I'm not a real doctor; I just play one in the Senate

From Chris Mooney of The American Prospect:
Senate Majority Leader Bill Frist -- or "Bill Frist, M.D.," as his Senate Web site proudly proclaims -- is on the defensive lately. In recent days, Frist has been skewered for delivering a Senate floor speech in which he challenged Florida doctors' careful diagnosis of Terri Schiavo's "persistent vegetative state," a reinterpretation that Frist apparently based on little more than "an hour or so" of video footage. "As a physician, I was astounded" by Frist's display, Howard Markel recently wrote in The New Republic. "Long-distance doctoring is problematic on many levels but especially for a doctor who has not practiced much medicine for more than a decade." Indeed, Frist's politicized "diagnosis" in the Schiavo incident follows closely a flap in which the physician-senator plainly distorted biomedical information, this time with the apparent objective of humoring conservative devotees of abstinence education. Last December on ABC's This Week, George Stephanopoulos pressed Frist to comment on a report by Representative Henry Waxman exposing the factually misleading nature of many federally funded abstinence programs. Put on the spot, Frist repeatedly refused to debunk the nonsensical notion that HIV can be transmitted through "sweat and tears," as one such program claims. Only after Stephanopoulos refused to relent did Frist finally admit that such transmissions would be "very hard." In each of these cases, we observe essentially the same phenomenon. Although he certainly knows better, being by all accounts an extremely intelligent man and a pioneering heart-transplant surgeon, Frist is clearly willing to sacrifice medical integrity to appease the religious right. In so doing, Frist has left himself open to the very serious accusation that he routinely exploits his medical credentials for political gain. From saving lives within the Capitol to his advocacy on the issue of AIDS in Africa, Frist has gained immense goodwill for being a doctor-politician. Simultaneously, he has repeatedly acted as the GOP's self-appointed political brawler on biomedical issues. Consider Frist's attacks in relation to the issue of embryonic stem-cell research during last year's presidential campaign. "John Kerry claims the president has put a 'sweeping ban' on stem-cell research," Frist declared in his speech at the Republican national convention. "What ban? Shame on you, Mr. Kerry." Frist also lit into John Edwards when the former senator claimed, on the stem-cell issue, "If we do the work that we can do in this country, the work that we will do when John Kerry is president, people like Christopher Reeve will get up out of that wheelchair and walk again." In both cases, Frist's attacks were particularly devastating because they came from an MD. It didn't hurt, of course, that Frist was basically in the right. The Kerry campaign, either incautious or uninformed, did indeed claim that Bush had "banned" embryonic stem-cell research; in actuality Bush had merely blocked federal funding of research on new lines (an action that placed a severe stranglehold on science but that nevertheless did not amount to a "ban"). Similarly, Edwards had no business making such a specific promise about future cures from a still youthful and even turbulent field of biomedical research. But while Frist may have scored political points in the past by acting as the voice of sweet medical reason, his recent exploits throw into question any claim to the high ground that he may have had in such debates. Indeed, disturbed by Frist's recent pandering, I surveyed some of his past statements on the issues of stem-cell research and cloning. Once again, I found him guilty of distorting science to favor the president's, and the religious right's, favored policies. Most troubling were some of Frist's statements in opposition to the cloning of human embryos for the purpose of deriving stem cells, work the good doctor opposed not merely on moral grounds but also by claiming that it wasn't medically necessary. "The promise and success of human embryonic stem-cell research does not depend on experimental research cloning," Frist boldly declared in June of 2002. It's extremely hard to see how Frist could possibly have known this at the time. Indeed, in the very same speech, he cautioned that this "uncharted new science" was in a very "early state" -- yet he was basically willing to slam the door on an entire avenue of inquiry. In fact, contrary to Frist's statement, it now seems clear that research cloning will be essential for a very basic form of embryonic stem-cell work. This procedure will allow scientists to obtain certain disease-specific embryonic stem-cell lines whose precise characteristics cannot be obtained simply by prescreening embryos left over from in vitro fertilization clinics. Similarly, in Frist's attack on Edwards, the doctor touted adult stem-cell research as an alternative to embryonic work, describing it as a field "where the president has absolutely no restrictions, no limitations, and there are about 140 treatments." Religious conservatives love to hype adult stem-cell research to make embryonic research seem less necessary, but the claim that more than a hundred treatments currently arise from this work is misleading. First, while it's true that blood-forming stem cells found in bone marrow have led to treatments, scientists have also had much longer to work with them than with embryonic stem cells. As for other types of "adult" stem cells, many experimental treatments may exist, but that hardly means that they meet the current standard of medical care for a particular condition, or that they've been proven effective in major clinical trials. As these incident suggests, the political distortion of biomedical science isn't exactly new for Frist. Instead, the recent Schiavo and "sweat and tears" incidents stand out more because of their flagrancy than because they're out of character for the "Senate's only physician" -- a man who has in fact repeatedly cashed in on his white-coat status to score political points. Shame on you, Dr. Frist.


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