The MacNeil/Lehrer NewsHour

MACNEIL/LEHRER NEWS HOUR

May 4, 1988

Intro

ROBERT MacNEIL: Good evening. Leading the news this Wednesday, explosions at a Nevada rocket fuel plant have killed at least nine people and injured up to 200, Israel ended its strike into Lebanon, claiming 40 guerillas killed. Poland`s Catholic bishops said spreading labor unrest filled them with fear. The FAA widened inspections of Boeing 737s for possible metal fatigue. We`ll have details in our news summary in a moment. Jim?

JIM LEHRER: After the news summary, we examine the government`s new AIDS pamphlet with Health and Human Services Secretary Bowen and Surgeon General Koop, and with Congressmen Waxman and Dannemeyer. Then correspondent June Massell reports on a newsmaking medical journal, and we close with a two- way discussion of why there is a flap over Mrs. Reagan`s use of astrology.

News Summary

LEHRER: There were a series of explosions at a jet fuel plant at Henderson, Nevada today. At least nine people were reported killed and up to 200 were injured, and many others are missing. The plant manufactures a component for the fuel used in the space shuttle`s booster rockets, Reports say the explosions destroyed the plant as well as another factory next door. Buildings 10 miles away in Las Vegas were shaken. Windows within six miles were shattered. There was no immediate word on the cause of the explosions, which shot a gigantic boom of smoke into the sky. Robin?

MacNEIL: Israel said it was ending its 48-hour search and destroy operation in Lebanon today, after claiming to have killed 40 guerillas. Israel said three of its soldiers were killed and 17 wounded. The Israelis today stormed the village of Mai Doon in the Bakah Valley just three miles from Syrian frontline forces. The bodies of some Shiite guerrillas were believed buried in the wreckage of bulldozed houses. A cobra helicopter gunship fired rockets to silence Lebanese artillery that shelled the Israeli force. A senior Israeli officer said the operation In Lebanon was over and that the forces were returning to base.

Meanwhile, in the occupied areas today, two Palestinians were reported killed in clashes with Israeli troops, Those deaths brought the toll in the 21-week uprising to 182.

And in Beirut, the pro-Iranian Islamic Jihad group released three French hostages they`d held for three years. The Associated Press reported the two diplomats and a journalist boarded a plane for Paris this evening. Jim?

LEHRER: Back In this country, President Reagan spoke warmly today of glasnost. He said in a Chicago speech that there are signs of change in the Soviet Union, and they must now be made permanent.

Pres. RONALD REAGAN: The indications, as I`ve said, have been hopeful. Over the past three years, some 300 political and religious prisoners have been released from labor camps. More recently the incarceration of dissidents in mental hospitals and prisons have slowed. And in some cases stopped completely. And while the press remains tightly controlled by the party and state, we`ve seen the publication of stories on topics that used to be forbidden. Topics like crime, drug addiction, corruption, even police brutality. Now, these changes are limited. The basic standards contained in the Helsinki Accords still are not being met. But we applaud the changes that have taken place, and encourage the Soviets to go further. We recognize that changes occur slowly. But that`s better than no change at all.

LEHRER: Mr. Reagan also said what Secretary of State Shultz and others have been saying lately that a new treaty to reduce by half U.S. and Soviet long-range missiles will probably not be ready for signing at the Moscow summit later this month. Meanwhile, the Soviets today conducted their fifth underground nuclear test this year. The Soviet news agency Tass said the blast was between 20 and ISO kilotons and was conducted in Soviet Central Asia in order to upgrade some military technology.

MacNEIL: In Poland, Catholic Bishops said today they were filled with fear by the wave of strikes now sweeping that country. The clergymen expressed concern, even as the church was sending mediators to help resolve the worsening labor Crisis. We have a report from Cindy Robinson of Visnews.

CINDY ROBINSON, Visnews: Workers at the Gdansk shipyard sang the Polish National Anthem as a symbol of their determination to defy the government, which says their strike is illegal. As their sit-in enters its third day, the dispute led by the banned trade union. Solidarity, spread to several other areas, including another shipyard, a copper mine in Western Poland, and a southern coal mine. In Warsaw, university students who planned to hold a one-day strike, held a rally of support for the workers. The strikers are demanding pay rises, protesting over the government`s economic reform program, which has led to huge price rises. Alarmed by the escalating dispute, Poland`s Roman Catholic Church has send mediators to talk with strikers. They met Solidarity`s leader Lech Walesa, who warned of a bloody revolution if the government fails to win the opposition support for its reform. The government refuses to negotiate with Solidarity and has threatened to jail strikers for three years. The church hopes to fill the widening gap between both sides and says it fears for the future of Poland if the unrest continues.

MacNEIL: The Polish government accused Polish strikers of terrorizing workers who`ve tried to return to their jobs, and threatened harsh action in response.

LEHRER: The U.S. government released its AIDS pamphlet today. The eight- page brochure will be mailed to 108 million American homes. It speaks in frank terms about condoms and other sexual matters. Health and Human Services Secretary Otis Bowen and Surgeon General Everett Koop held a new conference in Washington this morning to officially unveil the pamphlet.

C. EVERETT KOOP, Surgeon General: For the first time in our nation`s history, the Federal Government is sending information on a sexually transmitted disease to every home in America. We are taking this step because the epidemic of misunderstanding about how AIDS is spread and how it is not spread seems at times as difficult to control as the epidemic itself.

OTIS BOWEN, Secretary, Health & Human Services: This brochure cannot mince words and it doesn`t. It discusses the behaviors that put people at risk and it calls those behaviors by name as it must if we are to give people the information they need to protect themselves.

MacNEIL: Today was the final day for illegal aliens to take advantage of a yearlong amnesty program. All 107 Immigration and Naturalization Service offices around the country were remaining open until midnight tonight to handle last-minute applications for legal status. Five thousand persons applied in Houston yesterday, and today lines again were so long that enterprising vendors set up refreshment stands. INS offices in New York were also swamped today, even though a Federal Appeals Court extended the amnesty deadline by two weeks. The court acted to give the state time to clarify the legal status of parents whose U.S.- born Children receive welfare.

