A recent study suggests that vaccine hesitancy amongst key demographics – including females, younger individuals, and certain ethnic groups – could undermine the pursuit of herd immunity against COVID-19 in the United Kingdom. At the same time, the UK Joint Committee on Vaccination and Immunization (JVCI) indicated that it will not facilitate the choice between available COVID-19 vaccines. This paper reflects upon lessons from the introduction of the UK’s combined Measles, Mumps and Rubella (MMR) vaccine strategy of the 1980s when (...) Member of Parliament Miss Julie Kirkbride argued that had parents been allowed to choose between vaccine variants, then the crisis of low herd immunity – and subsequent outbreaks – could have been avoided. This paper explores this argument, as applied to the COVID-19 vaccination strategy, by considering how three key elements of informed consent – disclosure of risk, benefit, and reasonable alternatives – may be employed to tackle vaccine hesitancy and build vaccine confidence. (shrink)

The recent decrease in public confidence in the measles, mumps and rubella vaccine has important implications for individuals and public health. This article presents moral arguments relating to conflicts between individual autonomy and collective responsibilities in vaccination decisions with a view to informing and advising health professionals and improving the effectiveness of education policies in avoiding resurgence of endemic measles. Lower population immunity, due to falling uptake, is hastening the need for greater public awareness of the consequences for the population. (...) Vaccination refusals go hand in hand with responsibilities owed to future generations and society in not knowingly contributing to preventable harms. Issues such as parents’ rights are considered and balanced against: collective responsibilities for public health; permissibility of ‘free-riding’; conflicting duties of health professionals; and possible enforcement of vaccination. It is suggested that the arguments may form a persuasive tool for the practice of health professionals involved in informing and supporting parents’ vaccination decisions. (shrink)

Using the controversy over the MMR vaccine, I consider the reasons why non-experts should defer to experts, and I sketch a model for understanding cases where they fail to defer. I first suggest that an intuitively plausible model of the expert/non-expert relationship is complicated by shifting epistemic standards. One possible moderate response to this challenge, based on a more complex notion of non-experts' relationship with experts, seems unappealing as an account of the MMR controversy. A more radical suggestion is that (...) non-experts might have a political reason to defer to experts, when not doing so will involve ‘epistemological free-riding’. I investigate the implications. (shrink)

I shall argue that where a coercive public health policy is backed by a clear medical consensus, appropriately reconsidered in the light of claims of doubters, there is sometimes a moral obligation on the part of the public to defer to the experts. The argument will be geared to the continuing controversy in the UK over the safety of the measles/mumps/rubella (MMR) vaccine. vaccine.

ArgumentA number of issues related to vaccines and vaccinations in society are discussed in this paper. Our purpose is to merge an analysis of some recent changes in the vaccine market with social science research on the relationship between citizens and authorities. The article has two empirical parts. The first shows how the vaccine market, which for many years has had immense financial problems, nowadays seems to becoming economically vitalized, mostly due to the production of new and profitable vaccines. However (...) prosperous the future may appear, certain reactions from the public regarding vaccination initiatives offer insight into inherent problems of vaccine policies in many Western countries. In the second part of the article, these problems are exemplified with the recent controversy over the MMR (measles, mumps, and rubella) vaccine. We conclude that in spite of the improving profit-margins, the vaccine market remains vulnerable and insecure. Vaccines are permeated bysociety, even more so than pharmaceutics that are used to cure or alleviate illnesses. Radical changes in financial conditions with promises of a more profitable market will not, we argue, solve other even more fundamental problems. (shrink)

The extraordinary events surrounding the measles, mumps, and rubella vaccine in the United Kingdom have not only placed in jeopardy the use of this triple vaccine but have also spread concern to other parts of the world. Examination of the public’s worry about MMR vaccine reveals they have been exposed to a range of conflicting views resulting in the feeling of having been misled about the safety of the vaccine. There are various groups and individuals who have legitimate roles in (...) informing the public about such subjects. But is each one behaving in an ethically responsible way? And if confidence falters, vaccine coverage dips, and an outbreak of measles, mumps, or rubella ensues, who, if anyone, will stand and say “I misled them, I confused them, this is my responsibility”? We examine the ethical issues of each group with a voice in the debate about vaccine safety. (shrink)

