The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight the US/China relationship as seen by Haynes Johnson, Doris Kearns Goodwin, Michael Beschloss, and writer Bette Bao Lord; a look at the FDA's having to pull some recently approved drugs off the market; a report from the Northwest on saving the Chinook salmon; and a David Gergen dialogue on violence as entertainment. It all follows our summary of the news this Tuesday.% ? NEWS SUMMARY

JIM LEHRER: Microsoft won a court victory today. A three-judge federal panel threw out a lower court injunction that kept it from tying its Internet browser to its operating system. The court said the two software programs were integrated, not separate products. Microsoft's CEO, Bill Gates, spoke about the decision.

BILL GATES, CEO, Microsoft: The ruling upholds the ability of Microsoft and other companies to improve their products by including new features like Internet support. Our products have always been completely open and available for competitors to run on top of. The work we're doing to make it easier to get out to the Internet, now we have the freedom to continue that approach.

JIM LEHRER: The Justice Department said it was disappointed by today's action and would assess its legal options. The ruling does not affect the Department's broader monopoly suit that goes to trial in September. On the Food & Drug Administration, today it approved a new tuberculosis treatment, the first in twenty-five years. Yesterday it ordered a prescription painkiller pulled off the market. Four patients have died since taking Duract. Eight others needed liver transplants since it was approved last year. And today President Clinton nominated a new FDA commissioner. She's Dr. Jane Henney of the University of New Mexico. We'll have more on the FDA later in the program. President Clinton restored food stamps to many legal immigrants today. It was part of a $1.9 billion agriculture bill Mr. Clinton signed into law. It returns food stamp benefits to immigrants who lost them when the welfare system was overhauled two years ago. Mr. Clinton spoke in the White House Rose Garden.

PRESIDENT CLINTON: It rights a wrong. When I signed the welfare reform bill in 1996, I said the cuts in nutritional programs were too deep and had nothing whatever to do with welfare reform. Last year we restored Medicaid and SSI benefits to 420,000 legal immigrants. Today we reinstate food stamp benefits to 250,000 legal immigrants, including seniors, persons with disabilities, and 75,000 children.

JIM LEHRER: Congressional opponents said there was no justification for reinstating the food stamp benefits. The president also announced new Medicare regulations. They will guarantee access to specialists for all beneficiaries of private health care plans. They also require insurers to pay for most emergency room treatment and keep medical records confidential, among other things. The rules will take effect for 38 million beneficiaries in about a month. Another warning was delivered today about ending the violence in Kosovo. US Envoy Richard Holbrooke gave it to Yugoslav President Milosevic in Belgrade. NATO nations are considering what steps to take if Milosevic does not stop Serb attacks on Albanians in Kosovo. Holbrooke spoke earlier today with Kosovo's ethnic Albanian leader Ibraham Rugaba. President Yeltsin said today Russia's economic condition remains alarming. He said so at a special meeting with government officials in Moscow. He blamed the financial crisis in Asia and the drop in world oil prices, but he also said Russia's cabinet shared responsibility, and he urged the cabinet to take radical steps to correct the situation. Back in this country Defense Department Spokesman Kenneth Bacon said today traces of a deadly nerve gas were found in Iraqi warhead fragments. They were recently turned up by United Nations weapons inspectors during a routine search and sent to the Aberdeen Proving Ground for testing. The UN suspected Iraq had missiles with the nerve gas agent VX but had no clear proof. Chief weapons inspector Richard Butler is to brief the Security Council on the matter tomorrow when it takes up the issue of sanctions against Iraq. U.S. Ambassador to the UN Bill Richardson had this to say.

BILL RICHARDSON: Iraq is making a very bad case for lifting sanctions. If this allegation is correct, and we will know tomorrow with Ambassador Butler's briefing, that will set back Iraq's efforts to try to lift sanctions. It shows that they've been deceiving; that they've been concealing; that they've been lying; and it calls into question their commitment to disarmament.

JIM LEHRER: In Baghdad, a government spokesman called the news "an outrageous lie," and Deputy Prime Minister Tariq Aziz said Iraqi scientists experimented with VX but failed to make it weapons grade quality. On the president's trip to China today Democrats tied up the Senate debate to block Republican moves to vote on China matters. Minority Daschle said he did so to prevent the Senate from embarrassing Mr. Clinton during his nine-day tour. The president denounced China's decision today to withdraw the visas of three journalists from Radio Free Asia, a US Government agency that broadcasts into the country. We'll examine the US-China relationship right after this News Summary. Also coming, approving drugs, saving salmon, and a David Gergen dialogue.% ? FOCUS - CHINA RELATIONS

JIM LEHRER: President Clinton leaves for China tomorrow. His nine-day trip comes with much historical context and baggage. Kwame Holman begins our look.

KWAME HOLMAN: For the last 50 years, relations between Mainland China and the United States have been a roller coaster ride. The Communist takeover of China in 1949 shocked the United States and resulted in a deep freeze in relations that would endure for more than 20 years. In American politics, rivals traded charges and accusations over who lost China. The United States refused to recognize the Communist government in Beijing and helped keep China out of the United Nations. Instead, the US dealt only with the losers of the Chinese civil war, the government of Chiang Kai Shek, which fled to the island of Taiwan. The freeze between the US and the Mainland deepened in the Korean War, as China sent troops to aid North Korea, while soldiers from the United States and other members of the United Nations fought for South Korea. China also sent supplies--but no troops--to North Vietnam in a war that cost more than 50,000 US lives. The first thaw in the relationship between the two global giants came in 1972 when Richard Nixon became the first American president to visit China while in office. He called the historic trip "the week that would change the world." It was a first step in the normalization of relations between the United States and China. The president shook hands with China's legendary leader, Mao Tse-Tung and accepted a gift of two giant pandas. At the Great Wall, Mr. Nixon said, "We don't want walls of any kind between peoples." On President Gerald Ford's 1975 trip, no new agreements were reached but the visit gave Mr. Ford the chance to meet the next generation of leaders who soon would succeed Mao. The relationship took another positive turn in December 1978.