LEHRER: The Boeing 737 jetliners were expanded today. The Federal Aviation Administration ordered special looks at older 737s with at least 30,000 flights. The search will be for signs of cracks and corrosion in the planes fuselages. The Inspection order covers 291 planes built in the 1960s and `70s, but the FAA said it was unclear how many of those 291 were still flying, The action follows last week`s Aloha Airlines incident, where the forward fuselage of a 737 peeled away. A flight attendant was killed and 61 passengers were injured.

NASA conducted a special disaster drill today in Cape Canaveral, Shuttle astronauts were involved in the rehearsal of emergency procedures to be used in a launch pad fire. Escape baskets were tested, although no astronauts were onboard. But volunteers were used to simulate the rescue of injured personnel from the baskets. The shuttle program has been grounded since the Challenger disaster of 1986. The next flight is now scheduled for late August or September,

MacNEIL: A Senate subcommittee has concluded that Edwin Meese violated a White House ban on intervening in government contracts on behalf of friends, when he tried to help the Wedtech group. The Associate Press said all nine Republican and Democratic members of the Governmental Affairs subcommittee reached the same conclusion. The committee found that Meese violated the policy while counselor to the President, despite several warnings from White Counsel Fred Fielding. Meese is under criminal investigation In the scandal surrounding Wed tech contracts, in which his friend Robert Wallach has been indicted. Meese`s lawyer, Nathan Lewin, disputed the committee`s findings.

LEHRER: And that`s it for the news summary tonight. Now, the government`s new AIDS pamphlet, making news at the New England Journal of Medicine, and two views of the astrology flap.

Warning from Washington

LEHRER: An eight-page booklet about AIDS is our lead story tonight. The Federal Government will send it to 108 million American households. It`s title is Understanding AIDS. The format is frank question and answer. How do you get AIDS? What is all the talk about condoms? Should you get an AIDS test? And so on, It is being publicized in public service announcements like this:

Dr. OTIS BOWEN. Secretary, Human and Health Services: We all know something about AIDS. But how many of us really understand this disease? What it means to our families, to our children and our grandchildren. Soon you will be receiving a mailing from the Federal Government, and it`s called Understanding AIDS. In it you`ll find easy-to-read answers to your questions about AIDS, information that affects us all. Please take the time to read this brochure and share the information. If we understand AIDS, we can prevent It. The answers to your questions about AIDS are In the mail.

LEHRER: The pamphlet had its official unveiling today, and the two officials who did the unveiling are with us now for a joint newsmaker interview. Dr. Otis Bowen is the Secretary of the Department of Health and Human Services. Dr. C. Everett Koop is the Surgeon General of the United States. Mr. Secretary, what Is the message of this brochure?

Dr. OTIS BOWEN, Secretary, Department of Health and Human Services: The message Is, number one, to make sure that the people know how AIDS is transmitted, and also how it is not transmitted. Also to make sure that people know that it`s their behavior that puts them at risk for getting AIDS. It is not who they are, but it`s what they do. And the third reason is to get it out in the open so it can have good discussion with families, with sexual partners and with everyone.

LEHRER: Simply put, Dr. Koop, what does the pamphlet say about how it is transmitted.

C. EVERETT KOOP: Surgeon General: It makes it very clear that this is a sexually transmitted disease, but that you also can get it from sharing paraphernalia when you abuse illegal drugs.

LEHRER: And what points does it make about how it is not transmitted?

Dr. KOOP: Well, it makes it very clear that mosquito bites don`t do it, toilet seats, door knobs. And you don`t get it from sitting next to a child in school who carries the virus.

LEHRER: Do you expect people, Mr. Secretary, members of families, to get this brochure in he mail from the Federal Government and then to actually sit down and talk about this? Talk about anal intercourse, drug abuse, all the things that are in this brochure?

Dr. BOWEN: We expect them to read it and then to have family discussions, yes. But each family will have to make their own determination about how explicit their discussion would have to be.

LEHRER: But you would urge them to do so?

Dr. BOWEN: Yes.

LEHRER: And urge them to talk about this in very frank and open terms? Use the same terminology that is in the brochure?

Dr. BOWEN: Absolutely. That`s the same terminology they`ll hear on the street.

LEHRER: Why did you decide to send it to every home in America?

Dr. KOOP: Well, it was mandated by Congress that we do that. There was a good bit of debate in HHS about whether this was the best way to spend that kind of money, Whether we should do it in some other way. But then Congress took care of that matter, and we complied.

LEHRER: What kind of money? How much money is this going to cost?

Dr. BOWEN: This will cost $17 million, $13 million of which is the postage and S4 million is the production efforts.

LEHRER: White House Assistant Gary Bauer says that - questions the expenditure here and he says, "I question whether a 60-year-old couple in Topeka, Kansas, needs to be informed to avoid sharing dirty needles or engaging in anal intercourse." How do you respond to that?

Dr. BOWEN: Well, my response is that that 60-year-old couple will have children and grandchildren and they should know the information that is in this booklet. And that`s part of the family discussion.

LEHRER: Dr. Koop?

Dr. KOOP: I agree. And for every 60-year-oId couple that gets it, there are going to be two 30-year-old couples that get it who have children that arc young and should be taught.

LEHRER: What do you say to people who might be offended by this? Who do not want this kind of thing on a piece of paper coming into their mailbox?

Dr. KOOP: Well, It arrives In the mall sealed. And you don`t have to open it in front of your children if you don`t want to.

LEHRER: You tear it open, one side, like an IRS form?