This paper is concerned with how public health policy makers should respond to the public’s perception of risks. I suggest that we can think of this issue in terms of two different models of responding to the public’s view of such perceived risks. The first model I will call the public perception view (PP view) and the second the public good view (PG view). The PP view suggests that the public’s perception of any risks is so important that public health (...) policies should be formulated in direct response to knowledge about them. I will consider two possible ethical arguments that might be offered in support of such a view: the first argument is an autonomy argument and the second a consequences argument. I suggest there are serious problems with both arguments. I then outline an alternative model of public health policy formation that I call the public good or PG model. This model focuses on drawing distinctions between the clinical and the public health context, and argues that most of public health policy is primarily concerned with the creation and maintenance of various public goods. This latter fact means that the PP model is inappropriate for public health policy formation. (shrink)

Despite its intuitive appeal and the empirical evidence for it, the hypothesis of cognitive polyphasia (Moscovici, 1961/1976/2008) remains largely unexplored. This article attempts to clarify some of the ideas behind this concept by examining its operations at the level of individuals and by proposing a conceptual model that includes some elements of social cognition. Indeed, calls for a rapprochement between the theory of social representations and cognitive psychology have been made by Moscovici, in particular, in his 1984 paper on The (...) myth of the lonely paradigm and in his paper on La nouvelle pensée magique (1992) in which he argues that the theory of social representations provides an explanatory framework for the descriptions offered by cognitive psychology and that their combining could translate into a finer understanding of contemporary social phenomena.Building on the results of an empirical examination of the controversy that surrounded the MMR vaccination programme in the UK between 1998 and 2005, different ways of engaging into cognitive polyphasia are proposed, including what can be described as cognitive “monophasia”, that is, the exclusive use of one type of knowledge, at least at the level of the individual. A brief discussion about the implications of the proposed conceptual model for our understanding of cognitive polyphasia and of the different ways of making sense of the world around us concludes this article. (shrink)

This chapter contains sections titled: Adults with MMR Psychopathy and Disability MMR, Moral Responsibility, and Moral Community The First Puzzle: Criminal and Moral Responsibility The Second Puzzle: Degrees of Accountability Conclusion Acknowledgments References.

The public rejection of scientific claims is widely recognized by scientific and governmental institutions to be threatening to modern democratic societies. Intense conflict between science and the public over diverse health and environmental issues have invited speculation by concerned officials regarding both the source of and the solution to the problem of public resistance towards scientific and policy positions on such hot-button issues as global warming, genetically modified crops, environmental toxins, and nuclear waste disposal. The London Royal Society’s influential report (...) “Public Understanding of Science”, which spearheaded the now-thriving area of science... (shrink)

This paper argues that vice-charging, the practice of charging other persons with epistemic vice, can itself be epistemically vicious. It identifies some potential vices of vice-charging and identifies knowledge of other people as a type of knowledge that is obstructed by epistemically vicious attributions of epistemic vice. The hazards of vice-charging are illustrated by reference to the accusation that parents who hesitate to give their children the MMR triple vaccine are guilty of gullibility and dogmatism. Ethnographic and sociological research is (...) used to make the case that this charge is, in a significant range of cases, epistemically unjust and hinders attempts to make sense of vaccine hesitancy. This epistemic injustice consists in the representation of vaccine hesitant parents as less than full epistemic agents. A case is made for a more tolerant and inclusive approach, not only to vaccine hesitancy but also to other forms of unorthodoxy or non-compliance. The primary objective in these cases should be to achieve Verstehen of seemingly alien outlooks and practices so that policy makers and practitioners in public services can more effectively educate a sceptical public about the risks of vaccine hesitancy. (shrink)

