistic black/white assurance that this would not harm her children, an assurance which is not possible given the facts. The facts that Sacha did not wish to be informed about.

robotresearcher• 12 years ago

What happens if Sacha wants to inform her self by reading a few old nature papers?

She can go to pretty much any reference library in the world. I'm all for open access but let's not over-do it.

swayvil• 12 years ago

I like a consensus of experts as much as the next guy, but let's not get carried away.

Today's airtight methodology is tomorrow's tragic myopia.

0xdeadbeefbabe3• 12 years ago

Does that mean phrenology is not coming back?

logfromblammo• 12 years ago

Look, science, you can't have it both ways. You can't release knowledge into the wild and also keep it caged up under your control. It is no more possible than setting the barn afire then ordering the flames to go back into the lamp.

If you cannot tolerate the idea that everyone benefits from science done well, even including those who behave destructively towards scientific progress, then why are you doing science in the first place?

Screaming from the mountaintops, "No! No! You're doing it wrong! All wrong! You idiots! You morons! Stop what you're doing immediately and do as I say!" is not likely to help your cause. That is, after all, what people have been yelling at each other for centuries, even long prior to the development of modern scientific inquiry.

There may even be a branch of science that deals with social norms and cultural shifts, and perhaps the intentional guidance of groups towards given institutional goals. You could probably take the socio- prefix and append an -ology to it. Maybe ask a sociologist what usually happens when you strip a person of the ability to make their own choices, even if you are certain they are making those choices based upon flawed premises.

Applying force or coercion does little but change the portion of the behavior of a person that is visible to you. You cannot use it to change someone's mind, no more than you can make a person love you by smashing their ankles with a sledgehammer. You have to coax them to it, convincing them to change their own minds. But you can't do it for a non-rational person using only rational argumentation. It does not compile. You have to use other means to even get them close enough that argument will work.

You have to advertise. Use rhetoric. Flash some sideboob. Blow dragon smoke from your nose using cookies dipped in liquid nitrogen. Write a catchy jingle. Go viral. Write a hoax about cool teenaged kids getting electrotetanized by their musical Tesla coils. Get Bill Nye slimed on Nickelodeon's Kid Science Awards Show as he introduces the new Mr. Wizard, wingsuiting down to the venue from an orange zeppelin.

You have to make people want science to like them. And you're not going to get there by acting like a condescending know-it-all prick--even if you do actually know it all, and the other person is a clueless, drooling moron.

TallGuyShort• 12 years ago

Ok, fine, then you're not allowed individual sovereignty.

danielweber8• 12 years ago

This sat poorly with me. I thought "you're not allowed science any more" would mean that no one has to ever listen to her in any scientific debate. Instead, it meant that she got overruled about a medical decision.

Congratulations, you've amazingly found a way to be even worse than the antivaxxers. I didn't think it was possible.

epistasis• 12 years ago

I wouldn't be so quick to assume that the article is advocating for forced vaccinations, but I do think that your reaction to the forced vaccination does hint at what the article really was suggesting.

prestadige• 12 years ago

This is a fantasy of course, which is a defence mechanism for frustrated minds.

However, the quasi-religious defence of Science as a settled body of knowledge which people must be forcibly 'educated' about is becoming depressingly common. Becoming more like a religion isn't a good way to counter superstitious falsehoods.

The patient-doctor relationship has waned, IMO. Here in the UK for most ailments I see a GP for about 10 minutes. I never see her again. No follow up, no chat, etc. Different GP next time. Perhaps social media could help build trust within practices.

tokenadult• 12 years ago

There are a lot of comments here about the issue of how to communicate risk of different personal medical choices to patients who do not themselves have medical training. It is a tough problem. Professional stage magicians, and avid skeptics, Penn and Teller had an episode of their cable television series Bullshit report on the issue of risks and benefits of vaccination. Maybe a clip from their TV show (with language that many families would find inappropriate for viewing with their children) will help communicate the risk and benefit ratio of vaccination more clearly than documents written in a more clinical tone.

https://www.youtube.com/watch?v=RfdZTZQvuCo

(short clip above, long clip below)

https://www.youtube.com/watch?v=RLcOz4EKrxg

mynewwork2• 12 years ago

I'm confused by the awkward grammar in the title. Is it intentional for humor (like xkcd's 'going to try science') or is that wording acceptable use in British dialects?

I'm parsing it as "You're not allowed <to use> science" or "You're not allowed <to know> science", but it's right on the line of believable that I could see that sentence being used genuinely in another dialect.

CanSpice• 12 years ago

They're using science as a noun. Think of it like "You're not allowed oxygen any more."

mynewwork2• 12 years ago

Which still sounds wrong to me. I'd expect "You're not allowed to breathe oxygen" or "You're not allowed to have oxygen".

So I guess it's "allowed" which is being used in a way I'm unfamiliar with.

chris_mahan• 12 years ago

It's this reasoning that gave us the 401K.

Jtsummers4• 12 years ago

Aren't 401Ks mostly voluntary programs? I'm not aware of anyone being compelled to invest into them.

gretful5• 12 years ago

So here you have a Doctor trying to be Lawyer. There is a chance, however small, of a bad reaction to the vaccine. The Doctor knows this, therefore he cannot give this woman her 100% guarantee that nothing will go wrong because of the vaccination. He knows that if he tells this woman it will be OK and nothing will happen, that if something DOES happen he will be sued for medical malpractice.

gretful5• 12 years ago

Quick question: how many of you are against the flood of illegal immigrants making their way into the US? If you're worried about killing herd immunity, you should really be voicing your discontent over both the GOP and Democrat parties encouraging this with their amnesty plans.

Here's just one incident of an illegal bringing disease into the US:

http://news.yahoo.com/arrest-warrant-issued-man-tuberculosis...

lotsofmangos5• 12 years ago

Not like the brazen giant of Greek fame,

With conquering limbs astride from land to land;

Here at our sea-washed, sunset gates shall stand

A mighty woman with a torch, whose flame

Is the imprisoned lightning, and her name

Mother of Exiles. From her beacon-hand

Glows world-wide welcome; her mild eyes command

The air-bridged harbor that twin cities frame.

"Keep ancient lands, your storied pomp!" cries she

With silent lips. "Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!"

gretful5• 12 years ago

A beautiful poem, one that many a legal immigrant saw upon entering the US as they began inprocessing through the Ellis Island immigration station. One that the illegal aliens will not see as they illicitly cross our border, seeking to evade what agents we have stationed there.

thatjoist• 12 years ago

Nice strawman, "if you're against X you MUST be against Y".

What really matters is the cost-to-benefit ratio. A jab in the arm vs denying someone immigration, decide whatever you want but it's a sliding scale, not black-and-white.

gretful5• 12 years ago

so I'd take that as you're anti-anti-vaxer, but pro illegal aliens?

And nice job putting words into my mouth, I didn't say you HAD to be against Y, I said you SHOULD. And it wasn't denying immigration I was talking about, it was illegal aliens. Different words mean different things.

hasler• 12 years ago

You've had the opportunity to read the facts and the education to be able to analyse them, yet you have consistently chosen not to.

Perhaps if doctors understood the facts better, and could explain them better, this wouldn't be a problem:

http://jsfiddle.net/SamHasler/c22eR/embedded/result/

“You're not allowed science any more”

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