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Katayoun Chamany Introduction HEALTH POLICY HAS ALWAYS BEEN IN FO R M E D BY BOTH SCIENTIFIC research and political will. Though the National Academies of Science was established in 1863 w ith the role of inform ing governm ent on scientific m atters, President Dight D. Eisenhower was the first presi­ dent to appoint a science adviser. James Killian, a form er MIT presi­ dent, recognized the im portance of his newly appointed advisory role, and created the first President’s Science Advisory Committee (PSAC), which was followed some years later by the Office of Technology and Assessment (OTA). The creation of the presidential science adviser posi­ tion, the PSAC, and the OTA were in response to an increasing need to better understand our nation’s capabilities and shortcom ings as they related to space research and national security. However, over the years, this position, and its related offices and com m ittees, have been dismantled and resurrected to be m ore in line w ith each incoming adm inistration’s goals. We currently lack an OTA, our bioethics council is appointed by the president, and the presidential scientific adviser position has been dem oted to a staff position w ith very little technology expertise in the supporting office. Though we continue to look to science for m atters of defense and energy, we have arrived at a critical juncture in health policy. We have a populace th at suffers from age- and lifestyle-related disorders and a growing HIV/AIDS epidemic. W ithout specific agencies in place with balanced representation am ong members, it is not clear how we will incorporate science and its ethical implications into repro­ ductive health policies that relate to education, family planning, and stem cell research. social research Vol 73 : No 3 : Fall 2006 781 Policy governing scientific research has shifted over the years and is often tightly tied to economic and business interests. Early on, governm ent played a dom ineering role th at gradually gave way to a more inclusive approach that involved members of the general public and the scientific community. As scientists developed new technolo­ gies, the scientists themselves took the lead in preparing guidelines for research conduct, but quite coincidentally, scientific research increas­ ingly began to take place in the private sector, releasing scientists from the ethical oversight that accompanied federally funded projects. As we move into the twenty-first century, governm ent’s role in the form ation of health policy has begun to return to past practices that exclude com m unity involvement, involve m anipulation of scien­ tific data, and lack ethical consistency. Many scientists and public health scholars believe that scientific discovery and sound health prac­ tices are being squelched by policies that reflect ideology and represent a flight ftom reason. Some have decided to relocate to other countries, while others have moved into the private sector, be it in companies or academia. Still others have become m ore vocal, insisting that scientists do a better job of com m unicating their work to a democracy that can vote on these policies in an inform ed manner. In some cases, states have joined the m ovem ent and enacted laws that are at odds w ith federal funding restrictions. The essays in this section represent some of the fallout of such policies. Elders and Santelli, both leaders in adolescent health, walked away from government positions and continue to pursue their research goals in academia. Hurlbut and Cohen have moved in the other direc­ tion, becoming increasingly m ore involved in policymaking as it applies to stem cell research and in vitro fertilization techniques. Cohen’s essay eloquently quotes Max Weber and reminds us that science needs help. Surely this is true, considering the moral implications involved in stem cell research and other scientific endeavors; however, he extends his analysis m ore broadly as he points out that a balanced deliberation has been in question for some time. W hile the Bush admin­ istration has continued to push a pro-life agenda, Cohen reminds us that 782 social research the Clinton Bioethics Council did not have a single m em ber who opposed embryonic research...


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