
“You're not allowed science any more” - thisjepisje
http://www.nature.com/nature/journal/v489/n7414/full/489170a.html
======
micro_cam
Things like this makes me ashamed to have my name on papers in Nature.

First, lets set aside the hypocrisy of a non open access journal publishing
this[1]. (What happens if Sacha wants to inform her self by reading a few old
nature papers?)

I am pro vaccine but far too many doctors have this fantasy that they should
have unlimited control and articles like this just serve to validate that view
point.

Medicine is an inexact and continually evolving science and a good doctor
should always be willing to talk over the options with you and engage with you
on a level beyond just parroting the current recommendations. As someone who
is one of the people contributing to the body of often-vague statistics we
call medicine it is continuously annoying to have to get doctors to explain
their (often subjective) judgment calls they are making and actually present
their reasoning analytically.

Additionally, many doctors choose to forgo recommended treatments themselves
due to side effects [2].

[1] In fact you can pay extra to make your nature paper open access but it is
by no means fully open access. [2] [http://www.nytimes.com/2013/11/20/your-
money/how-doctors-die...](http://www.nytimes.com/2013/11/20/your-money/how-
doctors-die.html?pagewanted=all)

~~~
api
[https://en.wikipedia.org/wiki/Polio_vaccine#Contamination_co...](https://en.wikipedia.org/wiki/Polio_vaccine#Contamination_concerns)

I'm not at all anti-vaccination, but I am anti-authoritarian and anti-closed-
science. People have a right to know what they're putting in their bodies. The
SV40 contamination turned out to not be that serious, but it was a close call.
Had SV40 been potently carcinogenic, we would have had a medieval plague of
cancer.

In the end it reduces to the problem of freedom and open society: freedom
means tolerating people being idiots. Freedom means it's okay for the Ku Klux
Klan to mail me literature. It means it's okay for people to question
vaccination because some stupid celebrity told them it caused their son's
autism. It means it's okay for people to put pink plastic flamingos on their
lawns. The alternative is a closed, authoritarian society.

~~~
mpweiher
"People have a right to know what they're putting in their bodies."

Right, and the doctor was trying to give her that knowledge, and she refused.

~~~
crpatino
That does not sound like most doctors I have met.

Typical doctor's attitude is: "Look this white coat, that I happen to have and
you don't? It means even if I tried to explain to you all the implications you
are not smart enough to understand. So shut up and do as I say, I have more
important things to do!"

Edit: I originally wrote "black coat" instead of "white coat". There must be
some nasty stuff hidden in my brain's crawl spaces.

------
lotsofmangos
"You're not allowed sarcastic metaphors any more."

"Why not?" asked the scientist.

"Because you haven't learned to employ them in a way that doesn't alienate the
very people you are trying to help. Now please send in Dawkins on the way out,
we need to discuss internet memes with him."

~~~
VikingCoder
You're right, but you're wrong.

You're right - we shouldn't celebrate alienating people who need help.

You're wrong, because there is no argument that can convince someone who
doesn't care about evidence.

So, please forgive us our gallows humor about this. After all, these people
are content in risking the health of MY child on their Jenny McCarthy-inspired
HUNCH that vaccines are bad.

If anti-vaccine folks were only risking the health of their own children,
their anti-science stance (or selective-science stance) would be tolerable. As
it is, they're a menace.

~~~
jstanek
If your child is vaccinated, they aren't really at significant risk of
catching a preventable infection from an unvaccinated child, since that's the
sort of thing vaccines are designed to prevent. This isn't to say that anti-
vax is a rational position, but I don't think (disclaimer, I'm not a medical
professional) it puts vaccinated children at additional risk.

~~~
untothebreach
Vaccines by themselves are not 100% effective (see the Measles outbreak from
earlier this year [1]). The additional benefit of Herd Immunity[2] helps to
increase the effectiveness, which is at risk of being lost the more the anti-
vax movement gains traction.

1:
[http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6322a4.htm)
2:
[http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx](http://www.niaid.nih.gov/topics/pages/communityimmunity.aspx)

------
suprgeek
I think we should be making a financial/societal incentive to do the right
thing if the science is settled enough.

The trouble with the view presented here is that sure the children get the
vaccine due to this hypothetical rule. what happens when later the children
get a severe cold (say) and the mom who remembers the previous visit thinks -
bloody doctors I will just keep my kid home and pray for him to get better?

