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Advisors Put Under a Microscope

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Times Staff Writer

When psychologist William R. Miller was asked to join a panel that advises the National Institute on Drug Abuse, he thought he had been selected for his expertise in addiction. Then a Bush administration staff member called with some unexpected questions.

Did Miller support abortion rights? What about the death penalty for drug kingpins? And had he voted for President Bush?

Apparently, Miller said, he did not give enough right answers. He had not, for example, voted for Bush. He was never appointed to the panel.

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Researchers are complaining with rising alarm that the Bush administration is using political and ideological screening to try to ensure that its scientific consultants recommend no policies that are out of step with the political agenda of the White House.

Administration officials say they are merely doing what their predecessors have always done: using appointment powers to make sure their viewpoints are well-represented on the government’s scientific advisory boards, an important if unglamorous part of the policy-making process. There are more than 250 boards devoted to public health and biomedical research alone, composed of experts from outside the government who help guide policy on gene therapy, bioterrorism, acceptable pollutant levels and other complex matters.

But critics say the Bush administration is going further than its predecessors in considering ideology as well as scientific expertise in forming the panels. A committee that merely gives technical advice on research proposals, as opposed to setting policy, has even been subject to screening, something the critics say was unheard of in previous administrations.

“I don’t think any administration has penetrated so deeply into the advisory committee structure as this one, and I think it matters,” said Donald Kennedy, past president of Stanford University and editor of Science, the premier U.S. scientific journal. “If you start picking people by their ideology instead of their scientific credentials, you are inevitably reducing the quality of the advisory group.”

Many of the complaints concern agencies within the Department of Health and Human Services.

On Dec. 10, the Food and Drug Administration rejected a nominee for an advisory board who is known for his support of human cloning in medical research.

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Also recently, HHS Secretary Tommy G. Thompson’s staff rejected a nominee to a board of the National Institute for Occupational Safety and Health who supports federal rules to curtail repetitive stress injuries in the workplace.

The nominees had been chosen by officials within the FDA and occupational health agency but were then rejected by more senior officials. No specific reasons were given, but Bush opposes human cloning and last year signed a rollback of Clinton-era rules designed to limit repetitive stress injuries.

Those rejections followed incidents this fall in which public health advocates and Democratic lawmakers alleged that the administration had placed people sympathetic to industry on two panels at the Centers for Disease Control and Prevention. One panel advises CDC officials on the prevention of lead poisoning in children. The other makes recommendations on issues ranging from environmental toxins to bioterrorism preparations.

“They’re stacking committees to get the advice they know they want to hear, which is a charade,” said David Michaels, a professor of public health at George Washington University, who served in the Clinton administration. “Why have an advisory panel if you know what everyone is going to say, and they agree with you?”

Some critics also complain that Thompson has added an ideological cast to the mission of some advisory panels.

To the applause of antiabortion groups, the administration in October directed a panel to study what protections are offered to embryos during medical experiments, using language that equated embryos with “human subjects.” Health officials said their intent was to add protections to pregnant women who participate in experiments.

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Bill Pierce, a spokesman for the Health and Human Services Department, said Bush and Thompson were trying to add balance to the committees.

“This whole idea of a grand conspiracy here or a litmus test -- it’s just not true,” Pierce said. “When you look at the totality of any of these committees, you’ll find that they are highly qualified and represent a broad section of the thinking, so that you have a spirited discussion of the issues.”

Others said that some of the complaints may reflect a difference in style between Thompson, who as former governor of Wisconsin is familiar with using all the levers of power, and his predecessor in the federal government’s top health slot, Donna Shalala.

“This is a four-term governor. This is not an academic, as Dr. Shalala was,” said Dr. John Howard, director of the National Institute for Occupational Safety and Health. “This secretary scrutinizes appointments.”

But Thomas Murray, president of the Hastings Center, a New York bioethics center, said he saw a pattern in the rejection of nominees to health panels, including his own nomination to the Biological Response Modifiers Advisory Committee, an FDA panel that considers protein drugs, gene therapy and other matters.

“The fact that they would even bother to blacklist me is ... deeply sad,” Murray said. “It portends a distortion of the process of determining what the facts are on a health topic or in environmental policy.”

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Of all the incidents, several scientists say the most disconcerting involved a panel at the occupational safety agency.

Known as the Safety and Occupational Health Study Section, the panel reviews applications for research grants, ranking them based on their scientific merit. The process is known as peer review.

Dana Loomis, a professor at the University of North Carolina who is chairman of the panel, said Thompson’s office gave no reason when it rejected three proposed members several months ago. The nominees had been chosen last year by Loomis, the panel staff and other officials, and they were approved by the then-director of the occupational safety institute.

