WASHINGTON -- Speaking days after the last surgeon general told Congress that he had been muzzled by the White House, President Bush's new nominee for the post told senators yesterday that he would quit before he let politics interfere with science.
Dr. James W. Holsinger Jr., a Kentucky cardiologist, also sought to distance himself from a 16-year-old church paper in which he characterized gay sex as abnormal and unhealthy.
"I can only say that I have a deep, deep appreciation for the essential humanity of everyone, regardless of their personal circumstances or their sexual orientation," Holsinger, 68, told the Senate Committee on Health, Education, Labor and Pensions. "I have tried to live out my life in the practice of medicine caring for people regardless of their personal circumstances."
Holsinger's confirmation hearing came two days after former Surgeon General Richard H. Carmona told a House panel that Bush administration officials had barred him from spreading sound scientific information about such politically sensitive issues as teen pregnancy prevention and embryonic stem cell research.
"Anything that doesn't fit into the political appointees' ideological, theological or political agenda is ignored, marginalized or simply buried," Carmona, the nation's top doctor from 2002 to 2006, told the House Committee on Oversight and Government Reform.
Yesterday, Sen. Edward M. Kennedy, the chairman of the Senate committee, announced that he was introducing legislation to depoliticize the office by giving the surgeon general budgetary independence and the authority to hire his or her own staff.
The Massachusetts Democrat and other senators pressed Holsinger on how he would respond if pressured to modify his medical advice to accommodate political imperatives.
"The first thing I would do is to work to use the tried-and-true leadership techniques that I've used throughout my life, which is one of bringing people to consensus, based upon education," Holsinger said. "I would use the science to attempt to educate the policymakers that were involved in an effort to bring them to a point where the science would have the appropriate impact."
And if that failed?
"Quite candidly," he said, "if I were unable to do that and I was being overridden, if necessary, I would resign."
As the 18th U.S. surgeon general, Holsinger said, he would focus on childhood obesity. He said he could support a ban on advertising candy, soda, chips and sugary cereals to children and spoke of his work in Kentucky to rid school cafeterias and vending machines of such items.
But his nomination has met resistance from gay rights groups, which have expressed concern about a 1991 paper he prepared for a United Methodist Church committee that was studying homosexuality.
In "Pathophysiology of Male Homosexuality," Holsinger stressed the "complementarity" of men and women, and described the injuries and diseases that he said were risks for men who engaged in anal sex.
Kennedy said the paper "cherry picks and misuses data to support his thesis that homosexuality is unhealthy and unnatural."
Holsinger, a Methodist, said it was not a scientific paper but a response to a narrowly focused question posed by the church committee.
"I was writing for a lay audience composed of theologians, biblical scholars, pastors, Christian ethicists," he said. "Individuals who had difficulty understanding some of the issues surrounding the practice of homosexuality."
Returning to the subject later, Holsinger added: "The paper does not represent where I am today. It doesn't represent who I am today."
Sen. Barbara A. Mikulski focused on Holsinger's tenure as chief medical director of the Department of Veterans Affairs during the early 1990s. The Maryland Democrat chaired the Senate panel that funded the VA at the time. She described Holsinger as "indifferent and dismissive" of concerns about quality control, women's health and sexual harassment.
"Our experience was that you advocated the status quo," Mikulski said. "As we look at your role to be the chief spokesman in the area of health care for the United States of America and to be an advocate, what has changed?"
Holsinger said he was a "strong advocate for change in our structural systems" and described his work to establish a new electronic medical records system at the University of Kentucky, where he is a professor.
A graduate of Duke University, Holsinger worked for 26 years in the VA, rising to the department's undersecretary for health under President George H.W. Bush. He was later Kentucky's secretary of health and chancellor of the University of Kentucky Chandler Medical Center. He retired from the Army Reserve after 31 years in 1993 with the rank of major general.
The committee has not scheduled a vote on his confirmation.