JIMMY CARTER: The United States of America and the People's Republic of China have agreed to recognize each other and to establish diplomatic relations as of January 1, 1979.

KWAME HOLMAN: Though Mr. Carter never traveled to China while in office, a few weeks after formal relations were restored, he hosted Premier Deng Xiaoping during his nine-day trip to the US. Deng participated in talks at the White House and took a trip to a Texas rodeo. The two leaders agreed to upgrade their diplomatic representation and exchange ambassadors. Ronald Reagan was greeted with a 21-gun salute in Tiananmen Square in 1984. His visit, which took him to the Great Hall of the People and the Great Wall, resulted in formal agreements, furthering scientific and cultural exchanges and greater cooperation on the development of nuclear energy projects. On his February 1989 presidential visit, George Bush was presented with a bicycle. It was a reminder of how he got around Beijing when he served there as one of the first American diplomats during the Nixon and Ford administrations. Mr. Bush emphasized economic reforms, including more opportunities for trade. He too went to Tiananmen Square and during the visit, praised China's greater acceptance of human rights. Just four months later, Tiananmen Square took on a completely different symbolism for Americans and the rest of world when hundreds of democracy demonstrators were killed by the Chinese army. President Bush cut off all high level official exchanges between the two nations but sent a secret delegation to Beijing to persuade the Chinese to open their society. That mission was criticized by presidential candidate Bill Clinton.

BILL CLINTON: I believe the president erred when he secretly rushed envoys to resume cordial relations with China barely a month after the massacre in Tiananmen Square. The administration continues to coddle China, despite its continuing crackdown on democratic reforms.

KWAME HOLMAN: Since taking office, Mr. Clinton has pushed for what he calls a policy of engagement with China. Last year, he hosted Chinese President Jiang Zemin on his state visit to the United States. Today, members of Congress urged the president to press the Chinese leadership on the issue of human rights.

REP. SUE MYRICK: We're here today to call upon the president to push for freedom and democracy in China. Mr. President, we wholly agree that China is of enormous economic and strategic importance to the United States. A constructive dialogue with China is in our nation's best interest. But any dialogue with China must include a frank discussion of human rights.

KWAME HOLMAN: Tomorrow, Mr. Clinton departs for his own state visit to China, which will include a welcoming ceremony in Tiananmen Square.

JIM LEHRER: Some perspective on the US/China relationship from NewsHour regulars Presidential Historians Doris Kearns Goodwin and Michael Beschloss and Journalist/Author Haynes Johnson, joined tonight by Bette Bao Lord, novelist, chair of Freedom House and member of the Board of Governors, which oversees Radio Free Asia. And Bette Bao Lord, before anything else, let me ask you about Radio Free Asia, the Chinese government's decision to rescind some visas today for some folks who work for them. What's the story?

BETTE BAO LORD: Well, I think on Sunday they had given them visas, and then they called them up andsaid we rescind them. This is, you know, about half a week before they're supposed to get on the plane. The problem is that this was a great opportunity for them to show that they have changed. Their attitudes are much more liberal about journalists, but by rescinding this, they have made it seem that the more things change, the more they remain the same, just as the last summit, when Bush was there, they waylaid one person out of a dinner of eight hundred people; they couldn't stand that. And now three journalists on a plane of 375 are going to cover the president's trip, and they've made a fuss about this, and I think it's going to color a summit that they have prepared for and we have prepared for, and both sides want to have be a success.

JIM LEHRER: Do you think it's that serious a matter that it could really taint this whole operation?

BETTE BAO LORD: I think it has those possibilities, because here they have wanted to give the world through this summit a new picture of China. That's why in these nine days they've choreographed the economic improvements, the pollution improvements, also these improvements in China. But then you're reminded what happened. It can't tolerate three journalists among a pack of three hundred and seventy-five journalists.

JIM LEHRER: Well, we'll see what happens, and of course, this comes in this context of the history that we just outlined. Michael, as a matter of history, how important, for instance, was the Nixon trip? He said and Kwame quoted him as saying that it was a week that would change the world. Did it, in fact, change the world?

MICHAEL BESCHLOSS: Sure did. You know, we've had these 26 years of serious Chinese-American relations that might have been ten years or five years or actually even zero years had Nixon not gone. And just imagine what it would have been like had some other president been the one to create this opening to China in 1971 and '72, Kennedy would have loved to do that, so would Lyndon Johnson. They were terrified that someone like Richard Nixon would say, you, Mr. President, are going to China to shake the hand of Mao Tse-Tung, who just a few years ago was leading the cultural revolution but killed millions of his own people. That dissuaded Kennedy and Johnson from doing what probably was in the American and self-interest. We're all just lucky that Richard Nixon was enough of a creative global strategist that he could see how important China would be as a military and economic power in the 21st century, that he was able to toss away 20 years of opposing the Communist Chinese regime and essentially do what very few other political leaders in that time could have done.

