NEJM Backs Murthy for Top Doc, Condemns NRA 'Blackmail'

Marcia Frellick

March 21, 2014

The New England Journal of Medicine (NEJM) has entered the controversy surrounding President Barack Obama's nomination of Vivek Murthy, MD, for US surgeon general with an editorial calling the National Rifle Association's (NRA's) campaign to block the nomination "political blackmail."

"It is of great concern to us and to many other members of the health care community that Murthy's nomination is in jeopardy because of NRA opposition," write journal editors Gregory Curfman, MD; Stephen Morrissey, PhD; Debra Malina, PhD; and Jeffrey Drazen, MD. "The NRA opposes Murthy solely on the grounds that he has advocated reasonable and mainstream forms of gun regulation, including an assault-weapons ban, a limit on ammunition sales, and required safety training. Given that there are more than 30,000 firearm deaths in the United States each year, Murthy's views on potential safeguards are unsurprising."

NRA officials declined to comment despite multiple requests from Medscape Medical News. However, in a letter to congressional leaders dated February 26, NRA Institute for Legislative Action Executive Director Chris Cox spelled out the NRA's objections.

"The American people deserve a Surgeon General who will carry out the mission of the office unmotivated by political or ideological goals. Given Dr. Murthy's lengthy history of hostility towards the right to keep and bear arms along with his calls for the full weight of the federal government's health apparatus to be used to target lawful gun ownership, there is little reason to believe that he would not work to further a gun control agenda if confirmed as Surgeon General. Simply put, confirmation of Dr. Murthy is a prescription for disaster for America's gun owners," his letter said.

The NEJM editors note, however, that the surgeon general has no authority over firearm regulation and that Dr. Murthy testified before the Health, Education, Labor, and Pensions committee that his focus, if confirmed, will be obesity prevention and tobacco cessation.

Nomination Passed Senate Panel

Senators on the Health, Education, Labor, and Pensions Committee approved Murthy's nomination 13 to 9 on February 27 with support from all Democrats and 1 Republican. Sen. Rand Paul (R-KY) then placed a procedural hold on the nomination because of Dr. Murthy's gun control views, which prevents the Senate from voting. The White House subsequently announced it is rethinking its strategy surrounding a floor vote.

Pro-Obama Background Began Controversy

Medical organizations widely support Dr. Murthy's nomination, but it quickly became controversial with critics saying his affiliations were too partisan to keep bias from the surgeon general's office.

Dr. Murthy, 36, led a group that was first called Doctors for Obama in 2008, which helped elect the president, and was then called Doctors for America, which worked toward getting the Affordable Care Act passed.

The editorial, published online March 19, notes Murthy's qualifications for the nation's top medical position: He completed his education at top institutions, with an undergraduate degree from Harvard University, Cambridge, Massachusetts, and an MD and an MBA from Yale University, New Haven, Connecticut. He also has strong clinical experience, currently practicing at Brigham and Women's Hospital in Boston, Massachusetts, and as a member of the faculty of Harvard Medical School in Boston. In addition, he has demonstrated a commitment to disease control and health promotion, serving on the Presidential Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, and he cofounded Visions Worldwide, a nonprofit supporting HIV prevention and education. He also chairs TrialNetworks, which helps drug developers with clinical trials.

The editorial concludes: "The critical question is this: Should a special-interest organization like the NRA have veto power over the appointment of the nation's top doctor? The very idea is unacceptable.... By obstructing the President's nomination of Vivek Murthy as surgeon general, the NRA is taking its single-issue political blackmail to a new level."

Full conflict-of-interest information is available on the journal's Web site .

N Engl J Med. Published online March 19, 2014. Full text

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