Andrew Wakefield Vaccine LitReview

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One of the topics which inspired my interest in terms of divergent and incompatible world-views (a characteristic of the Epistemological Crisis) was the controversy and rhetoric surrounding vaccines. This is an Undergrad LitReview I did on the topic in 2016.

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Vaccines: A Review of the Literature

Kenneth E. Buchholz

University of Richmond

 

 

There has been an ongoing debate on the efficacy and safety of vaccines since their introduction two centuries ago.  The rhetoric has grown over the last twenty years, specifically on the topic of childhood vaccines.  Advocates on both sides of the debate have resorted to ridiculing those seen as opponents.  A central figure in this debate has been Dr. Andrew Wakefield, a British pediatric gastroenterologist, who in 1998 authored, along with twelve colleagues, an innocuously titled paper, “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children” (Wakefield et al., 1998).  It is one of the most cited sources in the fields of immunology and pediatrics, and among the top cited articles of any subject published by the prestigious British medical journal, The Lancet.  This paper will review some of the significant literature on the topic of childhood vaccines, with special focus on the 1998 Wakefield et al. paper, and examine the consequences of the original publication and subsequent retraction in the field of pediatric immunology.   Immunization research and development will benefit society only through rigorous science, careful implementation, and accurate communication with the public.

Childhood vaccinations are a key component in the modern healthcare system.  Writing a retrospective report on the Vaccines for Children program for the Centers for Disease Control, Whitney, Zou, Singleton, and Schuchat (2014) stated, “Vaccination is one of the most effective public health interventions” (p. 353).  The modeling estimates for their paper were based on the population of children born in the U.S. between 1994 and 2013.  They estimated 322 million illnesses and 21 million hospitalizations would be prevented for this population over the course of their lifetimes (p. 353), including more than 70 million cases of measles (p. 354).  An estimated “732,000 premature deaths from vaccine-preventable illnesses” would be avoided (p. 353).

Using a 2009 economic analysis, Whitney et al. (2014) found that for every dollar spent on vaccines, $3 in direct benefits and an additional $7 in societal benefits is realized (p. 354).   They extrapolated their data from the study and estimated a lifetime total “net savings of $295 billion in direct costs and $1.38 trillion in total societal costs” due to routine childhood vaccinations for the children born during 1994-2004 (p. 352).

Andrew Wakefield was a co-author of a 1995 paper which examined the measles vaccine as a potential risk factor for bowel disease through a longitudinal study.  Thompson, Montgomery, Pounder, and Wakefield (1995) relied on data collected from several other studies in the correlation of their results (pp. 1071-1072).  They detailed examples connecting measles virus infection with additional childhood diseases which indicated an “altered immunity” as a result (p. 1073).  Further, they connected measles infection with a variety of gastrointestinal diseases.  They showed “an association between measles vaccination and inflammatory bowel disease” (p. 1072).  However, they did acknowledge the data was insufficient to establish a causative link.  They asserted the measles vaccine had been associated with other negative reactions, thus laying some of the groundwork for connecting vaccines as an initiating factor for certain diseases (p. 1073).  The immediate academic reaction was critical of both the findings and methods of this study.

Patriarca and Beeler (1995), representing the U.S. Food and Drug Administration, authored an accompanying article in the same issue of The Lancet as the Thompson et al. (1995) paper. They agreed a measles virus infection can be a contributor to additional health complications (p. 1062), but raised concerns about how the participants were selected in the Thompson et al. study and the validity of the role of the measles vaccination in identifying groups and symptoms (pp. 1062-1063).  Patriarca and Beeler (1995) acknowledged the need for ongoing research into possible “adverse events following measles vaccination” in order to determine whether the effects are genuine or not (p. 1063).  It was their conclusion that would become the clarion call for researchers in the decades to come: “Meanwhile, we must not lose sight of the frequent and devastating consequences of wild measles virus infection, nor forget the millions of lives that have been spared as a result of vaccination” (p. 1063).

The month following the 1995 Thompson et al. paper, The Lancet published several researchers’ critical responses in their “Letters to the Editor” section (Farrington et al., 1995).  Nine separate researchers detailed similar concerns presented in the Patriarca and Beeler (1995) article.  They described serious questions regarding the methodology employed by Thompson et al. (1995) and expressed doubts regarding the conclusions that the measles vaccine or even the virus itself is responsible for some of the diseases linked by Thompson et al. (1995).  Further concern was raised regarding the possibility of unwarranted public hysteria which could lead to a reduction in immunization and a correlative increase in childhood deaths from measles infections (pp. 1062-1064).

Wakefield et al. (1998) investigated children with gastrointestinal diseases and “regressive developmental disorder” (p. 637).  A significant part of the paper dealt with the extensive clinical and laboratory investigations of the subjects which detailed gastroenterological and developmental symptoms.  These investigations included invasive and painful procedures (p. 637), though they stated all ethical guidelines were followed including parental “informed consent” (p. 638).  The connection the paper made between the measles, mumps and rubella (MMR) vaccine and autism was to have the greatest impact.  Though they did state they “did not prove an association” between the MMR vaccine and autism, a significant portion of the paper was spent making the connection (p. 641).

Wakefield et al. (1998) reported that for eight of the twelve children in the investigation, they found the onset of behavioral symptoms days after immunization (p. 638).  Despite the significant earlier criticism of the Thompson et al. (1995) paper, Wakefield et al. (1998) included a reference to this earlier study which supported the contention the “measles vaccination … [was] implicated as a risk factor for Crohn’s disease” (pp. 640-641).   They implied connections between certain gut diseases, diet, and the prevalence of autistic disorders (p. 640).  They concluded, “We have identified a chronic enterocolitis in children that may be related to neuropsychiatric dysfunction. In most cases, onset of symptoms was after [MMR] immunization” (p. 641).

In 2004, ten of the original thirteen authors wrote a brief three-paragraph “Retraction of an Interpretation” (Murch et al.,2004).  They reiterated no causal connection between MMR and autism could be made, but accepted the paper created the appearance of a link.  This apparent link caused significant negative impact on public health, and they felt compelled to issue a formal retraction of this part of the paper (p.750).  The timing for this statement arose from an investigation in early 2004 into allegations of misconduct made against the researchers of the Wakefield et al. 1998 paper.