Dr. KOOP: Right. But it`s happier news inside. But the important thing I think about it is that, families can take that, inject into the conversation their own moral, ethical and religious beliefs. We always expect there will be a certain percentage of people who won`t like that message. We tested this in the state of Alaska, Practically everybody in Alaska got a copy of my report of 1986 that the President requested that I write. Same frank language. And then a survey was taken of all the people that received it. And for the entire state, only 3% said they thought the language was objectionable. Ninety-two percent said it was great and the others didn`t know.

LEHRER: Are you willing to live with that kind of-

Dr. KOOP: We can live with 3%.

LEHRER: Okay. Mr. Secretary, what about drug users? People that don`t have neat and tidy mailboxes where they`re going to get this brochure? What are you going to do about them?

Dr. BOWEN: We have several outreach types of programs to get to them. And we have to admit right from the start those are the difficult ones to get the message to. But we have a sample of information with tear-off sheets that we`ll be able to place on drug store counters and in stores and post offices and other places where these people often come. And they can get the information from there. In addition to that, we have an outreach program where we`re trying to locate as many reformed drug users as we can who speak the language and know where they are and have as much one-on-one conversation with these people at the highest risk.

LEHRER: And get them to spread the word among their group, is that it?

Dr. BOWEN: Right.

LEHRER: Yeah.

Dr. KOOP: One of the problems with our drug addicts as compared with those abroad it that they are frequently illiterate. They lead terribly fragmented lives, and you can`t get them to a place where they will listen to a video or to a personal message. And although I know the word comic book is almost taboo in the subject now, but that is one way to reach people who can`t read. And we are trying to look at ways to reach blacks and Hispanics who are drug abusers with a message that can be seen visually and does not have to be read.

LEHRER: Dr. Koop, you said that Congress mandated this. But you and Secretary Bowen and others involved in the public health executive branch of government must have some kind of goal, do you not, as to what you want this pamphlet to accomplish? What is it?

Dr. KOOP: The goal that I have is to do what Secretary Bowen just said, -- get the discussion started. People understand the facts, but they don`t understand how to use them to affect their own lives,

LEHRER: is there evidence that the people, that there is not widespread knowledge about AIDS, what causes it, what doesn`t cause it?

Dr. KOOP: Yes. We contacted 288 groups before we started to write this. And then we had 80 different focus groups that met. And it was quite remarkable how many people still had all those misconceptions about toilet seats and door knobs and mosquitoes and how they were not quite sure about the sexual aspects of it either. They knew it was sexually transmitted but they didn`t know how or why. And we made that clear,

LEHRER: What la your message in this, Mr. Secretary, about heterosexual sex?

Dr. BOWEN: Well, the message is that it still depends upon behavior. Again, it`s not who you are, it`s what you do. And if you have sexual contact with somebody who has the infection in their system, somebody who has used intravenous drugs, that will put them at risk.

LEHRER: Whether it`s a homosexual relationship or a heterosexual relationship.

Dr. BOWEN: Right

LEHRER: And that`s said in very clear terms?

Dr. BOWEN: Very clear.

Dr. KOOP: Extraordinarily clear.

LEHRER: Okay. But back to my question, which I didn`t state very well. In your dream world, gentlemen, what would be the most - what would be success from this pamphlet? What - I mean, you`re going to reduce AIDS by such and such a percentage, or - how are you going to know whether to shake your hands, shakes each other`s hand in six months or six years from now and say, That was a really good Idea sending that pamphlet out.

Dr. KOOP: Well, there are two times that we can check on how good we`ve been. We are now testing, right at this moment, the National Center for Health Statistics is doing a survey of the country on what they know about what`s in that pamphlet. When this is all finished, in distribution on the 30th of June, then for the next three months we will be asking those same questions to see whether or not we have effected intelligence about this, as well as behavior. Unfortunately, because of the long incubation period, we won`t be able to know whether behavior has effected a change in the prevalence of this disease or not until about five years go by.

LEHRER: Five years. You want to add anything to that, Mr. Secretary?

Dr. BOWEN: Well, we will be conducting several prevalence tests, and also - -

LEHRER: What are those?

Dr. BOWEN: That tells how many people have the infection at the present time. And then incidence tests which would tell how many new cases are coming along, But again that`s going to take time.

LEHRER: Mr. Secretary, what do you say to critics who say this should have been done five years ago?

Dr. BOWEN: Well, maybe it should have been done five years ago. But I think that the pamphlet that we have put out now is of the highest quality, and I think that it is much better than it would have been five years ago, or even a year ago, The information that we have is more exact. And we can say with great confidence that you do not get it through casual contact.

LEHRER: Do you regret that it didn`t go out sooner?

Dr. KOOP: No. I truly believe if we had put this pamphlet out two years ago, we couldn`t have said things as frankly. The public was not ready for it.

LEHRER: Now, what`s happened? Why are they ready now?

Dr. KOOP: Well, I think that my report to the people that the President asked me to do and was released in October of 86, I think that caused a lot of controversy, but it certainly changed attitudes, and it made it possible to talk about sexuality in AIDS in public places. It changed laws in 17 states about sex education in schools. So a lot has happened. And if we`d done this too soon, it would have fallen on deaf ears or shocked ears.

LEHRER: Do you still believe, as many believe, that education is really the number one way to combat AIDS?

Dr. KOOP: It`s the only way we have at the moment, because we have no vaccine and no cure. But just having information won`t do it unless it is understood and you can`t really understand it until you discuss it with people and see how you`re going to work out your life with the new information.

LEHRER: Dr. Bowen - I call you doctor, you`re also a physician as well as being the Secretary of HHS but what about there`s other things besides education. Dr. Anthony Fauci, the head of the Federal Government`s drug testing on this, or some of the testing on this, has said he doesn`t have proper staff to conduct all the tests. Admiral Watkins, head of the Presidential Commission on AIDS, told Congress a few days ago that the Food & Drug Administration doesn`t have enough people and enough equipment to test AIDS drugs, What are you all going to do about that?