Notwithstanding diverse opinions and debates about mixing methods, mixed methods research (MMR) is increasingly being used in sport and exercise psychology. In this paper, we describe MMR trends within leading sport and exercise psychology journals and explore critical realism as a possible underpinning framework for conducting MMR. Our meta-study of recent empirical mixed methods studies published in 2017–2019 indicates that eight (36%) of the 22 MMR studies explicitly stated a paradigmatic position (five drew on pragmatism, two switched paradigms between qualitative (...) and quantitative elements of the study, and one was situated in relativist-interpretivism). The remaining 14 (64%) studies did not report their underpinning research philosophical assumptions. Evaluating the merits and limitations of these positions against critical realist assumptions suggests that several paradigmatic disagreements are potentially reconcilable. These include (a) maintaining that ontological and epistemological concerns are important for methodological integrity of a mixed methods study; (b) switching between paradigms in the same study is problematic; and (c) refuting the qualitative-quantitative incommensurability thesis, therefore allowing mixed methods research without compromising philosophical coherence. From a critical realist position, we suggest that both quantitative and qualitative designs are justifiable in a mixed methods study because (1) they help corroborate, refine, or refute plausible explanations of phenomena (epistemological), but (2) with different methodologies utilised to perform different tasks in the same research design related to different psycho-social system features (ontological). We call for a collaborative engagement by researchers across paradigmatic positions to work towards the advancement of methodological pluralism in our research community. (shrink)

Combining methods in social scientific research has recently gained momentum through a research strand called Mixed Methods Research. This approach, which explicitly aims to offer a framework for combining methods, has rapidly spread through the social and behavioural sciences, and this article offers an analysis of the approach from a field theoretical perspective. After a brief outline of the MMR program, we ask how its recent rise can be understood. We then delve deeper into some of the specific elements that (...) constitute the MMR approach, and we engage critically with the assumptions that underlay this particular conception of using multiple methods. We conclude by offering an alternative view regarding methods and method use. (shrink)

This paper argues that vice-charging, the practice of charging other persons with epistemic vice, can itself be epistemically vicious. It identifies some potential vices of vice-charging and identifies knowledge of other people as a type of knowledge that is obstructed by epistemically vicious attributions of epistemic vice. The hazards of vice-charging are illustrated by reference to the accusation that parents who hesitate to give their children the MMR triple vaccine are guilty of gullibility and dogmatism. Ethnographic and sociological research is (...) used to make the case that this charge is, in a significant range of cases, epistemically unjust and hinders attempts to make sense of vaccine hesitancy. This epistemic injustice consists in the representation of vaccine hesitant parents as less than full epistemic agents. A case is made for a more tolerant and inclusive approach, not only to vaccine hesitancy but also to other forms of unorthodoxy or non-compliance. The primary objective in these cases should be to achieve Verstehen of seemingly alien outlooks and practices so that policy makers and practitioners in public services can more effectively educate a sceptical public about the risks of vaccine hesitancy. (shrink)

Some parents take advantage of legal exemptions for the measles-mumps-rubella vaccine. While there are a variety of reasons parents do so—including having children with medical conditions that make vaccination medically unsafe—some parents appear to be driven, at least in part, by beliefs that vaccines cause a variety of diseases or conditions, such as autism. Those who delay or refuse the MMR vaccine because of false beliefs about its side effects elicit a strikingly strong response from many who endorse MMR vaccine (...) mandates. Accusations of moral wrongdoing, expressions of anger, indignation, resentment, or disgust frequently appear in social... (shrink)

In The March of Unreason, Dick Taverne expresses his concern that irrationality is on the rise in Western society, and argues that public opinion is increasingly dominated by unreflecting prejudice and an unwillingness to engage with factual evidence. Discussing topics such as genetically modified crops and foods, organic farming, the MMR vaccine, environmentalism, the precautionary principle, and the new anti-capitalist and anti-globalization movements, he argues that the rejection of the evidence-based approach nurtures a culture of suspicion, distrust, and cynicism, and (...) leads to dogmatic assertion and intolerance. Science, with all the benefits it brings, is an essential part of a civilized and democratic society: it offers the most hopeful future for humankind. (shrink)

