Chicago Tribune Editorial - 'Doctor of the nation'

Chicago Tribune Editorial - 'Doctor of the nation'
Copyright © 2007, Chicago Tribune
August 4, 2007


The president's nomination for the next surgeon general looks to be in deep trouble. The nominee, Dr. James Holsinger, wrote a graphic paper years ago on homosexuality that has riled gay and lesbian activists and others. In recent testimony before a Senate committee, Holsinger appeared to disavow the 1991 paper, saying that it has been taken out of context and "does not represent where I am today [and] who I am today." He said that if confirmed as surgeon general, he would be an advocate for the health of all Americans, regardless of sexual orientation. And then he pledged to crusade against childhood obesity.

Whether he gets that chance won't be known until the Senate votes on his nomination in the coming weeks. Given his disavowal of the 1991 paper, there do not seem to be strong reasons to vote against him.

But one thing is certain: Politics is playing a huge role in all of this. The administration chose its nominee carefully to reflect its political values. Many Democrats are likely to vote against confirmation for exactly the same reason.

Whether the administration is Republican or Democratic, the surgeon general's office is always under political pressure to trim its views to fit a political zeitgeist. Unfortunately, that has meant generation after generation of surgeons general frustrated by meddling administration officials -- and vice versa. Apparently this has become particularly heavy-handed in the Bush administration.

The former surgeon general, Dr. Richard Carmona, testified recently his speeches were censored to match administration political positions and that he was prevented from giving the public accurate scientific information on issues such as stem cell research and teen pregnancy prevention. He said officials tried to "water down" a significant report on secondhand smoke. The administration went so far as to order Carmona to mention President Bush three times on every page of his speeches, Carmona told a congressional committee.

"Anything that doesn't fit into the political appointees' ideological, theological or political agenda is ignored, marginalized or simply buried," Carmona told the panel. "The job of surgeon general is to be the doctor of the nation -- not the doctor of a political party."

He's right. And that's exactly what's wrong with the job as currently defined.

The Bush administration has been particularly heavy handed in its interference with the office, but other surgeons general testified that they faced political interference while serving other administrations.

If this office is worth filling, and we believe it is, then its description must change. The surgeon general should be an independent, impartial voice of medical science. He or she can't fill that role under the current system. Letting politicians oversee this office is like getting a medical opinion from a doctor who calls your congressman for a second opinion. It's a bad idea.

Sen. Edward Kennedy (D-Mass.) recently introduced legislation that aims to "ensure that sound science is not trumped by politics" in the surgeon general's office. That's moving in the right direction.

Here's what we'd like to see: an independent surgeon general who doesn't answer to politicians but is free to speak his presumably well-educated mind on the medical and scientific issues of the day. The model is the Federal Reserve System. Its members are appointed for 14-year terms to insulate them from day-to-day political pressures. A surgeon general probably wouldn't serve that long, but the basic principle stands. If we're going to have a top doctor, the position should be shielded from political interference.