Richard Charles Horton, the current Editor-in-Chief of The Lancet, authored two important concurrent articles in the same issue of The Lancet alongside the 2004 Murch et al. retraction.  Horton (2004b) wrote a summary response to “serious allegations of research misconduct” by Wakefield et al. (1998) which were brought to senior editorial staff at The Lancet (p. 820).  Horton cleared Wakefield et al. of allegations of intentional ethical misconduct and bias case selection and advised he lacked the evidence to suggest any wrong-doing (pp. 820-821).  Subsequent investigations would question this finding.  A financial conflict of interest allegation was found to be supported and Andrew Wakefield had failed to report this to the editors of The Lancet (p. 821).  He went on to exonerate Wakefield and found no intentional deception on the part of Wakefield et al.  Horton reserved the bulk of his editorializing for a second article he penned in the same 2004 issue of The Lancet.

In “The lessons of MMR,” Horton (2004a) criticized Wakefield et al.’s 1998 paper and Andrew Wakefield’s subsequent public appearances of fostering an atmosphere that “triggered a collapse in confidence in the UK’s MMR vaccination programme” (p. 747).  He reflected on the significant resources dedicated to the issues that arose directly out of Wakefield et al.’s 1998 publication, but urged that it was “time to look forward” (p. 747).  In addition to addressing autism research, he addressed issues of research integrity, vaccine safety, public engagement, and publication of controversial ideas.

Horton (2004a) admitted Wakefield et al.’s 1998 paper generated an enormous amount of controversy, and that much interest had arisen about the concept and practices involved in research integrity.  He recognized that the perception “of institutions investigating themselves … does little to strengthen public trust in a system that has such critical societal influence” (p. 748).  He urged the creation of an independent Council for Research Integrity and suggested it would be a critical component to scrutinize research and insure public confidence.

Horton (2004a) advised a more robust vaccine “library of evidence” be established for the collection of information from all sources rather than the isolated and discrete information that may be available for any given vaccine (p. 748).  He suggested the need for this type of compendium is due to the ubiquity of an immunization which makes controlled studies extremely difficult.  He emphasized that public confidence in vaccines may be subverted by a difference in vaccine implementation which follows different safety protocols from other drugs due to the universality of any given vaccine.

Horton (2004a) devoted substantial attention on the issue of public engagement.  He expressed “frustration” over the very public MMR debate and categorically rejected the proposition The Lancet was conspiring with government officials, vaccine manufacturers, and others in an “orchestrated campaign” to undermine the Wakefield et al. findings (p. 748).  He recognized the lowered levels of trust in pronouncements coming directly from the government, which he suggested necessitated an independent and neutral body to assess and convey public health information (p. 749).  He criticized public-health officials’ engagement for having ridiculed evidence as “poor science” simply because it “appears to contradict their official message” (p. 748).  This could be remedied by connecting with critics directly and clearly communicating with them (p. 749).  He recommended the public-health community acknowledge the complexity of issues regarding vaccination and try to better understand parents’ reasons for both vaccinating and not vaccinating their children (p. 749).

Finally, Horton (2004a) defended the practice of publishing new or controversial claims despite the inability to control the public response.  He offered suggestions that editors, researchers, and journalists all have a responsibility to report information accurately and all have a responsibility “to avoid encouraging anybody to go beyond the data or interpretations described in a paper” (p. 749).  He reserved his most pointed comments for Andrew Wakefield by suggesting that the 1998 paper would never have been published if the updated conflict of interest guidelines had been in effect at the time.  Wakefield et al.’s 1998 paper contained an interesting possible link between autism and bowel disease, without this, “dismissing the entire 1998 Lancet paper as poor science gives a clear and correct message to the public about the status of any claim regarding the safety of MMR” (p. 748).

The Editors of The Lancet (2010) issued a short, anonymous paragraph fully retracting Wakefield et al.’s 1998 paper.  This retraction was in response to the U.K. General Medical Council’s [GMC] Fitness to Practise Panel issued on Jan 28, 2010 which found multiple ethical violations committed by Wakefield and his colleagues and that multiple elements of the 1998 paper were false (p.445).  The GMC (2010b) 143-page report summarized an investigation that began in 2007 and concluded in January of 2010.  In their sanction report the GMC (2010a) “determined that Dr Wakefield’s name should be erased from the medical register” (p. 9).  These reports are technical, legal documents outside of the scope of this literature review, but are referenced here due to the relevance to the subject.

Maisonneuve and Floret (2012) authored a comprehensive retrospective timeline on the Wakefield case.  Similar to Horton (2004a), Maisonneuve and Floret (2012) placed some of the blame on journalists and an unsophisticated public who were incapable of distinguishing between assumptions and evidence (p. 828).  They were critical in questioning the reason it took twelve years to sanction Wakefield, whereas they noted it was typical for sanctions to be pronounced between one and three years (p. 830).  As a result of the public deception caused by Wakefield, immunization rates in the U.K. had fallen from 92 to 73% with a further drop to 50% in London (p. 831).  They accused Wakefield of being the sole author on the paper, criticizing the passivity of the other listed authors and were critical of the anonymity of the four scientific reviewers who ultimately approved the publication for The Lancet in 1998 (p. 831).  They reviewed and summarized twenty scientific studies published after the 1998 Wakefield et al. paper which found no link between MMR and autism (p. 832).  The majority of their most pointed criticism relied on the work of London Times journalist Brian Deer.

The British Medical Journal, ostensibly a competing medical journal to The Lancet, published a series of three articles on the Wakefield case by journalist Brian Deer in January, 2011.  Deer (2011) reported in 2004 on Wakefield having received legal funding (p. 78) which ultimately led to Horton’s (2004b) finding of a conflict of interest (p. 821).  Deer (2011) found that Wakefield’s patients had been “recruited through anti-MMR campaigners” (p. 78) including a boy who had been flown from California to London for this project (p. 77).  This directly contradicted Horton’s (2004b) verdict (p. 821) regarding Wakefield et al.’s (1998) original assertion that patients were “consecutively referred to the department of paediatric gastroenterology” (p. 637).  The patients had been selectively chosen contrary to what Wakefield had suggested, and the funding was much more than just an appearance of a conflict of interest.  In fact, Wakefield had been retained two years before the publication of his 1998 paper by Richard Barr, a lawyer pursuing a case against MMR vaccine manufacturers (p. 77).  Patients in the study reported they were told that Andrew Wakefield was seeking test cases to confirm his own negative views of vaccines (p. 81).

