With Surgeon General Carmona’s departure from the Bush administration, it’s time for the President to do what he does best: appoint qualified people for high-ranking positions in our Executive Branch. I’d say that the President has done a heckuva job so far.
The current position that is open is the nation’s physician, the Surgeon General. It’s a position that requires a deep understanding of human health, as well as a willingness to be outspoken on issues and an ability to communicate the science to a wide audience. The public pays for this, and the public expects a person with their best interests at heart. Disease prevention, health effects of food and drugs, and basic health science all cross the desk (and leave the mouth) of the nation’s doctor.
Holsinger faces opposition right away, based on allegations that he’s hostile toward homosexuality. Setting that aside right now, certainly human sexuality is central to American politics right now. AIDS prevention is at the forefront, with First Lady Bush’s recent oversight trip to Africa to see how U.S. AIDS money is spent (abstinence, abstinence, abstinence – I call it the 3A’s approach to AIDS prevention). Stem cells are connected to human sexuality through the current best means of getting them – embryos. The science of stem cells is quite separate from that, although the administration appears to made no distinction between the ethical debate about getting them and the scientific question of how to understand them. With those two issues getting headlines every week, clearly a Surgeon General needs to be ready to engage on human sexuality.
The allegations about Holsinger are interesting, so let’s dig a little. One allegation, which comes straight from the White House, is that Holsinger opposes federal funding of embryonic stem cell research [1]. However, there is some conflict on that statement, as Holsinger has apparently previously said, in public, that he supports loosening restrictions [1]. His testimony at the confirmation hearings will be interesting in resolving this. My own interest is in learning whether he appreciates the science, more than the particulars of how different means of procurement should be funded.
The second giant allegation is that he has a bias against homosexual behavior. At a time when the scientific questions about human sexuality – the genetic link, the influence of environment, etc. – are only beginning to be addressed, one can imagine a Surgeon General with a moral judgement setting the stage to rob that work of federal funding. There are definitely conflicting opinions about his view, and he himself has declined to discuss his views before the hearing [2]. I must say that, assuming the bits in the Wikipedia article are accurate, there is really no way of either ascertaining his views, nor inferring whether those views would actually influence his behavior. Surgeon General Koop, for instance, was personally opposed to abortion but shocked Republicans by refusing to say that conditions under which abortions are conducted by doctors are deplorable. Clearly, Koop demonstrates that personal views and public activity can be separated, when acting in accordance with a view toward the health of people rather than the fate of their alleged souls.
On the other hand, Holsinger’s now infamous paper on the “Pathophysiology of Male Homosexuality” draws some odd conclusions about homosexual acitivity vs. the same activity amongst heterosexual couples. His paper ends with a famous, and rather intellectually void, linguistic exploration of pipe fitting nomenclature and human sexuality. Yikes. Holsinger claims the paper was just a review of the literature at the time, much of which seems to have been biased by presuppositions about homosexuals and heterosexuals. Like I said, we’ll have to wait to see how he holds up under what I hope will be wilting questioning by the Senate.
[1] http://washingtontimes.com/article/20070709/NATION/107090065/1001
[2] http://en.wikipedia.org/wiki/James_Holsinger#Nomination_controversy_and_homosexuality
