Showing posts with label national academy of sciences. Show all posts
Showing posts with label national academy of sciences. Show all posts

14 March 2015

National Academy of Sciences on Financial Disclosure


In 2014, the Institute of Medicine C-123 Agent Orange committee had a presentation by a scientist who did not offer information about his $600,000 consulting contract with the Department of Veterans Affairs. Both he, and the Department, opposed C-123 veterans' arguments as to Agent Orange exposure aboard the former Agent Orange transports.

Because the VA proposed the question to the Institute of Medicine, it was improper for it to advocate a particular finding by the IOM. The consultant explained, in his preface to comments to the committee, that he was not there to represent the VA but to explain the science behind the VA's perspective on C-123 Agent Orange exposures. However, never did he discuss his unusual historical involvement with the VA and the US Air Force, and the C-123 veterans, including his personal role in 2009 recommending destruction of those aircraft.

At the time of the IOM meeting, it seems only VA was aware of the consultant's unusual no-bid, sole-source contract addressing post-Vietnam herbicide concerns. Later, the committee was informed that the scientist had a consulting relationship with the VA, and at some point after that, the amount of the contract was also made known to the committee by IOM staff.

Veterans and others presented IOM their financial statements; even the authors of papers sponsored by Dow and Monsanto met this fundamental ethical obligation. But not the VA consultant. The VA took no action, even though it had several representatives at the IOM hearing well-aware of the issue.

This writer is no scientist, and the nuances of this profession's ethical considerations are unfamiliar. Perhaps the consultant and VA were perfectly proper in the IOM presentation. It is hard, however, to find any positive spin to put on this: VA paid a lot of money to oppose veterans' Agent Orange exposure claims, and failed to reveal anything about this. Most of the work product of the consultant's contract was submitted in opposition to the veteran's claims, and nothing that was helpful...his view was quite clear and only information supporting that view was offered, a view he has espoused for decades.

This would be acceptable in a high school debate, but not as the National Academy of Sciences tried to address the health concerns of thousands of veterans.

In addition to tremendous amounts of its staff resources, VA spent hundreds of thousands of dollars to oppose the veterans. Not a penny was permitted to support the veterans' presentation to the IOM in which we argued that we'd been exposed Thus, VA presented its policy to the IOM, not an even-handed scientific analysis.

The VA was hardly neutral and should not have posed this question to the IOM with their ill-disguised objective of using IOM to obstruct veterans' exposure claims. VA selected only materials, reports, opinions and other materials for the IOM which argued against the veterans, withholding everything helpful to the veterans' cause. The only materials supporting the veterans' perspective were submitted by the veterans, by unpaid concerned scientists and physicians, or obtained by the IOM itself.

VA showed it was not seeking an objective examination of the C-123 Agent Orange exposure claims. Veterans were entitled to advocate the basis of their situation, but VA was supposed to be not only objective, but pro-veteran, and seek a clean scientific analysis through IOM of the issue. VA failed.

On March 8, 2015, the president of the National Academy of Sciences addressed the issue of financial disclosure and the importance in science that that ethical requirement plays. Although the particulars of his address dealt with climate change, the fundamental ethical problem is identical to the C-123 Agent Orange meeting:

By National Academy of Sciences President Ralph J. Cicerone
     March 6, 2015
The methods, motives, and results of scientists come under special scrutiny when
societal or economic matters are involved, for example, in cases involving medicine and health, governmental policies and regulations, and commercial applications.  Recently, two new examples have arisen, both involving the science of climate change and societal responses to it.  
One case involves allegations of failure to disclose financial interests and research support from corporate interests on the part of a researcher at the Harvard-Smithsonian Center for Astrophysics who testifies on behalf of organizations that discount the role of human activity in global climate change.  The other consists of requests to seven universities by Rep. Raúl M. Grijalva (D-Ariz.) for the names of funding sources for a group of scientists and policy analysts who have publicly disputed widely accepted scientific findings about the causes of climate change and the value of public responses to it.  An earlier Congressman’s request for professional and personal materials should also be remembered. 
These incidents and prior ones show that scientists must disclose their sources of financial support to continue to enjoy societal trust and the respect of fellow scientists, while also maintaining high standards in the enterprise of science. 

18 February 2013

VA Rejects Challenge From Physicians & Scientists re: C-123 Agent Orange Exposure


In ignoring their input, VA blatantly ignored members of the National Academy of Sciences, experts from other federal agencies, and faculty members from prestigious universities. These independent experts, according to the VA, are completely inadequate to sway the VA's Compensation Services to even grant veterans the "benefit of the doubt" required by law.
At least, the experts were assured that their independent opinions will be considered a source of evidence in C-123 veterans' claims. The veterans do not find this assuring, however, because while the VA says C-123 vets can qualify for benefits on one page of their web site, on others they explain why claims will be denied.

None of the concerned independent scientists and physicians were paid to research and present their expert opinions. 

The evidence associated with service on post-Vietnam C-I23 aircraft shows that
some of these aircraft contained dried residual traces of the Agent Orange herbicide
contaminant dioxin, which could only be obtained and measured by rubbing the interior
metal surface with the solvent hexane, You have stated that the dioxin obtained by this
process is sufficient to establish that the crewmembers were "exposed." However, the
scientists and medical doctors of the VA Office of Public Health have documented with
scientific literature that residual trace amounts of dioxin on metal surfaces is not
biologically available for skin absorption or inhalation because it is not water or sweat
soluble and does not give off airborne particles. As a result, they have concluded that the
likelihood of dioxin exposure was minimal, Your view of potential exposure must be
weighed against their view when VA evaluates a disability claim.
In addition to the issue of potential exposure, there is the issue of establishing a
medical nexus or link between the in-service event of flying on a post-Vietnam C-123
aircraft and development of a current Agent Orange exposure-related disease. VA laws
and policies related to Agent Orange exposure, whether presumptive or based on facts-
found evidence, address exposure contact that occurs during the actual spraying or
handling of the dioxin-containing liquid herbicide. There are no provisions for secondary
or remote exposure, as is the case with dried dioxin residuals on metal surfaces found
many years after the liquid state. The scientific evidence available to establish a medical
nexus in these cases is limited and the VA Office of Public Health has provided a medical
opinion that it is insufficient to establish the required nexus. While your letter focuses on
the issue of potential dioxin exposure, it does not offer an opinion on the medical nexus
issue nor does it address the potential for long-term health effects or disabilities resulting
from service on the post-Vietnam C-123 aircraft
Another issue you raised is the wording of the Agent Orange Act of 1991, which
establishes a presumption of exposure to "herbicide agents" used in Vietnam that
includes chemicals other than dioxin. You state that consideration should be given to
these other chemicals when considering disability compensation based on exposure
because they may have been present in the post-Vietnam C-I23 aircraft, However, since
there is no presumption of exposure to any herbicide agents without Vietnam service, this
legislation is not applicable. Additionally, the National Academy of Sciences' Institute
of Medicine, which is named in this legislation as a major source of scientific information
related to herbicide agent exposure and its adverse health effects, has determined that
dioxin is the primary "chemical of interest" associated with adverse health effects. If a
disability claim were based on exposure to other herbicide agents, the same evidence of
direct facts-found exposure and a medical nexus would be required for service
connection.

We appreciate your input and the evidence you have provided on the issue of
disability compensation for Veterans who served aboard post-Vietnam C-123 aircraft.
When VA receives claims from Veterans based on this service, they will be evaluated
based on the totality of the evidence, as described above, and determinations will be
made on a case-by-case basis.

/signed/
Director of Compensation Services