Similar to Maisonneuve and Floret’s (2012) assertion that Wakefield was the sole author, Deer (2011) reported that Wakefield had “put their completed data in tables and narrative form for the purpose of submission for publication” (p. 82).  He contacted two of the other authors of the 1998 Wakefield et al. paper, Walker-Smith and Murch, who, though they signed on to the paper, “did not even know which case was which” when questioned about specific patients (p 82).  Walker-Smith admitted to relying on trust in signing the Wakefield paper with “good intent” (p. 82).  Walker-Smith was removed from the medical register in the same 2010 GMC sanction which removed Wakefield, in part for invasive and unnecessary clinical procedures and subverting the ethical approval process (p. 78).  While Horton (2004b) cleared Andrew Wakefield of everything but a conflict of interest violation, Deer (2011) uncovered evidence supporting all six of the original allegations of varying levels of ethical impropriety.  While all of this undermined the credibility of the original 1998 Wakefield et al. paper, the crucial part was the investigation into the autism-MMR link itself.

Deer (2011) relied on both the substantial GMC (2010b) panel report and his own interviews with parents of the Wakefield patients to expose the deceptive findings.  He reported that only one patient was diagnosed with regressive autism, which contradicted the eight cited in Wakefield et al.’s paper (p. 80).  He found that not a single patient developed symptoms days after the MMR vaccine, which once again contradicted the eight cited by Wakefield and his colleagues.  Even the possible link between autism and bowel disease was discredited, which was the original reason given by Horton (2004b) for not fully retracting the 1998 Wakefield et al. paper in 2004.  He summarized his investigation, “No case was free of misreporting or alteration. Taken together, NHS records cannot be reconciled with what was published, to such devastating effect, in the journal” (p. 81).  The devastating effects were not confined to the U.K. however, and the MMR vaccine scare spread throughout the world and eventually landed in the U.S.  This further fueled a well-established anti-vaccine movement.

Seth Mnookin, like Brian Deer, is an investigative journalist specializing in science reporting. Unlike Deer, Mnookin (2012), currently the Director of MIT’s Graduate Program in Science Writing, had no connection with the Wakefield case when he began working on his investigation into the controversies of childhood inoculations in 2008 (p. 9).  After speaking with several parents of autistic children and attending autism conferences, he concluded that parents’ sense of isolation caused them to gravitate towards groups insulated from criticism, which in turn allowed them to embrace discredited findings while rejecting established scientific conclusions (pp. 12-16).

Throughout the book, Mnookin (2012) details the rise, and eventual fall, of many U.S. anti-vaccine proponents.  He included details from several court proceedings, including the Omnibus Autism cases, which attempted to link thimerosal, a mercury-based preservative in several multi-variant vaccines including the MMR vaccine, with autism.  This trial, which cost millions of dollars and lasted several years, ended in a 2009 judgement which found that no connection had been made (pp. 283-297).

Unlike much of the literature which discredits Wakefield and the anti-vaccine movement, Mnookin (2012) acknowledged the historical context for the rise of vaccine skepticism.  He reported on several episodes of unflattering behavior by government and researchers in skewing evidence on vaccines.  This included burying evidence of inadequate production controls of vaccines and research that contradicted the need of some immunization protocols.  This collaboration of government, research, and vaccine manufacturers seemed to give legitimacy and potency to the anti-vaccine advocates of the time (pp. 30-75).

Mnookin (2012) repeatedly detailed how anti-vaccine activists, often with the assist of a sensationalized media, would prey upon desperate families of autistic children.  It was the observation he made within the first pages of the book that resonated throughout, and continues to affect the vaccine debate:

Over the past two decades, the instant accessibility of information has dramatically reshaped our relationship to the world of knowledge … One of the first effects … was to unmoor information from the context required to understand it.  On the internet, facts float about freely and … has led to a world with increasingly porous boundaries between facts and beliefs. (p. 8)

It should be assumed the best interests of children are the focus of everyone involved in the investigation, implementation, and discussion of childhood vaccines.  While Andrew Wakefield brought the issue of vaccine safety to the fore, immunization rates decreased and preventable deaths occurred.  Unfortunately, the quality of discussion on safety and efficacy of childhood vaccines suffered prior to the official retraction of the 1998 Wakefield et al. paper.  It is worth investigating whether any of Richard Horton’s 2004 proposals have been implemented and to what effect.  Further, it is important to investigate whether the lessons learned from the publication and subsequent retraction of the Wakefield et al. 1998 paper have contributed to a safer and more efficacious vaccine protocol.

 

 

 

 

 

References

Deer, B. (2011). How the case against the mmr vaccine was fixed. BMJ: British Medical Journal, 342(7788), 77-82. doi:10.1136/bmj.c5347

Farrington, P., Miller, E., Calman, K. C., Minor, P., MacDonald, T., Miller, D., . . . Wakefield, A. J. (1995). Measles vaccination as a risk factor for inflammatory bowel disease. The Lancet, 345(8961), 1362-1364. doi://dx.doi.org/10.1016/S0140-6736(95)92559-7

General Medical Council. (2010a). Determination on serious professional misconduct (SPM) and sanction.  Retrieved from https://web.archive.org/web/20110809092833/http://www.gmc-uk.org/Wakefield_SPM_and_SANCTION.pdf_32595267.pdf

General Medical Council. (2010b). Fitness to practise panel hearing 28 january 2010. Retrieved from http://briandeer.com/solved/gmc-charge-sheet.pdf

Horton, R. (2004a). The lessons of MMR. The Lancet, 363(9411), 747-749. doi://dx.doi.org/10.1016/S0140-6736(04)15714-0

Horton, R. (2004b). A statement by the editors of the lancet. The Lancet, 363(9411), 820-821. doi://dx.doi.org/10.1016/S0140-6736(04)15699-7

Maisonneuve, H., & Floret, D. (2012). Affaire wakefield : 12 ans d’errance car aucun lien entre autisme et vaccination ROR n’a été montré. La Presse Médicale, 41(9, Part 1), 827-834. doi://dx.doi.org/10.1016/j.lpm.2012.03.022

Mnookin, S. (2012). The panic virus: The true story behind the vaccine-autism controversy. New York: Simon & Schuster.

