July 12, 2007 -- President Bush's nominee to be the next surgeon general said Thursday he would resign if the Bush administration tried to exert political pressure over the health advice he gives to the public.
The comments come two days after the last surgeon general, Richard Carmona, MD, testified on Capitol Hill that his reports and medical advice on a range of issues from smoking to contraception were repeatedly stifled by White House political officials.
James Holsinger, MD, the nominee to succeed Carmona, faced tough questioning from lawmakers in his Senate confirmation hearing Thursday. Senators, mostly Democrats, grilled Holsinger on a range of issues, including his willingness to deliver scientifically based health advice.
"The Office of the Surgeon General has become a morass of shameful political manipulation and distortion of science," said Sen. Edward Kennedy, D-Mass., the chair of the Senate Health and Education Committee.
Holsinger told lawmakers he would try to educate political higher-ups about the best available science if they were trying to influence him.
"Quite candidly, if I were unable to do that and I were being overridden, if necessary, I would resign," he said.
While the answer seemed to satisfy some of the administration's critics, Holsinger's nomination is still in flux.
Holsinger hit an immediate roadblock because of a 1991 paper he wrote labeling male homosexuality as pathological. The paper focuses on physical injuries that can result when men have sex with men, and gay rights groups have attacked Holsinger for basing the review on a narrow selection of scientific papers.
"This misuse of science gravely concerns me," Kennedy said during the hearings.
Holsinger defended the paper as a nonscientific review for a religious organization. He also strived to assure lawmakers that he was not bigoted against gays.
"I have a deep, deep appreciation for the essential humanity of everyone regardless of their personal circumstances or their sexual orientation."
Opposition and Support
A day before the hearing, the American Public Health Association said it opposes Holsinger's nomination. "We cannot support a nominee with discredited and non-evidence-based views on sexuality," Georges Benjamin, MD, the group's executive director, wrote in a letter to Congress.
Holsinger, who is from Kentucky, served a stint as the chief medical director of the Veterans Administration and was briefly Kentucky's top government health official. He was also chancellor of the University of Kentucky Medical Center from 1994 to 2003.
"There can be no debate on the breadth or depth of Dr. Holsinger's experience in medicine and public health," said Senate Republican Leader Mitch McConnell, who testified in support of the nominee.
Holsinger told lawmakers that his top three priorities as surgeon general would be curbing smoking, combating childhood obesity, and boosting the disaster-response capacity of the U.S. Public Health Service. He said he favors higher cigarette taxes as a way to cut down on smoking, a view not necessarily popular in tobacco-growing Kentucky.
Surgeon generals have little executive authority in the government. But they command the public's attention on a wide range of health issues.
A 1964 report on smoking and health produced by then-Surgeon General Luther L. Terry, MD, is credited with helping to cut smoking rates in the U.S.
On Thursday, Holsinger appeared to surprise lawmakers when he said he would support laws banning consumer advertising of prescription drugs as a way to help curb medical costs.
"It puts an unconscionable pressure on America's physicians to prescribe the blue pill or the pink pill or whatever the pill of the month might be, and I think that we have done a disservice to our physicians by allowing that to occur," he said.
Holsinger also said he supports White House limits on federal funding for embryonic stem cell research.
The committee that held the hearing is expected to vote on the Holsinger's nomination sometime this summer.
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