Dr. BOWEN: Well, the study of AIDS is very dynamic and is fluid, and it changes from day to day. We have many, many candidates for drugs that are being tested at the same time, and more and more are coming on. And as more and more of these come on, I suspect they will need more. I have had no requests from NIH or PHS for additional personnel. But certainly when a man of Dr. Fauci`s stature says they need more, we`re going to listen.

LEHRER: But you`re not saying, neither one of you are saying that we`ve got a pamphlet, we`re going to send it out and that`s the end of the Federal Government`s efforts on AIDS?

Dr. KOOP: Absolutely not. For example, we expect to be deluged with telephone calls. And we have 1000 operators lined up to answer those telephone calls and 300 additional who can handle Spanish-speaking calls. So we expect this to generate a tremendous amount of information-seeking. And the other thing that I think is very important is to know that there is a plan -- well, it`s a calculated risk here. Usually, with a pamphlet like this, it`s embargoed until a certain time on a certain day. We`re not doing that this time. Long before this will appear in mailboxes, we have given this to you, to the press, and we`ve said, Give it all the hype you can. We want people to be so interested, so curious about this that they will really sit down and read it.

LEHRER: And you don`t care why they read it as long as they read it.

Dr. KOOP: As long as they read it Okay.

Dr. BOWEN: There`s a lot more going on besides the education. We have about a third of the money that we are spending -- and that`s about a billion dollars this year - will go for education. And the other two-thirds for research on the basic research and research on finding cures and treatment and vaccine.

LEHRER: All right. Gentlemen, thank you both very much for being with us tonight.

MacNEIL: As we`ve heard, Congress mandated this mailing. And for reaction to it, we now turn to the Congress. Two members with very different opinions. Henry Waxman is a Democrat. William Dannemeyer is a Republican. Both are from California. They both join us from Capitol Hill. Congressman Dannemeyer, I gather you`re not happy about this brochure. Would you explain why?

Rep. WILLIAM DANNEMEYER (R) California: Well, there are things about it that I think are well stated, and I commend Dr. Koop and the other public health officials for those statements related to stressing that those who practice monogamous sexual relationship and are mutually faithful are at reduced risk for AIDS. That`s a correct statement. I would have preferred them to say that a monogamous relationship consists of a man and a woman. But at least they went as far as they did. The basic error of the report is that it failed to mention anything about the opportunistic diseases that themselves are contagious and infectious and communicable that persons with the virus for AIDS or ARC or AIDS itself have. Specifically, tuberculosis, cytomegalovirus and certain forms of pneumonia. When you read the report, you get the impression, Well, there`s really no risk in close contact with a person who has AIDS or ARC, Or with the virus. That`s simply medically is not true. For instance--

MacNEIL: You`re saying the report is misleading because it reassures people that people with AIDS are not Infectious? Is that what you`re saying?

Rep.DANNEMEYER: Let`s separate the transmissibility of AIDS itself from the transmissibility of opportunistic diseases that persons with AIDS acquire. Specifically, there`s a report in January of this year out of New York City which traces the increase and the incidence of infectious tuberculosis and finds that it`s associated with persons with AIDS in that city, The conclusion is that persons with the virus, otherwise asymptomatic, to a large extent have a form of infectious tuberculosis. And the tragedy of it is that the normal skin tests that we give for detecting the presence of tuberculosis for some reason we haven`t figured out, it may be negative but in fact they have TB that`s infectious. Now--

MacNEIL: Congressman Waxman, do you think this is a serious lapse in the pamphlet?

Rep. HENRY WAXMAN (D) California: This pamphlet has been worked over and checked over by the Surgeon General, the head of the National Institutes of Health and Centers for Disease Control. It is the latest up-to-date medical information. Mr. Dannemeyer now wants to place himself as the medical expert. He`s not a doctor, He`s not a medical expert. I say let`s listen to the medical experts and take their advice. And their advice is contained in this pamphlet, It`s very important, useful information. People need to know this information. So that if they`re at risk they can take appropriate actions. If they`re not at risk they can at least not be afraid and have some sense of compassion for those who are facing this horrible disease.

MacNEIL: Congressman Dannemeyer, you`re saying the pamphlet shouldn`t have been sent, or it shouldn`t have been sent to all the people it`s being sent to, or that it should contain different information?

Rep. DANNEMEYER: The latter is my preference. For instance, the public health official should be telling the American people about the presence of these opportunistic diseases that I`ve desc-- I didn`t make them up. They come out of the literature that is available for any layman or medical person to read. There`s another omission, serious omission, in this pamphlet. When you read it, you get the impression that the only means of transmissibility of the virus or AIDS is sex, blood and drugs. That`s simply not true. In 3% of the some 60,000 cases In the, published by the CDC, they can`t tell us how the persons got it. That`s a large number of people about whom we don`t know how they got it. And to suggest -- another form of the pamphlet it says that you can`t get it from kissing. Now, that`s In contrast to a former publication of the Public Health Service where it said that deep kissing is a suspected mode of transmissibility, in the literature, in fact, there`s a case in Northern California where an elderly couple, the husband got the virus from a blood transfusion, the wife got it later. Because of impotence on the part of the husband, the inference was they got it from kissing. These statements should be said in perspective. The proper way to phrase it is that the main means of transmissibility of AIDS is sex, drugs and blood. But It`s not the exclusive way. And our public health officials should be leveling with the American public and explaining it just that way.

MacNEIL: You think they are leveling, Congressman Waxman?