Much better approach: "Ok Sacha since you declined the vaccination now I have
to report it to all medical insurers. Your family insurance just doubled."

At school: "Sacha your kids are not vaccinated and we do not admit any
students not vaccinated."

Apartment: "Ok Sacha your kids are not vaccinated (per this website where we
can query); we will need to charge you a fee that is contributed to our
residents' medical fund to cover the risk of housing you."

If you really truly start to hurt in the pocketbook, I bet there will be much
more incentive to really read up on the Science.

~~~
ISL
Do you want people to read up on the science, or to accept what's "settled"?

As a professional scientist, there are few things more anathema than the idea
that a scientific theory is "settled". Experiments can only falsify theories;
they can never be proven to be correct. The best a theory can hope for is to
remain consistent with observation.

Once upon a time, it was well-settled in large communities that the universe
spun about the Earth.

~~~
jbooth
Yeah, but we're talking about not vaccinating your kids, here. It might be
that we're all living in a computer simulation and none of this matters but we
should still act on what we observe.

~~~
ISL
I'm personally convinced that vaccination is worthwhile; I've been convinced
of that by my education, my experience, and my understanding of the scientific
literature. The benefit to the individual and to society of vaccines is, to
me, well-established.

I'm willing to compromise part of my herd's immunity for those who wish not to
receive a vaccine, even if it increases my risk somewhat. I don't think that
anti-vaccine activists are correct, but it's a hell of a thing to inject stuff
into their children that they think could bring them harm. Though we do it
every day as a society, I don't want to be a part of a herd that resorts to
compulsion on ethical questions.

Inextricable from this discussion is the fact that the children won't reach
majority before the decision must be made. If we could wait until people
turned eighteen before presenting them with the choice of vaccination, this
debate would be different.

As a final thought -- if everyone else is immunized, it may be to your
advantage to skip vaccination to avoid a tiny risk of side-effects. There's an
equilibrium here, and it's not at 100% vaccination rates, even if 100%
vaccination could yield eradication.

~~~
rmrfrmrf
There's the rub: it's not about _you_ or what _you_ want. There are already
enough people who cannot be vaccinated -- people with egg allergies, people
with compromised immune systems, etc. Furthermore, vaccines don't always take,
so there may be more unvaccinated people out there than we actually know of.
Herd immunity works by everyone who _can_ participate participating; the more,
the better.

What irritates me about anti-vax more than anything is the selfishness and
privilege that goes along with it. "I don't need to put a vaccine in _my_
child's body; if herd immunity _really_ works, then _my_ children won't be the
problem!" Never mind the fact that every person this child comes in contact
with now has a greater risk for infection, or even transmission of diseases.

Lastly, your usage of "convinced" really rubs me the wrong way. Granted, you
have a "right" to believe whatever you want, but if you trust that evidence-
based science is correct, it's really not a "take it or leave it" kind of
situation.

------
spindritf
I have spotted this totalitarian streak among some of my friends who went to
med school. We should ban smoking, force everyone to do this or that. As bad
as they can be, we're probably better off with lawyers in charge.

~~~
lazyant
People die because some idiot parent didn't vaccinated their children, so I
say yes, enforce it or don't live in society, go to some isolated island
because you are causing harm, it's as totalitarian as allowing people to play
Russian roulette with other people's children (actually you'd go to jail so I
think we're too lenient with these parents).

~~~
autokad
your child has more chance of dying by going to the morning bus stop than
their child does of dying from not being vaccinated. in fact, i'd bet your
child has a better chance of dying by catching the flu from a vaccinated child
than some other child not vaccinated by MMR.

i understand if someone doesn't want their child vaccinated and they can't go
to public school, but forcing people is another thing, even if it is 'for
their own good'.

~~~
sliverstorm
_in fact, i 'd bet your child has a better chance of dying by catching the flu
from a vaccinated child than some other child not vaccinated by MMR._

Oh good, argument based on conjecture.

