The NewsHour with Jim Lehrer

JIM LEHRER: Good evening. I'm Jim Lehrer. On the NewsHour tonight: Margaret Warner looks at Kosovo as a presidential campaign issue, Susan Dentzer reports on rethinking a breast cancer treatment, Elizabeth Farnsworth conducts another post-Littleton discussion on responsibility-- tonight's is with a group of Denver area law enforcement officers-- and essayist Roger Rosenblatt pays tribute to his friend, editor Meg Greenfield, who died today. It all follows our summary of the news this Thursday.

NEWS SUMMARY

JIM LEHRER: President Clinton today urged World War II veterans to support the US role in Kosovo. He told a Veterans of Foreign Wars group ethnic cleansing was a cause worth fighting. We'll have an excerpt right after this News Summary. Betty Ann Bowser narrates our report of the events in Kosovo today.

BETTY ANN BOWSER: Western journalists were allowed to take these pictures of about 100 Yugoslavian army troops forming up, loading a T-84 tank, and boarding buses. Yugoslav army officials say this is clear evidence that Serbian soldiers are leaving Kosovo, but in Brussels, NATO Spokesman Jamie Shea was skeptical.

JAMIE SHEA: The numbers are utterly insignificant. I mean, 250, which is the figure that I saw, is less than 0.5 percent of the Serb forces in Kosovo. And therefore I would not even dignify this term as a partial withdrawal.

BETTY ANN BOWSER: In Beijing, the three journalists who were killed when NATO bombed the Chinese embassy in Belgrade last week were honored as revolutionary martyrs in the Great Hall of the people, and Chinese government officials issued another demand that United States and NATO leaders take full responsibility for the bombing. At the State Department in Washington, Spokesman James Rubin remained optimistic that the incident would not jeopardize any peace plan for Kosovo.

JAMES RUBIN: We do not believe that, at the end of the day, China will stand in the way of a peaceful resolution of the Kosovo conflict.

BETTY ANN BOWSER: In Moscow, French President Jacques Chirac met with President Yeltsin, reportedly looking for Russian support for a Kosovo peace plan. And in Geneva, United Nations Secretary-General Kofi Annan promised to intensify the search for peace.

JIM LEHRER: In Washington, House and Senate negotiators were completing work today on an emergency spending bill. Last night, they approved $11.7 billion for the Kosovo campaign, for countries affected by the refugee exodus and for military readiness. Another $1 billion was to go to the Central American Hurricane Relief Fund. President Clinton said he was encouraged by the action, even though it was nearly double the $6 billion he asked for. The President was not pleased with what the Senate did last night on gun control. It voted down mandatory background checks on weapons buyers at gun shows. Democrats had pushed the amendment as a rider to a youth violence bill. The President spoke from the South Lawn of the White House.

PRESIDENT CLINTON: For the life of me, I can't figure out how they did it or why they passed up this chance to save lives. There is simply no excuse for letting criminals get arms at gun shows they can't get at gun stores. Today, the Senate will have another chance to debate common-sense measures that most gun makers and sportsmen and ordinary citizens would welcome. The American people are watching this debate. They care very much about the result.

JIM LEHRER: And later in the day Senate Republicans did change course later in the day. They brought up a new amendment requiring 24-hour background checks for all transfers of firearms at gun shows.

SEN. LARRY CRAIG, [R] Idaho: We hope what we do today will change the thinking in America. Law-abiding citizens have and will always have constitutional rights to own and bear arms for a variety of reasons. And what we don't wantto do is create a huge federal bureaucracy that has so many tentacles in its webs that private law-abiding citizens get caught up in them.

JIM LEHRER: In Moscow today, the Lower House of Parliament, the Duma, debated impeachment charges against President Yeltsin. The Communist majority accused him of breaking up the soviet union, wrecking the economy, and launching a ruinous war against Chechnya. A Yeltsin aide said the charges were groundless. Yeltsin's term is to end next year. A 29 percent rise in gasoline prices pushed up US Wholesale prices in April, the Labor Department said today. And on Wall Street, the Dow Jones industrial average closed up 106 points to another new record, 11,107. The Justice Department filed an antitrust suit against American Airlines today. It accused American of illegally driving out smaller startup airlines from the Dallas-Fort Worth airport. Attorney general Reno said American cut fares, added flights, then raised its prices once it forced a low-cost rival out of the market. An American spokesman said the suit was unwarranted and undercut the very essence of free market competition. That's it for the News Summary tonight. Now it's on to Kosovo politics, treating breast cancer, a responsibility discussion, and a farewell to a friend.

FOCUS - FACING THE ISSUE

JIM LEHRER: The Kosovo campaign, as seen by President Clinton, and the people who want his job. First, the president, who spoke today to a group of veterans at Fort McNair in Washington.

