your connection to The Boston Globe

Ex-surgeon general accuses Bush officials of censorship

Says they chose agenda over facts

Dr. Richard H. Carmona said officials muzzled him. Dr. Richard H. Carmona said officials muzzled him.

WASHINGTON -- President Bush's first surgeon general alleged yesterday that administration officials prevented him from providing the public with accurate scientific and medical information on such issues as stem cell research and teen pregnancy.

"The reality is that the 'nation's doctor' has been marginalized and relegated to a position with no independent budget and with supervisors who are political appointees with partisan agendas," Dr. Richard H. Carmona told the House Committee on Oversight and Government Reform. "Anything that doesn't fit into the political appointees' ideological, theological, or political agenda is ignored, marginalized, or simply buried.

"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," said Carmona, who served from 2002 to 2006. "The job of surgeon general is to be the doctor of the nation, not the doctor of a political party."

Carmona testified alongside former surgeons general C. Everett Koop and David Satcher, who served in the Reagan and Clinton administrations, respectively. They also told the committee that they faced political interference, particularly on morally charged issues such as sexuality and drug use.

But Carmona said some fellow surgeons general told him the interference rose to new levels during his tenure.

"The surgeon general has to be independent if the surgeon general is going to have any credibility," said Representative Henry A. Waxman, Democrat of California and the committee chairman. The panel is considering changes that would insulate the surgeon general from political crosscurrents.

Administration officials had no immediate comment on Carmona's denunciation, but the Health and Human Services Department was expected to issue a statement. The House hearing occurred two days before a Senate panel is to meet to consider the nomination of Kentucky cardiologist Dr. James W. Holsinger Jr. to succeed Carmona. Holsinger already has drawn political fire from leading Democrats and gay and lesbian organizations. As a lay member of the United Methodist Church, Holsinger has strongly opposed the liberalization of church policies toward gays.

Surgeons general are viewed as public-health advocates who serve, in essence, as the nation's family doctor. Previous surgeons general have played pivotal roles in debates about smoking, drunken driving, mental health, and disparities in medical treatment between whites and minorities.

Carmona said that he expected that would be his role when he came to Washington, but that his attitude was politically naïve.

When the issue of federal funding for embryonic stem cell research came up early in Bush's first term, Carmona said, he felt he could play an educational role for administration officials and the public by openly discussing the latest scientific research.

Stem cells can be grown into any type of cell in the body, and some scientists see the promise of a cure for Parkinson's and other diseases in them. But producing embryonic stem cells has involved the destruction of human embryos, raising moral issues that some, including many religious conservatives, find profoundly disturbing. In 2001, Bush limited federal funding for stem cell research and has since blocked attempts by Congress to lift the restriction.

Carmona said he was told to stand down from playing any educational role because a decision had already been made. He also said administration appointees who reviewed the text of his speeches deleted from them references to stem cell research.

Likewise, on the issue of preventing teen pregnancy, Carmona said he was not allowed to deviate from the administration's position that abstinence was the best approach. In fact, he said, he believes a variety of approaches are needed, including contraception for sexually active teens. The administration did not want to hear the science, but wanted to preach, Carmona said.