The Importance of Credibility in Public Health

The Reproductive Drugs Advisory Committee experienced some controversy a few years back when a number of extreme conservatives were appointed to the panel, including Dr. W. David Hager.

Dr. Hager was noted in many articles for his conservative outlook on matters of women’s health, most particularly pre-marital sex, PMS, contraception and emergency contraception and voted against the advancement of Plan B oral contraceptives from RX to OTC.  The FDA did not follow the recommendation of the advisory committee and held up the Plan B approval for many months.  His nomination was opposed by many women’s health groups with some petitions reporting that he had prescribed prayer for PMS treatment.  Dr. Hager’s resume stated he was a professor from the University of Kentucky in Lexington. 

Yesterday, former Surgeon General Richard H. Coroma testified before the House Committee on Oversight and Government Reform that, according to the Washington Post,  "political appointees in the administration routinely scrubbed his speeches for politically sensitive content and blocked him from speaking out on public health matters such as stem cell research, abstinence-only sex education and the emergency contraceptive Plan B ."

Also quoted in the Post article, Dr. Caroma said of his time in the Bush Administration:

"Anything that doesn’t fit into the political appointees’ ideological, theological or political agenda is often ignored, marginalized or simply buried," he said. "The problem with this approach is that in public health, as in a democracy, there is nothing worse than ignoring science or marginalizing the voice of science for reasons driven by changing political winds."

Now, President Bush has nominated, Dr. James W. Holsinger, Jr. for the office of Surgeon General.  This nominee at one time wrote a paper entitled "The Pathophysiology of Male Homosexuality" in which he states that homosexuality is neither healthy or natural.  Considering that one of the greatest roles of any Surgeon General was that of C. Everett Koop who became very active in the nation’s AIDS crisis, one must wonder whether the appointment of a physician with such views might not be counterintuitive when it comes to objectivity in public health.  By the way, like Dr. Hager, he is from University of Kentucky. 

The nomination requires the approval of the Senate.  Every effort should be made to steer public health back to the realm of credibility, not away from it. 

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