PRESIDENT CLINTON: There are those who say Europe and its north American allies have no business intervening in the ethnic conflicts of the Balkans. They are the inevitable result, these conflicts, according to some, of centuries-old animosities, which were unleashed by the end of the Cold War restraints in Yugoslavia and elsewhere. I, myself, have been guilty of saying that on an occasion or two, and I regret it now more than I can say; for I have spent a great deal of time in these last six years reading the real history of the Balkans. And the truth is that a lot of what passes for common wisdom in this area is a gross oversimplification and misreading of history. The truth is that for centuries, these people have lived together in the Balkans and southeastern Europe with greater or lesser degree of tensions, but often without anything approaching the intolerable conditions and conflicts that exist today. People say, Okay, maybe it's not inevitable, but, look, there are a lot of ethnic problems in the world. Russia has dealt with Chechnya. And you've got Abkhazia and Ossetia on the borders of Russia. And you've got all these ethnic problems everywhere and religious problems. You've got -- that's what the Middle East is about. You've got Northern Ireland. You've got the horrible, horrible genocide in Rwanda. You've got the war now between Eritrea and Ethiopia. They say, "Oh, you've got all these problems." And therefore, why do you care about this? I say to them, there is a huge difference between people who can't resolve their problems peacefully and fight about it, and people who resort to systemic ethnic cleansing and slaughter of people because of their religious or ethnic background. There is a difference. There is a difference. And that is the difference that NATO -- that our allies have tried to recognize and act on. Bringing the Kosovars home is a moral issue, but it is a very practical strategic issue in a world where the future will be threatened by the growth of terrorist groups, the easy spread of weapons of mass destruction, the use of technology, including the Internet, for people to learn how to make bombs and wreck countries. This is also a significant security issue, particularly because of Kosovo's location. It is just as much a security issue for us as ending the war in Bosnia was. Though we are working hard with the international community to sustain them, a million or more permanent Kosovar refugees could destabilize Albania, Macedonia, the wider region, become a fertile ground for radicalism and vengeance that would consume Southeastern Europe. And if Europe were overwhelmed with that, you know we would have to then come in and help them. Far better for us all to work together to be firm, to be resolute, to be determined, to resolve this now.

JIM LEHRER: Now, Margaret Warner looks at the war in Kosovo as a year 2000 presidential campaign issue.

LAMAR ALEXANDER: I'm here this morning to declare that I will be a candidate for President of the United States.

MARGARET WARNER: By early this year, more than a dozen would-be presidential contenders had started gearing up for the year 2000 campaign. When the conflict in Kosovo erupted in late March, it quickly dominated the news, and forced many of these presidential hopefuls to take a position. Here's a sampling of what some of them have said. Two days after the air strikes began, Vice President Al Gore was interviewed on a New Hampshire Television program.

VICE PRESIDENT AL GORE: If the world stood by and did nothing in the face of such a brutal, bloodthirsty slaughter, we would feel awful bad about ourselves, and actually our future would be diminished, and the consequences of not acting therefore seemed clearly to be worse than the consequences of taking this risk to act.

MARGARET WARNER: Gore's sole Democratic challenger, former New Jersey Senator Bill Bradley, took the opposite tack in a statement that same week. "We are escalating our commitment without establishing a clear exit strategy. As with Bosnia, we run the risk of becoming bogged down in a quagmire whose end we cannot predict or control." Among the 11 Republican contenders, Arizona Senator John McCain spoke out early and forcefully.

SEN. JOHN McCAIN: We are in this military situation, this war, and we will win it, and we will take whatever means are necessary. If that means at some point we may have to use ground troops, than we may have to use ground troops. The consequences of failure are profound, both in Kosovo and around the world, and we cannot fail.

MARGARET WARNER: McCain also sponsored a Senate resolution to let the President deploy ground troops if needed. That measure was defeated last week. Former talk show host Patrick Buchanan, by contrast, has opposed the venture from the start.

PATRICK BUCHANAN: It has never been a vital interest of the United States whose flag flies over Pristina. And what are we doing bombing and attacking this tiny country that has never attacked the United States?

MARGARET WARNER: The early reaction from Texas Governor George W. Bush, who leads the early polls, came at a press conference the day after the bombing began. "Any time we commit American troops, I believe we must have a clear mission, an achievable goal, and a credible exit strategy," Bush said. "The ultimate question is, will this military action lead to the goal of ending the conflict and bringing peace and stability to the region?" By this week, Bush had toughened his rhetoric.

GOVERNOR GEORGE W. BUSH: We need to go on until we win. The objectives are to return the Kosovars to their homes, to remove the Serbs from Kosovar, and to have a political settlement that will yield autonomy.

MARGARET WARNER: Elizabeth Dole, the other leader in the Republican polls, supported the air strikes from the start.

ELIZABETH DOLE: Thank you so much for the chance to visit with you.

MARGARET WARNER: And in mid-April, Dole toured refugee camps in Macedonia and Albania for a firsthand look at the crisis. Many of the candidates also have posted their views on their web sites. Former Governor Lamar Alexander, for example:

LAMAR ALEXANDER: If NATO troops go in to Kosovo, let them be from our European allies. No American troops on the ground. It is time for Mr. Clinton to come forward and spell out with no weasel words his success strategy and his exit strategy. This is Lamar Alexander. Thanks for listening.

MARGARET WARNER: We're joined by two reporters who've been out covering many of the candidates since the Kosovo conflict began: Ron Brownstein of the "Los Angeles Times," and Dan Balz of the "Washington Post." Dan, how much impact do you really think the Kosovo conflict is having on this early stage of campaign?

DAN BALZ: I think that what we can see is where voters are beginning to pay attention or where voters are seeing candidates, it's having some impact. And we can see that in New Hampshire where John McCain, who has been perhaps the most outspoken of all the candidates on this subject, has actually moved demonstrably in the polls. He's doubled his numbers. It's a small move -- seven to 14. But it shows that among people who are looking and listening to the candidates, they are weighing this as part of it.

MARGARET WARNER: Do you find when you're out on the campaign trail, Ron, that voters are asking about it, asking the candidates?

RON BROWNSTEIN: I think along with the tragedy in Littleton, it's one of the two things that is shaping the environment in the early stage of race. And I think you are seeing - as the polls tell us -- both parties divided, both in their leadership and at the grass roots. On the Republican side, John McCain is moving up more out of a sense that he is being decisive and demonstrating leadership, rather than broad-based support in the party for an escalation of the conflict. There's a lot of division there. And on the Democratic side, I think you are slowly seeing a reassertion of this traditional reluctance to use military force abroad on the left that was largely suppressed at the outset of this conflict. And Bill Bradley is sort of beginning to reflect that.

MARGARET WARNER: Dan, there's been a lot of articles talking about well, this is showing a fault line in the Republican Party. I mean, there's so many candidates, it's hard to keep them all straight. But is there kind of a clear division that you can see?

