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During a typical week on Capitol Hill, says Rhode Islands ranking U.S. Senator Jack Reed, E.R.s Anthony Edwards seeks federal dollars for autism research while Spin Citys Michael J. Fox urges more studies of Parkinsons disease. More obscure activists, meanwhile, organize fund-raising galas in the hope of securing money to study their favorite diseases. All of these activities, said Reed, a member of the Senate subcommittee on public health and safety, raise the question whether research priorities are being set on medical grounds or political grounds.

On campus to deliver the Charles O. Cook Lecture in December, Reed told an assembly of professors, community members, and students in Alumnae Hall that legislators face tough choices when it comes to funding medical research. There is always the suspicion that basic research, lacking celebrity allure, may lose out, he said. I dont think we have as yet surrendered the medical and scientific perspective, but the real test will come when budgets decline.

Even with todays robust economy and federal budget surpluses, Reed noted, the competition for research money is fierce. As a result, the federal governments role in determining research priorities can result in a disproportionate amount of cash earmarked for politically savory but scientifically inappropriate projects. Scientists seeking money to do work on various diseases, he said, must compete not only with one other, but also with proponents of other social spending, a situation Reed described as a classic case of good versus good.

Some research ideas come with the politics built in. Fetal-tissue and stem-cell research are both topics [that] involve serious ethical concerns, Reed said. Likewise, both topics energize political-interest groups that have battled for decades over reproductive-health policies. The key to good decision-making in such politically volatile situations, Reed argued, is keeping an eye on the science. There is a danger that these research topics will be swept up into these pre-existing battles, he noted, without the opportunity to make thoughtful and, hopefully, balanced judgments.

Pharmaceutical companies that underwrite research, said Reed, are no alternative to sound government science funding. Such companies conduct little basic research, for example, because it rarely results in product development of new drugs. The fear arises that exclusively economic judgments will displace scientific judgments, he said.

Another Reed concern is medical education, which he described as a hostage in budget fights. He argued that funding it is a long-term public investment that decisively influences the quality of our health-care system. It is a classic public good.





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