JIM LEHRER: Do you agree, Doris, nobody else could have done it but Nixon?

DORIS KEARNS GOODWIN: Oh, I think it certainly helped that it was Richard Nixon. I mean, he was really part of that cabal in the 50's where you had Joe McCarthy, you had the Hearst Press, and you had the Henry Luce characters who really were part of a China lobby. And they started arguing within the Congress who lost China. And it became very virulent. People lost their jobs, their careers, and the State Department-it really denuded the State Department of a lot of the experts. So you had all of that background, and for Nixon to be the one, the more you think about it, that trip took place in February of '72. Only three months later comes Watergate. It just makes you so sad at something that Nixon had accomplished. Even Teddy Kennedy said at the end of that trip this was a bridge that would never last in the presidency of Richard Nixon and the communiqu that was produced, one of the most progressive in all of American diplomatic history, I mean, there was a sense of which he knew what he was doing, he knew his past allowed to do it, and he certainly deserves credit. I think now that we realize what a turning point it was, changing two decades of hostility into the beginning of some rapprochement, it seems to loom even larger. It's 25 more years ago.

JIM LEHRER: Yes. And he does get the credit, though, does he not, Haynes?

HAYNES JOHNSON: Absolutely. And he deserves the credit. This was a great moment.

JIM LEHRER: He's the one who made that decision.

HAYNES JOHNSON: Absolutely. Whatever else one ever says about Richard Nixon, this was a momentous event and it ended that isolation. Don't forget, we fought a war with Red China, although it wasn't declared so-called Red China, in Korea, when those forces came in. We didn't fight against the Russians in this century, but it was "the Red Chinese," and here was Nixon, as Doris just said, with all that background, you know, of the cowardly Communist and so forth and Red Chinese and traitors within, and he was the one that broke that mold. And it was a breathtaking display of diplomacy and creative movement because we need relations with each other, and that's-how that relationship works out, as Bette says-there's nothing maybe new. It still goes on. The old tensions are still there, but that was a great moment, Jim, no question about it.

JIM LEHRER: But, Bette, when we talk about relationship with China, we always talk about it president to premier, government to government. How would you characterize the relationship between the Chinese people and the American people through all these years?

BETTE BAO LORD: I think it depended on the political prism at that time whether the necessity of seeing them, the Communists, as it were in reformers and then our enemies, when they were the yellow horde coming down from Korea, and then we saw them as the blue ants working, and they had no other wishes, except to work, work, work, work, work, and then you had the red guards were the chaotic hordes again, because we had no relationships, as Doris said. We needed to picture the Chinese people in such an unnatural mode.

JIM LEHRER: But did we see them, Doris, as the enemy, the same way we saw the Russians as capable of bombing New York back to the stone age and that sort of thing?

DORIS KEARNS GOODWIN: I don't think so, not in quite the same way. I mean, we'd come out of World War II, where China was our partner, and then soon after that this nationalist and Communist battle took place, the civil war, and then right after that, just as we were beginning to worry about China, Truman was even beginning to think about recognizing China at that time, if there hadn't been this whole uprising domestically by the China lobby. But for most American people, I think, there wasn't as much fear of the Chinese as the Russians. When the nuclear bomb, the atom bomb was exploded by the Russians in 1949, that was where the emphasis go. I know as a little kid it was the Russians I dreamed of in my nightmares, not the Chinese.

JIM LEHRER: Now, Michael, some would say, all right, we had the Nixon trip, a major, major event, and then the next major event in their relationship was Tiananmen Square.

MICHAEL BESCHLOSS: And that's the big surprise. I do, and one never would have foreseen, I think, that it would have been so easy for American presidents through the beginning of Bush to conduct a serious relationship with China. It was almost a natural progression. Ford improved things-Jimmy Carter, was we saw in the setup piece, established relationships. Ronald Reagan during the '80 campaign flirted with rolling things back, said we had been unfair to Taiwan and perhaps he would distance the United States from China. There was such an enormous consensus in this country for better relations with Beijing that Reagan had to change his hymn book very quickly. All that changed, of course, in 1989. We all saw that blood and flame that horrible night in Tiananmen Square. And that was one of the great moments when Chinese-American relations really did become a source of partisan debate, because you had the Bush people essentially saying you have to observe self-interest, we may hate what we've seen, but this is going to be a very important power. We'd better not estrange ourselves. And then you see the governor of Arkansas, Bill Clinton, 1991 and 1992, saying, George Bush has been amoral. He has dealt with the butchers of Beijing. This is a horrible moment in American history, and now you see President Clinton just a few years later 180 degrees different from what he said in that moment of campaign rhetoric.

JIM LEHRER: So, Haynes, what now is at stake, or what is riding on President Clinton's trip?

HAYNES JOHNSON: Well, our future, among other things, economically.

JIM LEHRER: What else?

HAYNES JOHNSON: Economically, politically, militarily. You have the nuclear proliferation again on the subcontinent of Asia, the enemies of China, once again, they've talked about this on this program over and over again. Here you have that. You have a billion Chinese. We have the franchise to sell the goods to them. We do pretty well here on the show, and it is-

MICHAEL BESCHLOSS: The Chinese-

HAYNES JOHNSON: Exactly-right-but it is there. I mean, and it is I think not too much judgment to say that in the next century it is going to be incredibly important for how we deal with the Chinese, the kind of relationship.

JIM LEHRER: Does President Clinton have that kind of opportunity to make that kind of change?