This essay explores the boundaries of the moral community—the collection of agents eligible for moral responsibility—by focusing on those just inside it and those just outside it. In particular, it contrasts mild mental retardation with psychopathy, specifically among adults. For those who work with and know them, adults with mild mental retardation are thought to be obvious members of the moral community (albeit not full-fledged members). For those who work with and theorize about adult psychopaths, by contrast, they are not (...) members of the moral community (albeit not in such a full-fledged fashion as the insane). Both psychopaths and adults with MMR have a disability, and the essay is interested in how disability sometimes exempts one from the moral community and sometimes doesn't. It will be through two associated puzzles that we will eventually come to see the complicated tripartite relation between disability, responsibility, and moral community. (shrink)

The scientific community, we hold, often provides society with knowledge—that the HIV virus causes AIDS, that anthropogenic climate change is underway, that the MMR vaccine is safe. Some deny that we have this knowledge, however, and work to undermine it in others. It has been common to refer to such agents as “denialists”. At first glance, then, denialism appears to be a form of skepticism. But while we know that various denialist strategies for suppressing belief are generally effective, little is (...) known about which strategies are most effective. We see this as an important first step toward their remediation. This paper leverages the approximate comparison to various forms of philosophical skepticism to design an experimental test of the efficacy of four broad strategies of denial at suppressing belief in specific scientific claims. Our results suggest that assertive strategies are more effective at suppressing belief than questioning strategies. (shrink)

Brussen, Kerri Anne Ethically compromised vaccines are vaccines where the virus used in the manufacture of the vaccine has been cultured in a cell line developed from tissue grown from an aborted foetus. In Australia, an ethically compromised vaccine is the only vaccine available for Chicken pox (varicella), shingles (zoster), Hepatitis A, and Rubella (which is part of the MMR - measles, mumps, rubella - vaccine). The poliovirus vaccine component of Quadracel, available in Western Australia, is ethically compromised. However, the (...) poliovirus component of Infanrix-IPV is not ethically compromised and is used in all other Australian States and Territories. The rabies vaccine, Rabipur, is not ethically compromised and is the preferred option to Merieux Inactivated Rabies Vaccine (MIRV) which is an ethically compromised vaccine. This article lists the ethically compromised vaccines available in the various Australian States and Territories, and explains why they are ethically compromised. It also explains when and why vaccination should still be accepted even when the only available vaccine is ethically compromised. (shrink)

This chapter focuses on one of the common fallacies in Western philosophy called the false cause fallacy. This fallacy occurs when the “link between premises and conclusion depends on some imagined causal connection that probably does not exist”. There are three different ways an argument can commit the false cause fallacy: post hoc ergo propter hoc; cum hoc ergo propter hoc; and ignoring common cause. The chapter deals with post hoc ergo propter hoc. One example of the post hoc ergo (...) propter hoc fallacy that has had a great impact on public health has been the recent fear of childhood vaccines, particularly the measles, mumps, and rubella (MMR) vaccine and the concern it can cause autism. (shrink)

My research explores Maya perspectives on neo-traditional farming as a source of metabolic health and resilience to the global epidemic of type-two diabetes. This article is based on long-term ethnographic research and interviews in Maya Mountains Reservation communities in southern Belize, an area with low diabetes prevalence relative to national and global populations. Research participants see lower rates of diabetes in the MMR as the result of neo-traditional peasant and subsistence farming on ancestral lands. Good metabolic health represents the embodiment (...) of food systems that routinize healthy material and social relationships to the landscape. This research suggests that diabetes is endemic to modern food systems and proposes neo-traditional food ways as a societal antidote to nutritional disease. My research demonstrates and responds to a need for further disaggregated data on diabetes prevalence in Indigenous communities, contributes to the social scientific literature on the importance of small-scale agricultural models for community health, and provides a case study of success in diabetes prevention. I engage Maya perspectives with anthropological literature on embodiment and small-scale agriculture to suggest neo-traditional food ways as healthier alternatives to capitalist agricultural development. (shrink)

