Which stories within health care are told, are shared widely, and which are not? Who holds the talking stick power to tell their stories and have them listened to? The ethics of storytelling about health, illness, and healthcare experience is an important and overlooked aspect of medical and public health ethics.
One current event case in point: The NYT editorial board published a compelling piece this past week, “How to Inoculate Against Anti-Vaxxers.” They highlight the fact that the World Health Organization has added vaccine hesitancy (or outright refusal) as one of the top ten global health threats for 2019. And they point to the outsized power of the singular (and scientifically inaccurate) stories of anti-vaxxers who use emotionally-charged personal anecdotes of the “horrors of vaccination” to persuade people not to vaccinate themselves or their children.
Not included in this opinion piece is the fact that this is a significant health equity issue since the overwhelming majority of anti-vaxxers are affluent white people (a story that needs to be told). Hence, the current event here in the Pacific Northwest of Portland, Oregon (the whitest city in the US) being the epicenter of a large measles outbreak—because Portland is a hot spot of anti-vaxxers. Washington State Governor Jay Inslee has declared a public health state of emergency over the measles outbreak that has spread from Portland into southwestern Washington State and now up to Seattle.
Something else that is not talked about—a story not told—is the fact that so many naturopaths and other alternative/complementary medicine practitioners are actively anti-vaxxers themselves and pass this on to their patients.
Nurses play an outsized and important role in educating people—especially parents—about the benefits of vaccinations. As the NYT article points out, the vast majority of parents who are vaccine hesitant are open to conversations with healthcare providers about the risks and benefits of specific vaccines. Taking the time to listen to their concerns and answer their questions—using motivational interviewing techniques—can help lead to a healthier future for everyone. Nurses and other healthcare providers can tell true stories of all the uneventful vaccinations that led to healthy children.
The thing I hear a lot from people who are against vaccinating their children is that doctors and nurses get very little education about how vaccines work, so how could they know? And this is a problem. Doctors and nurses who have comparatively little background will struggle to answer follow-up questions about the dangers of vaccinations to patients and parents alike. But there’s also a different between taking courses in medical school about vaccinations and knowing how to read scientific literature with a fairly complex understanding of statistics. It’s the researchers and statisticians, not the doctors, that I trust most when it comes to weighing the pros and cons of vaccinations. And I say this as someone who works with family practice doctors everyday–though some of them can also just talk and talk about how vaccines work, regardless of how much they actually learned about it in school.