Policy trumps science in the Bush administration

Dr. Dana J Lawrence DC.

^*, Associate Professor, Palmer Center for Chiropractic Research

Not long ago, a group of more than 60 top United States scientists, including more than 20 past Nobel laureates and past scientific advisors to Republican administrations, accused the Bush administration of manipulating and censoring science for political purposes.¹ Included among those involved were David Baltimore, Paul Ehrlich, Leon Lederman, E.O. Wilson and Harold Varmus. The charges are quite serious and indicate that in nearly every case political considerations out-trump scientific ones and that little attention is given to the advice provided by some of the nation’s most prominent and senior scientists.

This has trickled down even to the chiropractic profession, for the gentle reader must stay mindful that there are chiropractors appointed to several national advisory and review panels, and they do not always represent mainstream chiropractic, leading to the question as to what considerations were taken into account when such appointments were made. I well know this, as for several years I had an assignment to the National Advisory Panel for the National Center for Complementary and Alternative Medicine.

It may be worth looking briefly at some of the charges:

• Over-the-counter contraceptives were banned, even though an independent panel of the Food and Drug Administration recommend approval;²

• The health risks of mercury were discounted after a White House staff person crossed out the work “confirmed” from a phrase describing mercury as a “confirmed national health risk;”²

• It was demonstrated that a fact sheet from the National Cancer Institute was doctored to suggest that abortion increases breast cancer even though the strongest studies showed the reverse;

• EPA reports discussing global warning were modified, then rewritten extensively and finally dropped from all reports once the Bush administration had decided to withdraw from the Kyoto Treaty on Global Warming. To this day, the Bush administration denies the existence of global warming. In fact, the government removed from one report a finding that human activity contributed to climate change – even though it had itself requested the report;

• All references to condoms and safe sex were removed from material pertaining to HIV as listed on NIH and CDC web sites. All references to successful sex education programs that included reference beyond abstinence-only approaches as found in scientific study were taken off the CDC website;

• Two distinguished scientists were removed from the presidential Council on Bioethics when they did not agree with the Bush administration line on stem-cell research;³

• The Bush administration has learned from Orwell. How else to account for the name of proposals such as the Healthy Forest Initiative (which removes barriers to clear-cutting vegetation) and the Clear Skies Initiative (which weakens safeguards on the release of mercury and other pollutants into the air).

• Consider this Bush appointment to the FDA’s Reproductive Health Drugs Advisory Panel: Dr. W. David Harger. He is an obstetrician with little research background best known for recommending Scripture readings to help cure PMS and for refusing contraceptives to unmarried women. Consider a second Bush appointment to that same panel: Dr. Susan Crockett. She is best known for writing the chapter “Using hormone contraceptives is a decision involving science, Scripture and conscience” in the book The Reproductive Technologies: A Christian Appraisal of Sexuality, Reproductive Technologies, and the Family – which was, by the way, edited by Dr. Harger. Other members of the panel have ties to the pharmaceutical giant Wyeth – who has a drug that will be reviewed by that same panel.³

• Dr. William Banner, a physician with no research background in lead poisoning, was appointed to the advisory panel that helps set standards for lead in children’s blood. His past work? He was an expert witness for the Lead Industries of America, who had testified that lead standards 10 times as high as currently allowed were completely safe, and that there is no link between lead and brain damage.

• Dr. Joseph McIlhaney was appointed to the Presidential Advisory Council on HIV/AIDS. He does not believe that condoms help to prevent the spread of this disease and he is an advocate of abstinence-only programs even though they have never been shown to reduce pregnancy rates in the young. He has not published hard research on the topic, but was then selected to serve later as a member of the Advisory Council to the Director of CDC.

• Numerous nominees to advisory panels were rejected after it was found that they had donated to other candidate’s political campaigns.

