For generations of Americans, the Surgeon General has been the "nation's doctor," the person they turned to for unbiased advice on everything from smoking to obesity and the HIV Aids pandemic.
And United States presidents have generally defended the Surgeon General's right to speak out on public health matters. But under President George W. Bush, the independence of the Surgeon General has been placed below industry lobbying and the demands of the religious right.
Damning testimony by Dr Richard Carmona, the Surgeon General from 2002 until 2006, has revealed that the Bush Administration frequently censored him and tried to mould his public statements to fit political goals. He was even ordered to mention Bush three times on every page of his speeches.
The Bush White House banned Carmona from speaking or issuing reports on stem cells, emergency contraception, sex education, prison, mental health and international health issues. For years the White House tried to "water down" a report on the dangers of secondhand smoke. When he tried to address the subject of embryonic stem cell research: "I was told to stand down and not speak about it. It was removed from my speeches. Much of the discussion was being driven by theology, ideology, [and] preconceived beliefs that were scientifically incorrect."
Even the Special Olympics were deemed politically suspect, because they receive support from the Kennedy family. "I was specifically told by a senior person: 'Why would you want to help those people?"'
Carmona, 57, was in the Army Special Forces during Vietnam. He became both a trauma surgeon and leader of an Arizona SWAT team. His testimony to a congressional panel comes as the Administration tries to appoint Dr James Holsinger as the new Surgeon General. He has stirred controversy for a report he authored which concluded that homosexual sex was both unnatural and unhealthy.
During a nine-month trial of the US tobacco industry, Carmona was heavily leaned on not to testify. The same went for sex education. "Anything that doesn't fit into the political appointees' ideological, theological or political agenda is often ignored, marginalised or simply buried. There is nothing worse than ignoring science or marginalising the voice of science for reasons driven by changing political winds."
The White House flatly rejected claims of political interference yesterday: "As Surgeon General, Dr Carmona was given the authority and had the obligation to be the leading voice for the health of all Americans," spokesman Tony Fratto said.