O que é este blog?
Este blog trata basicamente de ideias, se possível inteligentes, para pessoas inteligentes. Ele também se ocupa de ideias aplicadas à política, em especial à política econômica. Ele constitui uma tentativa de manter um pensamento crítico e independente sobre livros, sobre questões culturais em geral, focando numa discussão bem informada sobre temas de relações internacionais e de política externa do Brasil. Para meus livros e ensaios ver o website: www.pralmeida.org.
terça-feira, 7 de março de 2017
by System Administrator
Patrick Iber. Neither Peace nor Freedom: The Cultural Cold War in Latin America. Cambridge: Harvard University Press, 2015. 336 pp. $39.95 (cloth), ISBN 978-0-674-28604-7.
Reviewed by Stella Krepp (University of Bern)
Published on H-LatAm (March, 2017)
Commissioned by Casey M. Lurtz
Patrick Iber’s Neither Peace nor Freedom: The Cultural Cold War in Latin America is a study of the transnational political Left in Latin America. Suitably titled with a quote by Leon Trotsky, who in many ways epitomized the struggle within the political Left in Mexico, it relates how the project of a social democracy failed.
In the past two decades, scholars have called for new ways to write the history of a Latin American Cold War that would allow for Latin American agency and voices. As a result, historians have highlighted the local roots of the conflict; illuminated the inter-American dimension; and examined how Latin Americans colluded, shaped, and resisted the Cold War. However, by and large, scholarship still emphasizes a Cold War paradigm that places US-Latin American relations in the context of anti-communist struggle and US security policies, focusing the attention of Left and Right alike on military interventions, economic influence, and diplomatic relations to the detriment of cultural aspects of international relations. This makes Patrick Iber’s book on the cultural dimension of the Cold War within Latin America a very welcome contribution.
Highlighting the role of intellectuals as “privileged communicators” between the masses and the state (p. 1), Iber directs his focus not at the authoritarian Right but at the fragmented political Left in Latin America, more specifically Mexico, and its struggle regarding “how to bring about a humane socialism that would balance social justice and individual freedom” (p. 3). As Iber recounts, this was far from a united and solidary Left, but a fragmented one, and the major fault lines ran between the advocates of social democracy and proponents of socialism or communism. He advances this argument by studying the three major players in the Cultural Cold War—the Soviet Union, the United States, and Cuba—through their front organizations: the Soviet-sponsored World Peace Council (WPC); the Congress for Cultural Freedom (CCF) financed through the Central Intelligence Agency (CIA); and the Cuban Casa de las Américas, as each tried to mobilize and instrumentalize culture as a vehicle for its Cold War message and vision of social progress.
Iber convincingly relates how the cultural Cold War was rooted in the pre-Cold War history of the region, starting in the 1930s and 1940s, when exiles from the Spanish Civil War and communist dissidents such as Trotsky himself migrated to Mexico. These exiles carried with them the political divisions and animosities of their home societies. This “international civil war among left-wing intellectuals” acquired a new dynamic with the East-West confrontation after World War II (p. 47).
In chapter 2, Iber focuses on the WPC. Sponsored, supported, and guided by the Soviet Union, the WPC attempted to draft artists into a cultural Cold War through the promotion of “peace.” By the late 1950s, however, its never extensive influence had waned and was replaced by the Casa de las Américas as the defining cultural institution of the radical Left. Chapter 3 deals with the CCF. Backed by the United States and financed by the CIA, the CCF’s official aim was to promote social democracy and to denounce the totalitarian visions of the USSR and later Cuba. In one of the most fascinating accounts of the book, Iber narrates how the CCF nurtured the political Left in Cuba throughout the 1950s, and thus unwittingly enabled the revolution to succeed. In the end, the unmasking of the CCF as CIA-backed in the late 1960s spelled out the end of the reformist project.
The turning point that transformed the political Left was, without doubt, the Cuban Revolution of 1959, a home-grown socialist model that soon replaced the Soviet Union as the reference point in Latin America. Likewise, the Cuban Casa de las Américas became the central institution to spread this socialist vision, a story explored by Iber in chapter 4. However, despite inspiring a generation of the political Left in Latin America, the Cuban Revolution also exacerbated the already existing rift within the Left. Many of the earlier supporters of Fidel Castro were forced into exile or severely punished, and soon the regime drew criticism for its authoritarian streak and political as well as cultural censorship.