DAN BALZ: There is. I mean, there is a clear division between what you would call the internationalist wing of the party and the isolationist wing of the party. And, on the internationalist side, what McCain has had to say he puts in clearly in that camp. George W. Bush is in that arena, as is Elizabeth Dole. Pat Buchanan is clearly the leader of the isolationist wing. But there are others involved in that as well. So, there is a clear division among the Republicans. And you've also seen it in Congress in the votes in the House two weeks ago or three weeks ago when the House wouldn't even endorse the air war that was already ongoing. You could see that there were divisions among Republicans there.

RON BROWNSTEIN: You know, there is a point of view, a pretty widespread point of view in the Republican Party that there are almost parallel primaries going on -- a primary of the center and a primary of the right, where each side -- each wing is trying to produce a champion that will meet sort of like the NCAA playoffs in the ultimate final. And this is almost a litmus test, this really has become a litmus test within those individual primaries. Every one of the major conservative candidates, except for Steve Forbes has opposed the bombing. And every one of them, without fail, opposes ground troops. On the other side, almost all of the centrist candidates have supported the bombing and the three leaders - McCain, Dole, and Bush -- are talking about ground troops. So you really have two separate competitions going on in the Republican Party right now on this.

MARGARET WARNER: Now, George W. Bush was criticized for his initial reaction. Explain that. We ran a little bit of it. But what was wrong in the view of many in the party about his early statements?

DAN BALZ: There are two criticisms of Governor Bush from the beginning. One is that he was slower than other Republican candidates to stake out his position. His people say that's not quite fair. But most Republicans believe it to be the case. Second, he was somewhat tentative about being very clear in terms of his views. The ground troop issue is a good example of that. When he first talked about ground troops, he did it in the context of being very cautious about it, said he had real reservations about it. Since then, he has toughened progressively. In recent weeks, he has said very clearly that it was a big mistake to rule out ground troops from the beginning. But he was not that clear about ground troops in the first couple of days.

MARGARET WARNER: But maybe not a total surprise since he has no experience in foreign policy.

RON BROWNSTEIN: Well, I think the real reason it caused a problem for Bush was partially what you say, that he does not have experience in foreign policy. And that's one of the areas where people are going to be looking at him very closely, is to see if he can perform at this level, but also because earlier in the primary season, he had some trouble answering questions about abortion. And this sort of became another in a list of issues in which he seemed to be stumbling a little bit, raising some questions really, the big question, is he ready for prime time? So, it was more on that line than on the specifics of what he was saying, that this raised a problem. As Dan said, he has moved very much toward the McCain position of, if we are in this, we have to win.

MARGARET WARNER: So, in other words, as with McCain, it's more how assertively and confidently you assert a position and look like a leader than your position that seems to matter.

DAN BALZ: I think that's right. I mean, a lot of what people are doing at this point is looking at these candidates, not for all the policy positions or all the details of their policies but what kind of a leader are they. How strong are they? How decisive are they? How much do they know their own mind? And I think that those are the kinds of things that come through in this. There's a lot of gradations of this policy and a lot of confusion about it for the average person to figure that out with 11 or 12 candidates, it's impossible. But they can get clues to these candidates by looking at those leadership questions.

RON BROWNSTEIN: Of course, given the divisions in the party on this, it's not clear that will play out that way all the way through the end. If this turns sour, more sour than it is already, it's entire likely that some of the conservatives will attack the McCains and Bush for the substance of their position by the time the voters actually go to the polls next year.

MARGARET WARNER: All right, now, what about Elizabeth Dole, speaking of leadership? It's a truism - and it's borne out in the polls -- that when voters are thinking of a commander in chief, they don't usually think of a woman unless you're Maggie Thatcher. How has Elizabeth Dole thought about that?

DAN BALZ: Well, the first thing she did was she was the - she was over there very quickly to the refugee camps to show herself in the middle of the refugees. The second thing she did was she gave speech at the Naval Academy in which she was very tough in her rhetoric about winning the war, the use of ground troops if NATO commanders said that was the right thing to do, she said by all means, we should do it. She has taken a fairly hawkish position to overcome doubts that a woman can handle that.

MARGARET WARNER: All right. Let's turn to the democrats now. I mean, is this Al Gore's war, as much as it is President Clinton's war? In other words, is he completely tied to this policy?

RON BROWNSTEIN: I think absolutely. I mean, if you look at a general election, if you can get that far, certainly, the most important thing for Al Gore is voters wanting to basically maintain the same direction that the country has been moving in under Bill Clinton -- anything that causes that into question, and obviously a bad result in Kosovo would very much call that into question, is very harmful for him. In the primary, it is emerging as one of the distinctions between him and Senator-- Former Senator Bradley. As on many things, Bradley has not entirely specified his position here in all the detail. But as you saw in his original reaction, using a very charged, very specific Vietnam-era word of quagmire, he is mostly reflecting doubt. He criticizes President Clinton for not ruling out ground troops and also says we shouldn't have ground troops in there. He said the other day on the Don Ivas Program that you might consider a bombing pause. And he has talked about the need to move toward a negotiated settlement. So, he is reflecting some of that traditional skepticism here that is gradually bubbling back up after being quite suppressed at the outset o this conflict.

DAN BALZ: My sense is that Bill Bradley has a lot more to say than he has said. He's thought a lot about it. When you talk to him, you can't quite draw him out, but you know there's something there to get. When I talked to him a few weeks ago about it, it was clear that he was very worried about what this will do the US-Russia relationship which I think he believes is much more important in the long term than the US in the Balkans.

MARGARET WARNER: Do you think he -- is he trying to use it - for instance when he's out on the trail - is he trying to use it to really define himself against Vice President Gore?

