Subject: Koop's Stand on AIDS Turns Allies Into Critics, Foes Into Followers
Date: Published: 12/28/87 92 lines
Source:  WALL STREET JOURNAL. Copyright Dow Jones & Co. Inc. 

    Surgeon General's Stand on AIDS Turns
    Allies Into Critics, Foes Into Followers
    ---
    By Albert R. Hunt
    Staff Reporter of The Wall Street Journal

    WASHINGTON -- C. Everett Koop has aroused both passionate
 support and passionate opposition ever since he was named
 surgeon general of the U. S. almost seven years ago.
    That isn't unusual in Washington.  What is unusual is that
 his original passionate supporters -- mainly conservatives -- 
 now are the vehement critics, while he has won over some of
 his most ardent liberal foes.
    This says something both about the independent-minded Dr. 
 Koop and the changing social agenda in the country.  When he
 came into office, abortion was the major social issue; Dr. 
 Koop is a dedicated right-to-lifer.  Today, AIDS is the top
 social concern, and his advocacy of sex education, the use of
 condoms and his refusal to bash the homosexual life style
 have made him a darling of the public-health community and
 many liberals.
    Whether or not one likes his views, Dr. Koop has done more
 than anyone else in government to try to mobilize Washington
 and the nation on the AIDS issue.  "He has been very effective
 in bringing attention to the AIDS issue in a very sensitive
 and thoughtful way," says Harvey Feinberg, dean of Harvard
 University's School of Public Health.
    Dr. Koop turned out a 36-page booklet on AIDS last year
 that surprised many of his earlier champions and critics.  He
 insists that AIDS is a deadly epidemic and that radical
 measures must be taken to combat it.  While he advocates
 sexual abstinence and marital monogamy, he says that the real
 world demands other measures.  Thus, he supports sex education
 in elementary schools, and has called on physicians to
 recommend condom use for sexually active people, homosexual
 and heterosexual.  He also has blasted physicians who refuse
 to treat AIDS patients for engaging in "unprofessional
 conduct."
    Dr. Koop has been decidedly cool toward calls for
 widespread mandatory testing to uncover possible AIDS
 carriers.  He argues that such testing would serve mostly to
 drive underground victims who need treatment.  These stands
 have endeared him to many public-health and medical
 professionals as well as to homosexuals and political
 liberals; at the international conference on AIDS last June,
 while other administration officials were greeted with
 hostility, the 71-year-old Dr. Koop was welcomed as a hero.
    But this has infuriated many of the conservatives who once
 viewed him as one of their own.  Last spring, a number of
 politicians seeking conservative approbation -- including
 presidential contenders Robert Dole and Jack Kemp -- withdrew
 at the last minute as sponsors of a dinner honoring the
 surgeon general.  California Rep. William Dannemeyer, a
 conservative Republican, charges that Dr. Koop "has abrogated
 his responsibilities on this issue."
    Few medical experts share that view.  But most do recognize
 that there are real institutional limits on how far a surgeon
 general can go and how effective one can be:  The job involves
 less policy setting and more of a bully pulpit.  "His handicap
 is that he's a general with no troops," observes Harvard's
 Dr. Feinberg.
    That's especially true given the administration's deep
 divisions over AIDS issues.  While the surgeon general
 generally gets backing from his boss, Health and Human
 Services Secretary Otis Bowen, he is fiercely opposed by such
 ranking conservatives as Education Secretary William Bennett,
 who feels the Koop approach ignores the moral dimension of
 the AIDS issue, and Gary Bauer, the hard-liner who heads the
 White House domestic policy council.
    The anger of some conservatives is doubtlessly amplified
 by their earlier admiration for Dr. Koop.  Besides his
 anti-abortion stand, he once labeled amniocentesis, a medical
 test that spots birth defects, as a "search and destroy
 mission."  He also pushed regulations that would force
 hospitals and doctors to treat severely handicapped newborns
 even over the objections of their parents.
    Dr. Koop apparently hasn't changed any of these views -- 
 the idiosyncratic surgeon general says he's too busy for an
 interview with The Wall Street Journal -- but the agenda has
 shifted.  He insists that, despite his high political profile
 these days, his "is a health message, not a political
 message."

[This article is made available here by Dow Jones Co. for the 
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hope that it will be of some help to those who are suffering 
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