Ultimately, as Iber relates, by the 1970s all three utopias had failed and with them the belief that intellectuals and artists could and should play a fundamental role in mediating these social visions. Rather, and this would be a fascinating theme for another book, we see the rise of social scientists and technocrats from the beginning of the 1960s. These utopias failed on many fronts, but particularly because of the inherent contradictions in their political programs. In the case of the CCF, preaching liberalism but stifling dissent showcased the very limited notion of freedom the organization promoted. More important, as political events such as the 1964 military coup in Brazil and the blatantly illegal US intervention in the Dominican Republic of 1965 showed, building a social democratic Left with a benevolent and friendly United States was nigh impossible.
Likewise, by the late 1960s, with Ernesto Guevara dead and his foco theory proven wrong, as well as the Cuban endorsement of the 1968 Soviet invasion in Czechoslovakia, the Cuban model lost much of its appeal. In the case of the Casa de las Américas, proclaiming freedom but only within a very restrictive definition of the revolution along the lines of the famous dictum “within the revolution everything; against the revolution, nothing” led to disenchantment among the Left. Ultimately, these visions failed because every organization failed to practice what it preached.
Intriguingly, despite the close ideological and financial links with their backers, Iber shows how these front organizations were not simple instruments of hegemony, but hybrid organizations that allowed artists and activists to shape debates and “localize” the Cold War. Moving through different case studies, Iber demonstrates that distinct cultural and historic contexts mattered, just as much as the people who were involved. With his nuanced analysis, he denounces the view that the United States, and in consequence the CIA, was omnipotent or omnipresent. While the United States and the USSR financed and set the agenda for the cultural front organizations, local branches acquired their own dynamics and controlling staff or artists proved difficult to manage. In the end, the actions of the front organizations often had unintended consequences as the Cuban case aptly highlights. Iber narrates one such example in chapter 6, showing how the CCF successfully “modernized” and incorporated a number of Latin American voices in the Mexican case, while in the 1960s, such attempts yielded few results in Brazil and Argentina. Ultimately, modernization never fully materialized because CIA involvement in the CCF was uncovered in 1966-67.
Iber’s Neither Peace nor Freedom is a thought-provoking book and deserves much praise, so I have only minor quibbles to add. While the trope of Mexican exceptionalism is not helpful, one wonders if what Iber relates is truly a Latin American cultural war or, in essence, actually a Mexican one. While he offers excursions to Brazil, Argentina, and more extensively to Cuba, Mexico remains the pivotal center. Of course there are limits to the archival work historians can aspire to, but I was left wondering, as a non-Mexicanist, if the Mexican case was indicative for the whole region or rather a special case. My own impression is that the Cold War in South America acquired a very distinct trajectory. In sum, it raises the questions how to contextualize Mexican history in broader Latin American history.
This is a carefully crafted and elegantly written book that charts the ebb and flow of the cultural Cold War and simultaneously highlights the local Latin American dimension. The book is meticulously researched, and—no mean feat—an enjoyable read.
. Gilbert Joseph and Daniela Spenser, eds, In from the Cold: Latin America’s New Encounter with the Cold War (Durham, NC: Duke University Press, 2008); Greg Grandin, “Off the Beach: The United States, Latin America, and the Cold War,” in A Companion to Post-45 America, ed. Jean-Christophe Agnew and Roy Rosenzweig (Malden, MA: Blackwell, 2002); and Max Friedman, “Retiring the Puppets, Letting Latin America Back In: Recent Scholarship on United States-Latin American Relations,” Diplomatic History 7, no. 5 (November 2003): 621-636.
