How can you mend a broken trust?

A new article in PLoS Biology discusses the vaccines/autism controversy from a anthropological/psychological perspective: A Broken Trust: Lessons from the Vaccine–Autism Wars. The history is well-known to most regular readers of this blog, but this particular article is interesting because it identifies the way the idea that vaccines cause autism took hold among the lay public. The main reasons for this, according to the article, are:

* Basic distrust of science and scientists. In the era of “Question Authority”, many people feel that acting skeptically towards those perceived to be in authority and questioning their motives is the same thing as self-empowerment. Many don’t apply the same skepticism to the claims of those they perceive to be the underdog, and end up following them as blindly as they accuse medical convention to be following Big Pharma. Thus, the woo-monger fighting against “the system”, the ditzy blonde actress from MTV, and the lady who sounds so sure of herself (and cuts-and-pastes so extensively) on your Internet mommyboard are sources of information equivalent, if not superior, to your pediatrician or the CDC.

*The incapablility of most people (even smart ones!) to distinguish between good and bad scientific information. Most people simply don’t have enough specialized knowledge or do not utilize their critical thinking skills – if they possess them, that is – toward what they read on the Internet. In a world where whoa-whoa-whoa feelings trump information, scientists are perceived as the cold, unfeeling SOBs who dare confront the grieving mother of the vaccine-injured (i.e., autistic) child, over the ignorance she spreads. The fact is that being the mother of an autistic child (or even a genuinely vaccine-injured one) does not give one special insights into what causes autism or what cures it, but her lament is far more appealing to one’s gut than dry facts and statistics.

The fact that there are plenty of people out there – heck, a whole industry of people – who are deliberately spreading misinformation about vaccines in the hopes of getting desperate people to give them money in search of a non-existent “cure” that “they (meaning the medical establishment) don’t want you to know about” only serves to exacerbate parents’ confusion. As the article points out:

Thinking the institutions that were supposed to protect them from risk failed, Kaufman says, people now do their own research. But instead of leading to more certainty, she explains, “collecting more information actually increases doubt.”

The article suggests that as research into the actual causes of autism advances, the quack theories will eventually fall by the wayside. However, that isn’t happening nearly fast enough. Besides, I submit that the autism issue is now only one issue that preturbs the public about vaccines. We now have the ‘toxin’ issue and the ‘too many, too soon’ issue neither of which will be going away anytime soon, and even if anxious parents and woo-meisters won’t be able to blame vaccines for causing a child’s autism, they can still blame them for the kids’ asthma, eczema, or learning disabilities.

Another method suggested is that scientists and vaccine advocates, like antivaxers, adopt the use of narrative:

[Jenny] McCarthy emerged as a hero for some parents by telling her story. Personal stories resonate most with those who see trust in experts as a risk in itself—a possibility whenever people must grapple with science-based decisions that affect them, whether they’re asked to make sacrifices to help curb global warming or vaccinate their kids for public health. Researchers might consider taking a page out of the hero’s handbook by embracing the power of stories—that is, adding a bit of drama—to show that even though scientists can’t say just what causes autism or how to prevent it, the evidence tells us not to blame vaccines.

As I pointed out recently, some pro-vaccine resurces – though not enough, IMO, are using personal anecdotes to get the message out.

Another tactic not mentioned, but which seems to also be gaining traction, is use of the popular media. After all, it was the media’s complicity which helped get us into this predicament in the first place. OK, so we know Oprah is a woo-loving fool; maybe Dr. Phil or some other popular talk-show host may be willing to bat for vaccines? Maybe more newspapers and online news services should be persuaded to highlight (as in front page news) any and all information dispelling the vaccine/autism controversy, the dishonesty of those pushing the theory (like the Chicago Tribune exposes on the Geiers and their partner-in-grime, Dr. Mayer Eisenstein), and the research suggesting autism is largely a genetic disease?

Perhaps I was overly pessimistic, and it’s not too late to restore the public’s faith in modern medicine. But I suspect that a revamping of the science curricula starting in primary school, and the formal teaching of critical thinking skills, is what’s most necessary. Even more importantly, scientists must constantly police themselves and prove they are worthy of the public’s trust.