http://iraqwar.mirror-world.ru/article/179229
*U.S. Army delays, alters medical studies under a little-known
scientific censorship program*
By: Bryant Furlow on: 25.10.2008 [07:21 ]
*
U.S. Army delays, alters medical studies under a little-known scientific
censorship program.*
*
Policy 'stifles scientific discourse,' says an Army epidemiologist*
Since 2006 U.S. Army censors have scrutinized hundreds of medical studies,
scientific posters, abstracts and Powerpoint presentations authored by
doctors and
scientists at Walter Reed and other Army medical research centers---part
of a little-
known prepublication review process called "Actionable Medical
Information Review."
More than 300 scientific documents have been reviewed by Army censors to
date.
Fewer than half of them have been cleared for public disclosure in their
original form.
The program is intended to deny Iraqi and Afghan insurgents sensitive
data such as
combat injury and death rates. But dozens of studies reviewed under the
program did
not involve research directly related to combat operations. Instead,
they described
controversial topics like the effects of war on soldiers' children,
hospital-acquired
infections, post-deployment adjustment issues, refugees, suicide,
alcoholism,
vaccines, cancer among veterans and problems with military health care
databases.
An Army epidemiologist has been threatened with disciplinary action for
allegedly
violating the policy after sending a letter to Stars & Stripes lamenting
the Pentagon's
inadequate resources for tracking and studying diseases---as Congress
requires.
by Bryant Furlow
Whether Obama or McCain wins,
plans for health reform take a hit,
reports epi's Bryant Furlow in The
Lancet Oncology
Read the National Coalition Against Censorship's
The Knowledge Project: Censorship & Science
statement on the Army's policy
Experts quoted
Ann Ham, U.S. Army Medical Command (MEDCOM)
Katherine Rabb, NCAC , The Knowledge Project: Science & Censorship
Remington Nevin, M.D., M.P.H., U.S. Army
Jim Balassone, Markkula Center for Applied Ethics
Robert Fortner, Calvin College, Media Research Institute
Edward Herman, SUNY-Buffalo
Steve Aftergood, FAS Project on Government Secrecy
October 21, 2008---Army censors operating at a public relations office
in Falls
Church, VA, and elsewhere in the U.S. and Europe have quietly reviewed,
altered
and in several cases blocked publication of medical studies authored by Army
doctors and researchers, an investigation by epiNewswire has found. The
"Actionable Medical Information" (AMI) review policy was first
established with an
Army Medical Command (MEDCOM) memo dated December 2, 2005, and renewed
in 2006.
At least 312 unclassified medical studies and presentations have been
reviewed
under the policy since its inception, according to an AMI tracking
database obtained
with the Freedom of Information Act (FOIA).
Fewer than half have been approved for public release in their original
form. In
2007, 6 percent of papers were denied permission for public disclosure,
but so far
this year that denial
rate has nearly
tripled to 17 per
-cent.
Public relations
officers review each
scientific paper or
talk prepared by
researchers at Walter Reed Army Medical Center and other medical research
facilities. Their primary task is to identify papers that may reveal
sensitive information
from combat theaters, such as injury and death rates for U.S. soldiers,
and pass
them along to operational security censors, says Ann Ham, the Army Surgeon
General's Office public affairs official who heads up MEDCOM's AMI reviews.
But dozens of studies listed in the MEDCOM AMI tracking database appear
to have
fallen well outside the stated scope of the AMI policy, addressing
issues unrelated to
combat operations, noted Katherine Rabb of the National Coalition Against
Censorship's The Knowledge Project: Censorship & Science in New York, NY.
Examples include the effects of war on soldiers' children and families,
veterans' post-
deployment adjustment issues, refugees, suicide, alcoholism, vaccines,
sexually
transmitted diseases, problems with military health care databases and
even the
THC content of commercial hemp products. Also reviewed by censors was a
study
of cancer in veterans of the 1991 Gulf War and hospital-acquired infections.