. For a good overview on recent scholarship, see Andrew J. Kirkendall, “Cold War Latin America: The State of the Field,” H-Diplo Essay 119, November 14, 2014. See also Greg Grandin, The Last Colonial Massacre: Latin America in the Cold War (Chicago, IL: University of Chicago Press, 2004); Tanya Harmer, Allende’s Chile and the Inter-American Cold War (Chapel Hill: University of North Carolina Press, 2011); Piero Gleijeses, Conflicting Missions: Havana, Washington, and Africa, 1959-1976 (Chapel Hill: University of North Carolina Press, 2001); and Ariel Armony, Argentina, the United States, and the Anti-Communist Crusade in Central America, 1977-1984 (Athens, OH: Ohio University Centre of International Studies, 1997).
. Gilbert Joseph, “Toward a New Cultural History of U.S.-Latin American Relations,” in Close Encounters with Empire: Writing the Cultural History of U.S.-Latin American Relations, ed. Gilbert M. Joseph and Catherine LeGrand (Durham, NC: Duke University Press, 1998), 3.
Printable Version: http://www.h-net.org/reviews/showpdf.php?id=48095
Citation: Stella Krepp. Review of Iber, Patrick, Neither Peace nor Freedom: The Cultural Cold War in Latin America. H-LatAm, H-Net Reviews. March, 2017.
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
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Carmody on Weld, 'Paper Cadavers: The Archives of Dictatorship in Guatemala' [review]
by System Administrator
Kirsten Weld. Paper Cadavers: The Archives of Dictatorship in Guatemala. American Encounters/Global Interactions Series. Durham: Duke University Press, 2014. xvi + 335 pp. $26.95 (e-book), ISBN 978-0-8223-7658-3; $27.95 (paper), ISBN 978-0-8223-5602-8; $99.95 (cloth), ISBN 978-0-8223-5597-7.
Reviewed by Michelle Carmody (Leiden University)
Published on H-LatAm (March, 2017)
Commissioned by Casey M. Lurtz
Michelle Carmody on Kirsten Weld's Paper Cadavers: The Archives of Dictatorship in Guatemala
In critical studies of archives, it has become commonplace to cite Jacques Derrida’s phrase that “there is no political power without control of the archive ... [and] effective democratization can always be measured by this essential criterion: the participation in and access to the archive, its constitution, and its interpretation” (p. 16). Kirsten Weld takes this as a departure point but moves on to examine a related question, namely, what the process of (re)constructing an archive tells us about the political context in which this (re)construction is carried out. She does this by examining the creation of the Archivo Histórico de la Policia Nacional (Historical Archives of the National Police, AHPN) in Guatemala, a collection of documents taken from the police archives where they were “discovered” in a state of decay and disorder and subsequently restored, organized, and rehoused in the internationally funded AHPN. If democratization can be measured by access to the archive, Weld shows how this access came about, and how this process of opening the archive shapes the quality of democracy.
The book is organized in four parts. The first examines the immediate context of the (re)discovery of the documents and the commencement of the project to restore them and create the AHPN. The second returns to the period of repression to look at the construction of the document collection itself, as well as the development of the National Police, the institution that created the documents. Part 3 looks at the role of the construction of the AHPN in sociopolitical processes in the postwar period, focusing on the experiences of those involved in the project. And part 4 concludes the book by evaluating the impact of the completed archival recovery project on the postwar sociopolitical horizon in Guatemala and on other human rights and transitional justice initiatives locally
This is a work of ethnographic history, mixing ethnography of the project to reconstruct an archive in the years 2005-9 with archival work on the creation of the original document collection in the 1960s and 70s. The book illustrates the shifts in values and beliefs on the part of various groups involved in the reconstruction of the archive, from ex-revolutionaries to a younger generation of human rights activists and even police archivists themselves. It charts the way these actors reevaluate their memories and understandings of the revolutionary struggle and the period of state repression, at the same time as they reevaluate their understanding of relations between different groups in society in the post-authoritarian period.
This is the major contribution of Weld’s work: she shows that the synthetic process of creating the archives, reorganizing the documents from a logic of counterinsurgency to a logic of “agency and aperture” (p. 31), can be seen as a parallel for the transformation of society in the postwar period. Part 3, “Archives and Social Reconstruction in Guatemala,” explores this process. In this section, we see how the older generation of project workers struggled to work alongside the police and how the younger generation of activists within the project were confronted with things like working under a professional management structure and accepting foreign funding. Working together on a common goal—the reconstruction of the archives—allowed each of these groups to develop an understanding of each other. This is the synthesis that is produced when Cold War archives were transformed into postwar archives, a process that, she argues, is an example of bottom-up democratization and social reconstruction. Through an ethnographic account of a grassroots project, Weld shows us that transitions are created from the bottom-up, rather than top-down.