But the reasons “seem clear enough in at least one case: One of the rejected nominees is a respected expert in ergonomics who has publicly supported a workplace ergonomics standard,” Loomis wrote this month in a letter to Sen. Edward M. Kennedy (D-Mass.). Bush last year repealed such a rule, which was aimed at requiring employers to do more to reduce repetitive stress and related injuries.

That nominee, Laura Purnett, a professor at the University of Massachusetts in Lowell, wrote to Kennedy that she had been subjected to “an ideological litmus test” that presumed she could not be objective in her panel work.

A second nominee, Catherine Heaney, an associate professor of public health at Ohio State University, said she had no clue why she was rejected. But she noted that her most recent research has focused on ergonomics.

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In a related incident, a researcher who was nominated to the panel more recently said a member of Thompson’s staff called her in an apparent attempt to gauge her views on ergonomics and other issues.

“I took a neutral view” on ergonomics, said Pamela Kidd, a specialist in workplace injury prevention at Arizona State University in Tempe, who is now a member of the panel.

A range of scientists and research advocates said they were particularly disturbed that the administration would ask such questions of nominees to a peer-review panel. These panels do not set policy or make funding decisions, they said, but merely determine whether scientists who want federal funding have designed credible experiments that can truly answer the questions they are studying.

“The goal here is to fund the best science, the best-designed experiments,” said Anthony Mazzaschi, an assistant vice president at the Assn. of American Medical Colleges. “To stack peer-review panels based on political preferences rather than scientific competency is doing everyone a disservice.”

Loomis, the panel chairman, said the screening “tends to stifle the scientific spirit.”

“Regardless of what the intention was, this creates the appearance that review panel members are being politically scrutinized, which is directly opposed to the philosophy of peer review, which is supposed to be nonpolitical and transparent,” Loomis said in an interview.

Lawmakers and public health advocates have been vigorously complaining about changes to the two CDC advisory panels.

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They challenged several new appointments to the Advisory Committee on Childhood Lead Poisoning Prevention, saying the new members were too closely aligned with industry interests and might weaken protections for children against lead poisoning. The new appointees included Dr. William Banner Jr., an Oklahoma physician who, according to critics, has testified that lead is harmful only at levels well beyond the government’s current standards.

Another member, Dr. Sergio Piomelli of Columbia Presbyterian Medical Center in New York, announced at the committee’s first meeting in October that he was nominated to be on the committee by “someone from the lead industry,” whose name he could not remember. But Piomelli, a pediatric hematologist, also said he had conducted studies that were criticized by the lead industry.

“Advisory committees are supposed to give the government and the public expert, unbiased advice based on the best possible science,” Sen. Kennedy said. “By stacking these important committees with right-wing ideologues instead of respected scientists, the administration is putting the health and well-being of the American public at risk.”

This summer, the administration chose not to reappoint 15 of the 18 members of the National Center for Environmental Health Advisory Committee whose terms had expired. The committee advises the Centers for Disease Control on a range of issues, including bioterrorism preparedness and safe drinking water standards.

One of the new appointees is a former president of a research firm funded by the chemical industry, and another “has made a career countering claims of links between pollutants and cancer,” said Sens. Kennedy and Hillary Rodham Clinton (D-N.Y.) in a letter to Thompson.

Thomas Burke, an environmental health specialist at Johns Hopkins University in Baltimore who until recently was chairman of the committee, said: “I understand that this is the political process, and the pendulum swings. This is definitely a swing of the pendulum.”

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Pierce, the Health and Human Services Department’s spokesman, said the critics were singling out the few panel members whose views differ from their own, “and then attributing to them some superhuman ability to overwhelm everyone else on the committee.”

Pierce also said that the staff member who queried Miller, the addiction researcher, is no longer with the department. “To my knowledge,” he added, “‘we do not ask those questions.”

Miller, a professor of psychology and psychiatry at the University of New Mexico in Albuquerque, said he received a call early this year asking whether he would serve on the National Advisory Council on Drug Abuse, which guides funding and policy decisions at a unit of the National Institutes of Health.

Then came the call from someone at Thompson’s office.

“The first question he asked me was, ‘Are you sympathetic to faith-based initiatives?’ I said yes, and he said, ‘OK, you’re one for one.’ ”

Then the caller asked Miller about his views on needle exchange programs, the death penalty for drug kingpins and abortion, keeping a running tally of where his views agreed with those of the White House. Finally, the caller asked whether Miller had voted for Bush. When Miller said he had not, the caller asked him to explain.

“You have to admire the audacity,” Miller said last week. “It seemed rather clear that the White House wanted to make sure they wouldn’t receive any advice inconsistent with their own positions.”

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“In an ideal world, you’d choose people based on their scientific credentials, their knowledge of the literature,” he said. “Maybe that’s too ideal a world.”

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