Rep. WAXMAN: Well, it`s interesting that Mr. Dannemeyer would place himself at odds with the medical people in this Administration, allow whom are Reagan appointees, by the way, generally I guess share Republican philosophy. They are medical people, They have been looking at this thing for some time, They have given us their best judgment, Mr. Dannemeyer`s made these charges over and over again in our subcommittee hearings. They reject these kinds of statements as irresponsible, not factual, inflammatory. And then of course Mr. Dannemeyer usually attacks them as not being interested In public health. But these are the medical people, and they`re following the information that the researchers have given them and that the Centers for Disease Control has been able to get through an exhaustive evaluation of all the cases that they`ve heard about and know about, So I can`t tell you one thing or another on the basis of my own information, except to tell you what we have been told by the medical people. And the consensus is overwhelming. AIDS is transmitted through sex and through blood. That is how people put themselves at risk. And the message we need to get out to people is that if they engage in high risk behavior, which is sexual practices, they can get AIDS, or they can transmit it if they are infected by this virus. That`s the important point we need people to know about.

MacNEIL: Congressman Dannemeyer, what is your concern? That this pamphlet is going to make people less anxious about AIDS than they should be? You feel they should be more anxious about it?

Rep. DANNEMEYER: I think that the people of this country have a right to know the medical information that is available to our public health officials on the issue of opportunistic diseases that AIDS patients have, or those with the virus have. Because it goes to the point of to what extent are we going to openly associate with people with the virus? Or with ARC, or with AIDS?

MacNEIL: So you`re saying the pamphlet is misleading then when it says you can`t get AIDS from casual contact with people who have AIDS?

Rep. DANNEMEYER: That`s correct. That`s a misleading statement.

MacNEIL: You don`t agree with that, Congressman Waxman?

Rep. WAXMAN: If you look at what Mr. Dannemeyer is saying, he`s saying that people shouldn`t be misled into thinking they can associate with those who have the AIDS virus or the infection. That`s what Mr. Dannemeyer`s most concerned about. He doesn`t want these people to be in the mainstream, he wants them isolated, he wants to treat them as lepers and cast moral judgment upon them, rather than recognize the fact that they have a disease which at the present time is fatal. We need to be compassionate toward them and more hardheaded ourselves in terms of trying to make sure that we can stop the transmission of this disease. Further, we don`t have a vaccine. The only way we can deal with this is a strategy to give information to people so that they`ll change their behavior if they`re engaging in the kinds of behavior that put them at risk for AIDS, That`s the public health message. The other I think is a political exercise. And this is not a disease that should be politicized, it should be left to the health experts to deal with.

MacNEIL: Congressman Dannemeyer, you heard the Surgeon General say that he hoped that people getting this would read it themselves and then in terms of their own religious and moral beliefs and so on, discuss it with their families and with their children. Would you advise that?

Rep. DANNEMEYER: That`s good advice.

MacNEIL: You`ll go along with that?

Rep. DANNEMEYER: Let me respond to my friend Mr. Waxman who has made certain statements about my motives in this issue. My whole purpose is to just suggest to the people of this country and our public health officials that the civil rights of the uninfected American people are as much entitled to protection as the civil rights of the infected. And when the public health officials of this country, when you analyze the total sense of the report they put out, they`re treating this as a civil rights issue, not a public health issue. There are major fundamental steps that historically had been pursued to control any communicable disease that`s come down the pike in this country that are not being pursued today to control this epidemic. I`m talking now about the concept, the foundation, cornerstone of any public health policy, the reportability of those with the virus.

MacNEIL: So it`s not really the pamphlet you`re critici- you`re taking issue with so much as your point, which I believe you`ve made before with us, that there should be more testing as there is in - and more reporting as there is in diseases like syphilis, for example.

Rep. DANNEMEYER: I think it`s ludicrous for the Surgeon General of the United States to say that it`s a rational public health policy to give states the option to determine whether or not they want to report those with this disease.

MacNEIL: Well, gentlemen, thank you both for joining us. We have to leave it there.

LEHRER: Still to come on the NewsHour tonight, a newsmaking medical journal and two views of the astrology flap.

Embargo

MacNEIL: We move on now to another medical story. Really a story about medical journalism. Many of the stories about medical developments that you read in your newspaper or hear about on television news programs, including this one, originate in the prestigious New England Journal of Medicine. Our story tonight is about the journal itself. Correspondent June Massell has our report.

JUNE MASSELL: When Dr. William DeVries completed his landmark study of the artificial heart, the publication he submitted it to was the New England Journal of Medicine. When Dr. Stephen Rosenberg was looking for a place to publish his important research on the new cancer drug, Interluken 2, he also turned to the New England Journal of Medicine.

The New England Journal is the oldest, and many say the most prestigious, medical journal in the world. It is the first place most researchers go to have the results of their studies published. So it was no surprise that the National Institutes of Health, NIH, chose the journal to publish the results of the aspirin study they funded.

For five years, researchers monitored 22,000 doctors, the study`s participants. Half the group took aspirin, half took a placebo. Last December, scientists found that an aspirin every other day reduced the risk of heart attacks in healthy men by almost 50%. Their decision to publish in the journal touched off a controversy over how much power the New England Journal has. The center of the storm was the journal`s embargo policy.

Each week the Journal sends advance copies of the magazine to 250 news organizations. The embargo prohibits them from writing stories until Wednesday evening at 6:00 pm when the embargo is lifted. Most doctors who subscribe get their copies on Thursday, the official publication date. Dr. Arnold Relman is the editor of the New England Journal of Medicine.

MASSELL: What is the purpose of this embargo?

Dr. ARNOLD RELMAN: New England Journal of Medicine: The purpose quite simply is to see to it that doctors hear about the information in the Journal that they need in order to counsel and treat patients before their patients start asking them questions about, and hear about it in the newspapers.

MASSELL: And why is that important?

Dr. RELMAN: Because doctors have to have all the facts, all the detailed scientific facts in order to know how to tell patients whether they need a certain treatment or not. Doctors can`t base their professional decisions on newspaper headlines or TV stories.

MASSELL: But in January, the British news agency, Reuters, broke the agreement and went with the aspirin story ahead of time, claiming they had obtained the information from independent sources and not from their advance copy of the Journal. Desmond Maberly is the North American editor of Reuters.

