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Vaccination debates and the pain of dividuality

**Post originally published on Corpus: conversations about medicine and life, August 7, 2017; with thanks to Sue Wootton for editing and for permission to republish** 

Dividuality: “the close proximity and unexpected pull of others in one’s life” (Garish Daswani 2011).

syringeMy ears are full of screaming: the name-calling, the CAPS, the exclamation points!!! Whenever vaccination comes up online, and comments are enabled, the conversation quickly devolves into an extremity of outrage and vitriol that reads to me like ‘moral panic.’

Coined in the late 1960s, the term ‘moral panic’ makes no judgement on the value of the issues under discussion. Rather, it highlights the social processes in the associated  public discourse: the way that story, meaning, and affect coalesce around a particular social problem. Untangling an objective sense of risk from this is nigh on impossible. Besides, people are doing stupid, risky, and harmful things to each other, directly and indirectly, all day long, and in every part of the world. The question becomes not what to think of anti-vaxers, but why the panic about this particular issue, why here, and why now?  I believe the answer is not purely medical, but also social and moral.

In matters of morality the contemporary Western world cries ‘choice’ until the word is nearly meaningless. Liberalism snuggles up next to secularism. We fiercely defend our (and others’) rights to make personal decisions, based on personal beliefs. What the issue of vaccination makes horribly clear is the reality is that you can make your personal decisions, based on your personal beliefs, and they can still kill my child. There are limits to our liberalism. Is this the sore spot that the vaccination debate is poking its sordid fingers at? That the personal is social, always.

Arthur Kleinman What Really MattersArthur Kleinman – psychiatrist, clinician, social anthropologist – discusses morality by looking at “what matters most” or “what is at stake”. In matters of health this includes relationships, personal values and identity. What produces such heat in the debate about vaccine-preventable diseases is that it’s not only individual biographical identities that are threatened, but deeper cultural constructions of the ‘self.’ What the debate specifically grates on is our sense of ourselves as individuals: our clung-to Western vision of the autonomous, bounded, individual self. Silos. Self-governed islands.

Social anthropologists have compared the different notions of selfhood and personhood that emerge in diverse cultural settings. In many African communities, for example, ethnographic data paints a picture of the self as partible (capable of being divided), and porous (to both physical and spiritual substances) – not ‘individual’, but (according to ethnographers like Girish Daswani) ‘dividual’. This is quite a contrast to the ‘buffered self’ that is a feature of the Western secular age, where the ideal of healthy interpersonal relationships involves having strong interpersonal boundaries.

The vaccination debate invokes a sense of contamination and threat from other human beings. But bodies are never just bodies. They are the site of densely-packed social meanings, and the inspiration for the most accessible and powerful metaphors for pressing existential concerns. Thus the vaccination debate is not only expressive of anxieties about our biological health, but also about our social existence.  As each image of an ailing child looms large on our screens, how outrageous it seems to have to acknowledge ourselves as herd animals in this way – how sickening and scary that what matters most to us is at the mercy of those around us. How intolerable. How basically, inescapably, human.

Dividuality cannot just be the folk theory of some cultures… it is the basic reality of all communities. There is an Irish proverb I have always liked:

“In the shadow of each other we must build our lives.”

Though bleak, to me its comfort is in the embrace of that inevitable entanglement with other selves. You will shadow me, just as I will shadow me. I can no sooner extract my life from the influence of others’ dreams, decisions, and faults than I can remove myself from the biological systems of immunity and disease. A relinquishing of the singular pronoun is needed: I, we, are in so many ways collective.

beehiveRobyn Maree Pickens’ beautiful essay on bees (published in Turbine/Kapohau 2016) evokes something of this; the sense of ecological interconnectedness which must be cultivated against alarm bells. She concludes by beseeching us to attend to the “nested lives of others.”

The air of panic that hovers over the vaccination debate reflects the existential nature of the concerns being expressed: concerns over the threat of vaccine-preventable diseases to the physical wellbeing of our children; threats also to our clung-to visions of ourselves as bounded individuals. We struggle in the grip of an impossible longing for both freedom to make our decisions and freedom from the effects of others’ decisions. Yet this is the shadow-dance we live in. Confronted with a perfect biological metonym for this crumbling dream of moral autonomy, it seems we can do nothing but scream.


Written by: Dr. Susan Wardell 

References:

  • Cohen, S. (2002). Folk devils and moral panics.
  • Daswani, Girish. “(In-)Dividual Pentecostals in Ghana.” Journal of Religion in Africa41, no. 3 (2011): 256–79.
  • Kleinman, Arthur. “Caregiving as Moral Experience.” The Lancet 380, no. 9853 (November 9, 2012): 1550–51. doi:10.1016/S0140-6736(12)61870-4.
  • Pickens, R. M. (2016). We ask so much of them