Maternal expertise, vaccination recommendations, and the complexity of argument spheres.

• Author: Whidden, Rachel Avon
• Position: Report

For 30 years G. Thomas Goodnight's (1982) article "The Personal, Technical, and Public Spheres of Argument: A Speculative Inquiry into the Art of Public Deliberation" has influenced scholars of argumentation. Goodnight's typology for considering how public deliberation occurs continues to give argumentation scholars a valuable vocabulary and theoretical framework for considering controversies (Asen, 1999; Batt, 2003; Ceccarelli, 2001, 2005; Condit, Parrot, & Harris, 2004; Doxtader, 2000; Goodnight, 1991, 2005; Olson & Goodnight, 1994). Even though spheres can be constituted through discourse, underlying codes determine the types and purposes of arguments within a particular sphere. For example, people are in the personal sphere when they chat with a friend, and solidify their relationship as they take turns talking. Because it permits a looser construction of arguments, discussion in the personal sphere is more informal in nature and requires less empirical evidence than in the technical sphere. Arguments advanced in the technical sphere require specialized knowledge of a topic and are judged in terms of their strength within a context where there are clear epistemic standards distinguishing strong from weak arguments. The public sphere provides constructed rules and guidelines for participants that are more formal than those in the personal sphere, yet not as rigorous as those in the technical sphere. What Goodnight posits is that the elevation of personal and technical sphere arguments within the public sphere will slowly eclipse the potential for democratic deliberation. As he explains it, people become less able to see the effects of a dispute on the larger community if the standards that situate an argument are more grounded in the personal or technical sphere.

Most scholarly applications of Goodnight's theory focus on the problems that arise when one sphere's evaluative standards enter into the proper area of another: specifically, what happens when technical sphere arguments enter public sphere discussions (Asen, Gurke, Connors, Solomon, & Gumm, 2011; Boyd, 2002; Fabj & Sobnosky, 1995; Goodwin, 2011; Jackson, 2006; Katz-Kimchi, 2010; Keranen, 2005; Wallinger, 1989; Weber, Taylor, & Martin, 2010). Missing from this impressive scholarly archive is an exploration of other cases of usurpation. Recent public controversies highlight the fact that relationships between spheres have become more complex. When individuals evaluate arguments, they do so by employing the appropriate criteria given the purpose of the sphere. However, as arguments move from one sphere to another, interlocutors are able to advance an argument typical of one sphere while backing it with evidence from another sphere. The cross-pollination of evidentiary standards between spheres further complicates understanding of how usurpation affects public understanding and deliberation. It can become difficult for members of the public to discern with what authority one speaks, which standard of proof grants legitimacy to a claim, and for what purpose one advances an argument.

Vaccination controversies are a particularly fruitful subject area for making apparent the complex relationship between spheres and afford scholars of argumentation the opportunity to extend Goodnight's theory. Although government recommendations for vaccination are made for the purpose of protecting public health, the production of these vaccines inevitably falls to the pharmaceutical companies, and the decision to vaccinate becomes the parents' responsibility. Vaccination programs work only if parents are persuaded to vaccinate their children, making vaccination a parenting issue as much as a public health concern. The process of determining whether or not a vaccine ought to be administered necessarily requires an overlap between personal, technical, and public spheres of argument. In this paper, I turn to two case studies to illustrate the complicated relationship between personal, technical, and public spheres of argument. First, I consider the case of Merck's Gardasil vaccine advertising campaign as an instance of corporate colonization of the personal sphere. Second, I explore the controversy surrounding the connection between the MMR (measles, mumps, and rubella) vaccine and autism as a site in which personal sphere arguments inform technical sphere discourse. Together these cases illustrate ways in which the encroachment of one sphere on another affects how individuals evaluate arguments in order to make decisions regarding public health. If the purpose of public deliberation, as Goodnight (1982) states, is to "uncover, assess, and resolve shared problems," each practice "claiming to embody the public will or to represent the public voice--demands careful attention" (pp. 214, 215). If argument scholars permit these practices to continue without critique, he warns, "deliberative argument may become a lost art" (p. 215). In the conclusion to his 1982 essay, Goodnight acknowledges that a "complete investigation of these [argument] practices is the subject of a much longer treatise" (p. 218). I offer this essay as a chapter in that much longer treatise.