Release of dozens of other studies has been delayed as AMI reviews drag
on for
months, despite a 5-day time limit for reviews stipulated in the AMI
policy memo.
Ham failed to respond to requests to explain why studies unrelated to combat
operations were reviewed under the AMI program. By telephone, she emphasized
that very few researchers are completely denied permission to publish or
otherwise
release their studies. "We try to work with them, to identify problems
and find
solutions together so studies don't have to be denied approval," she
said. She was
unaware of any scientist appealing a denial decision or required
changes. Indeed,
the AMI appeals board has never convened to reconsider censors' decisions,
MEDCOM officials confirm.
"It is fairly obvious what the true motivation behind the policy is,"
said Maj. Remington
Nevin, M.D., M.P.H., of the Armed Forces Health Surveillance Center in
Silver Spring,
MD. "The war on terrorism has provided a convenient excuse to stifle
scientific
discourse and the release of information on government operations. Those who
stand to lose the most from this policy are the service members it was
ostensibly
designed to protect."
Nevin has been threatened with disciplinary action for allegedly
violating the AMI
policy by writing a letter to Stars & Stripes, an Army newspaper,
regarding the
inadequacy of the Pentagon's current health surveillance systems for
studying the
safety of mefloquine, an anti-malarial drug.
"If it smells like a duck and walks like a duck, it usually is a duck,"
said Jim Balassone
of the Markkula Center for Applied Ethics, at Santa Clara University.
The Army's
censorship policy lacks transparency and a clear description of what
content will and
will not be targeted, Balassone notes. "The censors lack a written
policy on what they
might change, alter, or delete---or even add. This gives them leeway to
censor
anything for any reason, unbeknown to the reader."
"The Army's AMI review policy is designed to review professional medical
research
intended for release in a public forum," noted Rabb. She reviewed the
documents
disclosed to epiNewswire by the Army. (Read her full statement about
AMI.) "The
policy specifically targets materials that utilize 'any medical
information derived from a
combat theater'," she said. "It appears that the policy has been used to
review
medical information other than that derived from a combat theater. The
motivation for
such review is unclear. The result, however, is an infringement on the
public's right to
know."
Rabb is looking into AMI and other Army censorship policies. "We would
like to know
more ... about the data actually removed and the reasons for
censorship," she said.
One policy, several ambiguous reviews
The AMI policy creates several separate review processes, including
operational
security, public relations and medical.
"The policy is aimed more at the public relations aspects of release of
information
than it is on the medical 'need to know' aspects," noted Robert Fortner,
Director of
the Media Research Institute and a professor at Calvin College in Grand
Rapids, MI.
"As far as I can tell, the appeal process does not include the right to
appeal the
determination of the medical review, only the right to appeal the
decisions of
command and public information portions. There may be reasons that make
sense
for this, but they aren't articulated in the documentation."
"The medical review is the least articulated part of the policy,"
Fortner said, "which
raises the question of who is doing the medical review, what their
qualifications are to
make the judgments required, and what their marching orders are in
completing the
review."
Fortner and other censorship experts worry that in the Army's effort to deny
insurgents sometimes-esoteric data, the value of that information to
civilian hospitals
and public health officials may be overlooked. "The policy seems aimed
only at the
military issues raised by medical practices in conflict zones, not on
their potential
value to responding to emerging threats to civilian populations," said
Fortner. "It is
difficult to know what information is being restricted, or changes
required."
AMI is just one of a daunting maze of reviews required of Army medical
researchers
seeking to publish or discuss their studies with other scientists.
Asked to describe in general terms the types of changes made to altered
studies,
Ham refused, saying that such information is "predecisional" and
deliberative, and
therefore exempt from public disclosure. Only unclassified information
about final
decisions has to be released to the public, she said.
But the changes required of authors by Ham and other AMI program censors
do not
appear to be "predecisional." Rather, they are pronounced with finality
in the tracking
database: "author instructed to make changes," "author notified of
clearance for
public release pending revisions," "approved with specified revisions."
