This transcript has been edited for clarity.
Hi. I’m Art Caplan. I’m at the NYU Grossman School of Medicine’s Division of Medical Ethics.
Robert F. Kennedy, Jr., has been in the news quite a bit, having been suggested as the head of the US Department of Health and Human Services (HHS), a $1.7 trillion agency that controls everything from the US Food and Drug Administration (FDA) and the National Institutes of Health to Medicare and Medicaid.This is a huge job with huge responsibilities.
Some immediately said that RFK Jr. is not qualified. Why? Because he’s not a doctor and he doesn’t have a public health background. He is a lawyer and attorney. In the past, I think almost all HHS directors have had some medical or public health experience. I don’t think the lack of a PhD or an MD is going to disqualify him, but there are other issues to think about as a practicing doctor, should he assume this position.
A large amount of attention is paid to the fact that he has historically been a vaccine skeptic, and that is true. He has certainly circulated the idea that vaccines could cause autism, and he has worked pretty vigorously to basically say that he doesn’t think vaccines are safe.
On that issue, there’s plenty of reason to be upset because I think vaccines are one of the great achievements of science for humanity.It’s not even arguable about the number of lives saved through vaccination, from smallpox to polio to many other infectious diseases. There really isn’t much arguing about their safety.
I’m going to say, surprisingly, I don’t think the vaccine issue is the real core of what practicing doctors will have to deal with should he assume control of HHS, and the reason is simple:We’ve already seen a large amount of relaxing of vaccine mandates at the state level. Nearly everybody watching this lives in a state where it’s very easy for a parent to get exemptions for their kids if they don’t want to vaccinate, and that is why we are seeing the recurrence of whooping cough and measles.
It’s easy to opt out, so that the whole issue of being antivaccine, I’m going to say, has already been translated into weakening public policies requiring vaccine mandates for kids. Obviously, adults do what they want. Most of them have not had a COVID-19 vaccine, most of them have not had a shingles vaccine, and most of them have not had an HPV vaccine.
Whatever his views about vaccines, I don’t think it’s going to actually sway what your patients are thinking about with respect to vaccination. They need persuasion about efficacy and safety. He may reinforce a false message, but some patients are already moving in the direction of saying no to vaccines.
I think he poses two other interesting challenges. One is that he really is strongly opposed to the way we eat and our food supply — too much fructose. I would tend to agree with him. I think our diet is poor.
He wants to shift us to organic foods, which is problematic for a whole host of reasons.First, there’s no definition of what organic is. Second, it’s not affordable. Organic foods, if we tried to shift our food supply, would raise prices enormously in terms of producing them.
He’s in an administration that the red states, where most of our agriculture is, are not going to make that shift a way from the fructose-heavy, corn-fed diet that we live on. I don’t know whether he’s going to be able to get where it would be nice to get patients to go. I suspect we’re going to see more patient interest in injectable drugs to control weight.
The other big challenge is that he is a proponent of less regulation and oversight of drugs. He thinks Big Pharma has too much sway. You can make that argument, too, but what he may suggest is opening the door to crank cures. He was a big proponent of ivermectin andhydroxychloroquine during the pandemic, all known by evidence not to work or be effective, but were simply wastes of money.
It may be that physicians are going to have to be ready to come up with evidence about what works and what doesn’t work if the FDA and government regulation got weaker under RFK Jr. or someone like him. Then it’s going to be even more of a problemfor you to get evidence-based information about what works and what doesn’t work in front of your patients.
I don’t think RFK Jr. is good for America’s health, but I think some of the opposition — such as that he’s too antivaccine — is ignoring some of the big ripples that would move through the healthcare system and really challenge physician practice and physician messaging.
I’m Art Caplan, at the Division of Medical Ethics at NYU Grossman. Thanks for watching.
COMMENTARY
HHS Nominee RFK Jr. Not Good for America’s Health, Ethicist Says
Arthur L. Caplan, PhD
DISCLOSURES
| December 03, 2024This transcript has been edited for clarity.