~~~
autokad
Do you want a gold star because someone on the internet, who said something
you didn't agree with on a post, did not publish citations? you failed human.

~~~
sliverstorm
We're getting an impressive variety here! After argument by conjecture fails,
we move on to ad-homenim!

------
ddalex
This is beyond stupid. You can't explain something, so you ban the person from
having a say so. I'm terrible afraid of people thinking that this is the way
to go.

As a doctor, which I am not, I would've said: the danger of your children
dying or being crippled by a preventable disease is about 1000 times the risk
of having an adverse reaction to the vaccine. Furthermore, I can guarantee
that the vaccine will not cause autism.

This is what I tell my "anti vac" acquittance, because I can't say I'm friends
with morons. But being a moron doesn't preclude the right to understand what's
actually happening and what the risks are when making a decision, even if you
refrained in the past to educate yourself.

But it's hard to educate, so the author would just ban the discussion
altogether. You, the author, are no better than the ones to which you would
ban explanations and discussion.

~~~
mpweiher
You didn't get the point at all.

"You can't explain something,"

That's exactly _not_ it. The doctor _wanted_ to explain the facts, with the
leaflet. Sacha wanted a simplistic assurance that wasn't possible, and refused
point blank to have it explained to her.

~~~
danielweber
Those were the words she used, which could be _entirely different_ from her
actual reasoning that she didn't feel like talking about. And if this were any
kind of world where doctors overrule you because "your argument is invalid"
then she will of course not be forthcoming with her doctor ever. She will
instead learn the magic words "oh, Johnny had a bad reaction to a vaccine at
his previous doctor in Canada."

The doctor's office is not a courtroom or an arrest where everything you say
can and should be used against you.

I'm reminded of people who think it would be awesome to bug lawyer's offices
or doctor's offices or confessionals to ferret out crime. It will work the
first time, but after that you have totally destroyed trust so you haven't
gained yourself anything and the public has lost a place to sensitive discuss
issues with people they trust.

~~~
mpweiher
"Those were the words she used, which could be entirely different from her
actual reasoning that she didn't feel like talking about."

Er, no.

She is a fictional character in a parable, entirely the author's creation. I
think it's safe to assume that the words "she" used were the ones "she"
intended to use.

------
vonklaus
If only there was a way to outsource all decision making to an over-arching
centralized authority to make all decisions for us. That entity would have all
our best interests at heart and make the tough decisions for us. It would be
auch a weight off my shoulders of I didn't have to think anymore. I would even
be willing to pay 20-30 percent of my paycheck to it, just so it could help me
stay safe. What would we call such authority?

~~~
nemo
You can give a medically informed body that understands the issues much more
deeply some authority over public health policy, while still being able to
think about those issues if you're interested. They wouldn't make all
decisions for you, just those that have such a broad and important impact to
society as a whole that irresponsible individuals wouldn't make choices that
could have a net effect of significantly harming others like skipping
vaccinations does.

Perhaps we could call that authority "civilization."

~~~
WorldWideWayne
Personal freedom, to me, is worth the price of possible death or illness due
to large swaths of the population not being vaccinated.

------
tokenadult
There are a lot of comments here about the issue of how to communicate risk of
different personal medical choices to patients who do not themselves have
medical training. It is a tough problem. Professional stage magicians, and
avid skeptics, Penn and Teller had an episode of their cable television series
_Bullshit_ report on the issue of risks and benefits of vaccination. Maybe a
clip from their TV show (with language that many families would find
inappropriate for viewing with their children) will help communicate the risk
and benefit ratio of vaccination more clearly than documents written in a more
clinical tone.

[https://www.youtube.com/watch?v=RfdZTZQvuCo](https://www.youtube.com/watch?v=RfdZTZQvuCo)

(short clip above, long clip below)

[https://www.youtube.com/watch?v=RLcOz4EKrxg](https://www.youtube.com/watch?v=RLcOz4EKrxg)

------
logfromblammo
Look, science, you can't have it both ways. You can't release knowledge into
the wild and also keep it caged up under your control. It is no more possible
than setting the barn afire then ordering the flames to go back into the lamp.

If you cannot tolerate the idea that everyone benefits from science done well,
even including those who behave destructively towards scientific progress,
then why are you doing science in the first place?

Screaming from the mountaintops, "No! No! You're doing it wrong! All wrong!
You idiots! You morons! Stop what you're doing immediately and do as I say!"
is not likely to help your cause. That is, after all, what people have been
yelling at each other for centuries, even long prior to the development of
modern scientific inquiry.

There may even be a branch of science that deals with social norms and
cultural shifts, and perhaps the intentional guidance of groups towards given
institutional goals. You could probably take the socio- prefix and append an
-ology to it. Maybe ask a sociologist what usually happens when you strip a
person of the ability to make their own choices, even if you are certain they
are making those choices based upon flawed premises.

