Tuesday, May 3, 2016
Invulnerability: The Threat of Failure (pt. II)
"No mortal can ever be made invulnerable." True? What do you see as the important implications of this for the issue of vaccination as public health policy?
For starters, here's a rather to the point, article by Jeffrey Kluger on "Why 'Tolerating' Anti-Vaxxers is a Losing Strategy".
Now more fully to be addressed in this final discussion on invulnerability and immunization is the treatment of public immunity as “impossible” and what broader implications that has for public health when used as an excuse not vaccinate.
The rather binary social deconstruction of vaccination as either “wholly viable” or “totally unrealistic” seems to foster a climate of choice in which individuals can say “Well, since 100% fail-proof public immunity isn’t possible anyway, I don’t see why I need to vaccinate my kid.” But that method of thinking and that route of address comes up nothing short of horrendously problematic for the notion of herd immunity I first brought up in part one of this discussion. If, let’s say even 30% of people think either that thought exactly or something similar enough that they are convinced not to vaccinate their child, only 70% of the populace is then appropriately vaccinated. The math is simple enough. But when, according to the TIME article linked at the beginning of this post, nearer to 90% of a given population has been shown to have been vaccinated to see a clearly effective “public immunity”, we are falling more than short.
To throw it out there all the more bluntly, vaccination, while individual by nature, is not a personal matter, it is a public health & safety issue. If you’re part of the crowd thinking “well the 100% isn’t possible anyway, so there’s no point in doing this”, you’re part of the problem.
To further conclude not only this final discussion but the entire Bioethics course more broadly, in reflecting on the texts we've read this semester, I think the most important thing for health-care providers and caregivers to do is to acknowledge the inevitability of circumstance. We’ve regarded a variety of issues pertaining to manners like these: death not as a failure of medicine, but something yet to come for all of us, refusal on religious grounds to seek particular kinds of treatment, etc. The common thread of inevitable circumstance tied between these things is not something that can be fought, it is not something that results much in success or failure. That is not to say that intervention has no effect on circumstance, rather the opposite. The point I would like to make, then, is that in acknowledging that life/circumstance/choice has put this patient into whatever particular route of care they are after, there are a limited number of particular outcomes to any situation (again, some seen as successes, some seen as failures), but when the list is so limited, a health-care provider or caregiver should always address that entire list of outcomes as viable, even if some options are preferred. This is all to say more simply, while the threat of “failure” is looming, first come to acknowledge it as a possibility, and then move on to look toward intervention (medical and otherwise) as a potential to make a change in someone’s life, make a change in their situation, and perhaps make a world of difference.