DAN BALZ: No, and in fact, quite the opposite. That's one of the frustrating things for reporters who are trying to get more information from Bill Bradley about position on something like this. I asked him why he would not say more about it and he said "Look, I don't have a vote. I'm not a policy maker at this point."

RON BROWNSTEIN: He says "I don't have the intelligence information."

MARGARET WARNER: George W. Bush said himself -

RON BROWNSTEIN: But I think Dan is absolutely right that Bradley-- it's not that he's out there leading with this. You really have to pull it out of him. And it's almost entirely from questions from the audience and from reporters where he talks about it at all.

MARGARET WARNER: So, what do you think it will take to have either Kosovo or foreign policy really be a defining issue when 2000 rolls around?

DAN BALZ: Well, if we are still involved militarily in Kosovo, it will be an issue. If we have ground troops in Kosovo at that point, it will very much be an issue. If it has gone terribly sour, it will be very much an issue. There are very few outcomes at this point look like they're going to be triumphant in the way the Gulf War looked at the end of the Gulf War. The question is how long this involvement goes on and how quickly if we get a resolution to this, we can move on from it.

RON BROWNSTEIN: I would not be surprised - as I said before -- to see the substance of the positions of the internationalist and the Republican Party become a point of debate before it is over if there is anything but a triumphant outcome. I think there is a lot of conservative antipathy toward this whole action - a lot of resistance to it, sort of a resurgence of America thinking in which there's an argument that we need to build up our military and simultaneously use it less. And I think that there are a lot of people in the Republican Party itching for that argument against George W. Bush, Elizabeth Dole, and John McCain.

MARGARET WARNER: But it's been a truism since the end of the Cold War and the 1992 election-- with the Cold War over, foreign policy is not a voting issue.

DAN BALZ: I think that's right. In most elections, it has not been. And it's only when we are in a difficult foreign policy environment, when it becomes an issue, Vietnam being the most obvious example of that. If we are in that kind of situation, obviously, it becomes significant.

RON BROWNSTEIN: And, certainly, Al Gore very much wants this to be over, wants people's attention to turn back toward the good news and the economy, crime, welfare, some of the social trends, and push back that sense of general satisfaction with the direction of the country, which ultimately is the most important factor in his ability to get elected President.

MARGARET WARNER: All right. Well, thanks, Ron and Dan.

JIM LEHRER: Still to come on the NewsHour tonight, a breast cancer treatment, a post-Littleton discussion of responsibility, and a Roger Rosenblatt good-bye to a friend.

FOCUS - HOPE OR HYPE?

JIM LEHRER: The breast cancer story as reported by Susan Dentzer of our health unit, a partnership with the Henry J. Kaiser Family Foundation.

SUSAN DENTZER: Nine of Joanne Ruddy's eleven children gathered in a hospital room last month to wish their mother a happy 55th birthday.

KIDS SINGING: Happy Birthday, Dear Mom, Happy Birthday to you.

SUSAN DENTZER: As she opened gifts and read cards from her two absent children, Joanne seemed eager to return home from Georgetown University Hospital after her latest bout of treatment for breast cancer.

JOANNE RUDDY: Thank you everybody -- a lot to look forward to when I get home.

SUSAN DENTZER: It's been almost a year since Joanne, a former school teacher, was diagnosed with inflammatory breast cancer. That is one of the most aggressive and least curable forms of the disease.

JOANNE RUDDY: "Dear Mom, everyone who still thinks you look terrific raise your hand"--

SUSAN DENTZER: Once the cancer was discovered, Joanne had chemotherapy to kill cancer cells that may have spread throughout her body. That was followed by a mastectomy and still more chemotherapy. Then, even as she celebrated her birthday, she was undergoing still another treatment -- doses of chemotherapy so powerful that they virtually destroyed her bone marrow, blood supply, and immune system. To keep Joanne from dying from the high-dose chemotherapy, special cells known as "stem cells" had been removed from her blood beforehand. They were mixed with a preservative and temporarily frozen. When the high-dose chemotherapy was complete, the cells were thawed. Then they were transfused back into Joanne Ruddy's body to help her bone marrow, blood supply and immune system regenerate.

HEALTH CARE WORKER: And then we're just going to do your vitals every fifteen minutes for one hour.

SUSAN DENTZER: Just days before Joanne Ruddy underwent the treatment last month, this same therapy made the news. Splashed across the front pages of the nation's leading newspapers were headlines like these. The stories reported on five major studies of breast cancer patients who had undergone similar high-dose chemotherapy and transfusions, known as "transplants". At first glance, most of the studies seemed to show little, if any, benefit from the procedure. Joanne Ruddy wasn't deterred.

JOANNE RUDDY: My doctor all along has told me that they don't have definitive answers, that they don't have enough information yet. I'm putting my trust in God that, you know, you have to take a chance.

DR. KENNETH MEEHAN: Hi! How's it going, okay?

JOANNE RUDDY: Yes --

SUSAN DENTZER: Joanne's physician, Dr. Kenneth Meehan, is a breast cancer transplant specialist at Georgetown.

DR. KENNETH MEEHAN: Most patients, in general, when they come to see me, they will do anything to try to live as long as they can without disease. Joanne, in particular, has a very large family, a number of children. She wanted to be very aggressive.

SUSAN DENTZER: That determination has hurtled Joanne into the midst of a raging medical controversy: How well -- and for which breast cancer patients -- do high-dose chemotherapy and transplants work? The debate constitutes a case study of the most difficult issues in medicine, where costly innovations offer new hope to the very sick -- however slim that hope may be. Dr. Lee Newcomer is medical director of United Health Group, one of the nation's largest health-maintenance organizations. A cancer specialist, he has reviewed hundreds of cases of patients seeking high-dose chemotherapy and transplants.