Murch, S. H., Anthony, A., Casson, D. H., Malik, M., Berelowitz, M., Dhillon, A. P., . . . Walker-Smith, J. A. (2004). Retraction of an interpretation. The Lancet, 363(9411), 750. doi://dx.doi.org/10.1016/S0140-6736(04)15715-2

Patriarca, P., & Beeler, J. (1995). Measles vaccination and inflammatory bowel disease. The Lancet, 345(8957), 1062-1063. doi://dx.doi.org/10.1016/S0140-6736(95)90810-2

The Editors of The Lancet. (2010). Retraction—Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 375(9713), 445. doi://dx.doi.org/10.1016/S0140-6736(10)60175-4

Thompson, N. P., Pounder, R. E., Wakefield, A. J., & Montgomery, S. M. (1995). Is measles vaccination a risk factor for inflammatory bowel disease? The Lancet, 345(8957), 1071-1074. doi://dx.doi.org/10.1016/S0140-6736(95)90816-1

Wakefield, A. J., Murch, S. H., Anthony, A., Linnell, J., Casson, D. M., Malik, M., . . . Walker-Smith, J. A. (1998). RETRACTED: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 351(9103), 637-641. doi:10.1016/S0140-6736(97)11096-0

Whitney, C. G., Zhou, F., Singleton, J., & Schuchat, A. (2014). Benefits from immunization during the vaccines for children program era – united states, 1994-2013. MMWR. Morbidity and Mortality Weekly Report, 63(16), 352. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24759657

 

Psychological Viewpoint Bonanza!

Re: The Psychological Viewpoint Questionnaire, William R. Miller

 

Behavioral – 12

Humanistic – 11

Psychoanalytic – 11

 

At first blush, I recoiled at the fact Behavioral was dominant. I find Skinner to be kind of creepy, so I have rationalized that Social Psychologist Zimbardo (though I am well aware some find Zimbardo kind of creepy) has enough Behavioral aspects, and that has kind of soothed that anxiety!

In ethics, we might say that I lack ‘parsimony’. My rationalizations and perspectives don’t follow a particularly consistent and ‘simple’ perspective. For this evaluation, items 18 and 20 are particularly revelatory:

18. Little or none of what people do is the result of free will. Behavior is controlled by lawful principles, and free choice is an illusion.

20. A person is free to be what he or she wants to be.

On their face, these would likely have opposite ‘answers’. If you agree with one, you are more likely to disagree with the other. If this was being scored by either a human or even an algorithm, this pair would likely be checked for ‘internal consistency’. I agreed with both of these though.

The subtle differences between these two was enough for me to, at least reflexively, agree with item 20 despite the fact I don’t believe in ‘free will’. I think ‘want’ is enough of a waffle word which allows me of convincing myself I can agree with both of the items.

But! Back to the overall results. I think it is fair to say that I both accept and reject these approaches equally. I think human ‘mind’ complexity may very well not be comprehensible by humans, and I think there is a certain kind of arrogance which I associate with the idea that humans are so awesome they can understand everything – even themselves.

I think lots of approaches (perspectives) can provide value, but I am skeptical any one approach (or even a ‘set’) can provide definitive understanding (and importantly, for me, ‘solutions’).

… kenny

Nature V Nurture

The ‘nature versus nurture’ ‘debate’ in psychology reminds me of the ‘free will versus determinism’ perspectives in philosophy. [This is probably because my focus is rooted in philosophy though!] The biological / nativists and behaviorists are far more aligned than the spectrum suggested in the text which places them at opposite ends. I tend towards determinism, though I like to present myself as a soft-determinist or compatibilist. I readily accept Kant’s rebuke of this as “wretched subterfuge”! I am a hard-determinist, but I lack the conviction to come out and say such. Daniel Dennett is way better at rationalizing (and explaining) compatibilism than I am. That giant empty space above determinism representing the great unknown (and, from my perspective, unknowable) weakens my confidence in hard determinism ¯\_(ツ)_/¯.

We are ‘meat puppets’ (or wind-up toys) who are biologically predetermined to react (and importantly – perceive) in a specific set of ways given set stimulus. The environment is the determinant of how our biological wiring expresses itself. Am I comfortable thinking about life (specifically my own) this way? Not really. Which is why I try not to obsess over it too much. My ‘out’ is there is so much I don’t know, and I comfort myself with the belief that much of it is unknowable as well.

I get the attraction of the idea of ‘free will’ / personal agency. It is, assuredly, unsettling to think of oneself as nothing more than pre-written code being executed within a larger pre-written program. I also (like to try at least to) share the optimism of the humanistic approach, though the post-modern facet of it is like ‘nails on a chalkboard’ to me. The bigger problem is the inherent contradiction:

I do not understand how we can have both an “innate need” (and drive) and assume we have “free will”. Accepting my limitations, maybe someone can ‘explain this to me like I am five’.

… kenny

Research Proposal

The University of Richmond

 

 

The Epistemological Crisis in the United States

 

A Research Proposal Submitted to

Professor Daniel Hocutt

In Masters of Liberal Arts MLA 500

School of Professional and Continuing Studies

 

 

 

By

Kenneth (Kenny) Buchholz

 

 

Richmond, Virginia

December, 2021

Contents

Introduction.. 4

Background. 5

Overview.. 5

Historical Context of Epistemology. 9

Linguistic Relativity. 12

Polarization.. 14

Digital E-Crisis. 15

Methodology and Methods. 16

Exploratory Interpretative Research.. 17

Distant and Thin.. 17

Analytic Autoethnography. 18

Introduction.. 18

Rationale and Execution.. 19

A Brief Word on Postmodernism.. 20

Contemporary Historical Analysis. 20

Selection Criteria. 21

Results and Discussion.. 23

Speculative Analysis. 23

Conclusion. 25

References. 26

 

 

“We feel bad for you that you can’t see the truth,” she said.

