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儿童健康与风险的社会理论:来自英国麻疹、腮腺炎和风疹(MMR)疫苗争议的见解

Children's health and the social theory of risk: insights from the British measles, mumps and rubella (MMR) controversy.

作者信息

Casiday Rachel Elizabeth

机构信息

University of Durham, Stockton-on-Tees, UK.

出版信息

Soc Sci Med. 2007 Sep;65(5):1059-70. doi: 10.1016/j.socscimed.2007.04.023. Epub 2007 May 30.

Abstract

Recent debates in the United Kingdom about the measles, mumps and rubella (MMR) vaccine and its alleged link with autism have centred on contested notions of risk. This paper presents findings from 87 parents' focus group and interview discussions of their decision-making about the vaccine in light of three streams of theoretical literature on risk (cultural theory, risk society, psychometric models of risk perception) and models of vaccination acceptance and resistance. In addition to the risks of infectious disease and autism, parents balanced other risk concerns-both biological and social-in making their decisions. Such decisions, made on behalf of children unable to choose for themselves, and in the midst of contradictory information and uncertainty, symbolised what it means to be a 'good parent'. To cope with uncertainty, parents sought explanations for why some children seem to be more vulnerable to adverse outcomes than others. Debates about children's risks may need special theoretical consideration beyond that offered by the current risk literature. Specific aspects of the MMR debate, namely, selecting between potentially competing risks, making risk judgements on behalf of dependent others, and tensions between private and public good, provide a platform for exploring how social theories of risk might be adapted for children's health controversies.

摘要

英国近期关于麻疹、腮腺炎和风疹(MMR)疫苗及其与自闭症之间所谓联系的争论,主要集中在有争议的风险观念上。本文依据关于风险的三类理论文献(文化理论、风险社会、风险认知的心理测量模型)以及疫苗接种接受与抗拒模型,呈现了对87位家长进行焦点小组访谈和个别访谈的结果,这些访谈围绕他们在疫苗接种问题上的决策展开。除了传染病和自闭症的风险,家长们在做决策时还权衡了其他风险因素——包括生物性和社会性的。代表无法自主选择的孩子做出这样的决策,且是在相互矛盾的信息和不确定性之中做出的,这象征着成为一名“好家长”意味着什么。为应对不确定性,家长们寻求解释,为何有些孩子似乎比其他孩子更容易出现不良后果。关于儿童风险的争论可能需要超出当前风险文献所提供的特殊理论考量。MMR疫苗争论的具体方面,即在潜在相互竞争的风险之间进行选择、代表受抚养的他人做出风险判断,以及个人利益与公共利益之间的紧张关系,为探索风险社会理论如何适用于儿童健康争议提供了一个平台。

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