HAYNES JOHNSON: No, of course not. This is a step, and it's ceremonial, and Bette talked about 335 journalists on this trip. There are going to be 1200 official party members. It's going to be four airplanes and sixty tons of communications gear. He will not make the kind of breakthrough that Nixon did, but this is important, how this comes out, and there's groundworking-

JIM LEHRER: What do you think-

BETTE BAO LORD: I think there's a longer range importance to this trip. I think the Chinese people, something is different from the days of Mao and days of Nixon. The people-this is the decade of the people. Look what the people did in the Philippines, what the people did in the Soviet Union, what the people did in Indonesia. We cannot neglect to take into consideration an informed Chinese public about the United States. That's why it is so important that we have journalists who know China who speak Chinese, who look Chinese to report on this trip. And it is to China's self-interest, because only when we truly understand each other from people to people, not just government policies that are swayed by both sides' domestic concerns, but for the longer range the peoples of China have to understand America and vice versa.

JIM LEHRER: But you think President Clinton could actually make a major difference in this?

BETTE BAO LORD: Yes, I do, because I think that to the Chinese people they look to America-after all, at Tiananmen Square it was the Statue of Liberty, it was Jefferson that wasquoted. It was Lincoln that was quoted. They regard-I know Americans are so cynical they don't think that, you know, this is just talk, but ideas-Lenin said-are much more powerful than guns, and they know that. And that's why the power of the idea of democracy and what America stands for do not underestimate how powerful a weapon that is.

JIM LEHRER: Doris, your thoughts on the Clinton trip.

DORIS KEARNS GOODWIN: Well, I think the one thing President Clinton has going for him that Richard Nixon did not with people to people is that Nixon was not the type to plunge easily into crowds. First of all, it was more choreographed when he was there, but also that wasn't his temperament. It is certainly, as we know, President Clinton's temperament. And to the extent that the Chinese people feel warmly toward us and want to embrace, as Bette was just saying, the ideas that we represent, I would look for a great sense of some sort of warmth and physicality in that relationship, which I think will show up great on television and will garner a certain kind of sense of the future that the people are looking to America, whatever the regime is trying to do.

JIM LEHRER: Well, Doris, Bette, Michael, Haynes, thank you.% ? FOCUS - RUSH TO MARKET?

JIM LEHRER: Still to come on the NewsHour tonight, approving new drugs, saving salmon in the Northwest, and a David Gergen dialogue.

JIM LEHRER: Spencer Michels begins our drugs report.

SPENCER MICHELS: The withdrawal late yesterday of a new painkilling drug by the Food and Drug Administration--after four deaths--has renewed debate about the agency's drug approval process. The FDA has primary authority to approve all new drugs and medications before they can be prescribed to the public. Though the FDA has enjoyed a long reputation for careful regulation, it has also endured continual criticism from patient advocate groups, drug manufacturers, and some members of congress who want drugs approved faster. Those critics have argued that the agency is often too slow to make drugs available to patients in urgent need. In response, last November President Clinton signed into law a measure to speed FDA approval of drugs and medical devices. The new measures include: easier access to experimental drugs for severely ill patients; and faster FDA review of medicines for aids, cancer and other diseases. For their part, drug companies are required to study the safety of so-called off-label uses of their drugs using a drug originally intended to treat one disease for something else--and to seek FDA approval for such uses within three years. But recently, three highly publicized cases have once again set off criticism of the approval process. But this time the issue is whether the FDA is moving too quickly and allowing unsafe medicines to reach patients before enough testing has been completed. Last fall, the diet drugs Redux and Fenflurimene were removed from the market after they were found to cause heart valve problems in a small number of patients. Earlier this month, Posicor, a medication prescribed for high blood pressure, was withdrawn when it was found to react adversely with about two dozen other medications. At that time, the FDA said it had received reports of 24 deaths associated with Posicor. And yesterday, the painkiller Duract, was pulled from pharmacy shelves after four patients died of liver failure and eight more required liver transplants.

JIM LEHRER: More from Elizabeth Farnsworth.

ELIZABETH FARNSWORTH: Joining us now is the Acting Commissioner of the FDA, Dr. Michael Friedman, and Dr. SidneyWolfe, Director of the Health Research Group of Public Citizen, a consumer advocacy organization. Dr. Friedman, is the FDA moving too quickly to approve drugs now?

DR. MICHAEL FRIEDMAN, Acting Commissioner, FDA: I think the answer to that is no. It's a very considerable challenge for us to take all the scientific information that we need to make a good decision. And once a decision is made it's constantly re-examined. But I think in these particular situations the answer is no.

ELIZABETH FARNSWORTH: What is the average review time now for a drug? It was about 30 months in 1992, as I understand it.

DR. MICHAEL FRIEDMAN: The average review time is a little over one year, but for the products that you've just been describing, for example, for Duract, that product required 27 months, two and a third years for review, and there was a study period of clinical trials of about a decade from 1984 to 1994. So I think it's fair to say that that period of time is fairly substantial and the 2,400 patients who received the product were part of a very careful analysis and evaluation.

ELIZABETH FARNSWORTH: Dr. Sidney Wolfe, do you think the FDA is moving too quickly?