“I feel the same way about you,” he replied.[1]

 

Introduction

Following up on a campaign promise, President Trump announced in 2017 the intention of the United States to withdraw from The Paris Agreement.[2][3][4] This accelerated an already growing divide in the country on the issue of Global Climate Change (GCC) between Democrats and Republicans.[5] Leading into the 2020 US Presidential election, climate change was the most polarized partisan issue.[6] The Paris Agreement seemed to take on the role of a proxy for this partisan divide as Democratic Presidential candidates pledged to rejoin the Paris Agreement in light of President Trump’s announcement to exit it. The November 19, 2019 United Nations Environmental Program (UNEP) Emissions Gap report exposed the artifice of the partisan disagreement on the Paris Accord.[7] Despite GCC and the Paris Accord being a live and strongly divided political topic, barely any mention of the UNEP report appeared in US media. US media mentioned the report’s finding of global temperature increasing 3.2C by 2100.[8] These media reports did not mention, however, that with the Paris Agreement, the temperature increased 2.7C, resulting in catastrophic consequences, even with the implementation of the Paris Agreement.[9]

The November, 2019 UNEP report was a critical point for me. It was one more piece of evidence about the growing GCC crisis. Leading into the 2020 US Presidential election, it exposed the chasm between reality and acted perceptions. Opposition and advocacy for the Paris Agreement, a voluntary and unenforceable framework, was based, as demonstrated by the UNEP report, on a symbolic reorientation of the Paris Agreement into something it was not. Opposing sides were creating their own realities about an issue and acting from that position. This signaled to me the existence of a further crisis – The Epistemological Crisis.

Background

Overview

What is a (The) Epistemological Crisis (E-crisis)?

This is the fundamental question of this research. As such, it necessarily follows that it requires definitional clarification. The suggestion of a crisis is such that it moves it beyond a disagreement over any given specific issue or claim. A secondary analysis of any given claim is the construction or foundation of that claim which requires the analysis of knowledge formation. This level of analysis may reveal that the differences in the foundation of knowledge construction could be a (or the) source of conflict. The tertiary and quaternary levels of analysis is the assessment of the validity of the sources of knowledge formation. If all knowledge sources are subjective and contextual, then the very idea of the existence of knowledge is uncertain. Though widely mocked by many people in certain segments of the media and public, Kellyanne Conway’s phrase “alternative facts” illuminated a stark question about the very nature of knowledge and its societal implications. [10]

‘The epistemological crisis … which one?’[11]

The IPCC Sixth Assessment Report (AR6) conveyed probably the bluntest warning yet in an IPCC report concerning the crisis facing the planet from GCC.[12] However, the immediacy of the past two years of enduring the COVID-19 global pandemic is likely a more visceral experience for many people.

The masking policy in the US with relationship to COVID-19 has persisted throughout as an issue with strongly divided partisan characteristics which has resulted in deleterious societal consequences.[13] The US masking issue is both illustrative of the E-crisis and demonstrative of the consequences. Anthony Fauci, a government official at both the NIH and White House Government Coronavirus Task Force who has played a leading role on US public policy on COVID throughout this past two years and spanning both Biden and Trump administrations, has played a central figure on the masking issue. Public support for Fauci has gone from relatively strong bipartisan sentiment in May, 2020 to strongly divided in the latter half of 2021.[14][15] The confluence of Fauci and masking is demonstrative (though not essentially so) of the current manifestation of the E-crisis.

March 8, 2020 Fauci’s public statement: “Now people should not be, there is no reason to be walking around with a mask”.[16] Generally, the focus has been on the latter half rather than the first part of this statement. There is more ambiguity in the latter part than the first part of this statement. In a February 5, 2020 personal correspondence, Fauci was declarative: “I do not recommend that you wear a mask, particularly since you are going to a very low risk location.”[17] During this early stage of the pandemic, the guidance from one of the most public and authoritative US government experts, Fauci, was that the public not wear masks, and it was not until April 3, 2020 the CDC encouraged mask-wearing.[18] Fauci said in July, 2020 that “the critical issue was to save the masks for the people who really needed them because it was felt there was a shortage of masks. Also, we didn’t realize, at all, the extent of asymptomatic spread.”[19] Leaving aside the moral and material efficacy of deceiving the public, Fauci’s post-hoc rationale to preserve masks seems belied by the personal correspondence in which he recommended the same. The very earliest published reports of COVID in January, 2020 included the presence of an asymptomatic infected child (10 years old) along with five other symptomatic family members (16.7% asymptomatic).[20] Published accounts in Europe at the end of February were reporting infection resulting from asymptomatic contact.[21] Both parts of Fauci’s post-hoc rationalization appear to be unsupported by available evidence, and it is difficult to assess the exact impact of deceptive and contradictory (and contraindicated) official US Government masking guidance in the early months of the pandemic.

It is striking, however, that US public polling seems to indicate that advocates of masking policies also have positive views of Anthony Fauci despite evidence which seems to indicate Fauci’s conflicting representation of masking in the early, critical, months of the pandemic. I do not believe that disambiguation of Anthony Fauci / masking policy or GCC / Paris Agreement would be central to solving either of these crises. However, it does seem that both dyads represent symbolism, and the positions on these is one of contradistinction rather than firm grounding in the substance of the positions themselves. This feature, essentially opposition qua opposition, makes the current E-crisis appear to be unique to a categorically similar so-called E-crisis. Is the current E-crisis unique and does it have meaningful societal impact?

Historical Context of Epistemology

‘The Epistemological Crisis … has been with us since Aristotle.’ [22]

Any study of the E-crisis requires a grounding in the philosophical field of epistemology. Epistemology provides the necessary descriptive foundation for the E-crisis. It is an open and ancillary question of whether epistemology simply describes the E-crisis, or has played a role in exacerbating or even been the central cause of the E-crisis.[23] The Greek philosophers provide us a good grounding in epistemology. The Meno dialogues concretize Socrates ideas on knowledge. It is not enough to simply possess a “true opinion”.  Guessing correctly the number of marbles in a jar does not reflect knowledge regarding the number or nature of marbles. “True opinion” becomes enduring and knowledge when “chained” to experience.[24] Spilling the marbles out of the jar, then counting them as you put them back reflects an experience that is bound to a “true opinion”. Knowledge endures because of the link to experience.