DESMOND MABERLY, Reuters: I believe in the responsibility of reporting the news rather than waiting to have it stage managed or news managed.

MASSELL: When Reuters announced they would continue to break the embargo in the future. Dr. Relman retaliated. He suspended the Journal`s subscription for six months.

Mr. MABERLY: I think, you know, the whole procedure was rather absurd. But it`s up to him to see things in the light he wanted, and his threats at the end of conversation with him when I said Reuters would not reach an accommodation or compromise with him on the embargo situation was an incredible attempt to stifle news flow.

Dr. RELMAN: I think it`s irresponsible. I think that that`s an example of news agencies putting their interests ahead of the public interest. They will argue that of course it helps the public to have that information. But what I`ve said and what I`ve tried to make clear is the doctors don`t think so, public health officials don`t think so. And the facts are that it`s not really helpful to the public to have headline and newspaper stories about medical facts they can`t interpret.

MASSELL: An argument Reuters doesn`t buy.

Mr. MABERLY: Now, I`m not sure that everybody`s standing on their doorstep, as far as doctors are concerned, panting for their edition of the New England Journal to be handed to them. There are other aspects to it. They serve with their circulation or subscription --I think it`s at 185,000 doctors. As I said earlier, there`s over 600,000 doctors in this country, So there`s an awful lot of doctors getting by without having that instant access to the Journal studies. And I don`t think they are probably for the most part serving their patients badly.

MASSELL: But Relman argues that the Journal has a safeguard ordinary newspapers don`t: a peer review process. Before any study is published, it is first reviewed by a panel of medical experts.

Dr. RELMAN: Our information has to do with people`s health and safety. Medical news Is not like other news. If you take the position that it`s simply a commercial marketplace out there, and any claim, any claim at all, any report, however flimsy and invalid, or fraudulent, it might be, should be unleashed on the public and let the public decide what`s right and what`s wrong and what`s true and what`s safe, then it seems to me you have a totally chaotic situation.

MASSELL: While the battle over the embargo received a great deal of attention, many journalists think the embargo serves a useful purpose by providing for the fair release of medical information to all reporters at the same time. But the debate over the embargo touched off a debate over another longstanding policy of the Journal, something called the Engelfinger rule.

The rule was named after Dr. Franz Engelfinger, a former editor of the New England Journal prior to Dr. Relman. Other medical journals have similar rules.

Dr. RELMAN: it`s simply a policy that says to authors, to would-be authors in our journal, that if you want us to consider your article for publication, you have to agree that you will not submit it elsewhere before we`ve had a chance to consider it, and that you will see that it does not appear in substance elsewhere before we publish it.

MASSELL: Dr. Relman says there`s a reason for the rule. The Journal`s peer review process is lengthy and costly.

Dr. RELMAN: We spend a lot of money and time and effort in providing a very important service to authors, namely the reviewing and the publishing of their work, which we do for nothing. And all that we`re saying to them is that if you want us to do this, here are our terms. If you don`t want to, you`re under no obligation. You can call a press conference tomorrow if you want, and exercise your freedom of speech. But then don`t send it to us.

UNIDENTIFIED MALE: As many as 100,000 or more per year may have their heart attack prevented-

MASSELL: NIH did hold a news conference, but they made a deal with the Journal to wait until the Journal`s article came out. In return, the Journal agreed to speed up their peer review and publish five weeks later, a process which normally takes much longer. While waiting for the Journal to publish complies with the Engelfinger rule, some researchers feel the aspirin study should have been an exception. They point to the fact that the chief investigators stopped the study two years early because "significant findings of major public health impact have now emerged."

Dr. HERBERT SCHEINBERG: Albert Einstein College of Medicine: Their data showed that there was absolutely no doubt that in healthy men who had never had a heart attack that one aspirin taken every other day reduced the risk of a heart attack by 47%.

MASSELL: Dr. Herbert Scheinberg is a medical researcher at the Albert Einstein College of Medicine and a participant in the NIH study.

Dr. SCHEINBERG: The data were absolutely overwhelming. The probability that this was due to a chance fluke was less than one in a hundred thousand.

MASSELL: Cris Russel is a medical reporter for the Washington Post and president of the National Association of Science Writers.

CRISTINE RUSSELL: Washington Post: I think that when medical research is being done and publicly funded by the government there again should be a process for getting it out to the public as responsibly as possible but as soon as possible. If the end all, be all is how can I get my article in the New England Journal, no matter what, then everybody is held kind of hostage to that process.

Dr. RELMAN: You`re assuming that decisions about the validity and reliability of scientific data can be made on the basis of who one knows and one`s confidence in the reputation of the investigators. It cannot. Decisions have to depend on review of the evidence. Only one in ten of the manuscripts that are sent to us are published. Some of those manuscripts contain information that`s totally unreliable. And if we and other journals like us did not make the effort to weed out what was worth publishing, and what is reliable, the profession and the public would be inundated with a lot of unreliable information.

MASSELL: But Russell believes the Journal`s power intimidates scientists from talking and limits what the public can learn about medicine and science.

Mr. RUSSELL: Well, I believe the peer review system is an excellent system. It is a good idea to have medical professional review research when it`s coming out. But as I say, I don`t think that should be the only way that something is reviewed. The traditional process of science has been that when you have new research and new results coming out, you often present it first at a scientific meeting to your colleagues. They may comment from the audience, Hey, I don`t think that`s the right direction, there`s a lot of feedback. What`s happened again in recent years in part because of concern about publish or perish, I want to get in the right medical Journal, is that sometimes people don`t present even their latest research finding to their colleagues at scientific meetings because they`re afraid, again, that somehow that will get in the way of their publishing in a journal. There`s nothing wrong with getting in the right medical journal, but it doesn`t mean you have to always wait until it comes out in that journal. And in some cases it could make a difference to certain patients to know these things ahead of time, or at least be aware of them.