FROM "TRUST YOURSELF" TO "WE SHOULD TRUST You"

The relationship between parents--most often mothers--and their child's doctor has undergone significant changes in the last century. These changes have affected the cultural assumptions about the relationship between expertise and evidence and, in some instances, made it possible for parents to conflate scientific proof with intuition in their childrearing decisions. For years, the adage "mother knows best" has lent credence to maternal decisionmaking by making it possible to grant legitimacy to a mother's actions for the seemingly tautological reason that she is a mother. Historically, however, the adage has not been accepted without qualification. The late 19th century belief in scientific motherhood led to an abundance of books about mothering and created a culture of mothers who felt the need to turn to medical science for child-rearing guidelines (Abbott, 1833; Beecher, 1856; Beecher & Stowe, 1869). These books seemed to simultaneously empower the role of the mother and undermine the view that she could possess inherent expertise. For instance, in the introduction to The Maternal Physician, one mother praises a "wise physician" for remarking, "You may yourself be your child's best physician, if you only will attend to a few general directions" (American Matron, 1811, p. 6). This culture of deference to physicians only became stronger over time and, by the end of the 19th century, child rearing instruction manuals scolded mothers for approaching mothering "as though it may be learned either by intuition or instinct or by affection," a practice that only could result "in a sea of trouble and uncertainty" from "tossing about without either rule or compass" (Chavasse, 1870, p. 14-15). As Hays (1996) summarizes, "Women had to be educated for motherhood, and of course only experts could provide the proper knowledge" (p. 40). Quite simply, "mother knows best" was true only if her knowledge came from medical science (see Apple, 2006). Recently, however, the adage has regained some of its cultural legitimacy.

The change in parenting philosophy in the 20th century was abrupt, shifting from the rigor of scientific motherhood to a model that placed a child's emotional needs above all. Leading the charge was Dr. Benjamin Spock (1945), whose book, Baby and Child Care famously comforted nervous mothers with his mantra: "Trust yourself. You know more than you think you do" (p. 1). With this statement, Spock set the tone for his book and empowered the young mother to rely on her instinct. As Spock's biographer remarks, "His avuncular style, with its hint of New England common sense, and his easygoing manner quickly built a loyal following" (Maier, 2003, p. 196). While extremely successful, Baby and Child Care was far from technical. It presented Spock's individual philosophy, backed by his experience and medical knowledge, which enabled him to validate maternal instinct. Spock was an expert, but as he noted himself, so were the mothers to whom he was writing. Sure, his medical degree afforded him a certain level of credibility, and yes, he did employ technical arguments to demonstrate the validity of his claims, but Spock's message came through the voice of a good friend.

Spock's "trust yourself" mantra shifted parenting philosophy because it changed the criteria by which parents could evaluate recommendations regarding their children's health. Spock's book facilitated such a paradigm shift that "women in the late forties and early fifties found themselves changing their methods in the middle of their child-raising careers" (Thurer, 1994, pp. 247-248). Out of this shift grew a culture of women helping other women, each with Spock's bible resting on her bedside table. This phenomenon has continued well into the 21st century and is exemplified quite clearly in discourse surrounding vaccination practices. Parenting websites, magazines, and books discuss vaccination as an informed decision made by parents (Eisenstein, 2010; Sears, 2011). Rather than addressing vaccination as a foregone conclusion, many of these resources support the belief that a parent can determine what's best for his or her child. In fact, an entire genre of vaccine information texts exists to help parents as they evaluate what vaccines, if any, they will consent to having administered. In the preface of The Vaccine Book, one of the most widely read texts on the topic, Dr. Robert Sears (2011) acknowledges that "today's parents are taking a more active role in making choices for their child's medical care" and sees his book as containing "open, honest, complete, and accurate information that all parents can use" ("Preface," para. 1). As a medical doctor, Sears bolsters his credibility by pointing out...