DR. LEE NEWCOMER: I think the big issue is what's the right thing to do, and do we have some science and some evidence to tell a woman facing this decision what she really has to look forward to in terms of side effects, and in terms of outlook.

SUSAN DENTZER: A woman, that is, like Joanne Ruddy -- or like 49-year-old Sandra Rolef, who had a mastectomy for breast cancer several months ago. By that time, the disease had spread to 16 of her underarm lymph nodes, putting her at very high risk for a recurrence. Along with her husband, Rolef is now consulting oncologist, Dr. Robert Siegel of George Washington University. They are considering whether to go ahead with the high-dose chemotherapy and stem cell transplant.

DR. ROBERT SIEGEL: It's not a slam dunk one way or the other.

SANDRA ROLEF: So you're not ready to really make a final recommendation to me yet?

DR. ROBERT SIEGEL: I just think it's important not to jump to conclusions before you have to.

SUSAN DENTZER: Although Dr. Siegel is uncertain, other doctors Rolef consulted encouraged her to proceed.

SANDRA ROLEF: One of the doctors said something to me that really is kind of sticking in the back of my mind, and she said, 'You know, it's kind of a personal decision. And if you're the kind of person that wants to make sure that no stone is unturned, that you have done everything humanly possible to fight this disease and make sure that you're rid of it, then you should do it'.

SUSAN DENTZER: The debate over the treatment's effectiveness has raged since the 1970s. Back then, high-dose chemotherapy and transplants were first used successfully to treat other forms of cancer, such as leukemia. Inevitably, doctors also began testing the approach in "advanced" cases of breast cancer in which the disease had spread to organs or bones. Such patients were given doses of chemotherapy drugs that were five to 30 times higher than those used in conventional treatment.

DR. LEE NEWCOMER: There was a lot of theory about the bigger the dose, the better the chance of getting rid of the cancer. By the middle 1980s this was a fairly common procedure.

SUSAN DENTZER: At the time, doctors used patients' own bone marrow for the transplants. They later switched to using blood stem cells when these proved just as effective. The treatment was costly -- as much as $200,000, or several times the price of more conventional breast cancer therapy. It was also very risky. Early on, as many as 1 out of 5 who got the treatment died from it, rather than from breast cancer. Besides the risks, there was also no hard scientific evidence that the treatment was effective. As a result, many health insurers balked at paying the costs. Breast cancer survivor Fran Visco is president of the National Breast Cancer Coalition, a group of 25 patient advocacy organizations.

FRAN VISCO: Physicians would say to women, a bone marrow transplant is the only thing that could possibly save your life. And you had situations where women sued insurance companies, requiring their company to cover a bone marrow transplant.

SUSAN DENTZER: The quest for treatment generated some of the highest-profile lawsuits brought against health insurers over the past decade. One involved this California woman, who sued her HMO, got the treatment, and subsequently died. In her case, as in others, courts ordered insurers to pay the costs.

FRAN VISCO: Well, insurance companies threw in the towel and started paying for bone marrow transplants broadly because of some of the verdicts.

SUSAN DENTZER: But there was still little hard evidence that the treatment worked -- the kind of information only gained from rigorous clinical trials. That's in part because assembling such studies was difficult. In a well-done clinical trial of this type, patients are randomly assigned to receive either the experimental treatment being tested or the standard, effective therapy. But many patients resisted entering trials, since they were convinced that the experimental treatment was their only hope.

DR. KENNETH MEEHAN: Patients nowadays are very intelligent. They do not want to be randomized to the chemotherapy line, despite my emphasis saying, 'We're not sure if this works at this point in certain situations. I would recommend this trial.' They would go elsewhere.

SUSAN DENTZER: Out of the estimated 12,000 women who underwent the treatment, only 1,000 participated in clinical trials.

FRAN VISCO: The real tragedy in this story is that if women had enrolled in the bone marrow transplant trials, if their physicians had encouraged them to do so, we would have had the answer years ago, and it would have saved lives.

SUSAN DENTZER: Gradually, though, major trials were assembled and began to accumulate results. One conducted from 1990 to 1997 tracked women with advanced cancer that had spread to organs or bones. After three years, the study showed no difference in survival rates between patients who got the new therapy and those who got the standard treatment. When this and other major studies made news last month, Sandra Rolef says --

SANDRA ROLEF: It had my telephone ringing -- lots of friends and family hysterical over it because of what the studies say. 'Why are you doing this, and, you know, why don't you just take your stem cells and freeze them and think about it?'.

SUSAN DENTZER: But the studies have not cleared up the controversy and they may actually have deepened it. On one side, Fran Visco's group argued that the procedure was fruitless.

FRAN VISCO: High-dose chemotherapy with bone marrow transplants for breast cancer is not an effective therapy.

SUSAN DENTZER: But other cancer specialists argue that the results of the studies were far more ambiguous. Dr. John Durant is executive vice president of the American Society of Clinical Oncologists, known as ASCO.

DR. JOHN DURANT: It's way premature to say this strategy doesn't work. I think the strategy will continue to be of interest as a means of improving survival.

SUSAN DENTZER: To bolster their case that the jury on transplants isn't yet in, Durant and other specialists point to the complexities of the studies. One important factor is just how sick were the patients in the clinical trials. For example, the studies suggested the new therapy did not improve survival of patients with advanced cancer that had spread to organs or bones. On the other hand, the treatment looked more promising for patients like Sandra Rolef, whose cancer had only spread to 10 or more underarm lymph nodes. In one study conducted in South Africa, these high-risk patients who underwent the experimental therapy were far more likely to survive. Some of the clinical trials will now continue, and in addition, doctors say new studies are needed. For example, they want to know how effective the treatment is for other forms of breast cancer, such as the inflammatory cancer that afflicts Joanne Ruddy. They also want to understand the effects of treatment innovations that have taken place since the first studies began. For example, new procedures have cut the transplant death rate to as low as 1 in 20 patients. And powerful new chemotherapy drugs such as Taxol may also have yielded better results.