Plato’s Allegory of the Cave extends this concept of knowledge. “Chained captives” in Plato’s Cave (of ignorance, in the Allegory) are shown nothing but “puppet” shadow shows, mirroring the Meno dialogues of chaining experience to (in this case, the perception of) knowledge. Escaping the Cave and ascending the “royal road out of the cave into the light … to the contemplation of the highest idea of being,” the Allegory is largely about the transformative nature of education to elevate knowledge into meaning.[25] The idea of chaining perceptual experience is also strongly echoed in the concept of “paradigms” described in 20th Century science philosopher Thomas Kuhn’s The Structure of Scientific Revolutions. Kuhn’s scientific paradigms proscribe both what is real and how to investigate the real, but they also, like Plato’s Cave, “often suppresses fundamental novelties” or new ways of thinking about and seeing the world.[26] Kuhn’s paradigm sets a conceptual framework that perceptual knowledge and the process of investigation are both chained to an established acceptable range commensurate with that paradigm. Existence within one paradigm is so proscribed that it is functionally an entirely separate world or epistemic bubble from another paradigm.

Seventeenth Century philosopher Rene Descartes frays the chains of Socrates/Plato with the formalization of doubt and skepticism in Meditations of First Philosophy. Senses which “sometimes misled us” are our source of “truth and certainty”, “it is the best part of prudence not to place absolute confidence in that by which we have even once been deceived.” [27] Judgements (knowledge and meaning) resulting from potentially flawed sense information may be commensurately flawed. Descartes’ skepticism set out a formalized and functional methodological skepticism for approaching knowledge and certainty through comprehensive self-reflection. An epistemic structure (bubble) is proportionate to the epistemological foundation.

Friedrich Nietzsche extended Descartes’ methodological skepticism into an ideological skepticism upon Descartes’ presuppositional (and famous) cogito ergo sum (I think therefore I am), and there is no way to establish certainty that there is “thinking” and it is “I” that is doing that thinking.[28] Nietzsche’s skeptical nihilism leads to Baudrillard’s conclusion that meaning itself is ephemeral and is therefore of no value.[29] Baudrillard’s and Nietzsche’s nihilism exposes the potential end point of turning methodological skepticism into ideological skepticism and combining it with the pure contextual subjectivity of post-modernism. Nothing means anything and everything means nothing; we just exist.

Along with any idea of an E-crisis is the likely possibility of the presence of Sartre’s Existential Crisis. Unlike the common or colloquial usage of the term ‘bad faith’, Sartre’s bad faith self-deception is when negation of possibility applies to oneself. Bad faith is a firmly held faith which limits and constrains the individual into a self-imposed definition of who they are. Unchaining oneself from their current paradigm or epistemic bubble will move them into unknown territory. The Existential Crisis results when a person moves to escape the limits of bad faith only to find themselves “paralyzed with nothingness.”[30] Dismantling the illusion that one cannot be or believe in anything but what and who they are in that instant may also result in believing in nothing, akin to the nihilism of Nietzsche and Baudrillard.

Ludwig Wittgenstein’s language-games is one of the better analogous descriptors for the E-crisis. Words and language as mutable, “[w]hen language-games change, then there is a change in concepts, and with the concepts the meanings of words change.”[31] As people exist within separate epistemic bubbles (or Kuhn’s paradigms or Wittgenstein’s language-games), their worldview is held and expressed in ways that are incommensurate with people who inhabit other distinct language-games. This makes even the act of communication fraught with uncertainty even with people who ostensibly communicate in the same language if they are not, themselves, existing within the same language-game (epistemic bubble).

Linguistic Relativity

Linguistics are inherent (arguably self-definitional) to any communication. The translation of ideas into communication, though constrained by Wittgenstein’s language-games, is particularly relevant to research which has epistemology as a central focus. It moves the process of pure theoretical philosophical navel-gazing into more concrete descriptive and application. Regardless of the exact interpretation or perspective, there is an undeniable interrelationship between epistemology and linguistics.

Language and ‘human’ are inextricably linked concepts for some philosophers (and linguists). According to Nietzsche, the human drive to form a metaphorical construct from sense data is translated into images then sounds. It is these sounds (language) which then form the basis of our beliefs, so that our beliefs don’t reflect a natural reality, but a false and constructed metaphor. Language is an “aesthetic impulse to represent the external world,” and in so doing, it compels humans into a false belief of reality (natural world).[32]

Edward Sapir does not dismiss these types of Nietzschean impulses, but for him, “[l]anguage is primarily a cultural or social product.”[33] Linguistics integrates into and across all fields of study. It is language which forms the “real world” or “social reality” so that “worlds in which different societies live are distinct worlds, not merely the same world with different labels attached.”[34]

A recent example and arguably related to my research proposal is the German word schadenfreude, broadly described as the derivation of pleasure from misfortune. Online dictionary Merriam-Webster reported “lookups spiked 30,500% on October 2, 2020” following the official announcement that President Trump had COVID-19.[35] Recent research describes schadenfreude as multi-modal exhibiting four distinct functions or reasons for expression in social media – compensation, identification, aversion, and injustice.[36] The interplay between the spike reported by Merriam-Webster may be related to the concept of “emotional contagion” – the spread of emotions through social media.[37]

Polarization

One artifact of the E-crisis is the presence of political polarization in the United States. Superficially, this reflects the elementary level of the E-crisis – the presence of disagreement over specific claims. The growing partisan sorting has been correlated to authoritarian impulses which reflects more concern about cognitive style than issue preference or positions.[38] This undermines the idea that polarization (and therefore the E-crisis) is simply a matter of a disagreement (or series of disagreements) on any specific issue or even an issue set. While I disagree with Hetherington and Weiler that authoritarianism is the causal variable leading polarization, I do think there is a correlation between, as a minimum, cognition and polarization and that authoritarianism may play a strong role in US political polarization, though my sense is that it is opposite from what they propose. Rather than authoritarianism leading polarization, the polarization is leading to authoritarian impulses.

