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No litmus tests?


By Jeffrey P. Kahn, Ph.D., M.P.H.
Director, Center for Bioethics
University of Minnesota

President Bush made two nominations for high-level science policy positions this week -- Dr. Elias Zerhouni as director of the National Institutes of Health and Dr. Richard Carmona as surgeon general.

This comes nearly a year and a half after Bush's election and after many other possible nominees had been suggested.

Reportedly they were rejected for having views on controversial issues -- like embryonic stem cell research -- that differed too much from those of the president and influential members of Congress.

Only a few commentators have gone so far as to call questions about prospective nominees views on stem cell research a litmus test. But if other qualified nominees were rejected because of their stance, that distinction may be academic.

These would not be the first high-level nominations for which litmus tests were applied, with the most obvious recent examples being judicial appointments that hinged on the appointees views regarding abortion.

Applying such narrow criteria to important policymaking positions has its pitfalls, and the question is whether something is lost when science policy makers are chosen less for their experience and expertise and more for where they stand on issues of social controversy.

Why worry about litmus tests?

When politicians are involved in areas like the government's biomedical research or public health efforts, they should be free to make policy -- within limits.

Such political constraints could have an obvious impact on leadership of agencies with multi-billion dollar annual budgets such as the NIH.

The hope and expectation is that the NIH director will feel free to advocate the best use of taxpayer dollars and act upon his or her views -- not merely act as a mouthpiece for the administration.

Some have claimed that less is at stake in the case of the surgeon general, since the office is mostly symbolic.

But recent surgeons general have had significant impact on public health policy -- C. Everett Koop on smoking and tobacco policy, and David Satcher and Antonio Novello on sex education.

They were all able to speak their minds and advocate what they understood to be in the public's health exactly because they were independent of explicit political constraints. But that's not likely with current and future surgeons general.

Politics and policy

It doesn't make sense to argue that politics should play no role in nominations to such posts. Those who occupy them are rightly known as political appointees, after all.

But placing too much emphasis on the politics of these appointments leads to nominees with limited public records to reduce what can be used against -- or for -- them in the nomination and confirmation processes. And limited public records are likely the product of limited public policy experience.

Nominees who fail a test of their views or past actions on controversial issues may have the skills, expertise and experience needed for the job, but ironically, their experience will actually count against them.

So is an inexperienced pool of policy makers the price of limiting the controversy around science policy appointments? Not necessarily, since there are many ways to gain the sorts of expertise that make for successful policy leaders, and Drs. Zerhouni and Carmona may well have the right stuff.

The point is that there are many reasons why it doesn't serve the interests of science or the public to mix politics and science policy. One is the difficulty in finding qualified and willing candidates for leadership positions occupying the top of the list.

After nearly two years and counting, there are still more new vacancies than new appointees in the Bush administration, which says more about the process than about the supply of leaders.

Visit the
"Ethics Matters" Archive
where you'll find other columns from Jeffrey Kahn
on a wide range of bioethics topics.

"Ethics Matters" is a biweekly feature from the
Center for Bioethics and CNN Interactive.


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