The other day, I read this essay by Katha Pollitt in The Nation about the fundamental problem at the heart of creationism (h/t Sully, I think):
Do you know what the worst thing about the recent Gallup poll on evolution is? It isn’t that 46 percent of respondents are creationists (“God created human beings pretty much in their present form at one time within the last ten thousand years or so”). Or that 32 percent believe in “theistic evolution” (“Human beings have developed over millions of years from less advanced forms of life, but God guided this process”). Or that only 15 percent said humans evolved and “God had no part in this process.” It isn’t even that the percentage of Americans with creationist views has barely budged since 1982, when it was 44 percent, with a small rise in the no-God vote (up from 9 percent) coming at the expense of the divine-help position (down from 38 percent). Or that 58 percent of Republicans are creationists, although that does explain a lot.
Why does it matter that almost half the country rejects the overwhelming evidence of evolution, with or without the hand of God? After all, Americans are famously ignorant of many things—like where Iran is or when World War II took place—and we are still here. One reason is that rejecting evolution expresses more than an inability to think critically; it relies on a fundamentally paranoid worldview. Think what the world would have to be like for evolution to be false. Almost every scientist on earth would have to be engaged in a fraud so complex and extensive it involved every field from archaeology, paleontology, geology and genetics to biology, chemistry and physics. And yet this massive concatenation of lies and delusion is so full of obvious holes that a pastor with a Bible-college degree or a homeschooling parent with no degree at all can see right through it. A flute discovered in southern Germany is 43,000 years old? Not bloody likely. It’s probably some old bone left over from an ancient barbecue. To celebrate its fifth anniversary, the Creation Museum in Petersburg, Kentucky, has installed a holographic exhibit of Lucy, the famous proto-human fossil, showing how she was really just a few-thousand-year-old ape after all. [emphasis added]
First of all, as regards evolution I agree with everything Pollitt writes in the essay. But it was how the same kind of thinking pervades another fraught topic that occupied my thoughts this past weekend.
I refer, of course, to those who refuse to vaccinate their children. Swap out “evolution,” “false” and “scientist” in the highlighted sentences and replace them with “vaccination,” “dangerous” and “doctor” and you have precisely the same issue. (Well, OK, there are probably very few paleontologists or geologists who choose to involve themselves in the vaccination debate. You get my drift.) In order for vaccinations to be the harmful substances that their strident detractors claim, their continued administration would require a gigantic, malicious conspiracy on the part of physicians, nurses, researchers and pharmaceutical manufacturers.
I alluded to this in my earlier post about why everyone should get vaccinated. I’ve been out of training for the better part of a decade, and have been out of medical school for more than a dozen years. In that time I have given vaccines to hundreds of children (probably thousands), and have worked with pediatricians who have been in practice for far longer and have vaccinated countless children more. None of us have observed anything like a credible link between autism and vaccines, and we all continue to recommend them strongly. What kind of depraved indifference to the well-being of our patients would be required for us to turn a blind eye to harms that were actually being done? Creationists can attribute a belief in evolution to satanic delusion (which is what I was taught in the church of my youth). To what would anti-vaccination zealots attribute my motivation to deceive and harm my patients?
This is why taking care of vaccine refusers is a losing proposition for medical providers. It’s not merely that refusing immunizations for one’s children deviates so widely from the standard of care and leaves them needlessly vulnerable to potentially devastating diseases. (Though, y’know, dayenu. It’s reason enough.) It’s that believing vaccines to be harmful betrays a suspicion of all of medicine, and erodes any sound physician-patient relationship. Obviously I do not expect my patients or their parents to unthinkingly believe everything I say, and I reject the paternalistic model that demands physicians be treated as unquestionable authorities. But if a question has been asked and asked and asked, and answered and answered and answered, but the suspicion does not dissipate… well, then, how on earth can you trust me about anything? If you believe I am so blind or malevolent as to recommend use of a substance that is supposedly quite obviously harmful, then why on earth would you listen to me when I recommend any other medication or treatment? How can a belief in vaccines be an isolated lacuna in an otherwise-reliable professional expertise?
In truth, I don’t believe that it can. Refusal to vaccinate one’s children evinces an underlying suspicion of the entire apparatus of medical research and care. I simply cannot see how a stable physician-patient relationship can be established in the context of such a frank rejection of medical science. I don’t need my patients to think I’m a god, but I cannot have them thinking I am a fool or a liar.