Cross-country studies have shown that political polarization is strongly correlated to trust in government and income inequality, and mitigation of polarization is achieved through government investments and expenditures.[39] Ironically enough, Marc Hetherington has recently acknowledged trust in the US government is linked to “federal involvement in social policy.”[40] The correlative between authoritarian impulses and fascism is revealed in the fostering of mistrust in the existing governmental structure which is a feature of Umberto Eco’s Ur-Fascism in which he likened fascism as a game “not unlike Wittgenstein’s notion of a game.”[41]

Digital E-Crisis

Dissemination of information (production, consumption, and distribution) forms an (perhaps obvious) important role in epistemology. Most Americans obtain news and information through online sources which dominate by orders of magnitude other sources (television, radio, print) for US adults under fifty, including a plurality under thirty who rely on social media for information.[42] There is a clear and demonstrable interplay between online and offline engagement.[43] The blurring of online and offline self is a notable transformation over the past decade from what the online world had been described as a “potential space”.[44] That is not to say online epistemic bubbles are not different from offline, they are. The basic understanding of information flow in epistemological models has largely remained unchanged since the time of Descartes – sense information flowing from transmitter to receiver. Digital social media is a multi-nodal network which presents a more complex and potentially vulnerable epistemic environment.[45] Recently, Facebook whistleblower Frances Haugen revealed Facebook benefits from the “spread [of] anger, hate, and disinformation” which resulted in algorithms which amplified this type of engagement.[46] While this type of antagonistic engagement could reasonably be considered characteristic of the E-crisis, it is more difficult to tell whether social media is leading, following, or a more complex mix of interplay of cause and effect. Though it is outside of the scope of this paper, the field of digital E-crisis is a live and active current field.[47] As such, it is imperative to continue to track this field as supplementary to my research. I have no strong position on this field, though I presume the interplay is a complex mix. Social media would not be causing the antagonism without a preexisting priming of the society it is affecting.

Methodology and Methods

Define the Epistemological Crisis in the United States and describe the societal effects.

The two dyads I presented in the Introduction and Background Overview, GCC/Paris and Fauci/Masking, are not critically important examples to either the issues (GCC and the Pandemic) or the topic of this research (E-Crisis in the US). They are examples which attempt to demonstrate the societal effects. The E-crisis is not one of mere disagreement on any given issue or claim; in some instances, it seems difficult to tell whether there is a disagreement on a claim for any other sake than disagreement’s sake. It is comprised of the four levels outlined in the Background Overview. The crisis nature of the E-crisis, aside from the criticality of the issues in my two examples (GCC and the pandemic), is the appearance of opposition which substance and background is arbitrarily and evanescently grounded. It is not just that there appears to be no common ground; there does not even appear a way to arrive at common ground. Even for low stakes, this condition would be more than just problematic.

Exploratory Interpretative Research

The type of research proposed here is both investigative and limited exploration.[48] Epistemology is rich with diverse multidisciplinary inquiries; the topic of the E-Crisis in the United States seems arbitrary and lacks clarity. Labelling the current state of the epistemological landscape of the US as an E-crisis limits the focus, accurately or not, to perceived problematic dialectical public (and often political) discourse.

This will be secondary research and will not utilize any primary research methods. It will likely employ quantitative data, but not include any directed method, to discover broad high heat trendlines, as in the example earlier of schadenfreude. It will rely on qualitative ethnographic analysis to reveal, as in the case of Gibbons and Seitz, the “main insight” obtained through qualitative analysis only after the quantitative methods (and data).[49]

Distant and Thin

Commensurate with the broad goals of exploratory-type research, Mueller posits “distant and thin treatments foster primary, if tentative and provisional, insight … vital glimpses of an interconnected disciplinary domain … that define and cohere widespread scholarly activity.”[50] My initial impulse was to apply the more traditional approach of thick description of an analogical model – a thorough analysis of something which seemed to demonstrate characteristics of the E-crisis. My problem with that approach is that revealing a phenomenon in an isolated example does little to reveal (or even suggest) a broad societal level feature. Extracting information across wide (and demonstrably representative) samples is a more useful analytic data set to assess societal level characteristics, analogous to Morretti’s “devices, themes, tropes—or genres and systems.”[51]

Analytic Autoethnography

Introduction

After moving to Richmond, Virginia from Vancouver Island, British Columbia in 2003, I enrolled at the University of Richmond School of Professional and Continuing Studies Liberal Arts undergraduate program in 2016 at the age of fifty-two. The first course I took was ‘Polarization and the Presidential Election’, and the topic of my term paper was Vaccine Hesitancy. Jill Stein, the Green Party candidate, simultaneously labelled anti-vax and big pharma shill by the two “opposing” sides after she expressed vaccines are valuable and care needs to be taken in setting vaccine policies and procedures. I did not include Stein in my paper. She was not important or remotely central to the topic apart from cynical political caricature, but she was a near perfect symbolic representation of the two ‘opposing’ sides. Seth Mnookin captured this, writing, “the instant accessibility of information has dramatically reshaped our relationship to the world of knowledge … has led to a world with increasingly porous boundaries between facts and beliefs.”[52]

I have seen this pattern repeat over the past two decades living in the United States on issues big and small, culminating in this being a central feature over the past two years of the COVID pandemic.

Rationale and Execution

I am not simply a passive or minimally obtrusive observer, I am a member of the culture which I am researching with biases and perspectives, “the potential power of autoethnography to address unanswered questions and include the new and unique ideas of the researcher is inspiring to me.”[53] Autoethnography permits an alternative approach to a new kind of epistemology, at least with regard to traditional research techniques and methodologies. More formally, Leon Anderson has detailed a list of five key features necessary for analytic autoethnography: “(1) complete member researcher (CMR) status, (2) analytic reflexivity, (3) narrative visibility of the researcher’s self, (4) dialogue with informants beyond the self, and (5) commitment to theoretical analysis.”[54]

My proposal includes the implementation of a publicly available and open WordPress based Website/Blog hosted on the University of Richmond blog server. Rigorous and transparent adherence to posting my research materials along with my assessment and analysis of the material and maintaining open comments would satisfy Anderson’s second through fourth features. The success or failure of this research will be demonstrated by the quality of the theoretical analysis to provide materially transformative understanding of the topic.

A Brief Word on Postmodernism

I understand the impulse to place autoethnography within a postmodern perspective, particularly as a new methodology challenging traditional approaches. As Carolyn Ellis wrote, “[autoethnography] acknowledges and accommodates subjectivity, emotionality, and the researcher’s influence on research, rather than hiding from these matters or assuming they don’t exist.”[55] I am firmly of the belief that all of these play a role even in the most objectively prescribed natural science research, and I embrace and value the “radical honesty” suggested by autoethnography.[56] However, I see postmodernism susceptible to sliding into the nihilism of Nietzsche and Baudrillard, a position I am not comfortable with. Rather, I see the potential of autoethnography (particularly as described by Anderson) as aligning with Kant’s public use of reason and necessity of establishing democratic epistemic canons, which is a position I embrace.

