Koop’s Stand on AIDS Turns Allies Into Critics, Foes Into Followers

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
personal and non-commercial use of callers to this bbs, in the
hope that it will be of some help to those who are suffering
from the disease and others who are seeking to help them.]

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