Applying force or coercion does little but change the portion of the behavior
of a person that is visible to you. You cannot use it to change someone's
mind, no more than you can make a person love you by smashing their ankles
with a sledgehammer. You have to coax them to it, convincing them to change
their own minds. But you can't do it for a non-rational person using only
rational argumentation. It does not compile. You have to use other means to
even get them close enough that argument will work.

You have to advertise. Use rhetoric. Flash some sideboob. Blow dragon smoke
from your nose using cookies dipped in liquid nitrogen. Write a catchy jingle.
Go viral. Write a hoax about cool teenaged kids getting electrotetanized by
their musical Tesla coils. Get Bill Nye slimed on Nickelodeon's Kid Science
Awards Show as he introduces the new Mr. Wizard, wingsuiting down to the venue
from an orange zeppelin.

You have to make people _want_ science to like _them_. And you're not going to
get there by acting like a condescending know-it-all prick-- _even if you do
actually know it all, and the other person is a clueless, drooling moron_.

------
prestadige
This is a fantasy of course, which is a defence mechanism for frustrated
minds.

However, the quasi-religious defence of Science as a settled body of knowledge
which people must be forcibly 'educated' about is becoming depressingly
common. Becoming more like a religion isn't a good way to counter
superstitious falsehoods.

The patient-doctor relationship has waned, IMO. Here in the UK for most
ailments I see a GP for about 10 minutes. I never see her again. No follow up,
no chat, etc. Different GP next time. Perhaps social media could help build
trust within practices.

------
kstenerud
This is so telling. The sheer arrogance is plainly visible, as is the doctor's
complete lack of empathy. There are plenty of ways to motivate people, and
this is most certainly not a good one. You don't get a mule to move by pushing
it.

~~~
falcolas
Arrogance, which I'd call exasperance in this case, in the face of repeated
ignorance of reality, is justified. You can only deal with willingly ignorant
people for so long before giving up on the human race.

And the doctor in the tale did try and educate the mother before she was cut
off. She just didn't want to listen.

~~~
kstenerud
It's fine to feel exasperated. It's not fine to treat people in such a
condescending manner. People are rational, and want to understand, but unless
you make the information properly accessible in the UX sense, your
exasperation is due to your own fault.

The doctor did not try to educate the mother. He tried to lecture her. He
offered her a bad user experience, which she naturally rejected. People are
not machines. You don't just feed the same information format in and expect
the same result from everyone.

~~~
sliverstorm
So when it comes to anti-vaxxers, the problem is simply that the scientific
community simply hasn't been _accommodating_ enough?

It's good to know that, yet again the fault does not lie with the common man.
It is always someone else's fault.

~~~
kstenerud
It's not a question of accommodation; it's about accessibility. The anti-
vaxxers offered better UX for many who felt shut out from scientific
knowledge.

The fault does technically lie with the common man in the sense that he
behaves the way he does. But we KNOW that he behaves a certain way, and
further we have the knowledge necessary to mitigate the effects of those
deleterious behaviors and grant the people knowledge despite them. And yet
many in the scientific community still refuse to take those psychological
lessons to heart, preferring to blame it on "the willful ignorance of the
masses".

When you continually run up against failure, blaming the object of failure is
not a path towards solving the problem.

~~~
threatofrain
Fully committing to this UX analogy would mean for the doctor to pretend that
his medicine comes from a religious framework, simply because it's more user-
friendly.

------
jebus989
A more computational crowd might enjoy "You're not allowed bioinformatics
anymore": [http://biomickwatson.wordpress.com/2014/07/21/youre-not-
allo...](http://biomickwatson.wordpress.com/2014/07/21/youre-not-allowed-
bioinformatics-anymore/)

------
swayvil
I like a consensus of experts as much as the next guy, but let's not get
carried away.

Today's airtight methodology is tomorrow's tragic myopia.

~~~
0xdeadbeefbabe
Does that mean phrenology is not coming back?

------
gretful
Quick question: how many of you are against the flood of illegal immigrants
making their way into the US? If you're worried about killing herd immunity,
you should really be voicing your discontent over both the GOP and Democrat
parties encouraging this with their amnesty plans.