Contemporary Historical Analysis

Influential crises have strong epistemological interconnections throughout the entirety of human history. My focus, as it reflects the current state, will be on the Anthropocene (mid-20th Century forward), an epoch “shaped by human activity.”[57] Hinge or inflection points during this period would be ideal for populating a “thin and distant” data set, if they are also concomitant with some or all four levels of the E-crisis.

An early example concerning GCC is the 1965 President’s Science committee publication of Restoring the Quality of Our Environment which described the “national necessity” of moving away from the burning of fossil fuels because of the risk of “climatic change.”[58] Days after the release of this report, the president of the American Petroleum Industry, Frank Ikard, delivered remarks to his industry regarding the “catastrophic consequences” of GCC by 2000.[59] Yet the contemporaneous Washington Post publication on this report merely mentioned that the government would “continue to measure carbon dioxide over the next several decades” and “stimulate industry … for automobiles and trucks that will not produce noxious effects.”[60] This deep disconnect between what the media told the public and what government and industry knew have led to the very catastrophic consequences Ikard was warning about as GCC has become emblematic of the current E-crisis.

Selection Criteria

The ideograph will be the unit of analysis. While some may reasonably describe the ideograph as vaguely defined representing an ambiguous set of ideas, McGee presents “analysis of ideographic usages in political rhetoric … reveals … “structures” … which have the capacity both to control “power” and to influence (if not determine) the shape and texture of each individual’s “reality”.”[61] Selection of historical ideographs would be characterized by meeting more than a single level of the E-crisis and demonstrate a link between “power” and the shaping of epistemological “reality”.

The events of September 11, 2001 may be such an example. One simple demonstration is the difference between President Bush’s statements about ‘they hate us for our freedoms’, and on the other ‘side’ a comment by Ward Churchill alluding to ‘chickens coming home to roost’. Ideographs of justice, freedom, terrorism, and hate drove the political will and power to create decades long impressions to individual and cultural reality.

The selection criteria are subject to two complications. This, broadly, is an exploratory research topic and any predefined set would artificially restrict the scope of a topic which I contend is broad-ranging. I would also subject my bias into the establishment of a criteria set. Set criteria would, I suggest, result in an amplification of my bias, and artificially restricts the scope making the project narrower and more bias than broad unstructured criteria set. The best selection criteria I imagine is frequency – making sure that I post to the blog a minimum frequency (once per week) of material and initial analysis of items that resonate to me as relevant to this project.

Results and Discussion

‘years of analysis for a day of synthesis’[62]

The E-crisis is the focus of my MLA program at UR. I currently (and provisionally) scheduled one course per semester for the next four and a half years.

The proposed blog will serve as clearinghouse/archive for this specific research proposal and my MLA coursework. The open-source nature of WordPress provides flexibility to adapt it to an autoethnographic methodology.[63] The proposed interpretative approach will permit identification (tagging) and theme development (pages) within the site. The ‘thin and distant’ approach will generate a data set. Systematic analysis will lead to the emergence of identifiable core characteristics which will be indicative of a definable feature set of the E-crisis. Additionally, and significantly, autoethnography permits adaptation and revision of the project which can be tracked and evaluated for coherence. The cross and multi-disciplinary approach of my MLA program integrates with the proposition the E-crisis is a broad societal-level phenomenon rather than isolated and temporal. The blog will be the repository of material and analysis upon which I would write a synthesis report.

Speculative Analysis

What is the E-crisis and describe its Societal Effects

If a thing can be identified and it occurs frequently enough, it is reasonable to presume it has significance. The E-crisis may be an emergent phenomenon or an assemblage of phenomena which are homogenous or potentially heterogenous. The E-crisis may simply be a repeated signpost which reveals flaws of the underlying social structure akin to the same way that Cubitt’s “glitch reveals the pure indifference underpinning the logic of exchange on which it is founded.”[64] Alternatively, the E-crisis may be the street lights which illuminate the existing structure and insure that as the only viable path.

It is possible the E-crisis is only the appearance of a distinct phenomenon reflected by the kinds of epistemic bubbles central to related research in the digital social media field. The COVID pandemic pushed social discourse online which further amplified these digital epistemic bubbles while the distinction between online and offline behaviors and attitudes dissolved, therefore transposing the digital epistemic bubbles into real life epistemic bubbles. I do not believe this is the case, but accept it may be a possibility.

I believe the E-crisis signals, interacts, and manifests the cultural superstructure of the United States revealing and amplifying fundamental flaws. This is similar to Nietzsche’s perspective (and arguably with an equally pessimistic outcome) on language – an instinctual impulse which imperfectly mimics the ‘real’ which then reinforces a flawed perception because it is forced through this flawed filter. The E-crisis is the crisis of the United States. Currently, and in the context of this proposal, I am reticent to offer a meaningful analysis of the foundational crisis of the US. I do not know whether relevant analogous models throughout history may apply, since I am under the impression the US in the Anthropocene is too unique to be able to establish effective analogous modelling.

Conclusion

I have excluded Narrative (Criticism) from this draft proposal despite my belief of its importance. Borrowing from Dan Richard’s lecture material quoting David Ropeik, “Emotions are the filters through which we see the facts.”[65] Because of the emotional power of narrative, it plays a critical role for both individual and social epistemology, and therefore its standing with respect to the E-crisis. My next class in the MLA program is Erik Nielsen’s Voice of Hip Hop course, and this will, hopefully, provide an opportunity to further revise this research project to include Narrative. I have not included here references to issues with broad domestic consensus, but oppositional (and often antagonistic/militaristic) positions with other countries. This ‘internationalization’ of the US E-crisis is worthy of consideration in subsequent revisions, particularly as it interacts with the internal domestic E-crisis.

Positivist, postmodern, or Kantian, this research topic will follow me through these next five years (in one form or another), and I hope the journey will be as valuable as the destination, if not more so.

 

 

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