Conscientious Object-ion: Rhetoric, Professional Communication, and Medical Controversy

Vaccination is power—power to prevent disease, power to shape populations, power to define sickness and health, and power to compel scientific beliefs into the bodies of people around the globe. It is unsurprising, therefore, that vaccinations have garnered centuries of dissent. Specifically, the conscience—the parent or patient’s perceived right to make vaccination decisions based on personal perceptions of acceptable risks—has been used since vaccination’s inception as a rationale for individual rights to refuse vaccines in the face of the very public health goals that vaccinations aim to achieve.

Existing studies of vaccine disputes in medical literature have understood vaccine questions to be a problem of scientific knowledge or literacy, claiming largely that vaccine skepticism arises from a lack of proper comprehension or understanding of the scientific and medical bases for vaccination or statistical evidence proving vaccines are safe and effective. Studies of vaccination controversy in social science, communications, and historical literatures have largely examined the role that alternative notions of risk valuation, sources of trusted health information (such as preferring the advice of friends and neighbors to doctors), or conceptions of uncertainty have played in largely parental decision making about childhood vaccinations. Despite these extensive studies of vaccine sentiment, vaccine skepticism and refusal remains a small, though significant, voice in public debate.

This dissertation examines vaccine discourses as object-oriented rhetorics—as rhetorics shaped and defined by the physicality of the vaccine’s operation—as a way of re-conceptualizing the vaccine debate. Using object-oriented theories from computer programming, philosophy, and rhetoric, this research examines the professional and public voices that make up contemporary vaccine controversy. Through three data sets, including interviews with physicians, parent discourses produced on the Internet, and survey responses from young adults, this dissertation observes that vaccines function as objects that have multiple, coexisting operations for different actors across the medical system. Consequently, vaccination controversy can be conceptualized not as accurate versus inaccurate understandings of science or as a conflict of perspectives, but instead as a by-product of multiple ontologies of vaccines at work under competing disease exigencies.