Hi. I’m Art Caplan. I’m at the NYU Grossman School of Medicine’s Division of Medical Ethics.
Robert F. Kennedy, Jr., has been in the news quite a bit, having been suggested as the head of the US Department of Health and Human Services (HHS), a $1.7 trillion agency that controls everything from the US Food and Drug Administration (FDA) and the National Institutes of Health to Medicare and Medicaid.This is a huge job with huge responsibilities.
Some immediately said that RFK Jr. is not qualified. Why? Because he’s not a doctor and he doesn’t have a public health background. He is a lawyer and attorney. In the past, I think almost all HHS directors have had some medical or public health experience. I don’t think the lack of a PhD or an MD is going to disqualify him, but there are other issues to think about as a practicing doctor, should he assume this position.
A large amount of attention is paid to the fact that he has historically been a vaccine skeptic, and that is true. He has certainly circulated the idea that vaccines could cause autism, and he has worked pretty vigorously to basically say that he doesn’t think vaccines are safe.
On that issue, there’s plenty of reason to be upset because I think vaccines are one of the great achievements of science for humanity.It’s not even arguable about the number of lives saved through vaccination, from smallpox to polio to many other infectious diseases. There really isn’t much arguing about their safety.
I’m going to say, surprisingly, I don’t think the vaccine issue is the real core of what practicing doctors will have to deal with should he assume control of HHS, and the reason is simple:We’ve already seen a large amount of relaxing of vaccine mandates at the state level. Nearly everybody watching this lives in a state where it’s very easy for a parent to get exemptions for their kids if they don’t want to vaccinate, and that is why we are seeing the recurrence of whooping cough and measles.
It’s easy to opt out, so that the whole issue of being antivaccine, I’m going to say, has already been translated into weakening public policies requiring vaccine mandates for kids. Obviously, adults do what they want. Most of them have not had a COVID-19 vaccine, most of them have not had a shingles vaccine, and most of them have not had an HPV vaccine.
Whatever his views about vaccines, I don’t think it’s going to actually sway what your patients are thinking about with respect to vaccination. They need persuasion about efficacy and safety. He may reinforce a false message, but some patients are already moving in the direction of saying no to vaccines.
I think he poses two other interesting challenges. One is that he really is strongly opposed to the way we eat and our food supply — too much fructose. I would tend to agree with him. I think our diet is poor.
He wants to shift us to organic foods, which is problematic for a whole host of reasons.First, there’s no definition of what organic is. Second, it’s not affordable. Organic foods, if we tried to shift our food supply, would raise prices enormously in terms of producing them.
He’s in an administration that the red states, where most of our agriculture is, are not going to make that shift a way from the fructose-heavy, corn-fed diet that we live on. I don’t know whether he’s going to be able to get where it would be nice to get patients to go. I suspect we’re going to see more patient interest in injectable drugs to control weight.
The other big challenge is that he is a proponent of less regulation and oversight of drugs. He thinks Big Pharma has too much sway. You can make that argument, too, but what he may suggest is opening the door to crank cures. He was a big proponent of ivermectin andhydroxychloroquine during the pandemic, all known by evidence not to work or be effective, but were simply wastes of money.
It may be that physicians are going to have to be ready to come up with evidence about what works and what doesn’t work if the FDA and government regulation got weaker under RFK Jr. or someone like him. Then it’s going to be even more of a problemfor you to get evidence-based information about what works and what doesn’t work in front of your patients.
I don’t think RFK Jr. is good for America’s health, but I think some of the opposition — such as that he’s too antivaccine — is ignoring some of the big ripples that would move through the healthcare system and really challenge physician practice and physician messaging.
I’m Art Caplan, at the Division of Medical Ethics at NYU Grossman. Thanks for watching.
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
TOP PICKS FOR YOU