An associated argument that Weld makes is that archives and archival surveillance should be integrated into the study of the Cold War. Part 2, “Archives and Counterinsurgency in Guatemala,” looks specifically at the Cold War period and supports this argument by recounting the assistance offered by US development agencies to help the Guatemalan National Police address their poor organizational infrastructure, including their lack of attention to record keeping. In this section, she draws on the archives of the International Cooperation Administration (ICA, the predecessor of USAID) to show that the US saw record keeping as directly contributing to their ability to control subversion. She demonstrates a clear link between this goal, which necessitated a strengthening of the capacity of the security forces and the technical assistance the ICA provided in the realm of record keeping. This is a clearly substantiated and illustrated argument which calls for further consideration of the types of everyday, mundane technical development assistance that was used to wage the Cold War in Latin America and beyond. She shows us that technical assistance, including that of record keeping, functioned as an extremely effective conduit for the transfer of ideas and the reshaping of ideology through the reshaping of practice.
Weld’s purpose in conducting this ethnography was, as she eloquently puts it, “to document the process, not process the documents” (p. 23). This marks her contribution as distinct from the other studies that have emerged in recent years of recovered counterinsurgency and police archives across Latin America. These studies draw on declassified and (re)discovered materials to write new histories of the Cold War and state repression in the region. Her work goes beyond this and sits comfortably alongside Duke’s other critical and reflexive monographs on archives. While most critical work on archives looks at colonial archives, Weld extends these insights into both Cold War archives and postwar archives.
With this book Weld seeks to examine the process by which Guatemalans make sense of both the physical records of the past and of their memories of that past, analyzing this process for traces of articulations about the future. Her ethnography deftly achieves this, while at the same time it demonstrates the applicability of theoretical reflections on archives to new contexts, and expands our critical understanding of the Cold War and of the postwar in Guatemala. This book is therefore recommended for researchers interested in expanding their understanding of either of these two periods—the Cold War or the postwar period—with theoretical insights that can and should be tested in other contexts.
. Kathryn Burns, Into the Archive: Writing and Power in Colonial Peru (Durham, NC: Duke University Press, 2010); and Antoinette Burton, ed., Archive Stories: Facts, Fictions and the Writing of History (Durham, NC: Duke University Press, 2006).
Printable Version: http://www.h-net.org/reviews/showpdf.php?id=48085
Citation: Michelle Carmody. Review of Weld, Kirsten, Paper Cadavers: The Archives of Dictatorship in Guatemala. H-LatAm, H-Net Reviews. March, 2017.
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 United States License.
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ANN: The Cold War in Latin America: Reviews of New Works
by Casey Lurtz
Continuing our series of collected reviews of new works in Latin American history, I'm happy to bring you a brief special issue on the Cold War in Latin America. As well as new reviews of Kirsten Weld's Paper Cadavers and Patrick Iber's Neither Peace nor Freedom, we have a review of the conference "Traveling Technocrats: Experts and Expertise in Latin America’s Long Cold War" held at Yale in the fall of 2016. I have also included cross-listings of roundtables put together by the H-Diplo network on other relevant works not yet reviewed for H-Latam.