MASSELL: Heart attacks are the biggest cause of death in the country. About 500,000 Americans die each year from a heart attack. Dr. Scheinberg says lives could have been saved if the results of the aspirin study had been announced immediately instead of waiting five weeks for publication in the Journal.

Dr. SCHEINBERG: There were thousands of heart attacks that occurred in those six weeks. And something like 1300 deaths also would have been prevented. Because a fraction of that - I think there were roughly 15% of the heart attacks that the study turned up, about 15% were fatal.

UNIDENTIFIED MAN speaking January 27. 1087: All of these factors now must be weighed in light of this new finding.

MASSELL: But Dr. Relman argues that holding a press conference prior to publication would not have been in the public interest.

Dr. RELMAN: They may then go out and start to take aspirin without checking with their doctor, which would be a mistake. Because it turns out that aspirin isn`t safe for many people. Only some people should take aspirin. For others it might be very dangerous. It might even kill them. And for other groups of patients it wouldn`t help at all.

MASSELL: Dr. Scheinberg says that news stories could have carried appropriate warnings.

Dr. SCHEINBERG: A press release could have said one should be cautious about this if one has high bloodpressure, if one has had a stroke, you ought to consult your physician. But the good that would have been done, even if everybody in the country had started taking one aspirin every other day, I think would have vastly outweighed the very, very slight risks involved.

MASSELL: For many medical journalists, the aspirin debate highlights a growing concern.

Ms. RUSSELL: I think if you give all the power to one source, and if one journal becomes the only journal, then that can`t really be good for the whole process.

MASSELL: As for whether the journal wields too much power, Dr. Relman denies it. As for the embargo, so far only Reuters has taken a firm stand against it. But the Journal fears that if Reuters continues to break the embargo in the future, other news agencies may follow. And that could lead to the collapse of the Journal`s control over when its information can be used.

Charting the Course

LEHRER: Former White House Chief of Staff wrote in his kiss and tell book that Mrs. Reagan used astrology to help fix President Reagan`s schedule. The White House confirmed it, and the great astrology flap was on. Charlayne Hunter-Gault will now explore whether it deserves all the attention it is getting. Charlayne?

CHARLAYNE HUNTER-GAULT: Jim, the issue of the Reagans and astrology dates back to their California days. Mr. Reagan denied charges then that astrology influenced the time he chose for his inauguration as governor, just after midnight. But syndicated astrologers today called the Reagan`s longterm involvement with astrology an open secret. The White House yesterday confirmed Mrs. Reagan`s interest in astrology and said it intensified after her husband survived an assassination attempt in March 1981. We pursue some of the questions raised by the Reagan`s use of astrology now with Jeremy Stone, a mathematician and the president of the Federation of American Scientists, a Washington-based public interest group. And in the studios of WGBH in Boston is Darrell Martinie, an astrologer and host of a syndicated radio program on astrology, He`s called the Cosmic Muffin. Mr. Martinie, do you see what all the flap is about with this?

DARRELL MARTINIE: astrologer: No, not at all. In fact, I was -- I wasn`t pleased at the news that the Reagans, you know, had gotten out that they had seen an astrologer. But I tell you I think it`s absolutely incredibly intelligent. I give them 20 points in the direction of IQ for doing it,

HUNTER-GAULT: Why weren`t you incredibly pleased?

Mr. MARTINIE: Well, because of the kinds of silliness that we get as a reaction to all of that. From fundamentalist Christian groups, and also members who are humanists in the scientific community who have for years badmouthed astrology and incidentally God also, So you get both extremes going at you. And- it`s a fact that they did it, yes.

HUNTER-GAULT: Mr. Stone, what`s your reaction? I mean, do you see what all the fuss is about?

JEREMY STONE, Federation of American Scientists: Well, we wrote President Reagan when he was running for President about an interview that he had given himself that alarmed us. It concerned his discussion of future telling by one of his friends Jean Dixon, who is one of the most famous of the people in the country that claim to be able to tell the future. And it also discussed his interest in astrology and his faith in Aquarians. So we- -

HUNTER-GAULT: He is an Aquarian.

Mr. STONE: He is an Aquarian. And he had said in this interview that 80% of the famous people in the New York Hall of Fame were Aquarians. And he had also said that Jean Dixon in the "foretelling part of her mind," had made a successful prediction about him. So we wrote and asked him while he was a candidate whether he wouldn`t please deny this, since we didn`t feel we should have a president whose decision-making might be biased by belief in these superstitions.

HUNTER-GAULT: What`s the harm?

Mr. STONE: Well, you can well imagine the harm if you read some of the things that Ms, Dixon has said. For example, she has said that the trouble with the invasion for the hostages in Iran was that it was done five days off from when it should have been done. If the President Is going to throw her advice into the hopper with the meteorologists and the politicians and the strategists as to when to launch the invasion, then there`ll be an additional bias to the decisions.

HUNTER-GAULT; Well, is there anything to suggest to you that he would use this kind of advice In his decisions?

Mr. STONE: Well, we were alarmed because of his faith in Jean Dixon and his reference to the foretelling part of her mind. And so we interviewed her and talked to the author of the article to make sure it was accurate. When President Reagan wrote us before the election and said he didn`t take the astrology columns very seriously, didn`t make decisions based on them, and when he made no mention of the foretelling and future telling part of it, we dropped the subject.

HUNTER-GAULT: Mr. Stone, how do you respond to what you just heard? I`m sorry, Mr. Martinie, from Mr. Stone, his concerns?

Mr. MARTINIE: Well, first of alt, he`s making some very silly statements. Number one, that Jean Dixon is a friend of President Reagan`s, that`s not true, Mr. Stone. And the second thing is that when President Reagan said that there are more Aquarians in the Hall of Fame, I`ll tell you, that Is statistically correct, and the reason for that is that there are more people born In January and February. And as a mathematician, you count it back nine months from January and February, you`ll find out why.