"It is heartening that nearly half the papers submitted for review were
passed without
change, indicating some effort not to be draconian in interpreting the
policy, but the
reasons for some papers to be delayed, altered or rejected, cannot be
determined
from the material provided" by the Army, said Fortner. "The cases of
most concern to
me would be those whose only 'flaw' was raised by public information
personnel."
Fortner and other censorship experts contacted for this report expressed
concern
that the AMI policy is being too broadly applied---reaching beyond its
originally
intended scope and undermining public access to government medical research.
"We fear the Army is using this seemingly narrow policy to broadly
censor truthful,
scientific reaserch," Rabb said. "The National Coalition Against
Censorship believes
the public has a right to know non-classified, scientific information
generated by
government researchers. The AMI policy for prepublication review of
medical data
puts this right at risk."
"It is reasonable to review information pertaining to operational
security, weapons
systems, critical technology and weapons of mass destruction prior to
their release,"
said Edward Herman, who studies government information and censorship
policies at
the State University of New York at Buffalo. However, he said the AMI
policy is "very
broad and could cover almost anything the military wants covered."
Data gleaned from the AMI tracking database reveal that only 152 of 312 AMI-
reviewed studies and presentations have been approved for public release
without
mention of required revisions. Several categories of de facto denials
were evident in
the AMI tracking database:
Censors demanded alterations to 46 papers and presentations
39 studies were still undergoing review as of last month
36 studies were formally denied permission for public disclosure or were
restricted to publishing only for military audiences ("For Official Use
Only"
designations)
15 studies had been referred to other agencies for additional reviews
4 studies were withdrawn from consideration by the authors
4 studies were submitted too close in time to intended presentation dates to
allow for AMI reviews to be cleared for release
No information was available regarding the status of 20 studies
Full disclosure?
Ham said she does not know whether or not scientists whose manuscripts
have been
altered at the direction of AMI censors, disclosed this fact to the
medical journals
publishing their revised papers. There is no Army policy directing them
to do so, she
admitted. A search by epiNewswire of three medical literature
archives---PubMed, ISI
Web of Science and Elsevier's Science Direct---failed to identify even a
single
medical paper disclosing AMI review or resulting alterations among
studies published
by Army authors in 2007 or 2008.
"Without a clear definition of what has been censored, how do readers
trust the data
and conclusions?" said Balassone. "I could envision some censorship,
that if openly
disclosed might ensure that the crucial data and judgments are intact,
or some form
of peer review attesting to that fact."
The AMI policy's ambiguities and contradictions leave plenty of room for
abuse,
experts caution. For example, Herman says, the AMI policy states that
materials
developed on personal time using personal equipment and open sources do not
require clearance, but that unclassified information can be censored
from scientific
studies, because, according to the 2005 MEDCOM policy memo, "information
that
appears in open sources does not necessarily constitute
declassification. The
combination of several open source documents may result in a classified
document."
"This is very silly, unless it is an attempt to prevent publication of
almost anything,"
said Herman. "I question how likely it is two documents available to the
public can
result in a third document that ought to be legitimately classified."
'Classification by compilation' is supposed to be rare, agrees Steve
Aftergood of the
Federation of American Scientists Project on Government Secrecy. "And
while it may
be applicable in some cases to information about sensitive military
technologies, it is
hard to see how it could reasonably apply to published medical studies,"
he said.
Delays
Many papers languish in the AMI review process for months, despite a
requirement in
the 2005 policy memo that all reviews be completed within 5 days. Of the
39 papers
still undergoing review in September 2008, 38 had been awaiting AMI censors'
decisions for more than a month. Most had been submitted for review in 2007.
MEDCOM seems to be in the habit of flaunting deadlines. The agency took more
than a year to disclose the AMI tracking database requested by
epiNewswire, despite
a 20-day statutory response time limit under the Freedom of Information Act.
"The War on Terrorism has provided a convenient excuse to stifle
scientific discourse and the release of information on government
operations. Those who stand to lose the most from this policy are
the service members it was ostensibly designed to protect."
http://www.epinews.com/