Michelle Carmody on Kirsten Weld, Paper Cadavers: The Archives of Dictatorship in Guatemala (2014)
Stella Krepp on Patrick Iber, Neither Peace nor Freedom: The Cultural Cold War in Latin America (2015)
Timothy W. Lorek and Andra B. Chastain on “Traveling Technocrats: Experts and Expertise in Latin America’s Long Cold War” (2016)
Relevant Roundtables from Other Networks
Thomas C. Field, Jr. From Development to Dictatorship: Bolivia and the Alliance for Progress in the Kennedy Era (2014), roundtable from H-Diplo, March 2015
Michael E. Donoghue, Borderland on the Isthmus: Race, Culture, and the Struggle for the Canal Zone (2014), roundtable from H-Diplo, April 2015
Alan McPherson, The Invaded: How Latin Americans and their Allies Fought and Ended U.S. Occupations (2014), roundtable from H-Diplo, July 2015
William M. LeoGrande and Peter Kornbluh, Back Channel to Cuba: The Hidden History of Negotiations between Washington and Havana (2014), roundtable from H-Diplo, August 2015
Renata Keller, Mexico’s Cold War: Cuba, the United States, and the Legacy of the Mexican Revolution (2015), roundtable from H-Diplo, November 2016
domingo, 3 de maio de 2015
The Washington Dissensus: A Privileged Observer’s Perspective on US-Brazil Relations; His Own Man
Reviewed by Richard Feinberg
The troubled U.S.-Brazilian relationship also provides the backdrop for the novel His Own Man. The book’s climactic scene involves a confrontation between the novel’s narrator, a Brazilian diplomat stationed in Los Angeles, and a former chief of the CIA station in Brasília, now retired in La Jolla, California, whose garage is stacked with documents detailing Washington’s covert attempts to foment anticommunist military coups in Latin America in the 1970s. “Maybe that’s why we stand alone today . . . isolated as hell,” the old spook muses, “unable to deal with a world that for the most part despises us.” The historical memories of Americans are famously short, and Ribeiro, a veteran Brazilian diplomat, clearly wants to remind readers in the United States of the cost of U.S. support for the military dictatorship that ruled Brazil from 1964 until 1985—and of the scars carried by people throughout Latin America whose lives were forever altered by the torture and murders carried out during the Cold War by Washington’s authoritarian allies in the region. As His Own Man makes clear, that legacy helps explain the attitudes and behaviors of today’s elites in Brazil—members of the generation that suffered under military rule—and their lingering distrust of U.S. power.
domingo, 15 de fevereiro de 2015
Paulo Roberto de Almeida
After a week in the hospital, my temperature fell and my legs became stronger. Tests showed that it was not polio; the infection was never identified.1
My mother and father feared debility and death due to pathogens. They were raised in immigrant New York neighborhoods at a time when diphtheria, typhoid, and tuberculosis were rife. My parents also knew that microbes were not restricted to the newly arrived and poor. Polio had struck the patrician FDR in his prime.
The world of my parents, and that of their children, dramatically improved in the latter half of the twentieth century as modern medicine introduced an array of effective vaccines and antibiotics. When the Salk vaccine against the polio virus became available a few years after my mysterious illness, I was inoculated, along with my siblings. The idea of preventing or curing dreaded infectious diseases “naturally,” relying on the body alone, hardly entered our minds.
But two generations later, such ideas have considerable traction in our society. Eula Biss, a writer who teaches at Northwestern University, seeks to understand their appeal, and whether they should be given credence. On Immunity is an effort to reconcile her divided feelings, fearing both infection and the imagined risks of vaccination. Her book weaves metaphor and myth, science and sociology, philosophy and politics into a tapestry rich with insight and intelligence.
It all became part of the landscape of new motherhood, where ordinary objects like pillows and blankets have the power to kill a newborn…. It was as if the nation had joined me in the paranoia of infant care.The strain of the virus was potent for children and teenagers, not only those who typically suffer severe cases of influenza, like the elderly and diabetics. Public health officials recommended widespread vaccination. But among her group of new mothers, “every exchange about the new flu vaccine was an extension of the already existing discussion about immunization, in which all that is known of disease is weighed against all that is unknown about vaccines.”
