Seven words that federal scientists are no longer supposed to use (one is “science-based”)

fitzgeraldWhat’s going on at the Centers for Disease Control and Prevention?

It’s a federal agency with a $7 billion budget and more than 12,000 employees working across the nation and around the globe on everything from food and water safety, to heart disease and cancer, to infectious disease outbreak prevention. Its work and guidance on health matters long has been heeded and well respected.

But the Washington Post — in a story that sounds like it might have leaped from the satirical pages of The Onion or from a monologue by the late comedian George Carlin — has reported that CDC experts have been banned from using seven words in any upcoming communications with Congress about the 2019 budget.

These are the now naughty terms: vulnerable, entitlement, diversity, transgender, fetus, evidence-based and science-based.

The newspaper got a gobbledy-gook answer from the Health and Human Services (HHS) department, the CDC’s overseer, when it inquired about the term ban, unveiled in an agency meeting. Brenda Fitzgerald, the CDC’s chief, took to social media to deny that the her agency bans terms.

But the Washington Post has noted that HHS, under the Trump Administration, has grown wary of mentions of sexual orientation, lesbians, gays, and the transgendered, purging discussions of them from agency web pages and dropping them in department considerations.

CDC officials have said, off the record, that they also have been told to steer clear of explaining how medical scientists base their thinking, budgeting, and action. They were told, for example, to drop science-based or evidence-based, and say, instead, “CDC bases its recommendations on science in consideration with community standards and wishes.”

In my practice, I see the harms that patients can suffer while seeking medical services and the damage and disservice done to them when so-called experts fail to inform them fully about their medical care in acts of omission or commission — such as talking with them in confusing or unclear language. Informed consent — ensuring that we know what doctors propose to do to and with us and why — is a fundamental patient right, and rigorous, evidence-based policy ought to be a cornerstone of how lawmakers oversee and fund the U.S. health system.

It is wrong for politicians to try to handcuff one of the pre-eminent public health agencies on the planet with silly, counter factual, arbitrary, and un-scientific edits of their correct language. The seven terms that HHS or budget bureaucrats want to strike are critical for CDC staff to use because they’re charged with protecting and improving the health of women, members of the LGBT community — of all Americans.

The CDC may find itself in choppy political waters these days  in part because of its new chief Fitzgerald, 71, an obstetrician-gynecologist, onetime Air Force major, and the former Georgia public health commissioner. She was a political ally in the Peach State of Tom Price, the disgraced HHS secretary who resigned after Politico caught him spending taxpayer dollars, so he could fly on private or charter jets. She has chosen to be a low-key, almost invisible CDC chief.

Fitzgerald and her husband, Thomas Fitzgerald III, an emergency medicine physician, have worked hard and done well financially, with the Washington Post reporting:

Financial-disclosure forms show that she and her husband have combined assets worth $3.8 million to $16 million. A 48-page document shows that the couple’s portfolio has included a wide variety of health-care, pharmaceutical, food and tobacco holdings through companies and investment funds that, for the most part, are widely traded.

But five months into her time as head of the CDC, Fitzgerald and her husband have struggled to divest themselves of their considerable holdings. This means she must steer clear of some significant health policy matters. Sen. Patty Murray, the Washington Democrat, has asked how Fitzgerald can lead the agency, if, for example, ethical concerns about her personal finances bar her as they do now from anything to do with the opioid drug abuse epidemic or cancer?

Fitzgerald needs to step up her financial divestment or the Trump Administration should thank her for her service thus far and move on and find someone else for her critical role.

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