Wednesday, July 11, 2007

IHT: former US Surgeon General cites political interference

International Herald Tribune reports that Dr Richard Carmona testified that the Bush administration interfered with his job as Surgeon General of the US, by politicizing science.

Dr. Richard Carmona, a former U.S. surgeon general, told a congressional panel that top Bush administration officials repeatedly tried to weaken or suppress important public health reports because of political considerations.

The administration, Carmona said Tuesday, would not allow him to speak or issue reports on the subjects of stem cells, emergency contraception, sex education or prison, mental or global health issues. Top officials tried to "water down" a landmark report on secondhand smoke and delayed it for years, he said. Released last year, the report concluded that even brief exposure to cigarette smoke can cause immediate harm.

Carmona said he was ordered to mention President George W. Bush three times on every page of his speeches. He also said he was asked to make speeches to support Republican political candidates and to attend political briefings.

Administration officials even discouraged him from attending the Special Olympics because, he said, of that charitable organization's longtime ties to a "prominent family" that he declined to name. "I was specifically told by a senior person, 'Why would you want to help those people?' " Carmona said.

The Special Olympics is one of the nation's premier charitable organizations to benefit disabled people, and the Kennedy family has long been deeply involved in it. When asked after the hearing whether that "prominent family" was the Kennedys, Carmona responded, "You said it. I didn't."

and Human Services, said the administration disagreed with Carmona's statements. "It has always been this administration's position that public health policy should be rooted in sound science," Hall said.

Emily Lawrimore, a White House spokeswoman, said that the surgeon general "is the leading voice for the health of all Americans. It's disappointing to us if he failed to use this position to the fullest extent in advocating for policies he thought were in the best interests of the nation."

Carmona is one of a growing list of present and former administration officials to charge that politics often trumped science within what had previously been largely nonpartisan government health and scientific agencies.

Carmona, 57, served as surgeon general for one four-year term from 2002 to 2006 but was not asked to serve a second. Before being nominated to the post, he was in the Army Special Forces, earned two Purple Hearts in Vietnam and was a trauma surgeon and leader of the special weapons and tactics team of Pima County, Arizona. He received a bachelor's degree, in biology and chemistry, in 1976, and his M.D. in 1979, both from the University of California, San Francisco. He is now vice chairman of Canyon Ranch, a resort and residential development company.

His testimony came two days before the Senate confirmation hearings of his designated successor, Dr. James Holsinger Jr. Two members of the Senate Health Committee have already declared their opposition to the Holsinger nomination because of a 1991 report he wrote that concluded that homosexual sex was unnatural and unhealthy. Carmona's testimony may further complicate the Holsinger nomination.

In his testimony, Carmona said that at first he was so politically naïve that he had little idea how inappropriate the administration's actions were. He eventually consulted six previous surgeons general, Republican and Democratic, and all agreed, he said, that he faced more political interference than they had confronted.

On issue after issue, Carmona said, the administration made decisions about important public health issues based solely on political considerations, not scientific ones. "I was told to stay away from those, because we've already decided which way we want to go," Carmona said.

He described attending a meeting of top officials in which the subject of global warming was discussed. The officials concluded that global warming was a liberal cause and dismissed it, he said.

"And I said to myself, 'I realize why I've been invited. They want me to discuss the science because they obviously don't understand the science,' " he said. "I was never invited back."

Carmona testified under oath at a hearing before the House Oversight and Government Reform Committee chaired by Representative Henry Waxman, Democrat of California. The topic was strengthening the office of the surgeon general. Dr. C. Everett Koop, who held the post during the Reagan administration, and Dr. David Satcher, who served during the Clinton administration and the first year of the administration of George W. Bush, also testified.

Each complained about political interference and the declining status of the office. Satcher said the Clinton administration discouraged him from issuing a report showing that needle-exchange programs were effective in reducing disease, but he released it nevertheless. Koop said he discussed the growing AIDS crisis despite being discouraged from doing so by top officials in the Reagan administration.

All three men urged major changes in how the surgeon general is chosen and how the office is financed.

Carmona described being invited to testify at the government's nine-month racketeering trial of the tobacco industry, which ended in 2005. He said top administration officials discouraged him from testifying while simultaneously telling the lead government lawyer in the case that he was not competent to testify. Carmona testified anyway.

Sharon Eubanks, director of the Justice Department's tobacco litigation team, was in the gallery during Carmona's testimony. "What he said is all correct," she said. "He was one of the most powerful witnesses. His testimony was very important."

Carmona said he felt that the duty of the surgeon general, often called "the nation's doctor," was to tackle many of the nation's most controversial health topics and to issue balanced reports about the studies underlying them.

When stem cells became a focus of debate, Carmona said he proposed that his office offer guidance "so that we can have, if you will, informed consent."

"I was told to stand down and not speak about it," he said. "It was removed from my speeches."

The Bush administration rejected the advice of many top scientists on stem cells, including that of the director of the National Institutes of Health, Dr. Elias Zerhouni.

Similarly, Carmona wanted to address the controversial topic of sex education, he said. Scientific studies suggest that the most effective approach includes a discussion of contraceptives.

"However, there was already a policy in place that did not want to hear the science but wanted to preach abstinence only, but I felt that was scientifically incorrect," he said.

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