This paper argues that vice-charging, the practice of charging other persons with epistemic vice, can itself be epistemically vicious. It identifies some potential vices of vice-charging and identifies knowledge of other people as a type of knowledge that is obstructed by epistemically vicious attributions of epistemic vice. The hazards of vice-charging are illustrated by reference to the accusation that parents who hesitate to give their children the MMR triple vaccine are guilty of gullibility and dogmatism. Ethnographic and sociological research is (...) used to make the case that this charge is, in a significant range of cases, epistemically unjust and hinders attempts to make sense of vaccine hesitancy. This epistemic injustice consists in the representation of vaccine hesitant parents as less than full epistemic agents. A case is made for a more tolerant and inclusive approach, not only to vaccine hesitancy but also to other forms of unorthodoxy or non-compliance. The primary objective in these cases should be to achieve Verstehen of seemingly alien outlooks and practices so that policy makers and practitioners in public services can more effectively educate a sceptical public about the risks of vaccine hesitancy. (shrink)

Consider this hypothetical scenario involving a choice not to vaccinate a child. Ms. S has a niece who is autistic. The girl's parents are suspicious that there is some relationship between her autism and her Measles Mumps and Rubella vaccination. They have shared their concerns with Ms. S. She then declines to have her own daughter, Jinny S., vaccinated with the MMR vaccine. To bypass the state's mandatory vaccination requirement, Ms. S claims a state-legislated philosophical exemption, whereby she simply attests (...) to the fact that she is opposed to vaccinating her daughter due to a conscientiously held belief. At the age of four, Jinny goes on a trip by airplane to Germany with her mother. After returning to the United States, she attends daycare despite having some mild cold symptoms. Subsequently, she develops a classic measles rash, at which point her mother brings her to a pediatrician and keeps her home from daycare. (shrink)

Esports are a rapidly growing phenomenon and understanding of factors underlying game performance are therefore of great interest. The present study investigated the influence of satisfaction of basic psychological needs (competence, autonomy, and relatedness), type of motivation (amotivation, external regulation, introjected regulation, identified regulation, integrated regulation, and intrinsic motivation), and number of matches played (time on task) on individuals’ performance on a matchmaking rating (MMR) in the video game Defence of the Ancients 2 (Dota 2). Collected data from 315 participants (...) was included in the analyses. A web-based questionnaire was used to collect data and structural equation modelling (SEM) was performed to analyze the data. The results show that perceived competence and autonomy were the only significant predictors of MMR performance beyond matches played. Fulfillment of relatedness, as well as motivational factors, were not found to be predictors of MMR scores. The strong effect of matches played, used as proxy of time on task, emphasize the effect of time and practice as a critical aspect of video-game expertise. (shrink)

This paper illustrates the importance of monitoring health facility-level information to monitor changes in maternal mortality risks. The annual facility-level maternal mortality ratios (MMRs), complications to live births ratios and case fatality ratios (CFRs) were computed from data recorded during 2007 and 2009 in 31 upgraded public sector health facilities across Pakistan. The facility-level MMR declined by about 18%; both the number of Caesarean sections and the episodes of complications as a percentage of live births increased; and CFR based on (...) Caesarean sections and episodes of complications declined by 29% and 37%, respectively. The observed increases in the proportion of women with complications among those who come to these facilities point to a reduction in the delay in reaching facilities (first and second delays; Thaddeus & Maine, 1994); the decrease in CFRs points to improvements in treating obstetric complications and a reduction in the delay in receiving treatment once at facilities (the third delay). These findings point to a decline in maternal mortality risks among communities served by these facilities. A system of woman-level data collection instituted at health facilities with comprehensive emergency obstetric care is essential to monitor changes in the effects of any reduction in the three delays and any improvement in quality of care or the effectiveness of treating pregnancy-related complications among women reaching these facilities. Such a system of information gathering at these health facilities would also help policymakers and programme mangers to measure and improve the effectiveness of safe-motherhood initiatives and to monitor progress being made toward achieving the fifth Millennium Development Goal. (shrink)

In 1998, The Lancet published a research paper by Andrew Wakefield that provided support to the formerly-discredited theory that the Measles, Mumps, Rubella (MMR) vaccine could cause colitis and autism spectrum disorders (Wakefield et al. 1998). Although this paper was fully retracted in 2010 after being exposed as fraudulent, it served as a catalyst for concerns about the safety of vaccination, both the MMR vaccine in particular and vaccination in general. While the scientific consensus concerning both the MMR vaccine and (...) others that are routinely provided to persons in developed Western countries is that the benefits of receiving them far outweigh the risks, there is still serious concern on the part of some parents about the safety of vaccinating their children. Moreover, in addition to concerns about the safety of vaccination some parents are concerned about the effects that receiving certain vaccinations will have upon their childrens’ volitional actions. For example, the possibil. (shrink)