Biss reflects on the myth of Achilles, and the profound maternal desire to make a child impervious to harm. Achilles’ mother dipped him into the river Styx, but holding him by his heel, which left him vulnerable:
Immunity is a myth, these stories suggest, and no mortal can ever be made invulnerable. The truth of this was much easier for me to grasp before I became a mother. My son’s birth brought with it an exaggerated sense of both my own power and my own powerlessness. I found myself bargaining with fate so frequently that my husband and I made a game of it, asking each other what disease we would give our child for prevention against another—a parody of the impossible decisions of parenthood.For Biss, decisions about which, if any, vaccines should be given to her son were made “impossible” by allegations on the Internet and anecdotes from other mothers about their long-term risks:
We fear that vaccination will invite autism or any one of the diseases of immune dysfunction that now plague industrialized countries—diabetes, asthma, and allergies. We fear that the hepatitis B vaccine will cause multiple sclerosis, or that the diphtheria-tetanus-pertussis vaccine will cause sudden infant death. We fear that the combination of several vaccines at once will tax the immune system, and that the total number of vaccines will overwhelm it. We fear that the formaldehyde in some vaccines will cause cancer, or that the aluminum in others will poison our brains.Her anxiety is amplified by a larger culture of suspicion. In contrast to my parents, who put complete trust in the integrity and authority of their doctor, Biss and her fellow mothers distrust government, pharmaceutical companies, and journalists who seek to inform and reassure the public:
The fact that the press is an unreliable source of information was one of the refrains of my conversations with other mothers, along with the fact that the government is inept, and that big pharmaceutical companies are corrupting medicine. I agreed with all these concerns, but I was disturbed by the worldview they suggested: nobody can be trusted.One of her efforts at calm is to understand how emotions color perception of risk. Scientists typically present the risks of a vaccine by citing the numbers of people suffering side effects against the total numbers given the treatment. Reviewing the work of the scholars Paul Slovic at the University of Oregon and Cass Sunstein at Harvard Law School, Biss notes:
Risk perception may not be about quantifiable risk so much as it is about immeasurable fear. Our fears are informed by history and economics, by social power and stigma, by myth and nightmares. And as with other strongly held beliefs, our fears are dear to us. When we encounter information that contradicts our beliefs,…we tend to doubt the information, not ourselves.How should she keep herself informed? Should she give weight to the anecdotes told by fellow mothers? Listen to mainstream doctors, among them her father, a blunt-speaking man dismissive of her crowd? Or should she trust the antiestablishment clinicians on the Internet? And might there be ethical tenets to help her make a sound choice to vaccinate, or not?
“Our bodies prime our metaphors,” writes James Geary in I Is an Other, his treatise on metaphor, “and our metaphors prime how we think and act.” If we source our understanding of the world from our own bodies, it seems inevitable that vaccination would become emblematic: a needle breaks the skin, a sight so profound that it causes some people to faint, and a foreign substance is injected directly into the flesh. The metaphors we find in this gesture are overwhelmingly fearful, and almost always suggest violation, corruption, and pollution.Biss moves from the power of language to the demographics of sociology. She cites a 2004 analysis of data from the Centers for Disease Control and writes: “Unvaccinated children…are more likely to be white, to have an older married mother with a college education, and to live in a household with an income of $75,000 or more—like my child.” Such unvaccinated children generally live near one another, which means that if they contract a disease, it can be readily passed on to others. Then there are so-called undervaccinated children, those who have received some but not all of their recommended immunizations. They “are more likely to be black, to have a younger unmarried mother, to have moved across state lines, and to live in poverty.”
These demographic distinctions inform Biss’s understanding of the scientific concept of “herd immunity”:
If we imagine the action of a vaccine not just in terms of how it affects a single body, but also in terms of how it affects the collective body of a community, it is fair to think of vaccination as a kind of banking of immunity. Contributions to this bank are donations to those who cannot or will not be protected by their own immunity. This is the principle of herd immunity, and it is through herd immunity that mass vaccination becomes far more effective than individual vaccination.Her physician father articulates the value of herd immunity in public health, and Biss extends his analysis to a political principle she holds dear:
“Vaccination works,” my father explains, “by enlisting a majority in the protection of a minority.” He means the minority of the population that is particularly vulnerable to a given disease. The elderly, in the case of influenza. Newborns, in the case of pertussis. Pregnant women, in the case of rubella. But when relatively wealthy white women vaccinate our children, we may also be participating in the protection of some poor black children whose single mothers have recently moved and have not, as a product of circumstance rather than choice, fully vaccinated them….
