Validating Vaccines: Understanding the Rhetorical Dynamics of Expertise Amid a Manufactured Controversy Lauren R. Archer A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2014 Reading Committee: Leah Ceccarelli, Chair Christine Harold LeiLani Nishime Program Authorized to Offer Degree: Department of Communication ©Copyright 2014 Lauren R. Archer University of Washington Abstract Validating Vaccines: Understanding the Rhetorical Dynamics of Expertise Amid a Manufactured Controversy Lauren R. Archer Chair of the Supervisory Committee: Professor Leah Ceccarelli Department of Communication This dissertation examined the rhetorical dynamics of expertise around a manufactured science- based controversy. Exploring the rhetorical creation and evolution of various claims to expertise across different discursive contexts illuminates why (and in what situations) the rhetoric of expertise persuades or fails to persuade. Using the ongoing debate surrounding vaccine-induced autism as a case study, this work explored the persuasive means used by voices competing for recognition as an expert on a contested issue with technical elements. This study focused most closely on two key figures within AVC discourse: Andrew Wakefield and Jenny McCarthy. While the involvement of these two personalities in the AVC occurred on separate continents and transpired almost a decade apart, they sparked key moments in the life of this science-based manufactured controversy. In order to offer new insight into these key moments, this dissertation employed a textual-intertextual approach to rhetorically analyze key discursive moments in the evolution of this controversy while also examining reception among audiences to understand how discourses of expertise influence decision making around an issue portrayed as uncertain. This analysis revealed that the clarity of expert language practices used in technical settings becomes obscured in public contexts, introducing ambiguity that allows for reported research to be interpreted as more certain than it is and creating discursive openings for manufacturing scientific controversy. It also uncovered the rhetorical power of style and appeals to ethos as substitutes for credentials or specialized knowledge when enacting expertise for non- specialist audiences who rely on judgments of trustworthiness rather than assessments of epistemic accuracy in determining which experts to believe and whose advice to follow. Examination of parental discourses regarding vaccines illustrated that vaccine decisions derive from complex risk assessments that consider the diseases being vaccinated against, the public health threats in an individual’s local environment, and the perceived vulnerability of one’s child as means for gauging whether the risks posed by vaccines outweigh the risks of not vaccinating. Additionally, a careful rhetorical analysis of maternal discourses about vaccines revealed that while mothers explicitly deny believing in vaccine-induced autism, language choices and expressions reveal that an underlying sense of doubt about the issue remains. Current public discourses that portray vaccines as chemical concoctions that operate aggressively to elicit an immune system response help heighten concerns about vaccine risks. Framing vaccines as medical aids that help protect vulnerable children and localizing public health messages to highlight the risks for a particular community offer promise for addressing vaccine hesitant attitudes in meaningful ways. Additionally, medical experts must become rhetorically savvy and recognize the opportunities and constraints presented by their rhetorical situation. Moving beyond supplying more information to dialoging with parents about the risks involved creates opportunities for building trust between practitioners and patients and encouraging acceptance of expert advice. Ultimately this dissertation argued that while the debates surrounding manufactured, science-based controversies seem to center on whether or not people believe the science, such issues are actually about which experts people trust. Such an understanding should reframe rejection of expert communication not as a matter of audience ignorance but as a failure in persuasion. Recognition of this should shift responses away from debates that can too easily become entrenched in issues of highly technical obscurities or demarcation of various forms of expertise that bear little meaning or influence on non-specialist audiences and instead focus on rhetorical opportunities for building ethos and communicating common ground. Acknowledgements Although this dissertation bears only the name of one author, many others had a hand in helping to shape it and support its development and eventual completion. First and foremost, I am deeply indebted to my chair, Leah Ceccarelli, whose generosity in providing sage advice, astute insights, and eagle-eye readings not only made this project better, but also helped me become a significantly better scholar than I would be otherwise. To my committee—Christine Harold, LeiLani Nishime, and Bruce Hevly—thank you for all the kind words, helpful reading suggestions, and provocative questions you asked; every time I had the pleasure of conversing with you about my work, I walked away the benefactor. I would like to express my gratitude to Communication Librarian Jessica Albano for her help in tracking down artifacts and other important resources in the early stages of this project. Additionally, the Department of Communication offered support for the development of this dissertation in many ways, including the Laura Crowell Fund for graduate and student research and travel and the Daniel and Margaret Carper Dissertation Award. To the mothers who shared with me their time (a very limited resource!) and their perspectives, thank you for helping me develop a deeper appreciation for the subtle complexities of the vaccine issue. Thanks as well to the many amazing colleagues who offered encouragement, support, and links to any story about Jenny McCarthy along the way. A few deserve to be mentioned by name. I am endlessly grateful to Lindsey Djordjevich, for our weekly lunches, which helped me save money on a therapist and get to this point with my sanity still intact. I am also thankful for Jen Malkowski, Meara Faw, and Sheetal Agarwal, who never tired of talking with me about the autism-vaccine issue; these conversations helped me tremendously in making sense of this issue in order to make progress on the dissertation. To my family, words cannot capture how much gratitude I have for your love, support, encouragement, and endless faith in me. Your unquestioning confidence in my success helped me persevere during moments of doubt and exhaustion. Thanks especially to my parents for reassuring me that it was okay to “still” be in school and for making it possible for me to continue pursuing this goal. Finally, I would like to thank my husband, Brian, who has been through all the ups and downs of this journey with me and married me anyway! Your own passion, dedication, and work ethic inspired me to continually keep working toward my dream. Thank you for all your support in making this project come to fruition, from always keeping an eye out for any story related to vaccines to letting me talk endlessly about expertise to having patience with me and taking on all the household chores when I only had time to write and sleep. I could not have completed this dissertation without you, so this achievement is as much yours as it is mine. TABLE OF CONTENTS Chapter 1 ................................................................................................................................... 1 Introduction: Enacting Expertise Chapter 2 ................................................................................................................................. 33 Hidden in a Hedge: The Harms of Expert Language Practices in Scientific Discourse Chapter 3 ................................................................................................................................. 74 Accommodating Expertise: The Disappearance of Hedges and Demarcations in Reception of Wakefield’s Research Chapter 4 ............................................................................................................................... 103 Mommy Instinct: Parenthood as Expertise Chapter 5 ............................................................................................................................... 149 Perceptions of a Playboy Bunny: Responding to McCarthy’s Enactments of Expertise Chapter 6 ............................................................................................................................... 168 Parental Choice: Assessing Experts and Making Vaccination Decisions Chapter 7 ............................................................................................................................... 208 Lessons Learned: Unweaving the Rhetorical Dynamics of Expertise Amid Controversy Bibliography ........................................................................................................................... 227 Appendix A: Interview Respondents ...................................................................................... 244 Appendix B: Interview Questions Guide ................................................................................ 245 i Chapter 1 Introduction: Enacting