HUNTER-GAULT: But what about his larger point, that it`s very disturbing that he would use this kind of advice that he would get from people like Jean Dixon, say, in making decisions?

Mr. MARTINIE: Mr. Stone doesn`t understand the type of advice. What we`re talking about here is not whether you`re an Aquarian or a Cancerian or any of that. That`s garbage. That is not astrology. But what we`re talking about here is that if, let`s say, on full moons we know that people get more crazy, accident rates go up, admissions to hospitals go up. That if the President and Mrs. Reagan decided that they were going to have a party and they elected to not do that on a full moon but to schedule it after that when people would be less crazy, I consider that intelligent.

HUNTER-GAULT: What`s the harm in that, Mr. Stone?

Mr. STONE: Well, you know, we`re all very familiar nowadays with racism. But we don`t think much about birthism. If the President started hiring people because they were Aquarians and not hiring people in the White House because they had a birth sign that he thought conflicted with his own, this would be a form of birthism that would bias again the decisions in the White House. You can imagine

Mr. MARTINIE: Why not, Mr. Stone? You have bias in favor of scientific method, you humanists. Nothing that can`t be proved by scientific method you say you don`t believe in, including God. Now, let me tell you something else--

HUNTER-GAULT: Well, let me -- let him respond to that. Mr. Stone?

Mr. STONE: Well, the superstition we`re talking about is 5,000 years old. And it`s been practiced all over the world by court sorcerers at one time or another. It`s dressed up in this country with scientific rigamarole because there`s so much faith in science. But in fact there`s no effort to explain why it should be true. These - if you compared the reports of these horoscopes with different astrologers, you`d find a great deal of confusion in them.

Mr. MARTINIE: You`re not listening to me, Mr. Stone, and you`re going to say what you`re going to say without responding or listening. And that`s fine by me. I can handle that. Well, the fact of the matter is -- and I want to make this point -- that there is no such thing as an Aquarian. By sun sign it doesn`t mean anything. As we are talking right now, the planets are changing every four minutes of time. It will take over 26,000 years, if we`re standing still, for all the planets to be back In the same position. What we astrologers say is that there arc not duplicates. You cannot divide people Into 12 signs any more than you can do predictions based on shoe size.

HUNTER-GAULT: All right, Mr. Martinie, let me just ask you since Mr. Stone has told us what - given us some examples of .the kinds of things that trouble him. I mean, do you see benefits in the President using astrology to help him make schedules or decisions or whatever?

Mr. MARTINIE: Oh, I think it`s incredibly important. And I think it`s incredibly useful. For example. President Jimmy Carter - I`m not saying anything against Mr. Carter made every major decision when the planet Mercury was backing up, including the Camp David Peace Accord. I wrote articles about it at that time, just saying for research purposes for astrologers, this cannot work, Now, President Reagan has avoided all of those nasty cycles, with the exception of the one coming up, the summit in Moscow, when the planets Venus will be backing up, and Mercury. And if his policies were being determined by an astrologer as to the time of his important meetings, I`m telling you, whatever astrologer scheduled this one in Moscow had a lobotomy.

HUNTER-GAULT: Mr. Stone, you could react to what you just heard if you like, and also, I mean, dating back to the ides of March and Julius Caesar, right on up through Winston Churchill, Indira Gandhi, FDR, Teddy Roosevelt, many world leaders have been associated with an interest in astrology. Are they just all wrong?

Mr. STONE: Well, this astrology is just part of an iceberg of different superstitions that can bias the decision-making of a leader. One of the problems we face with our presidents is they`re usually very successful people, that`s how they got to be President. And they`re vulnerable to people who tell them you`re ordained to be successful and you`re going to be this and that. That`s what Jean Dixon told the president, and she told me in `62 and `63 she told Reagan that his ultimate destination was to be President. That he was the reincarnation of a great American and a great leader. And I wonder o there`s no evidence for it -- but it makes you wonder whether people might be President, listen to that sort of thing and decide that if they thought Star Wars would work then, well, what the scientists thought didn`t matter, they had a touch and a confidence in themselves that was more important.

HUNTER-GAULT: You think that`s likely to happen, Mr. Martinie, that someone in a position to be President or a President would discount advice from scientists and rely solely on the advice of astrologers?

Mr. MARTINIE: No, Only with the exception if they`re as paranoid as Mr. Stone. And whatever Jean Dixon said in 1962, who cares! Jean Dixon is not the astrologer to the President. Anybody In the National Enquirer can say whatever they want to, it`s not going to influence the President of the United States.

HUNTER-GAULT: Very briefly, what impact do you see this flap having on astrology and the use of it in this country? We want to get two quick responses. Mr. Martinie?

Mr. MARTINIE: Well, I think a heightened interest and awareness of people who understand that the President and Mrs. Reagan are very fine intelligent people, using it in a very intelligent way. And maybe perhaps they ought to look at it.

HUNTER-GAULT: All right, let me get it from Mr. Stone. What`s your response on the impact?

Mr. STONE: Well, I think it depends on what is in Mr. Regan`s book. And our feeling is that if astrology`s not taken too seriously by the people that look in it, then it`s not a serious thing. But if the astrology is taken very seriously by the people involved, then it is a serious thing. So a lot depends on what the facts are. And how seriously the President takes it.

HUNTER-GAULT: All right, Mr. Stone, thank you for being with us, and Mr. Martinie in Boston, thank you.

Recap

MacNEIL: Once again, the main points in the news. A hospital spokesman in Nevada said at least nine persons were killed and as many as 200 injured in an explosion at a rocket fuel plant near Las Vegas. The FAA widened inspections of Boeing 737s for possible metal fatigue after last week`s Incident in which an Aloha Airlines jet lost the top of its fuselage. And Israel announced the end of its 48-hour search and destroy mission in Lebanon. Good night, Jim.

LEHRER: Good night, Robin, We`ll see you tomorrow night. I`m Jim Lehrer. Thank you and good night.