Vaccination is one of history's most successful public health interventions. Since 2000, vaccination campaigns against measles, which is highly contagious but preventable through the measles‐mumps‐rubella (MMR) vaccine, have reduced both the global incidence of the disease and measles deaths by 80 percent. However, progress toward measles elimination has slid backward in several previously well‐protected global regions. With more communities below or at risk of falling below the 95 percent immunization rates required for herd immunity—due more and more to vaccine skepticism (...) and declination rather than lack of access—many U.S. states and countries must reappraise their vaccination policies and programs. (shrink)

We present English translations of two French documents to show that the main reason for the rejection of Semmelweis's theory of the cause of childbed fever was because his proof relied on the post hoc ergo propter hoc fallacy, and not because Joseph Skoda referred only to cadaveric particles as the cause in his lecture to the Academy of Science on Semmelweis's discovery. Friedrich Wieger, an obstetrician from Strasbourg, published an accurate account of Semmelweis's theory six months before Skoda's lecture, (...) and reported a case in which the causative agent originated from a source other than cadavers. Wieger also presented data showing that chlorine hand disinfection reduced the annual maternal mortality rate from childbed fever from more than 7 per cent for the years 1840–1846 to 1.27 per cent in 1848, the first full year in which chlorine hand disinfection was practised. But an editorial in the Gazette médicale de Paris rejected the data as proof of the effectiveness of chlorine hand disinfection, stating that the fact that the MMR fell after chlorine hand disinfection was implemented did not mean that this innovation had caused the MMR to fall. This previously unrecognized objection to Semmelweis's proof was also the reason why Semmelweis's chief rejected Semmelweis's evidence. (shrink)

Purpose This paper aims to discuss research ethics in mixed-methods research and MMR development with a focus on ethical challenges that stem from working with technical instruments such as mobile eye-trackers. Design/methodology/approach The case of an interdisciplinary mixed-methods development study that aimed at researching the impacts of emerging mobile augmented-reality technologies on the perception of public places serves as an example to discuss research-ethical challenges regarding the practical implementation of the study, data processing and management and societal implications of developing (...) instruments to track and understand human practices. Findings This study reports challenges and experiences in ethical decision-making in the practical implementation of the study regarding the relationship to research subjects, the use of mobile research instruments in public places and the interdisciplinary cooperation among research team members. Further, this paper expounds on ethical challenges and recommendations in data processing and management and with a view to societal implications of method development and the aspirations of transdisciplinarity. This study concludes that institutionalized ethics need to become more flexible, while applied ethics and reflection must make their entry into university curricula across disciplines. Originality/value Complex interdisciplinary mobile and mixed-methods projects that involve sensors and instruments such as mobile eye-trackers are on the rise. However, there is a significant lack of engagement with practical research ethical challenges, practices and requirements in both mixed-methods and method-development literature. By taking a context- and process-oriented perspective focusing on doing ethics, the paper contributes a concrete empirical case to these underdeveloped fields. (shrink)

Yinyang philosophy encompasses an essential understanding of the mechanism and laws of nature, cosmos, and human society in Chinese culture, and reaches to many other parts of Asia and around the world. The purpose of this article is to explore how yinyang philosophy can serve as a philosophical underpinning of mixed methods research (MMR). In particular, harmony, one of the important features in yinyang philosophy, is applied to interpret the design of mixed methods research. Guided by this philosophy, other beliefs (...) about an integrated approach to using qualitative and quantitative methods fit in with the MMR approach. These underlying precepts are not necessarily held by researchers, and will be shown to indicate harmony and a dynamic equilibrium of yin and yang. This perspective provides a novel window for considering controversial issues that have arisen about the use of different philosophical underpinnings for MMR during its emergence over the past several decades. The implications are for a softer interpretation, for example, when selection of quantitative rules needs to harmonize with certain types of MMR, and validity of self-developed questionnaires needs to consider different levels of criteria for MMR. (shrink)