DR. SIDNEY WOLFE, Public Citizen: For certain categories of drugs, like drugs for cancer and AIDS and life-threatening illnesses, we applaud the idea that the FDA is moving rapidly. Most drugs don't fall into that category, and in the last couple of years the FDA has broken two records. They've approved a record number of drugs, 92 drugs in 1996 and '97, more than ever in any two-year period, and a record number of drugs has been found so dangerous they had to be taken off the market. Most of these 92 drugs were not breakthrough drugs. There were another one of these-25th or 30th painkiller, and all of the drugs that came off the market were not for any life saving purpose. So we think that in the last couple of years, certainly under pressure from the Congress, the FDA has been more reckless than they ever have been and the ducks are coming home to roost, so to speak, because we are having one drug after another taken off the market. The fact that it took such a long time for the drug that came off the market yesterday to be looked at doesn't really mean anything, because at the end of that time the answer should have been don't approve it. It caused an extraordinary amount of liver damage in people. This was known before approval, and there were many people in the FDA who did not think it should be approved.

ELIZABETH FARNSWORTH: What about that, Dr. Friedman, how do you explain the approval of Duract and then its withdrawal less than a year later?

DR. MICHAEL FRIEDMAN: With all due respect, I believe the use of the term "reckless" is in itself reckless, and I think it doesn't add to the thoughtful debate that we're trying to have. I think that the family of products that Duract is from, the non-steroidal anti-inflammatory drugs, all have the side effect of irritating and inflaming the liver. All can cause liver damage. Drugs that are over the counter like Tylenol can do so, but many other drugs can as well. If Duract is used as labeled for 10 days or less, the drug is extremely safe. The incidence of serious side effects with liver damage is perhaps one in one hundred thousand patients. Now, in order to study one or two or three hundred thousand patients, decades would be required. The side effects that were noted during the clinical trials were mild elevations of liver enzyme abnormalities, mild liver abnormalities, these are very frequently seen. And our responsibility is not to approve one, two, or five drugs in a family. The legal requirement that we have is as a new product is submitted to us to make the very best scientific assessment that we can of that product.

ELIZABETH FARNSWORTH: Dr. Wolfe, yes, go ahead.

DR. SIDNEY WOLFE:I agree with that plan, but internal FDA documents show that one of the physicians at the FDA thought that this drug before approval was more dangerous than any of the other drugs, the non-steroidal and non-inflammatory drugs. And it was originally studied to be used for longer periods of time, so lots of patients and lots of doctors used this drug for months and months and months when it was studied for arthritis. And it was so dangerous that they had to decide that it should not be used for more than 10 days. The drug caused an enormous amount of liver damage in animals known even before clinical trials on people were exposed. So this drug was really unique in its liver toxicity, and it is because of this it came off the market. The idea of some FDA spokesperson yesterday it shows the system works because we picked up these things after approval is itself a really irresponsible statement, because if the system worked, this drug never would have come on the market, and all the people who have died or had liver transplants or have had near misses in terms of liver toxicity would be spared.

ELIZABETH FARNSWORTH: Dr. Friedman.

DR. SIDNEY WOLFE: And it's not the only one. The same is true of a couple of the other drugs. Evidence known at the time of approval and recommendations by several FDA advisers were that this heart-blood pressure drug, Posicor, shouldn't be approved until the results of a study, ongoing then, came out. And when the results of that study came out, it was taken off the market a couple of weeks ago. Two hundred thousand people were needlessly exposed to that drug, and many of them died.

ELIZABETH FARNSWORTH: Dr. Friedman.

DR. MICHAEL FRIEDMAN: Well, I disagree strongly with many of the assertions that Dr. Wolfe is making. There's always a vigorous internal debate within the agency amongst our scientists as to how best to review and approve a product. I think the balance here is between having perfect information and having sufficient information. We all recognize that there's no product that's perfectly safe or perfectly effective, and so we don't ask for that. What we do ask for is a sufficiency of information so it can be properly used by a health care provider and that there's proper information for a patient to utilize that. With all respect, I think what's expected is to provide that good information. Many times, in fact, in the large majority of cases, that information becomes more evident, both for benefits and for toxic side effects, after a product is on the market. Our responsibility is an ongoing one, and again respectfully, I disagree with Dr. Wolfe. I think the system worked very well in this case.

ELIZABETH FARNSWORTH: I'd like to move this on to products that have been on the market a while, and that's the case, for example, with the Fen-Phen diet drug, and then it's discovered that they have adverse reactions with other drugs. How is the system, Dr. Friedman, for monitoring drugs that have been on the market for a long time? Because the Journal of the American Medical Association reported that 100,000 Americans die each year from adverse reactions.

DR. MICHAEL FRIEDMAN: Well, that article in the Journal of the American Medical Association says that those patients die from known side effects of medicines used quite properly. Their point is that these are deaths which are in a sense unavoidable. I'm more concerned about deaths that are avoidable and new toxicities that have never previously been described. For example, with the diet products that you've been mentioning, Fenfleuremine was a product that was first approved in 1963. The product has been used in tens of thousands of individuals for decades. The side effects that were seen-the subtle new heart valve toxicity-was very rare, very subtle, and required the greatest scrutiny in order to observe it. In fact, I think it's safe to say that there are many products which cause side effects that we don't properly appreciate. The challenge to us to try and have the most vigilant, the most dynamic, the most proactive system for tracking side effects, and then having an agency that's prepared to revisit decisions and to make re-evaluations whenever that's possible.