Here's just one incident of an illegal bringing disease into the US:

[http://news.yahoo.com/arrest-warrant-issued-man-
tuberculosis...](http://news.yahoo.com/arrest-warrant-issued-man-
tuberculosis-192756320.html)

~~~
lotsofmangos
Not like the brazen giant of Greek fame,

With conquering limbs astride from land to land;

Here at our sea-washed, sunset gates shall stand

A mighty woman with a torch, whose flame

Is the imprisoned lightning, and her name

Mother of Exiles. From her beacon-hand

Glows world-wide welcome; her mild eyes command

The air-bridged harbor that twin cities frame.

"Keep ancient lands, your storied pomp!" cries she

With silent lips. "Give me your tired, your poor,

Your huddled masses yearning to breathe free,

The wretched refuse of your teeming shore.

Send these, the homeless, tempest-tost to me,

I lift my lamp beside the golden door!"

~~~
gretful
A beautiful poem, one that many a legal immigrant saw upon entering the US as
they began inprocessing through the Ellis Island immigration station. One that
the illegal aliens will not see as they illicitly cross our border, seeking to
evade what agents we have stationed there.

------
hasler
> You've had the opportunity to read the facts and the education to be able to
> analyse them, yet you have consistently chosen not to.

Perhaps if doctors understood the facts better, and could explain them better,
this wouldn't be a problem:

[http://jsfiddle.net/SamHasler/c22eR/embedded/result/](http://jsfiddle.net/SamHasler/c22eR/embedded/result/)

------
lnanek2
Pretty funny wish fulfillment where someone forces their own views on others.
I fully support vaccination, but don't support this.

~~~
bnejad
Don't support what? Mandatory vaccination?

~~~
WorldWideWayne
I don't support mandatory vaccination for the same reason I don't support the
drug war. No government has the right to tell me what I can or cannot put into
my body. Simple as that.

~~~
bnejad
But vaccination is a public health issue. You endanger others by not getting
vaccinated, which is why for instance kids have to be vaccinated before they
are allowed to go to school. I am much in agreement with personal liberty but
part of the social contract is to take these preventative steps to improve the
quality of life in our society.

~~~
WorldWideWayne
Not letting kids into school is already a good way to handle this issue. It
ensures that the majority will _decide_ to be vaccinated. I'm fine with the
way it is.

------
cowbell
I feel this way about non-technical management calling the shots on software
projects :)

------
mhb
Roald Dahl: Vaccines, Measles and his Daughter

[https://news.ycombinator.com/edit?id=8080516](https://news.ycombinator.com/edit?id=8080516)

------
mynewwork
I'm confused by the awkward grammar in the title. Is it intentional for humor
(like xkcd's 'going to try science') or is that wording acceptable use in
British dialects?

I'm parsing it as "You're not allowed <to use> science" or "You're not allowed
<to know> science", but it's right on the line of believable that I could see
that sentence being used genuinely in another dialect.

~~~
CanSpice
They're using science as a noun. Think of it like "You're not allowed oxygen
any more."

~~~
mynewwork
Which still sounds wrong to me. I'd expect "You're not allowed to breathe
oxygen" or "You're not allowed to have oxygen".

So I guess it's "allowed" which is being used in a way I'm unfamiliar with.

------
gretful
So here you have a Doctor trying to be Lawyer. There is a chance, however
small, of a bad reaction to the vaccine. The Doctor knows this, therefore he
cannot give this woman her 100% guarantee that nothing will go wrong because
of the vaccination. He knows that if he tells this woman it will be OK and
nothing will happen, that if something DOES happen he will be sued for medical
malpractice.

------
danielweber
This sat poorly with me. I thought "you're not allowed science any more" would
mean that no one has to ever listen to her in any scientific debate. Instead,
it meant that she got overruled about a medical decision.

Congratulations, you've amazingly found a way to be even worse than the
antivaxxers. I didn't think it was possible.

~~~
epistasis
I wouldn't be so quick to assume that the article is advocating for forced
vaccinations, but I do think that your reaction to the forced vaccination does
hint at what the article really _was_ suggesting.

------
ErikRogneby
I wonder if the "producer at the BBC" reference was from the BBC not giving
air time to climate change skeptics in debate anymore?

~~~
capnrefsmmat
No. This article is from 2012.

------
TallGuyShort
Ok, fine, then you're not allowed individual sovereignty.

------
chris_mahan
It's this reasoning that gave us the 401K.

~~~
Jtsummers
Aren't 401Ks mostly voluntary programs? I'm not aware of anyone being
compelled to invest into them.