DR. KENNETH MEEHAN: I think that in the long run there will be a small advantage to transplant. It's not going to be 50, 60, 70 percent. It may be 10 percent, maybe a little bit higher.

SUSAN DENTZER: But Durant says it will be a while before those results are in.

SUSAN DENTZER: On a scale of one to ten, one being we know almost nothing about all of this, ten being that we know everything, where are we?

DR. JOHN DURANT: Oh, we're at two or three probably.

SUSAN DENTZER: The uncertainty raises the stakes for patients like Sandra Rolef.

SANDRA ROLEF: I don't want to look back in a year, or two years, or five years and say I should have, when they have more data, and maybe the data is going to end up saying that it does help. And how could I live with myself?

SUSAN DENTZER: After all, for Rolef, Ruddy and their families, the goal is living to celebrate more birthdays.

KIDS: All right! clapping

SUSAN DENTZER: The transplant studies will be a major topic of discussion next week. That's when cancer experts meet in Atlanta for ASCO's annual conference.

SERIES - RESPONSIBILITY

JIM LEHRER: Now, another of our discussions about responsibility in light of the Colorado high school tragedy. Elizabeth Farnsworth has talked to groups of students, and of parents and teachers. Her third, last night at the county courthouse in Denver, was among police and juvenile justice personnel.

ELIZABETH FARNSWORTH: Thank you all for being with us. Tonight we're going to talk about what you can do, what you feel it's your responsibility to do, you who work in the justice system with problem kids every day. And, to begin with, I want to know what you see, what you see every day, what kind of problems you see. Steve Rickard, you're with the Denver gang unit. You go to both city schools and Denver and you go to suburban schools. Tell us what you're seeing, what kind of problems.

STEVE RICKARD, Denver Police, Gang Unit: Well, it seems like recently, I've noticed, particularly in suburban areas, that a lot of kids are doing bizarre crimes. Like, some kids were having a keger and found a -

ELIZABETH FARNSWORTH: Having a what?

STEVE RICHARD: A keger, a beer party. And they found a guy who died of a heart attack. Rather than calling the police, they urinated on the body. These are kids from primarily upper middle-class families.

ELIZABETH FARNSWORTH: Do you have any explanation for that behavior?

STEVE RICKARD: I think that kids have no rules these days. They have no sense of right or wrong. Do I get caught? That's what makes a crime a crime - did you get caught stealing. They have no moral guidance. And it's not necessarily a religious guidance. It's just having a moral right or wrong. And that's what the kids are lacking these days.

LT. LOU LOPEZ [Ret.], Denver Police Department: I saw this same thing years ago in the Denver public school system. And I think there is a great example at Columbine how these kids all of a sudden separated themselves from their peers, and they had to exhibit themselves in the form that would set them apart. It's just something to attract the attention. Eventually what you start to see is a spark develop between somebody else over here that doesn't care for the way they're dressing or something of that nature. Pretty soon you have problems, a problem resulting in -- a lot of times -- in violence.

ELIZABETH FARNSWORTH: Given that, when you get those sparks or any of the other problems you're seeing, what's your responsibility for dealing with it?

OFFICER DAVE ADAMS, School Resource Officer: Well, some of the things that I've - when I've seen those - is first of all confront it and say we recognize there's a problem here. And we tend to bring those groups together in kind of a moderator type of format where we have somebody to kind of moderate between the two, try to identify what the problems are. We've done that with groups of students with their parents and just kind of laid it out on the table. You know, why are you guys having this problem and then try to correct it.

ELIZABETH FARNSWORTH: Is it important to do be in the school to be able to do this sort of thing? Do you need to be in the schools?

OFFICER JOHN HUNT, School Resource Officer: I think most definitely. The strength of having law enforcement involved in the schools is that it shows to students and it also gives a message to the parents that we are a community. And we are working together to ensure the safety of the schools to the best of our ability, and to do what all parents want for their kids, and that's to get a good education.

LT. LOU LOPEZ [Ret.]: I think that the significantly important thing about the officers assigned to the schools is the opportunity for them to follow up and to be present with those kids. And I guarantee you that you probably have bonded with a lot of these kids. I'm going to ask you something. Do you go to the home? Do you rap on the door? Do you go inside and sit down with those parents and the kids?

OFFICER DAVE ADAMS: Yes, and that is such a -

LT. LOU LOPEZ: To me it is. To me it is.

OFFICER DAVE ADAMS: It is to me, and that's what I hear from a lot of my administrators at the schools, is that's something they can't do. And we can leave the school and go out to the house, sit at the kitchen table with the mother and the child and say, "let's talk about this." And we can visit, and...

ELIZABETH FARNSWORTH: Doesn't the parent say "what are you doing here? You're a policeman. My kid doesn't have a problem."

GERARD O'HARE, Jefferson County Juvenile Assessment Center: But I think it would be easy to focus on, also, on traditional models of whom we think is a bad kid or a bad parent. We see kids at the assessment center regularly from Columbine High School in that area. We see kids of all colors, all creeds, and all socioeconomic backgrounds. And they come in as apparently normal kids with normal issues who've maybe made a mistake-- maybe who got caught for possession, or who maybe made, you know, made an error of judgment, who you need to slap on the wrist, and maybe a diversion. But upon further assessment and upon further digging, you find some quite frightening aspects to their character and to their family life. And part of the issue with Columbine is that the country seems to be having a tough time developing a frame for what happened, as if these issues are new. They're not new to the inner city. They're not new to America.

LT. TRACIE KEEZEE, Denver Police Youth Academy: And I think that's the issue, is the fact that they predominately have been in the inner city; that a lot of people just can't comprehend the fact that this is happening.

