The Senate Labor and Human Resources Committee voted 13-4 last week to approve the nomination of Dr. Joycelyn Elders to be Surgeon General.
The full Senate may consider the nomination as early as this week.
The vote came after Ms. Elders fielded queries at a hearing about her finances and her views on preventing pregnancy and sexually transmitted diseases among teenagers.
Her voice breaking with emotion, Dr. Elders said in her opening statement, “I’ve seen bright young people all over this country in an ocean surrounded by the sharks of drugs, violence, homicide, AIDS, and teen pregnancy, while we argue over which values to teach.’'
The daughter of Arkansas sharecroppers, she said she had never seen a physician before her first year in college, and recalled her mother screaming as she delivered children without medical help.
“I want to be a voice and the vision for the poor and the powerless,’' Dr. Elders said. “And if confirmed, I would make it my utmost goal to educate our people on how to stay healthy.’'
Bouquets and Venom
A pediatric endocrinologist, Dr. Elders served for six years as the health director of Arkansas before resigning earlier this month following her nomination.
During her state service in Arkansas she gained a national reputation for supporting the use of school clinics to provide birth control to students, earning bouquets from liberals and venom from conservatives.
Her nomination hearing was interrupted briefly when opponents used an arcane procedural rule to halt the session.
Sen. Edward M. Kennedy, D-Mass., the chairman of the committee and one of Dr. Elders’s staunchest backers, said the move was engineered to give opponents more time to hurl darts at her.
“I will not permit scurrilous accusations to be made against this nominee,’' he said.
When the session resumed, Dr. Elders said she would be a vocal spokeswoman for health education. “I believe the only way to heal our nation is through prevention, and prevention requires education,’' she said.
Schools are an ideal venue for promoting good health because they are “accessible, affordable, and age-appropriate,’' she said.
In response to a question, Dr. Elders said she was not “for abortion but about preventing unwanted pregnancy.’'
She also denied that she had ever said that girls should not go out on a date without a condom, as had been widely reported.
“The only thing that works 100 percent is abstinence,’' she responded. But, she added, “we know our children are not being abstinent.’'
In the most heated questioning of the day, Sen. Dan Coats, R-Ind., grilled Dr. Elders about an incident in which a shipment of condoms that had been distributed to Arkansas clinics and high schools was later found to be defective.
Dr. Elders said she did not order a recall in her capacity as the state’s top health official because to have done so would have created a panic and could have influenced some people never to use condoms. As a public health leader, she said, she tried to do the greatest amount good for the greatest number of people.
Questions About Finances
The committee had delayed the hearing for a week to investigate questions about the propriety and legality of Dr. Elders’s financial affairs.
During the session, she assured the committee that she and her husband had paid Social Security taxes for her mother-in-law’s health aide.
Dr. Elders also fended off insinuations that she was guilty of “double dipping’’ by serving as a consultant to the federal Department of Health and Human Services while remaining on the Arkansas payroll. Such arrangements, she told the panel, are common and legal.
Dr. Elders also had come under fire for her role as a director of the Arkansas National Bank, which was found by federal authorities to be mismanaged.
She said the letters of reprimand that she and other directors each received were not a reflection on their personal conduct.
Dr. Elders has amassed more than 200 endorsements, including those of the American School Health Association, the American Academy of Pediatrics, and the American Federation of Teachers.
On Solid Ground
“Dr. Elders understands this critical link between health and learning,’' said an A.F.T. statement supporting her selection. “She’s not making policy from a lofty distance.’'
The Association for the Advancement of Health Education said it endorsed her nomination wholeheartedly, saying she has a deep appreciation of the health needs of children and their families.
