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Whose advice? Expert committees get a makeover. (capital report).

Every administration reserves the right to appoint its own scientific advisors. Typically, individuals are selected based on expertise, credibility, and whether their views on a given subject are within a reasonable range of political acceptability. Generally, efforts are made to avoid appointing those with blatant conflicts of interest or obvious and vociferous points of view. An unspoken rule of committee construction is that the most strident perspectives will always be heard--even when uninvited--and therefore do not necessarily warrant a seat at the table. What aids policymaking most--if that is the goal--is convening groups with the collective expertise to consider and deliberate all facets of an issue before delivering a set of recommendations. Acknowledging that the resulting advice need not be heeded, many science policy veterans assert that the process of developing and delivering expert counsel can be as crucial as the message itself.

In an effort to restructure the Department of Health and Human Services advisory system--which includes more than 250 committees--Secretary Tommy Thompson has begun the process of eliminating or replacing sitting committees. Where this administration is breaking with tradition is in its apparent lack of concern about how this process is viewed by the broader scientific community and its seating of lobbyists and political operatives on such committees. "It's unfortunate, but not surprising," said Robyn Nishimi, a veteran of numerous advisory efforts in Washington, including the now-discarded congressional Office of Technology Assessment, which was created, in part, to counteract biases created by federal advisory committees. "After all, this is an administration that permitted abortion politics to scuttle the potential nomination of a world-class scientist and administrator, Dr. Fauci, as NIH Director," said Nishimi.

In September, Thompson allowed the charters of two expert committees to expire before their work was complete, thus laying to waste several years of volunteered time and staff resources. First to go was the Secretary's Advisory Committee on Genetic Testing (SACGT), which was created in 1998 to advise DHHS on, among other things, "the adequacy of regulatory oversight of genetic tests and provisions for assuring the quality of genetic testing laboratories." In a 2000 report the committee recommended that the Food and Drug Administration expand its regulation of the growing genetic testing industry, which has remained free of such oversight. For a while it seemed that the FDA was going to assert its authority in this area, but since January 2001, momentum has slowed, and the FDA has not advanced any regulatory guidance in this area.

The second committee to expire was the National Human Research Protections Advisory Committee (NHRPAC), created under President Clinton to address inadequacies in the federal system for protecting human research subjects. The committee was scheduled to meet in August but was abruptly notified that its charter was not being renewed. Some NHRPAC members felt that politics were influencing what one called "a quintessential nonpartisan issue--protecting people from preventable harms in research." According to some sources, the committee's "pro-subjects" orientation was interpreted as being anti-industry and religious conservatives were angered when NHRPAC did not support Thompson's efforts to include fetuses under a federal regulation pertaining to research on newborns.

A third committee, formed to advise the Centers for Disease Control on the effects of environmental chemicals on human health, was informed that nearly all of its members will be replaced. Replacements include, among others, Becky Dunlop of the Heritage Foundation and the American Conservative Union, a large lobbying organization for which she is a board member, and Dennis Paustenbach, a toxicologist who served as an expert witness for Pacific Gas and Electric in the lawsuit made famous by the movie Erin Brockovich. Paustenbach is now a vice president at Exponent, a consulting firm whose clients include the country's largest utilities and chemical, petroleum, and pharmaceutical companies.

In a recent article in The Washington Post, DHHS spokesman William Pierce "defended Thompson's prerogative to hear preferentially from experts who share the president's philosophical sensibilities." Critics contend that the administration should not exercise that right under the guise of seeking independent expert advice. And some staffers worry that as the process becomes more politicized, fewer scientists will be willing to serve as advisors.

On the other hand, stacking panels to achieve a foregone conclusion does not always work. In July, Bush's bioethics council delivered a sharply divided opinion on whether cloning for biomedical research purposes should be permitted. That such a divide would occur on a panel chaired by Leon Kass, a vocal adherent to the president's philosophical sensibilities, was a surprise to many.

Kathi E. Hanna is a science and health policy consultant in Prince Frederick, Maryland. She has served as a consultant to SACGT and NHRPAC.
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Author:Hanna, Kathi E.
Publication:The Hastings Center Report
Geographic Code:1USA
Date:Nov 1, 2002
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