DR. SIDNEY WOLFE: That's a theory which I couldn't agree with more. The problem is that these drugs, Posicar, the blood pressure drug that came off the market two weeks ago and the drug Duract, the painkiller that came off yesterday, never would have been approved ten years ago. Ten years ago the FDA was much more careful, much more vigilant, and when a serious question-I mean, Dr. Friedman said you can't have perfect evidence, I agree with that. You have to have sufficient amount of information. But if there's a sufficient amount of information to raise serious questions about the safety of a drug, ten years ago they would have said, no, we're not going to approve it. We did a study a few years ago showing then that many more drugs came on the market in France, Germany, and the United Kingdom and then had to be banned because of safety reasons. Then was the case in the United States. That gap, then an advantage to Americans, is narrowing significantly with the kinds of reckless approvals and now safety withdrawals that are occurring. I would bet that there are going to be another two or three of these record number of 92 drugs approved in 1996 and '97 that are going to have to come off the market. Unfortunately, instead of having good congressional oversight that says can we learn something from this, can we do a post mortem, not avoid that, the FDA is pummeled by the drug industry and its indentured service in Congress, who hold hearings to actually weaken the FDA, not to approve it.

ELIZABETH FARNSWORTH: I need to get back to Dr. Friedman. Here, we just have a little time left, Dr. Friedman, for a response.

DR. MICHAEL FRIEDMAN: Please. I think the rhetoric, again, is unfortunate. This is hardly reckless. These are scientists who evaluate things so carefully and take the responsibility so seriously. Dr. Wolfe speaks of pressures that are on the agency, and I think he's quite correct. There are important expectations layered upon the agency by the public. There are important expectations laid on by Congress as the voice of the public, by industry, by health care providers, by advocacy groups and others. But I submit that the biggest pressures, the most intense pressures felt by the agency, are those from within each of the staff reviewers. They take so seriously their responsibility to act in a speedy fashion but to act responsibly and carefully. Scientists may disagree about certain scientific information, but I think it's irresponsible to speak of the decisions that the agency goes through as being reckless or ill considered-quite the contrary.

ELIZABETH FARNSWORTH: Thank you both very much for being with us.

DR. MICHAEL FRIEDMAN: Thank you.% ? FOCUS - SALMON RESCUE

JIM LEHRER: The battle in the Northwest to save the Chinook salmon. Lee Hochberg of Oregon Public Broadcasting reports.

LEE HOCHBERG: A booming economy has lured thousands of newcomers to the Seattle area. They find a vibrant natural environment and waterways seemingly teeming with fish. Ironically, though, the fish that symbolizes the region and entertains shoppers at Seattle's Pike Place Market, is in peril. The federal government has proposed listing Chinook salmon, celebrated in Seattle's public art and on city buses and revered by the region's native Americans, as an endangered species. Rob Jones is from the National Marine Fisheries Service.

ROB JONES, National Marine Fisheries Service: Most of our Chinook populations are really struggling, going from numbers in the millions to in some cases disappearing altogether from various areas up and down the coast.

LEE HOCHBERG: The federal government has given Northwest policy makers a year to draft a plan to save the Chinook. The fish have been harmed by hydroelectric dams on Northwest rivers, over-logging, over-fishing, and urban development in Seattle and Portland. Salmon hatch in the streams of the Cascade Mountains, swim through rivers in those cities to the Pacific Ocean, then return to their birthplace years later to spawn. For the fish to recover, habitat changes have to be made all along that route, including in those two major Northwest cities. It's the first time that an urban area has been told to recover a threatened species. In Seattle, that task has fallen to King County government's top administrator, Ron Sims.

RON SIMS, King County Executive: There's so many stakeholders. We have timber interests, agricultural interests, business interests, home building interests, environmental interests, urban neighborhood interests, road building interests. I mean, we have everything clashing. How can we do this and allow our economy to continue to grow? It's going to be a very, very daunting task.

LEE HOCHBERG: By boat, on Seattle's industrialized Duwamish River, one gets a sobering look at how daunting it will be.

BOB FUEISTENBERG, King County Ecologist: 97 percent of the estuary has been lost since about the turn of the century, so we're down to this remaining piece.

LEE HOCHBERG: King County Ecologist Bob Fueistenberg points to a river whose bottom has been filled and banks hardened to accommodate warehouses and heavy industry. Once it was home for 300,000 wild Chinook and other salmon. Only 60,000 salmon remain today, most of them hatchery, not wild fish.

BOB FUEISTENBERG: This isn't Seattle's industrial land, and it's very difficult to convince people they should remove riffraff or bulkheads or change the shore line when they believe that it impacts their business.

LEE HOCHBERG: Even the Boeing Company's parking lot alongside the river harms the salmon.

BOB FUEISTENBERG: Those cars, many of them, leak a little bit of oil, and much of that material, when it rains, comes off into the river itself. The effect on salmon in many cases is if it doesn't kill them directly, by and large, it can really compromise their ability to survive or to escape from predators even to feed in some places.

LEE HOCHBERG: Ecologists say Seattle businesses could eliminate 70 percent of the area's water quality problems and help the Chinook by installing systems to process storm water runoff. Boeing has begun doing that, but other landowners have balked at the cost. County Executive Sims has proposed a $1.1 billion sewer system expansion to reduce overflow into rivers and help salmon. He says needed habitat acquisition and restoration could cost another $900 million. And the county will need new road building methods and a new approach to development. Builders, though, are resisting.

ROBERT PANTLEY, Builder: If we don't allow these homes to be built, where do our working class people live, where does the firefighter live, where does the police officer live, where does the teacher live?

LEE HOCHBERG: Robert Pantley built these homes only 25 feet off a salmon stream in suburban Seattle. He says proposals to keep new houses at least 100 feet from the streams would prevent homes from being built and are bad policy in a city with intense growth pressures.

