This paper argues that significant aspects of the vaccination debate are 'deep' in a sense described by Robert Fogelin and others. Some commentators have suggested that such disagreements warrant rather threatening responses. I argue that appreciating that a disagreement is deep might have positive implications, changing our moral assessment of individuals and their decisions, shedding light on the limits of the obligation to give and respond to arguments in cases of moral disagreement, and providing an incentive to seek alternative ways of going on in the face of intractable moral disagreement. Non-coercive, non-reasoned strategies have been used or recommended to increase vaccination rates. Such strategies look problematic when judged by the standards of ideal moral and rational argumentation, but more acceptable if seen as responses to deep disagreements.
[Show abstract][Hide abstract] ABSTRACT: It is proposed that motivation may affect reasoning through reliance on a biased set of cognitive processes--that is, strategies for accessing, constructing, and evaluating beliefs. The motivation to be accurate enhances use of those beliefs and strategies that are considered most appropriate, whereas the motivation to arrive at particular conclusions enhances use of those that are considered most likely to yield the desired conclusion. There is considerable evidence that people are more likely to arrive at conclusions that they want to arrive at, but their ability to do so is constrained by their ability to construct seemingly reasonable justifications for these conclusions. These ideas can account for a wide variety of research concerned with motivated reasoning.
[Show abstract][Hide abstract] ABSTRACT: Why do so many otherwise intelligent patients and therapists pay considerable sums for products and therapies of alternative medicine, even though most of these either are known to be useless or dangerous or have not been subjected to rigorous scientific testing? The author proposes a number of reasons this occurs: (1) Social and cultural reasons (e.g., many citizens' inability to make an informed choice about a health care product; anti-scientific attitudes meshed with New Age mysticism; vigorous marketing and extravagant claims; dislike of the delivery of scientific biomedicine; belief in the superiority of "natural" products); (2) psychological reasons (e.g., the will to believe; logical errors of judgment; wishful thinking, and "demand characteristics"); (3) the illusion that an ineffective therapy works, when actually other factors were at work (e.g., the natural course or cyclic nature of the disease; the placebo effect; spontaneous remission; misdiagnosis). The author concludes by acknowledging that when people become sick, any promise of a cure is beguiling. But he cautions potential clients of alternative treatments to be suspicious if those treatments are not supported by reliable scientific research (criteria are listed), if the "evidence" for a treatment's worth consists of anecdotes, testimonials, or self-published literature, and if the practitioner has a pseudoscientific or conspiracy-laden approach, or promotes cures that sound "too good to be true."
Academic Medicine 04/2001; 76(3):230-7. DOI:10.1097/00001888-200103000-00009 · 2.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Most countries promote mass immunisation programmes. The varying policy details raise a raft of philosophical issues. I have two broad aims in this paper. First, I hope to begin to remedy a rather curious philosophical neglect of immunisation. With this in mind, I take a broad approach to the topic hoping to introduce rather than settle a range of philosophical issues. My second aim has two aspects: I argue that the states should have pro-immunisation policies, and I advance a view of the subsequent and more specific question as to which sorts of pro-immunisation policies they should prefer. I use the immunisation policies of the United States and New Zealand to frame my discussion of these substantive questions. Immunisation is effectively compulsory in the United States. New Zealand, by contrast, requires evidence not of immunisation but of immunisation status upon school enrolment: New Zealand's policy effectively makes immunisation choice compulsory. I argue that, as between the pro-immunisation policies of the United States and New Zealand, the latter should be preferred. Though the threshold question as to whether states should have pro-immunisation policies should be answered affirmatively, the move to compulsory immunisation cannot be justified.
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