"Do-it-yourself": Vaccine rejection and complementary and medicine (CAM)
"Do-it-yourself": Vaccine rejection and complementary and medicine (CAM)
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DOI：
10.1016/j.socscimed.2017.11.022
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发表时间：
2018-01-01
影响因子：
5.4
通讯作者：
Leask, Julie
中科院分区：
文献类型：
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作者：
Attwell, Katie;Ward, Paul R.;Leask, Julie
在这篇文章中，我们阐明了互补和替代医学（CAM）和拒绝，或犹豫，接种疫苗之间的共生关系。2013年9月至2015年12月，我们在西澳大利亚州弗里曼特尔和南澳州阿德莱德对29名拒绝或推迟为孩子接种部分或全部疫苗的家长进行了深入采访。我们的定性分析发现，对于许多人来说，他们自己动手的道德和个人机构是通过自我指导的CAM使用，以及（有时是非正式的）CAM从业者的指导来增强的。这些父母将“自然”具体化，避免接种有毒和掺假的疫苗，并将CAM作为疾病之前，期间和之后免疫系统的保护策略。使用者认为CAM是无害的，当非使用者认为CAM无效时，他们的理由恰恰相反。他们还普遍掩盖了其利润动机。CAM作为对抗西医的专家系统的一部分出现。CAM的面孔被信任和熟悉，它的山寨资本主义似乎基本上没有“大制药”的污点。一些家长对CAM模式进行了科学批评-少数人对其利润动机持怀疑态度-但其他人拒绝了支撑生物医学的认识论，将CAM视为一种不受贪婪毒害的知识;一种智慧，其证据基础（轶事和历史）被傲慢的科学过程贬低，只允许相信可以量化的东西。然而，所有的父母都用西医治疗骨折，有时也用医学诊断。我们的分析表明，由于一些父母决策的认识基础，寻求解决CAM在疫苗排斥中的作用的亲疫苗接种卫生专业人员，政策制定者和信息提供者面临着重大挑战。然而，我们提出了一些建议的专业实践和政策，以提高信任的疫苗接种。
In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013-December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction. Reifying 'the natural,' these parents eschewed vaccines as toxic and adulterating, and embraced CAM as a protective strategy for immune systems before, during and after illness. Users saw CAM as harm-free, and when it came to experiences that non-users might interpret as demonstrating CAM's ineffectiveness, they rationalised to the contrary. They also generally glossed over its profit motive. CAM emerged as part of an expert system countering Western medicine. CAM's faces were trusted and familiar, and its cottage capitalism appeared largely free from the taint of "Big Pharma." A few parents employed a scientific critique of CAM modalities - and a minority were dubious of its profit motive - but others rejected the epistemology underpinning biomedicine, framing CAM as a knowledge not poisoned by avarice; a wisdom whose very evidence-base (anecdote and history) was demeaned by an arrogant scientific process only permitting belief in that which could be quantified. However, all parents engaged with Western medicine for broken bones and, sometimes, medical diagnoses. Our analysis suggests that pro-vaccination health professionals, policymakers and information-providers seeking to address the role of CAM in vaccine rejection face significant challenges due to the epistemic basis of some parents' decisions. However, we make some suggestions for professional practice and policy to enhance trust in vaccination.