ROBERT PANTLEY: What are our highest values? Is it saving a stream that handles a hundred fish really what we should be doing?

LEE HOCHBERG: King County Councilman Rob McKenna sees an even bigger problem with the drive to save Chinook. He says other types of salmon are still plentiful and asks whether the Endangered Species Act is being misinterpreted.

ROB McKENNA, King County Council: Salmon are the only endangered species that you can buy for $6.99 a pound at Safeway. Salmon are abundant in Alaska. They're abundant in British Columbia. And they're abundant in the Puget Sound area in terms of Sockeye and Coho, and we're not-

LEE HOCHBERG: Different types.

ROB McKENNA: Different types of salmon.

LEE HOCHBERG: He adds that while protecting endangered species makes sense in natural environments, cities are built for people, not animals.

ROB McKENNA: How realistic is it to maintain levels of wild animals in an urban area? What other wild animals are we attempting to preserve in the urban environment-cougars, bears? Sometimes in an urban area the best you can do with wild animals is to go see them out at a zoo. The human costs of trying to maintain a purely wild species in an urban environment may simply be too large.

LEE HOCHBERG: County executive Sims answers that in the Seattle area, where 56 water bodies don't meet government clean water standards, it's unwise to ignore a threatened species.

SIMS: People don't want to see a species become extinct. It's been a part of our culture here forever, a sign of good fortune and good luck. Many of us talk and brag about our salmon-communities. We shouldn't have development at a cost of the natural beauty we have in this region.

LEE HOCHBERG: One hundred sixty miles to the South in Oregon political leaders are exploring policies that might minimize that investment. They've been trying to stave off an endangered species listing for another threatened fish, the steelhead. In addition to approving a billion dollar program to expand sewers and reduce storm water overflow, Portland is trying to change the habits of ordinary citizens. The city is offering $50 to homeowners who disconnect their gutters from the sewer system and let rainwater drain into their yards. Thirty-five hundred homeowners have participated, keeping an estimated 56 million gallons of water out of the city's overflowing sewers.

ERIK STEN, Portland City Commissioner: Well, this is Johnson Creek, and what we've done is restored steelhead habitat down here.

LEE HOCHBERG: But City Commissioner Erik Sten has seen there are limits to public cooperation. In an attempt to restore habitat and reduce flooding at this steel head spawning creek in Portland, the city bought and knocked down 20 houses and spent $3 million to develop a park on the creek's flood plain. But even before new trees have taken root, a neighboring property owner has moved aggressively on a $13 million development that threatens to counteract all the city has accomplished.

ERIK STEN: It's just every inch in a developed city is being contested. His development will continue to put pollutants in this creek, and there's nothing I can do about it. Here the city is spending money to fix things here and losing ground across the street.

LEE HOCHBERG: Builder Bruce Wood says Portland leaders have long encouraged development in the depressed urban neighborhood and questions if salmon should be a priority.

BRUCE WOOD, Developer: We're going to bring in the neighborhood of three hundred and three hundred and fifty jobs, family wage jobs, into an area that arguably could use it. We had already given over eight acres of the total developed area to environmental issues. I mean, at some point you have to kind of drop the line and say too much is too much.

LEE HOCHBERG: Even if urban areas do all they can do, some environmentalists say it won't be enough. They argue salmon won't recover until the Northwest's expensive chain of hydroelectric dams is altered. To keep fish from being ground up in the ground's turbines, the Army Corps of Engineers has been barging them around the dams for more than 20 years. Government scientists, though, say the $3 billion barging program has accomplished little. But legislation has been introduced in Congress to prevent any changes to the dams that would cut production of electricity or availability of water for irrigators near the river. With opponents, both rural and urban, lining up, saving the salmon may be very much like swimming upstream.% ? DIALOGUE

JIM LEHRER: Finally tonight, a Gergen dialogue. David Gergen, editor at large of "U.S. News & World Report," engages Sissela Bok, a fellow at the Harvard Center for Population and Development Studies, author of "Mayhem: Violence as Public Entertainment."

DAVID GERGEN: Sissela, you begin your book on violence on television by talking about the gladiators in Rome.

SISSELA BOK, Author, "Mayhem:" Yes. In fact, when I began to think that I wanted to use them as an example was when I came across Nicholas of Damascus, who wrote about dinner parties for the Romans where people would actually have their food, have their drink, and then lie back and watch live pairs of gladiators fight to the death and be thrilled at seeing that at such close hand. And that struck me then as a real example of entertainment violence, of taking pleasure and thrill in actual killing, which the Romans were such experts at.

DAVID GERGEN: There was a phrase from St. Augustine about the gladiators and what it was like to watch that I thought had so much resonance today.

SISSELA BOK: Yes. He talked about a young friend of his who was determined not to watch the violence and went to the arena with his friends and did watch it anyway and felt that his soul was stabbed. So St. Augustine had the sense that he then explained the effect of violence on people and on their spirits and their souls.

DAVID GERGEN: The stabbing of the soul.

SISSELA BOK: The stabbing of the soul.

DAVID GERGEN: You come at this issue as a teacher of moral philosophy and of practical ethics. And you frame the issue in those terms. Tell us about that.

SISSELA BOK: Yes. I'm interested really in entertainment violence, because it has so much to do with the kind of life we really want to lead, and that has so much to do with the main questions of ethics, namely what kinds of people do we want, how do we want to spend our time, what do we think watching all this violence might be doing to us. Iris Murdock, the British philosopher, also talks about maiming the spirit or the soul. And the word "mayhem," in fact, really means to maim. And what I wanted to ask was whether the constant exposure to extreme violence and very graphic violence, much more than the Romans had, and in our own homes on the screen, whether that can be in some sense maiming, and, in particular, I feel for children who have no choice about the matter. We adults can decide what we want to watch, but they are indoctrinated, acculturated, without any choice at all.