GERARD O'HARE: But systemically, we need to dig, we need to dig in at an early level, okay? You stole a shirt from the mall, but what else is going on your lives?

ELIZABETH FARNSWORTH: How do you see your responsibility as law enforcement officers or juvenile justice administrators to recognize a problem in a kid and intervene before it becomes a really dangerous situation?

STEVE RICKARD: We need the tools to intervene. If society expects us to intervene, we need the tools to intervene.

ELIZABETH FARNSWORTH: Like what?

STEVE RICKARD: For example, the same people who criticize the police responding would criticize if we don't respond. If we have too strict of a dress code, if you have no dress code, then you fail there. It's kind of a catch-22.

ELIZABETH FARNSWORTH: Any other answer?

DETECTIVE GEORGE MUMMA, Jefferson County Juvenile Assessment Center: I agree with Steve. We've created a juvenile assessment center.

ELIZABETH FARNSWORTH: What do you do?

DETECTIVE GEORGE MUMMA: We've got a collaboration of people to address all those issues. Everybody needs to be there. If they're not there, those things go away. How much do you want to spend to fix the kids? How much do you want to put into kids?

ELIZABETH FARNSWORTH: Okay, now let me ask you, because you're law enforcement people, is it sad that we're having this discussion, that policemen have to be in the schools, that we have to have this conversation about what law enforcement can do? Or is it perfectly okay?

LT. TRACIE KEEZEE: It's time.

ELIZABETH FARNSWORTH: It's time?

LT. LOU LOPEZ: How many view this as an awareness thing? You know, we've lost inner-city kids for so long that I can't.-- I mean it just went on and on and on. And just -- it seemed like nothing was happening. Had this happened ten, fifteen years ago, and when we were losing those inner-city kids, we could have been that much further along with this problem. And it wasn't addressed. All of a sudden, we see the President calling in people, having all kinds of power-type people coming in, and they're addressing the problem, and so on and so forth. My feeling is it should have started a long time ago.

STEVE RICKARD: But look at the difference, though, when you look at inner- city gang kids, for example, compared to some of the violence in the suburbs, in suburban areas. At least the inner-city kids, their violence is defined, if they have a defined enemy, where in suburbia, everybody's the enemy. And then they, you know, you don't find gang kids massacring 15 of their classmates. They may kill one gang member.

ELIZABETH FARNSWORTH: You said we have to be careful that we're not just thinking about kids who are sort of stereotypically problem kids. How do you avoid that? I mean, you're looking at the way certain people dress, you said, or if it's a certain sign of a gang, or how do you avoid stereotyping somebody and coming down on them when you shouldn't?

GERARD O'HARE: Kids are complex, and what this country doesn't do is look at them as complex organisms with -- or complex people with complex issues. Kids have some complex issues, so we need a very complex response.

DETECTIVE GEORGE MUMMA: A classic example: The kids that come into the district attorney's office on a case of simple theft, theft under $100. When you sit down and you bring all the components together and say, "Why is this kid stealing?" And Junior says, "Well, my parents got a divorce, and they're concerned with each other, but they're not concerned with me. So I stole something, now they're concerned with me." And that's how Junior gets his attention. We need to look at that. We address that problem-- we do a divorce recovery program, or we do some other intervention.

LT. TRACIE KEEZEE, I think one of the things that brings that to light is with the officers in the schools, it shows the parents that there's a barrier. There's only so much we can do as police officers. The parents have to engage at some time. We can bring these things to your attention, but we're not in the house 24-7. We can't be there to tell you, "Look at this. This is happening."

ELIZABETH FARNSWORTH: What are the main obstacles you face in doing your work?

OFFICER JOHN HUNT: I think one is perception by other adults about what is the role of a police officer. I know I've had a lot of adults in the schools that I've been at, parents who are amazed, "Wow, you actually called me on the phone and told me about this, a preventative measure, rather than waiting until you have arrested my son or daughter."

STEVE RICKARD: But aren't we missing the boat, though? I mean, the same thing that drives a suburban kid into the Trench Coat Mafia will drive an inner-city kid into a gang. They're going there for e same reason. They're going there because they're lacking something, usually in the home setting. And so they're going to get that love, they're going to get that respect they're going to get that - whatever they're looking for, from either their family or from me subculture.

ELIZABETH FARNSWORTH: Given what happened at Columbine, does it make you think that schools should now be tougher? I ask this because one parent in our discussion last week said all the doors but one should be shut in the high schools, if possible; there should be more police officers, there should be metal detectors, and there should be video cameras on everybody. Would that help?

LT. TRACIE KEEZEE: But what's their response? Is it, "maybe I should take some responsibility as to what my child's actions are and what they're doing in the school?" It goes back I mean, we are -- we can't be responsible for everything.

ELIZABETH FARNSWORTH: You're saying that this just isn't that won't do it.

LT. TRACIE KEEZEE: That it got the whole system approach -- I mean -- we all can't -- we'd all love to have a lot of officers in the school. I know I would have felt safer for my daughter if there were more officers in the school, but it's not realistic. It's not going to help them cope. It's not going to help them move on. But you have to look at from all aspects of it. What are the parents doing? What are the schools doing? What's everyone doing together to try to get going?

DETECTIVE GEORGE MUMMA: And at the same time, if you just committed a crime-- let's say for instance he's in the school, and he's caught with marijuana, and we take the nurturing approach and the school administrator takes it away and says, "Junior, don't do that again" -- doesn't call in law enforcement. The way to look it, and the way the statistics show it is, if Junior just got caught, he's done it 17 other times. And if you don't take action at the low end with the school officer, you know what -- next time he's going to be a dope dealer, and the time after that, there'll be something else. We need to get back and do something early on when there's some intervention in order to prevent down the road.

ELIZABETH FARNSWORTH: But what would you all do different in your own work because of what happened at Columbine, anything?