Immunity…is a common trust as much as it is a private account. Those of us who draw on collective immunity owe our health to our neighbors.But do we owe so much to the collective that we should sacrifice our autonomy? I learned in On Immunity that the term “conscientious objector” came out of resistance to a British law passed in 1853 requiring the vaccination of all infants. Forty-five years later, the government added a “conscience clause,” allowing parents to apply for an exemption. The exemption clause was rather vague, requiring only that the objector satisfy a magistrate that it was “a matter of conscience.”
Biss turns to her sister, a philosophy professor at a Jesuit college who studies Kant. She explains Kant’s contention that we have a duty to ourselves to examine our conscience, the “inner judge” that unites thoughts and feelings. An individual might resist flaws in the dominant moral code and thus create the possibility for reform, or conscience can be what keeps your actions in line with publicly defendable moral standards.
Biss, while aware that a conscientious objector to vaccination may contribute to an epidemic, affirms that “our laws allow for some people to exempt themselves from vaccination, for reasons medical or religious or philosophical. But deciding for ourselves whether we ought to be among that number is indeed a matter of conscience.” Yet this seems too facile a conclusion, since the freedom to exempt oneself negates a responsibility not only to society, but to one’s own children who do not have the agency to decide for themselves.
Another vaccine opponent is Dr. Joseph Mercola, who heads the Mercola Natural Health Center in the Chicago suburbs. Mercola offers information on a website about the dangers of water fluoridation and metal amalgam in dental fillings, as well as speculation that AIDS is not caused by HIV. Biss notes that the site is visited by nearly two million individuals a month, and “products available for purchase range from tanning beds to air purifiers to vitamins and supplements. The website and Mercola LLC generated an estimated $7 million in 2010, and in 2011 Mercola donated $1 million to a number of organizations” that oppose vaccination.
Offit’s book debunks the claims of such antiestablishment clinicians. But his criticism extends to the morality of parental “conscience” when imposed on the health of children. Offit recounts painful tales of children dying from diseases that could be easily prevented or cured if parents had accepted the advice of doctors. In his most recent book, Bad Faith, he argues that we fail minors by giving permission to parents who seek exemptions from vaccination on religious grounds. Sacrificing the lives of vulnerable minors, he contends, negates God, since all human beings are created in His image. But, to date, legislatures and the courts have been loath to override religious beliefs that reject life-saving treatments for children.
When I asked the pediatrician what the purpose of the hep B vaccine was, he answered, “That’s a very good question,” in a tone that I understood to mean this was a question he relished answering. Hep B was a vaccine for the inner city, he told me, designed to protect the babies of drug addicts and prostitutes. It was not something, he assured me, that people like me needed to worry about.Biss’s pediatrician may be left of center, but she discovers that he is not reliable in his reply. Biss won the 2009 National Book Critics Circle Award for Notes From No Man’s Land, a collection of essays on race, and she is alert to suggestions of stigma. She cites epidemiological data indicating that there is a decline in the incidence of hepatitis B only when all children are vaccinated against the infection:
One of the mysteries of hep B immunization is that vaccinating only “high risk” groups, which was the original public health strategy, did not bring down rates of infection. When the vaccine was introduced in 1981, it was recommended for prisoners, health care workers, gay men, and IV drug users. But rates of hep B infection remained unchanged until the vaccine was recommended for all newborns a decade later. Only mass vaccination brought down the rates of infection, and it has now virtually eliminated the disease in children….
This is a radical inversion of the historical application of vaccination, which was once just another form of bodily servitude extracted from the poor for the benefit of the privileged. There is some truth, now, to the idea that public health is not strictly for people like me, but it is through us, literally through our bodies, that certain public health measures are enacted.Still, Biss wonders if there may be reasonable alternatives to vaccination that effectively protect children:
Some parents feel that the immunity produced by the chicken pox vaccine is inferior to immunity by natural infection because it does not last as long. To carry immunity through adulthood, when chicken pox can be quite serious, one must get a booster in adolescence. “So what?” my father says. I am trying to explain the phenomenon of chicken pox parties to him. I say, “Some people want their children to get chicken pox because,” and pause to think of the best reason to give a doctor. “They’re idiots,” my father supplies.But Biss understands what appeals to these mothers: “I do not think they are idiots. But I do think they may be indulging in a variety of preindustrial nostalgia that I too find seductive.”
