{"id":69,"date":"2018-11-20T16:23:21","date_gmt":"2018-11-20T03:23:21","guid":{"rendered":"https:\/\/blogs.otago.ac.nz\/inplural\/?p=69"},"modified":"2018-11-20T16:23:34","modified_gmt":"2018-11-20T03:23:34","slug":"vaccination-debates-and-the-pain-of-dividuality","status":"publish","type":"post","link":"https:\/\/blogs.otago.ac.nz\/inplural\/vaccination-debates-and-the-pain-of-dividuality\/","title":{"rendered":"Vaccination debates and the pain of dividuality"},"content":{"rendered":"

**Post originally published on Corpus: conversations about medicine and life<\/a>,\u00a0August 7, 2017; with thanks to Sue Wootton for editing and for permission to republish**\u00a0<\/strong><\/p>\n

Dividuality: \u201cthe close proximity and unexpected pull of others in one\u2019s life\u201d (Garish Daswani 2011).<\/em><\/p><\/blockquote>\n

\"syringe\"My 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 \u2018moral panic.\u2019<\/p>\n

Coined in the late 1960s, the term \u2018moral panic\u2019 makes no judgement on the value of the issues under discussion. Rather, it highlights the social processes in the associated\u00a0 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\u00a0this<\/em>\u00a0particular issue, why here, and why now? \u00a0I believe the answer is not purely medical, but also social and moral.<\/p>\n

In matters of morality the contemporary Western world cries \u2018choice\u2019 until the word is nearly meaningless. Liberalism snuggles up next to secularism. We fiercely defend our (and others\u2019) 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\u00a0your\u00a0<\/em>personal decisions, based on\u00a0your<\/em>\u00a0personal beliefs, and they can still kill\u00a0my<\/em>\u00a0child. 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.<\/p>\n

\"ArthurArthur Kleinman \u2013 psychiatrist, clinician, social anthropologist \u2013 discusses morality by looking at \u201cwhat matters most\u201d or \u201cwhat is at stake\u201d. 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\u2019s not only individual biographical identities that are threatened, but deeper cultural constructions of the \u2018self.\u2019 What the debate specifically grates on is our sense of ourselves as\u00a0individuals:\u00a0<\/em>our clung-to Western vision of the autonomous, bounded, individual self. Silos. Self-governed islands.<\/p>\n

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) \u2013 not \u2018individual\u2019, but (according to ethnographers like Girish Daswani) \u2018dividual\u2019. This is quite a contrast to the \u2018buffered self\u2019 that is a feature of the Western secular age, where the ideal of healthy interpersonal relationships involves having strong interpersonal boundaries.<\/p>\n

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.\u00a0 As each image of an ailing child looms large on our screens, how\u00a0outrageous<\/em>\u00a0it seems to have to acknowledge ourselves as herd animals in this way \u2013 how sickening and scary that what matters most to us is at the mercy of those around us. How intolerable. How basically, inescapably, human.<\/p>\n

Dividuality cannot just be the folk theory of\u00a0some\u00a0<\/em>cultures\u2026 it is the basic reality of\u00a0all\u00a0<\/em>communities. There is an Irish proverb I have always liked:<\/p>\n

“In the shadow of each other we must build our lives.\u201d<\/em><\/p><\/blockquote>\n

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\u2019 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.<\/p>\n

\"beehive\"Robyn Maree Pickens\u2019 beautiful essay on bees<\/a>\u00a0(published in\u00a0Turbine\/Kapohau 2016<\/em>) 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 \u201cnested lives of others.\u201d<\/p>\n

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\u00a0to\u00a0<\/em>make our decisions and freedom\u00a0from\u00a0<\/em>the effects of others\u2019 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.<\/p>\n

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Written by:\u00a0<\/b>Dr. Susan Wardell\u00a0<\/a><\/p>\n

References:<\/strong><\/p>\n