Monday, December 18, 2017

Health care leaders and groups lash out over CDC word ‘ban’

Words matter—but a recent selection of phrases has brought on ire from medical professionals and organizations nationwide.

On Friday, The Washington Post broke news that the Centers for Disease Control and Prevention—an organization under the U.S. Department of Health and Human Services—had “banned” a list of words from budget documents.

The Post reported:

Policy analysts at the Centers for Disease Control and Prevention in Atlanta were told of the list of forbidden terms at a meeting Thursday with senior CDC officials who oversee the budget, according to an analyst who took part in the 90-minute briefing. The forbidden terms are “vulnerable,” “entitlement,” “diversity,” “transgender,” “fetus,” “evidence-based” and “science-based.”
In some instances, the analysts were given alternative phrases. Instead of “science-based” or ­“evidence-based,” the suggested phrase is “CDC bases its recommendations on science in consideration with community standards and wishes,” the person said. In other cases, no replacement words were immediately offered.

Questions and speculations have swirled around since The Post’s report was published.

The New York Times reported:

There seemed to be confusion around the public health agencies about whether the ban originated at the agency’s parent department, Health and Human Services, or inside the C.D.C. itself; and whether such a ban would apply beyond budget documents. The Food and Drug Administration was quick to note that it had gotten no such instruction. An agency spokeswoman, Jennifer Rodriguez, said, “We haven’t received, nor implemented, any directives with respect to the language used at F.D.A. to describe our policy or budget issues.” The National Institutes of Health referred inquiries to Health and Human Services.

The Times also reported that some CDC sources said the move was not a direct ban, but rather an effort to “tone down language,” which might potentially soften Republican members of Congress when the organization applies for funding.

Even without an official ban on certain words, such a move has caused concerned leaders at health care and advocacy organizations to speak out.

PBS reported:

But some in the scientific community said that forbidding certain words could help change the direction of policies at the CDC, the nation’s top public health agency.
“If you are saying you cannot use words like ‘transgender’ and ‘diversity,’ it’s a clear statement that you cannot pay attention to these issues,” said Dr. Sandro Galea, dean of Boston University’s School of Public Health, to the Associated Press.

Others lashed out at the news in statements and on Twitter.

CNN reported:

"To pretend and insist that transgender people do not exist, and to allow this lie to infect public health research and prevention is irrational and very dangerous," Mara Keisling, executive director of the National Center for Transgender Equality, said in a written statement.
… Calling the order "reckless" and "unimaginably dangerous," Dana Singiser, vice president of public policy and government affairs for Planned Parenthood Federation of America, also weighed in.
"You cannot fight against the Zika virus, or improve women's and fetal health, if you are unable to use the word 'fetus.' You must be able to talk about science and evidence if you are to research cures for infectious diseases such as Ebola," Singiser said.
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The Chicago Tribune reported:

Rush Holt, chief executive of the American Association for the Advancement of Science, said: "Among the words forbidden to be used in CDC budget documents are 'evidence-based' and 'science-based.' I suppose one must not think those things either. Here's a word that's still allowed: ridiculous."

Over the weekend, the CDC has been on the defensive, calling reports that it banned words a “complete mischaracterization” of what the organization has discussed internally.

The New York Times reported:

“The assertion that H.H.S. has ‘banned words’ is a complete mischaracterization of discussions regarding the budget formulation process,” an agency spokesman, Matt Lloyd, said in an email. “H.H.S. will continue to use the best scientific evidence available to improve the health of all Americans. H.H.S. also strongly encourages the use of outcome and evidence data in program evaluations and budget decisions.”

CDC director Dr. Brenda Fitzgerald has been directly involved with damage control and has posted statements on Facebook and in a series of tweets:

However, Fitzgerald’s words haven’t assuaged critics—nor concerned medical and health care professionals. The negative attention continues to grow following reports that other Health and Human Services organizations have received similar guidance.

Chicago Tribune reported:

A second HHS agency received similar guidance to avoid using "entitlement," "diversity" and "vulnerable," according to an official who took part in a briefing earlier in the week. Participants at that agency were also told to use "Obamacare" instead of ACA, or the Affordable Care Act, and to use "exchanges" instead of "marketplaces" to describe the venues where people can purchase health insurance.
At the State Department, meanwhile, certain documents now refer to sex education as "sexual risk avoidance."
… It's not clear whether other federal agencies have been instructed to avoid certain words, and if so, to what extent, in preparing their budget documents for next year. Officials interviewed at the two HHS agencies said the language restriction was unusual and a departure from previous years.


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