The most damning material comes from the Union of Concerned Scientists.¹ Their report is entitled “Scientific Integrity in Policymaking” and is subtitled “An investigation into the Bush Administration’s misuse of science.” It has 4 general sections: (1) Suppression and distortion of research findings at federal agencies; (2) Undermining the quality and integrity of the appointment process; (3) An unprecedented pattern of behavior; (4) Conclusions and recommendations: what is at stake? Topics covered include, in part:

• Distorting and suppressing climate change research

• Censoring information on air quality

• Distorting scientific knowledge on reproductive health issues

• Suppressing analysis on airborne bacteria

• Misrepresenting evidence on Iraq’s aluminum tubes

• Manipulation of science regarding the Endangered Species Act and on Forest Management

• Office of Management and Budget rulemaking on “peer review” (see below)

• Industry influence on lead poisoning prevention panel

• Political litmus tests on workplace safety panels

• Under-qualified candidates in health advisory roles

Should this matter to Canadians? I would argue strongly so. There are both real world and cautionary implications here. In terms of the real world, science does not occur in a vacuum. The work done by scientists in one country will be of interest and use to those in another. The United States has for a long time provided great leadership in scientific matters, and while I am not naïve enough to think that science is completely pure, I am intelligent enough to know that where possible good scientists try to reduce bias. In my opinion, the Bush administration has strayed over the line in its desire to place policy ahead of science, to the point of rejecting the science it does not agree with.

This has other real world implications. Rejecting the science on global warming only increases the risk that global warming will get worse. The levels of mercury in the air will continue to rise. Preventing individuals in Africa from obtaining appropriate information on the use of condoms only increases the risk that the AIDS/HIV rate will continue to rise in a country where the rates are staggering. These are only some of the implications.

In one of the most egregiously political moves, the White House Office of Management and Budget has proposed rule changes that would affect how the federal government collects and reviews scientific information. What this proposed rule does is centralize control of the review of scientific information at OMB. It would prevent most scientists who receive federal funding from a government agency from serving as a peer reviewer. It would, however, allow those who work for industry to serve as a reviewer. The effect would be to give industry a far greater level of control over the scientific review process. Think of the import – the best scientists, those who are strong enough to merit federal funding because their work is so rigorous, would be prevented from reviewing any science in their area of expertise. Any chiropractor with a federal grant could no longer review any chiropractic work; we would no longer have input. At the national level, this would restrict the ability of our best scientists to provide input to the government.

And in all of this, the information generated in the United States would impact that in other countries. It would impact Canada. There are few opportunities for Canadian chiropractic researchers to obtain funding, and problems with PR have impacted on the public perception of the profession.

There is a cautionary lesson as well. The people must keep mindful of what their government is doing. In general, the people of the United States have a schizophrenic relation with science. While we appreciate what science does in our lives, many of us have no understanding of the process that is used. Science is seen as evil, and many people seem not to care about what science has to say. The Bush administration counts on this. As a corollary, look within our own profession. We have some people, not a huge group, who understand the scientific process and make decisions largely on what the science says. We have many who practice as they were taught, with little thought as to the science behind what they do. And we have a fairly vocal minority who decry science and the scientific method, making claims that cannot be tested and which require belief alone, or perhaps the willing suspension of disbelief. Do we politicize science? To a certain extent, yes – but notably, it is not the scientists who do so, but the politicians. We also place science secondary to our political goals. But nowhere has this been done so strongly as in the current United States administration. It brings to mind the state of science in Russia when Lysenko’s ideas were promulgated, ideas that were far more in line with governmental thinking than Mendel’s were. It put the Soviets a generation behind the US. While I am not attempting to conflate the state of science in the United States with the situation in Russia in the early part of this century, the lesson to be taken from what happened is that when science becomes subservient to political needs, science suffers. As a result, people suffer. What happens here should be of concern to those of us located elsewhere. The United States Congress, acting in lockstep with the administration, has not provided the needed leadership and funding to change this. The lawmakers do not get the best scientific advice- and in some cases are prevented from getting it. The public health is threatened. What can be done?

Scientists should encourage their professional organizations to become involved and engaged. They should contact their elected representatives. They should provide guidance on how science works, and how it plays a role in the formation of policy. The public should, in the words of the Union of Concerned Scientists, “voice its concern about these issues to its elected representatives, letting them know that censorship and distortion of scientific knowledge by the federal government will not be tolerated, and reminding them that the public trust is difficult to regain once lost.”

We can do no less, not if we wish to enable our science to serve the functions it should.