Then there is “Dr. Bob” Sears, who hews to a supposed middle ground. In The Vaccine Book, he claims to offer a compromise between vaccinating and not vaccinating. Sears endorses changes in the schedule of childhood vaccination for parents worried about overtaxing the immune system. He proposes a selective vaccine schedule, so a parent can provide only the vaccines that Dr. Bob believes most important. But Biss notes his omission of vaccines against hepatitis B, polio, measles, mumps, and rubella. Another strategy of Dr. Bob is to spread out over eight years all the vaccines a child typically receives in two years.
Biss rightly takes him to task, disputing his claims that tetanus is not a disease that affects infants and that measles is not that bad: “He does not mention that tetanus kills hundreds of thousands of babies in the developing world every year,…and that measles has killed more children than any other disease in history.”
After much indecision, the altruistic principle of herd immunity and its benefits for children of all socioeconomic and racial groups ultimately moves Biss to embrace vaccination.
Countering such actions by state officials, the father of a six-year-old boy who had leukemia and still suffers from reduced immunity has asked the superintendent of his Marin County school district to keep unvaccinated children out of the classroom, since they pose a significant threat to his own son. The county health officer expressed sympathy for the father’s concern, but would not enforce such a ban on unvaccinated pupils.4
Measles in particular is one of the most contagious viruses, causing illness in more than 90 percent of those who are exposed to it. There is legitimate concern that the outbreak, which originated in California, will spread throughout the nation, particularly in locales where parents have sought exemption from vaccinating their children. Those at greatest risk for debility and death from measles have impaired immunity, like the child in remission from leukemia, or newborns whose immune systems are not yet strong enough to resist the virus. The outbreak, which is said to affect more than a hundred people in some fourteen states as of the beginning of February and is getting increasing public attention, will force the issue around parental choice and social responsibility. Governor Chris Christie of New Jersey waffled when asked whether vaccination should be mandated, asserting that there should be room for parents to choose. President Obama strongly supports the science behind vaccination, but it will take more than statements from a bully pulpit to safeguard the nation from epidemics that would be prevented through vaccination. Ultimately, either lawsuits or legislation will be needed to protect the health and welfare of children in schools and other public institutions.
My wife and I are physicians. We are acutely aware that every clinical intervention carries a potential downside. We also question clinical data from research studies and challenge the idea of a single authority that always wisely weighs risk and benefit. But we also know firsthand what infectious diseases can do. When our children were born, we vaccinated them. The natural world of unopposed pathogens is full of danger; it should not be presented as idyllic.
Last autumn, there were more than a hundred
reports of unexplained paralysis following viral infections in the US.
See Catherine Saint Louis, “After Enterovirus 68 Outbreak, a Paralysis
Mystery,” The New York Times, January 12, 2015. ↩
See my “Libertarian Medicine: And Why It Doesn’t Work,” a review of Paul Offit’s Do You Believe in Magic? The Sense and Nonsense of Alternative Medicine, The New Republic, October 21, 2013. ↩
Adam Nagourney and Abby Goodnough, “Measles Cases Linked to Disneyland Rise, and Debate Over Vaccinations Intensifies,” The New York Times, January 22, 2015. ↩
Tamar Lewin, “Sick Child’s Father Seeks Vaccination Requirement in California,” The New York Times, January 29, 2015. ↩
domingo, 1 de fevereiro de 2015
Confessions of a Book Reviewer
- Confessions of a Book Reviewer, 1946 [L.m./F.s.: 2013-08-30 / 0.16 KiB]
- ‘The best practice, it has always seemed to me, would be simply to ignore the great majority of books and to give very long reviews — 1,000 words is a bare minimum — to the few that seem to matter...’
- Texto completo neste link:
sexta-feira, 7 de novembro de 2014
terça-feira, 15 de julho de 2014
Estive em Bretton Woods recentemente, onde adquiri este livro:
Benn Steil: The Battle of Bretton Woods (Keynes vs White)
ainda vou ler...
Paulo Roberto de Almeida