DAVID GERGEN: So what does it do to the moral framework of a child?

SISSELA BOK: Well, it does several things. First of all, I think it does affect their resilience, their sense of empowerment and growing up as young people with resilience, and it takes away also the capacity, which is the most basic capacity for making moral choices, and that is having empathy. This is something quite normal. Children two or three develop a feeling for other people. They notice when somebody is hurt or is in pain. And seeing so much violence that really asks them to take delight in violence and to shut out any empathy is, I think, very damaging, especially for those who see a lot.

DAVID GERGEN: So instead of being resilient, able to bounce back, one is fearful life.

SISSELA BOK: Yes.

DAVID GERGEN: And instead of being empathic, one is de-sensitized.

SISSELA BOK: Right. Both of those things are probably the most important. When it comes to the fears, you know, we hear now more and more about children being clinically depressed at earlier and earlier ages, and people are talking about giving them Prosac and anti-depressants, and they're not really stopping to ask first of all, what is the world of these children, what is it that they're seeing so much of? And they can't tell the difference between real violence and fictional violence.

DAVID GERGEN: You also went on to make the argument that beyond the lack of resiliency and the question of empathy there are also the issues of self-control and, as one's appetite grows, and a respect for others.

SISSELA BOK: And a respect for others. And, of course, that is cut away as well when we are asked in so many of these programs where disrespect is shown, where extreme violence, rape, torture-children see it all-in self defense they have to almost feel less and less, feel less and less pity for people and less and less respect for the victims.

DAVID GERGEN: When I talk to people in the television world or people out in Hollywood, they say that this isn't real; it's not like the gladiators. That was real. People were seeing real live violence. This is make-believe, and people know it, and they also argue that it has a cathartic effect. It enables you to deal with your fears. Now how do you respond to those?

SISSELA BOK: Yes. Both of those arguments are interesting. It's true that much of what we see isn't real. It's enacted. And for us, as adults, we can tell the difference on the whole. It's not at all clear that young people can, and it's definitely sure that small children cannot tell that difference at all. As for the cathartic effect, this was a theory in the 1950's, some people thought that if you could see violence on the screen, somehow, and live it out in your imagination, you'd be less likely to carry it out in reality. And that has really been totally disproved. Now, of course, also we have much, much more graphic violence, much more serious violence. And scholars are, more or less, agreed that this is not true at all. On the contrary, a certain number of people become more violent as a result.

DAVID GERGEN: What can people do to combat these problems?

SISSELA BOK: Well, this is what I really want to do, do partly in writing the book. I feel in going to schools and talking to parents people are so helpless and paralyzed and some of them even feel that it is an assault on free speech if they even tell their children so much, you know, the fact that programs are problematic or dangerous. I'm noticing more and more how much people are already doing. Families are doing a lot. They can do a lot. There are many more outlets than people often know about for children to watch other kinds of videos, for instance, non-violent programs. The on-off button is very important. But then there are also technological means, and there are screening technologies that people are going to be able to use more and more. The V-chip is only one of many. Then now and this, to me, is perhaps the most encouraging-we now have-on the Internet we have web sites for groups against media violence. There is an international clearinghouse for children and television violence, so that for the first time the consumers can band together and see what they can learn from one another. In the past it was only the producers who had the combined and collected effect.

DAVID GERGEN: You pointed to two countries that you thought were particularly innovative in the way they approach these issues. One was Canada and the other was Norway.

SISSELA BOK: Canada has had a much longer discussion than we have had and a much more articulate discussion about media violence. It was initiated by the government, but it involved teachers, parents, people in the industry, kids, adolescents, so many people, to try to figure out what you can do as a community and what individuals can do, without getting into censorship, which they agreed and I agreed very strongly is not the way to go at all. And so they really-they, for instance, prepared V-chip themselves, tested it. They arrived at voluntary standards for the industry, with respect to violence on the screen, violence before certain hours at time, and others. They, like the Norwegians, were talking about an anti-violence campaign. Now, the Norwegians, who, after all, had lived under the Nazis and knew everything there was to know about government control over the media, did not want to go in that direction, but they also had what they call an anti-violence campaign that was-involved the whole people. Media literacy was very important in both societies, namely helping viewers to be much more critical in what they see and to be aware of who is trying to send a message to them here, who is trying to get them to buy things, who is trying to indoctrinate them in a way to enjoy violence, and what the results might be and what the risks with that might be. So, to me, Canada and Norway, I used those two examples, but there are others all around the world and everywhere-in Japan, for instance, now many other societies-people are getting really disturbed about the environment that children and young people are growing up in and asking what to do.

DAVID GERGEN: Sissela Bok, thank you for helping find some of the answers.

SISSELA BOK: Thank you.% ? RECAP

JIM LEHRER: Again, the major stories of this Tuesday, a federal appeals court threw out an injunction that kept Microsoft from tying its Internet browser to its operating system. President Clinton announced rules guaranteeing access to specialists for Medicare beneficiaries or private health plans, and the Defense Department said traces of a deadly nerve gas were found in Iraqi warhead fragments, found by UN weapons inspectors. We'll see you on-line and again here tomorrow evening. I'm Jim Lehrer. Thank you and good night.