The Politics of Science and the Science of Politics

Or: What Do Bill Maher, Robert F. Kennedy Jr., Rand Paul, and Chris Christie Have In Common?

The 2016 Presidential campaign is off to a rousing start, and who would have predicted that one of the first hot-button issues of the political season would be national immunization policy? Thanks to a highly publicized multi-state outbreak of measles that began in January and continues to this day, considerable attention has been focused on the increased number of parents rejecting the US Centers for Disease Control and Prevention (CDC) recommendations for childhood vaccination. On February 2, President Obama made a strong statement in support of vaccination, characterizing the scientific evidence for safety and effectiveness as “pretty indisputable.”

For a couple of weeks, the glare of media attention on this issue was so bright that the entire class of presidential hopefuls was required to state a position, and a few of their responses drew quick attacks.

United States Senator Rand Paul of Kentucky holds a doctor of medicine degree from Duke University School of Medicine, but on February 3rd he was quoted saying, “I’ve heard of many tragic cases of walking, talking, normal children, who wound up with profound mental disorders after vaccines.” In an attempt to recover from the criticism that followed, Rand Paul later asserted that all parents should get their children vaccinated and allowed a reporter to accompany him as he got a Hepatitis A booster shot.

Similarly, after initially suggesting that vaccination is a parental choice, Chris Christie was forced to clarify his position, saying that “there is no question kids should be vaccinated.”

Finally, as what might be called “Vaccine Week” wore on, some science-minded people began to wonder whether comedian Bill Maher, a long-time member of the anti-vaccination crowd, might change his tune. After all, he is pro-science on global warming; surely now that measles outbreaks were becoming more common he would see the light and change his position on vaccination. (Spoiler alert.) Unfortunately, it didn’t turn out that way. On his Friday, February 6th HBO show, Maher said “I’m not an anti-vaxxer.....” but then went on to cast doubt on the safety of immunization, going so far as to suggest that vaccinations might be weakening our immune systems.

Vaccine Week demonstrated something quite remarkable about this issue: it creates strange bedfellows. The table below presents my own—somewhat subjective—categorization of recent positions taken by the President and those most likely to be in line for his job. Although, to my knowledge, he is not a presidential hopeful, I also included Robert F. Kennedy, Jr. because he is an outspoken Democratic activist who has lobbied members of Congress on the alleged perils thimerosal, a preservative that has not been used in childhood vaccines since 2001. Just last summer Kennedy published a book on thimerosal, and he has recently restated his concerns in the context of the current measles outbreak.

Table 1. Political figures, their political affiliations, and their position on the vaccine issue. *Not a presidential hopeful but outspoken on the issue.

A quick look at this table shows that, unlike most other political issues, the immunization question does not break down on party lines. To further muddy the political waters, I would place Bill Maher, who appears to be a liberal on most issues (he reportedly voted for Barack Obama in 2008 and contributed to President Obama’s 2012 campaign), in the Democratic (liberal) parental choice box with Robert F. Kennedy Jr.

Vaccines and Moral Foundations Theory

Recent research in social psychology may shed some light on why people of varying political stripes might share this anti-science view, taking very different paths to arrive similar positions. Moral Foundations Theory, introduced by Jonathan Haidt and Craig Joseph and outlined in a highly readable form in Haidt’s 2012 book The Righteous Mind, suggests that liberals and conservatives can be separated on the basis of five moral values.^[1] Joseph and Haidt’s research (with various colleagues) identifies the five foundations listed in the table below and has shown that liberals and conservatives express these moral values in roughly the manner I have indicated in the table. Conservatives value all five of these moral foundations to a moderate degree; whereas, liberals give great weight to the Care/Harm and Fairness/Cheating foundations and much less to the other three.

Table 2. How liberals and conservatives use five values of Moral Foundation Theory. (Based on Figure 1 of Graham, Haidt, and Nosek, 2009.^[2])

This theory may help explain the liberal attack on vaccines. Liberals are moved by the caring dimension of Moral Foundation Theory, and more than any of the other foundations, caring for children plays a role in the liberal opposition to vaccines. Parents in the anti-vaccine movement care deeply about the well-being of their kids and have been sold a false story of fear. Unfortunately, their caring appears to be very locally focused. A similar sense of concern does not extend to the other children and adults they imperil by choosing not to vaccinate their children.

Because doctors, the CDC, and other authority figures are the ones recommending vaccination, one might think there is an anti-establishment aspect to the liberal attack—and perhaps there is—but according to research by Haidt and others, liberals are less moved by the Authority/Subversion moral foundation. Instead, it appears that the Fairness/Cheating foundation plays a more important role. The villain of the liberal anti-vaccination melodrama is typically the powerful pharmaceutical industry.^[3] The CDC is thought to be controlled by Big Pharma, and last summer anti-vaxxers claimed that the CDC was suppressing damaging data about vaccinations. According to this narrative, powerful business interests are pursuing vaccine profits at the expense of the weak and vulnerable. As I mentioned in last month’s column, a similar David and Goliath narrative applies in the anti-genetically modified foods movement.

