TCS Daily

A One-Sided Lancet

By Sydney Smith - November 19, 2002 12:00 AM

There is something very disturbing afoot in the world. Something other than terrorism and Islamofascism, I mean. It is something just as widespread and disturbing, and potentially just as dangerous. That something is the slow and steady creep of politics into all things, public and private. Even into areas that are seemingly apolitical - like science. Like medicine.

Take, for example, the American Public Health Association's report card on terrorism preparedness. This is the organizational body of the men and women who are responsible for implementing the plans for bioterror preparedness. Their report card on the state of preparedness, however, isn't concerned so much about the mundane issues of educating physicians and the public, or to getting the public health infrastructure up to par, or refining the logistics of terrorism response plans. Instead, it's heavily weighted toward the political - things like addressing poverty, and social injustice, ending the conflict in Afghanistan, and preventing "hate crimes." The APHA couldn't resist cataloging its criticisms of the Bush Administration policies in these areas. It's far from reassuring to realize that the people who are in charge of putting together our defense and response to bioterrorism are allowing themselves to be distracted from the job by their politics.

Presumably, the APHA represents public health professionals of all political stripes, but you wouldn┬╣t know it. Their terrorism preparedness report card reads more like a political party platform, than a rational assessment of and plan for the defense needs of the nation.

And they aren't content to keep their politics within their own field, either, but are busy proselytizing to the scientific community in general. Last month, Science Magazine published as an editorial a long, detailed letter (pdf file) from a group of public health academics accusing Health and Human Services Secretary Tommy Thompson of disbanding the National Human Research Protections Advisory Committee and the Advisory Committee on Genetic Testing, because their advice "apparently conflicted with the religious views of certain political constituencies." In truth, the charters of both committees expired this past summer, and the National Human Research Protections Advisory Committee has been replaced with the smaller, presumably less expensive, Secretary's Advisory Committee on Human Research Protections. The editorial offered no proof of their claims that "religious views" were responsible for the disbanding, and the editors of Science evidently felt that innuendo alone was sufficient.

The editorial also lambasted the Administration for appointing its own choices to the Advisory Committee to the Director of the National Center for Environmental Health and the Advisory Committee on Childhood Lead Poisoning Prevention instead of reappointing scientists and physicians whose terms have expired. The charge is that these impartial scientists are being replaced by industry partisans. What they are really complaining about, however, is that people with views other than their own have been appointed to the committees. Lead poisoning provides a pertinent example. The Science editorial accuses Secretary Thompson of selecting new members with the intent of subverting an upcoming review of the current CDC recommendations on blood lead levels in children. Apparently, the authors assume that the previous committee would have recommended lowering the acceptable levels even further, a move that is in itself controversial.

The current accepted levels for lead in children are quite low at 10 micrograms/deciliter. Levels above that are presumably associated with cognitive impairments. The higher the level, the worse the impairment. Lead levels have actually been declining for some time, and continue to do so. Symptomatic lead poisoning is extremely rare.

There are those within the public health community, however, who would like to fix the limit at an even lower level than it is now. This, of course, would increase the number of lead poisoning cases. It would also increase the costs for private citizens who would be required to rid their properties of lead. You don't have to be a lead industry advocate to see the potential harm of this position, especially when its benefits are marginal at best. The whole thing is reminiscent of the arsenic controversy from a year ago - a lot of exaggeration and very little concrete science.

Unfortunately, the editorial caught the eye and the imagination of the editors of The Lancet, a well-respected, widely read, and supposedly unbiased British medical journal. In an editorial this week entitled, apparently without irony, "Keeping Scientific Advice Non-Partisan," the editors used the Science editorial as a launching platform for a diatribe against the Bush Administration and the Republican Party that was worthy of the Democratic Caucus. Not only did it repeat the accusations of the Science editorial, but it alluded to Republicans "seizing" control of the House and Senate as if they had staged a coup, repeated popular media smears against a minor FDA nominee based on his religious affiliation (evangelical Christian) and repeated pro-abortion activist accusations that the removal of a webpage discussing the association between breast cancer and abortion (there is none) from the National Cancer Institute's website was politically motivated. In truth, the existence of the web page in the first place was politically motivated. Let's face it, women facing an unwanted pregnancy and considering abortion aren't likely to put the minor statistical association with breast cancer high on their list of considerations. The only people who care about it are the pro-choice and pro-life activists who have been using it as arguments for and against abortion among themselves. Removing a webpage discussing it is hardly a threat to the rights of women.

Regrettably for the reputation of The Lancet, this isn't the first time they've ventured away from medical science and toward the politics. In April, they published an editorial that was blamed Israel for Palestinian health woes without more than a passing mention of the role of Palestinian terrorism in the conflict. Like the APHA and Science, The Lancet seems to have confused itself with a political organization. This is bad news for all of us. We already have newspapers, radio, and television to give us a biased view of the news. If we allow our scientific journals and professional associations to follow suit, then we lose the fundamental basis of freedom - the truth.

The author is a family physician who has been in private practice since 1991. She is board certified by the American Board of Family Practice, and is a Fellow of the American Academy of Family Practice. She is the publisher of MedPundit.



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