WASHINGTON — President Bush's candidate for surgeon general, facing an uphill struggle to win confirmation, told the Senate on Thursday that he's committed to science and would resign if pressured to slant his recommendations for ideological reasons.
"I would use the science to attempt to educate the policymakers," said Dr. James W. Holsinger Jr., a prominent Kentucky physician, medical educator and former government official. "Quite candidly, if I were unable to do that and I was being overridden ... I would resign."
Still, no Democrats indicated they would support him, and fewer than half the members of the Senate panel holding the hearing on his nomination attended.
Holsinger's nomination is opposed by major gay and lesbian groups and others concerned about views he expressed in a 1991 paper suggesting that homosexuality is abnormal.
Separately, concerns that ideology has trumped medical science in the Bush administration were heightened this week after former Surgeon General Richard H. Carmona told Congress that his professional advice was censored to conform to political and religious views.
Holsinger struck some independent notes Thursday before the Senate Health, Education, Labor and Pensions Committee. He said he supported an advertising ban on prescription drugs. He underscored his advocacy for higher tobacco taxes. And he said that using condoms was important for preventing pregnancy and sexually transmitted diseases, and suggested condoms were appropriate for teens.
Those stands could put him at odds with administration positions.
But Holsinger also indicated support for the president's restrictions on federal funding for stem cell research -- putting him at odds with a majority of lawmakers in Congress and many in the scientific community.
If confirmed as surgeon general, Holsinger has vowed to launch a national crusade against childhood obesity.
After more than two hours of answering questions from senators, it was unclear if he convinced any skeptics.
Holsinger's difficulties initially stemmed from a paper he wrote in 1991 arguing that sex between men was contrary to nature's design and was associated with infectious diseases and cancer. The paper was prepared for a committee of the United Methodist Church, in which Holsinger has served as a high-ranking lay official. The church has been embroiled in a contentious debate over policies toward gays.
The paper has been taken out of context and "does not represent where I am today ... who I am today," Holsinger said. But he did not spell out his current views, and the controversy has lingered.
"Many of us are concerned about aspects of Dr. Holsinger's record that indicate that Dr. Holsinger has let his ideological beliefs cloud his scientific judgment," said Sen. Edward M. Kennedy (D-Mass.), the committee chairman. "These concerns are serious at any time, but all the more so in light of Dr. Carmona's alarming testimony."
Kennedy also cited a letter he recently received from a group of leading AIDS physicians, concluding that "Dr. Holsinger's paper is not based on science, but rather is ideology with a veneer of science." One of the letter's authors, Dr. William F. Owen of San Francisco, was cited as a source by Holsinger in his 1991 paper.
"The paper implicitly attempts to show that there is a scientific consensus for the proposition that homosexuality is abnormal, when in fact the scientific consensus in 1991 was much more strongly in favor of the concept that homosexuality is not abnormal and is not a disorder," the letter said. "That consensus has only strengthened over time."
Holsinger said that if confirmed as surgeon general, he would be an advocate for the health of all Americans, regardless of sexual orientation. As the top state health official in Kentucky, he said, he made sure the needs of lesbians were addressed in a major conference on women's health in 2002, despite strong political opposition from some state legislators.
"Everyone who is a [medical] practitioner needs to understand the health needs of our gay and lesbian community," he said.
Holsinger has received support from former Surgeon General C. Everett Koop and former Health and Human Services Secretary Louis W. Sullivan. But the nonpartisan American Public Health Assn. has called on the Senate to reject his nomination because of his writing on gays.