STEVE RICKARD: You can look back and say, okay, now we see what we think we knew then. If we had it to do over again, would we have taken some sort of action? But you can take these same symptoms that people say to watch for troubled kids, and you could probably identify 20 kids at any high school-in inner city Denver or suburban areas -- and then you pull those kids out of school and lock them up in a jail. Is that - what -- is that the answer?

LT. LOU LOPEZ: I don't think, you know, you have to follow through on that stuff. I mean, you just -- it can't be brought to your attention and just sit there and say, "well, I don't have a complainant, and subsequently, I'm going to kiss it off because I don't want to get involved." You have to follow through. And I keep going back to this home visit stuff. Five minutes after you're in a house, you're going to be able to tell why that kid is having problems. But we -- you know there's always -

GERARD O'HARE: We shouldn't lose perspective. I mean, Columbine is not America. If it is, we're in really deep trouble.

OFFICER JOHN HUNT: I think the word the being "watchful." We have to continue to be watchful about the things around us and not necessarily blow those things off. And I keep hearing about, you know, earrings and blue hair and things like that. To me, it's behavior that I'm most concerned about, and probably many of us fit in that same boat. It's behavior from the kids that look like Joe A. Student, as well as the kids with the blue hair. So I want to focus on their behavior and be watchful.

ELIZABETH FARNSWORTH: Yes. Lieutenant?

LT. TRACIE KEEZEE: Right. Even from a training standpoint in our academy, when we train new officers, having them... Giving them actually the ability to identify those little problem areas, and then giving them the resources to make the connections. A lot of times it's a five- minute stop, and then they move on. It's the ability to say, "let me get a name and a number, and I can pass this on to my school resource officer," and to make those connections and to have that communication go on with everyone. I mean, that's the key for us, I think, is communication.

ELIZABETH FARNSWORTH: Okay, that's all the time we have. Thanks very much to all of you for being with us.

ESSAY - WOMAN OF DISTINCTION

JIM LEHRER: Finally tonight, essayist Roger Rosenblatt pays tribute to a friend, Meg Greenfield, the editor of the editorial page of the "Washington Post" and a columnist for "Newsweek" magazine. She died this morning in Washington of lung cancer.

ROGER ROSENBLATT: In the late 1970's, when I was writing columns and editorials for the "Washington Post," Meg Greenfield had just been appointed editorial page editor. Meg was canny enough only to assign me only those editorials that required no thought or knowledge; thus, when a golfer in Maryland was accused of murdering a goose on a golf course for interfering with his game-- he also ate the evidence- - the piece was my meat. I wrote the goose editorial on deadline, but I needed a head, a title, so rushing past Meg's desk, I shouted, "What shall we call this?" Without looking up and evoking Nixon's final days, she said, "Honk if you think he's guilty." That's how quick she was, and clever, and hilarious besides. Next to James Thurber, she was probably the funniest serious person who ever lived. She was learned and scrupulous and very brave. She spent the past three years dying of cancer, yet so alive was she with ideas about world events, with the stuff of her post-editorial and her columns for "NewsWeek" magazine, that she made one forget she was dying. Her small, frail body would shake with rage or with laughter and Clinton and Monica, at Congress, at her beloved city of Washington, which she would ridicule in private and defend against outside assault as one would a foolish child. How she loved the news. Meg lived alone, and in a way, the news was her family-- frequently stupid, crooked and dangerous, but family. It might even be correctable. More deeply, the news was her invitation to apply her monumental intelligence to human behavior.

SPOKESMAN: The central question at this point is simply put: What did the President know, and when did he know it?

ROGER ROSENBLATT: The question of her journalism was not "what did Nixon know and when did he know it?" But, "did we know Nixon?" "Did he know himself?" Under that blandness, who was Jimmy Carter? Under that bonhomie, who was Ronald Reagan or George Bush?

GEORGE BUSH: Please be seated, my heavens.

ROGER ROSENBLATT: Beside her friend and employee Kathryn Graham, she was the most powerful woman in Washington, yet she never flaunted her power or made a big deal about her womanhood. All Washington gathered to her, not for her influence as an opinion-maker, but for her wit, her common sense and heart. Liberals and conservatives, Senators, cabinet members, high government officials were true friends. And she had an eye for younger, once-obscure journalists, who she thought might do good in the world: Charles Krauthammer, Michael Kinsley, George Will, David Remnick, even, with some governing, the guy who wrote about the goose. Journalism for Meg offered a chance to apply knowledge outside the news to the news. She was saved from the corrosive boredom that ruins other journalists by her knowledge of English literature, which she studied at Smith and later at Cambridge, and by her curiosity about history and biography and philosophy. In her 50's, she took up Greek. And then, if life showed any danger of becoming too solemn, she would do things like sending me a human leg made of solid milk chocolate, which she admired in a catalog, or she would dote on the children of her friends. With heroic effort, she made it to our daughter Amy's wedding last spring. The following morning, I watched her huddle with Amy the way she did when Amy was four years old, two sweet heads in conference. She was the worst driver in North America-- I'm probably being too limited. Routinely, she would park half her car on the street, half on the sidewalk, and consider the job well-done. She also had no sense of direction. Confronted recently about her stunning inability to drive to an intended destination, Meg responded that she went to places not accessible to normal people. I should say so. I'm Roger Rosenblatt.

RECAP

JIM LEHRER: Again, the major stories of this Thursday: President Clinton urged veterans to support the US role in Kosovo, telling them ethnic cleansing was a cause worth fighting. About 100 Yugoslav troops were seen leaving Kosovo, but NATO was skeptical of the withdrawal. And Mr. Clinton criticized the senate for voting down mandatory background checks at gun shows. We'll see you online and again here tomorrow evening, with Shields and Gigot, among others. I'm Jim Lehrer. Thank you and good night.