- © 2007 Canadian Medical Association or its licensors
Last night, as I sipped my favourite beer, sampled turkey curry and searched for conversation among strangers, I read for the first time the label on the can of beer I was holding. It stated that this particular product met the standards of the Bavarian purity law. The beer suddenly turned distasteful and I tossed the rest.
Whereas the quest for safety in products and personhood is laudable, the quest for purity propels us down the slippery slope of intolerance and self-righteousness and lands us in the gutter of “social hygienic” initiatives that can hover beneath the guise of public health science. As a practitioner of that science, I strive to identify and avoid such extremist tones.
For history's lessons in this regard we need look no further than Nazism — but let's not get stalled there. A much smaller event occurred this year and like most lessons of import and resonance, it began with the normal course of routine matters and revealed itself through hindsight, reflection and escalation.
My normal workday begins with a stroll past a line of receptionists' desks in our office. At the entry point of these desks lie the obligatory tactile objects that invite public handling: a box of Kleenex, a desktop calendar and business cards. Further in, tucked away from public gaze, lie the personal objects that help each of us get through the day: the extra pair of shoes, the dental floss and the fitness class schedule. At the back, within the full gaze but beyond the reach of the public, are the tacked up photos and artworks by beloved children and grandchildren. Wedged occasionally between these are cuddly toys — gentle reminders that life is not all work and that inevitably, 4:30 and Fridays will roll around.
Rarely do these personal items advance to the frontline. One morning last August they did, in streams. Upon entering the office I encountered an infant-ry of toys lined up at the edge of reception desks. Notables among the ranks included Thomas the Tank Engines, Dora the Explorer figurines and Sesame Street pals and collectibles. Flanking this battle line were clusters of indignant office staff patrolling the sidelines, congregating in corners and plotting revenge in hushed tones.
What prompted the string of sentimental items to be advanced to the frontline? The United States Consumer Product Safety Commission, which identified excessive lead levels in these products.
Overnight, toys became toxins, toy companies negligent profiteers and individual Chinese businessmen (some of whom tragically committed suicide) conspiring murderers. Mothers blamed the toy companies, the toy companies blamed the suppliers, America blamed China and China blamed a few men. As complex public health and regulatory system failings were reduced to theories of human greed and conspiracy, the roots of nationalism, xenophobia, Puritanism, self-preservation and intolerance grew a smidge deeper.
This overreaction was partially fuelled by scientific illiteracy, both on the part of the media and the reader. Media accounts failed to mention basic epidemiological concepts, such as attributable fraction, (i.e., a measure of the overall contribution of a risk factor, such as exposure to lead in toys, to the overall occurrence of a disease in a population, such as neurodevelopmental delay). Attributable fraction is sometimes difficult to calculate, but not to comprehend, and should be included in any reasonable discussion about risk. It was missing. No one would dispute the necessity to recall these toys, but the pitch of the recall and reaction, and the consequent sense of injury, seemed out of proportion to the level of certainty around the magnitude of risk and exposure. Values trumped knowledge. Purity and the self were preserved.
This quest for purity, especially if unchallenged, can get us into a lot of trouble. Some religious doctrines start with the assumption of original sin, which seems to me to be a crafty way of getting around and beyond our eternal quest for purity so we can get on with more important matters — like compassion, empathy and forgiveness. Unless, of course, this inborn quest for purity is our original sin — in which case we seem to be locked into a logical fallacy of fairly cosmic proportions. A conundrum, as I contemplate reaching again for my favourite beer, aware now that both the act of imbibing and boycotting this product satisfies a taste for purity. Is nothing pure?
Footnotes
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