WASHINGTON — After six hours of often rancorous debate, the Senate on Tuesday confirmed the appointment of Dr. Joycelyn Elders, a controversial 59-year-old Arkansas endocrinologist, as the nation's next surgeon general.
The 65-34 vote was cast largely along traditional ideological lines: only four Democrats opposed the nomination, while 13 Republicans voted for it. Both of California's senators, Democrats Dianne Feinstein and Barbara Boxer, voted to approve her nomination.
In a statement clearly meant to address some of the chief concerns raised about her by conservative Republicans, Elders said after the vote: "I am, by training and temperament, a healer."
And in a clear signal that she intends to pursue positions that were a source of controversy during consideration of her nomination--namely abortion rights and condom distribution--she added: "It is time to look forward--not back--to a time when all American children are planned and wanted, when all American children are immunized, when all American citizens have the security of quality health care and when all dread diseases are a distant and haunting memory."
As has been the case since she was selected for the post by President Clinton earlier this summer, Democrats throughout Tuesday's debate praised Elders for her plain-spoken, no-nonsense approach to a host of touchy social issues, while conservative Republicans objected to her abortion rights stance, her advocacy of health and sex education for teen-agers and what they viewed as intemperate remarks that angered powerful constituents, most notably, the Roman Catholic Church.
As surgeon general, Elders assumes a largely bully pulpit post, one without any real authority to make public health policy. However, surgeon generals can have a powerful influence on the American public--depending on the strength of their personalities and convictions.
Elders, who served as head of the Arkansas Department of Health, has said on numerous occasions that she intends to use the position--as she did in Arkansas--to push for child, teen-age and women's health programs, with a special focus on preventing teen-age pregnancy.
Elders' nomination was initially debated in August before the Senate's monthlong recess but the vote was stalled by her chief opponent, Sen. Don Nickles (R-Okla.), who insisted that he and other Senate critics, including Sen. Trent Lott (R-Miss.), needed more time to examine her record.
Questions were raised--and ultimately resolved--about Elders' financial dealings as a member of the board of an Arkansas bank and her husband's failure to pay Social Security and other taxes for a nurse who had cared for his ailing elderly mother. She also was criticized for drawing her state salary while working last spring as a consultant to the Department of Health and Human Services, although it was determined that the double salary was legal.
Most of Tuesday's debate in the Senate focused on Elders' past comments criticizing abortion foes, particularly the Catholic church, and her support for abortion rights and contraception for sexually active individuals, including teen-agers, prostitutes and others.
"My reason for opposing Dr. Elders . . . is because of several statements she has made that I think . . . disqualify her for this position," Nickles said. "Dr. Elders has a very radical agenda. I think she's made very strong intolerant statements, which, to say the least, are troubling (and) clearly out of the mainstream. . . . "
She once characterized anti-abortion Americans as "very religious non-Christians" and she talked bluntly of reasons for making condoms available to young people, saying at one point that young people had to be taught how to behave both in the front seat and the back seat of a car.
Elders also caused a commotion with her reference to opposition to abortion by a "male-dominated" church. The comment was taken by Roman Catholics as a criticism of their church. Elders later apologized for that remark.
Again on Tuesday, Lott criticized what he called her "divisiveness," and predicted that she would be a "polarizing" influence on the American public.
"We need a healer in the position of surgeon general, not somebody who can't control what she has to say," Lott said. "She may turn out to be a great surgeon general and I hope she does but I have to vote my own conscience and my own constituency."
Numerous senators rose to defend her with enthusiasm, saying that her candor would provide an important wake-up call for Americans when little else has worked--particularly in the age of AIDS and the nation's high rate of teen-age pregnancy.
"By her record, her character and her intellect, Dr. Joycelyn Elders is superbly qualified to take on these challenges and be surgeon general," said Sen. Edward M. Kennedy (D-Mass.), Labor and Human Resources chairman. "She is a diamond in the rough. Her opponents see the rough, but they also miss the diamond."
Sen. Carol Moseley-Braun (D-Ill.) declared that "nothing had changed" in Elders' qualifications since the Senate recessed in August and she described efforts by Elders' opponents, including the delay, as "character assassination."
Elders is a daughter of southwest Arkansas farmers--one of eight children--who finished high school at 15 and graduated from Philander Smith College, a small, black Methodist college in Little Rock, Ark. After college, she enlisted in the Army and later entered the University of Arkansas Medical School on the GI bill. She served as professor of pediatrics there before becoming Arkansas health chief in 1987 under then-Gov. Bill Clinton.