The liberal motives driving Democrats into the anti-vaccination movement are fairly clear, but does Moral Foundations Theory provide any answers to why some conservatives are “parental choicers” on this issue? As originally described, the theory does not appear to help much. However, the use of the words “choice” and “voluntary” by some conservative candidates is a hint to a different motivation for this position—one that Haidt and colleagues have recently begun to explore. After initially limiting their research to conservatives and liberals, Haidt’s group recognized that libertarians—a growing force in American politics—may be motivated by somewhat different moral principles than either Republicans or Democrats, and they have begun to revise the theory accordingly.

In a 2012 study, Haidt and colleagues began by looking at how libertarians line up on the same five moral foundations of the original theory.^[4] What they discovered was that libertarians look like liberals on the last three moral foundations, relatively unmotivated by issues of Loyalty/Betrayal, Authority/Subversion, or Sanctity/Degradation, and more like conservatives on the remaining two dimensions, moderately concerned with Care/Harm and Fairness/Cheating. All of which indicates why libertarian views can sometimes appeal to either liberals or conservatives.

Table 3. Libertarians in comparison to conservatives and liberals. (Based on Figure 1 of Iyer, Koleva, Graham, and Haidt, 2012.)

In general, libertarians were not strongly moved by any of the five original dimensions of Moral Foundation Theory. In fact, Haidt has described libertarians as being “very much like liberals but just lower in compassion.” Using a number of other measures, the 2012 study produced a picture of libertarians that is remarkably consistent with the philosophy put forward by Ayn Rand. Relative to conservatives and liberals, libertarians were (a) rationalists—moved more by reason than by emotion (note that Reason is the name of a popular libertarian magazine) (b) fierce defenders of liberty and individual freedom, and (c) more individualistic and less collectivist in their concerns. For the libertarians in the study, both economic liberty and lifestyle liberty were very important.

These findings suggest that libertarians, who appear to be a growing sector of our electorate, have different personalities and value systems than either conservatives or liberals. In order to accommodate these results, a recent revision of Moral Foundations Theory includes a sixth moral foundation, Liberty/Oppression, which libertarians value much more strongly than any of the original five.^[5]

So how does this help us understand the conservative appeal of the anti-vaccination movement? In the case of Chris Christie, it may not help. He is not a libertarian and, in fact, has been a critic of libertarian foreign policy positions. Sometimes—and perhaps especially in the case of someone like Chris Christie—there is little rhyme or reason to the things a politician will say. Recall that Christie was also involved in the unjustified quarantine of a nurse who had treated Ebola patients in West Africa. In that case, he was willing to squelch the individual rights of the nurse in the interest of the collective wellbeing—directly opposite of his vaccine position. Hard to figure.

In the case of Rand Paul, the connection is obvious. The Kentucky Senator is the son of Ron Paul, perhaps the most visible representative of libertarianism in the United States. Although, like his father, Rand Paul is a member of Republican Party; he is a strong supporter of libertarian values. In this case, although libertarian rationalism might put him on the side of vaccination, liberty is the overriding virtue of libertarianism. A concern for individual freedom, combined with the libertarian’s diminished sense of compassion and collectivism could easily lead a candidate—even a candidate physician—to support parental choice over public health.

So, some liberals and libertarians appear to have found common ground in the promotion of parental choice on vaccination, but according to Moral Foundations Theory, they arrive at their positions for different reasons.^[6] Liberals appear to be motivated by compassion (emotion) and a sense of unfairness. Libertarians share the pro-vaccination valuing of reason but are unmoved by collectivist concern. Instead, individual freedom is their dominant moral principle.

Disclaimer: the above represents my own interpretation of vaccine policy resistance in light of Moral Foundations Theory. I don’t believe any study has provided actual data connecting the six moral foundations to views on child vaccination. But this analysis seems reasonable based on the available information.

A Final Question

Can this kind of research on moral and political motivations help us in the effort to promote science-based policies? It might. The interpretation above suggests that different appeals are needed to answer different kinds of objections. In the case of vaccine resistance, we need liberal anti-vaxxers to be more reason-based and more knowledgeable about the methods of science. Their compassion is admirable, but their poor understanding of evidence and their choice of a perceived (but false) individual good over the collective good are obstacles. Libertarians, on the other hand, are more accepting of reasoned argument but lower on compassion. Most importantly libertarians are reluctant to sacrifice individual freedoms for the general good.^[7] So, in this case, it may be more effective to choose arguments that appeal to reason and, perhaps, to the individual freedom of movement and choice enjoyed by those who live in a society free of infection.

Often in the past, science advocates have seemed to adopt a single approach. They have raised the flag of science and evidence and used it to beat down the claims of pseudoscientists and shamans. But now that many issues of science and the public good have become so sharply politicized, it may be time for the champions of science to become a bit more politically savvy. Science doesn’t care about your personal politics. Its power transcends the political world. But as issues of science become more politicized, it may be time for science advocacy to get more political too. Understanding the different moral and political motives behind the rejection of science can only help.