Trump Bans CDC From Using Words Like “Science-Based” and “Evidence-Based” [Updated: Likely Self-Censoring]

In a continued assault on science and medicine, the Trump administration has decided on a list of seven words that they have banned CDC officials from using in any official publication or internal document that has anything to do with the CDC budget of 2019, according to a report by Washington Post.

These are “science-based”, “evidence-based”, “transgender”, “diversity”, “fetus”, “entitlement” and “vulnerable”. CDC analysts interviewed said that it was likely that other divisions of the Health department would be under the same restrictions and could not recall that this kind of ban on content deemed controversial by a current administration has ever happened before.

Being evidence-based is apparently controversial for the Trump administration. Many people during the meeting were reported to have reacted with surprise and incredulity and the CDC analyst interviewed stated that “Our subject matter experts will not lay down quietly — this hasn’t trickled down to them yet.” Thus, it seems like a brewing storm is coming.

CDC banned from using “science-based” and “evidence-based”

Striking at the heart of scientific and medical research, the Trump administration banned the use of “science-based” and “evidence-based”. One cannot help but wonder why it is so controversial for CDC research to be based on science and evidence.

Perhaps this is to be expected considering the fact that Donald Trump has engaged in a long war against scientific research and pushed a lot of anti-science misinformation on a wide range of topics, including vaccines, climate, research into the negative health effects of coal mining and strengthening the scientific credibility forensic science. His first budget proposal also included massive cuts to science funding, including National Institutes of Health (NIH) and Food and Drug Administration (FDA).

This is not even the first time that the Trump administration has banned scientific terminology from different governmental organizations, including the White House, the State Department, the Department of Energy, Department of the Interior, Environmental Protection Agency, and the National Institutes of Health. It was, in many ways, an attempt to scrub inconvenient facts about climate science from governmental websites. However, denying problems that humanity is facing and denying well-supported scientific facts does not make it go away.

It is time for those who do not seem to understand the growing threat to science posed by the Trump administration to start paying some real attention. They might have been complacent when climate science was scrubbed, but now the Trump administration is launching an outright attack on biomedical research. Research that keeps us health and saves lives.

For some of the terms, replacement phrasing has been made available. For instance, instead of using words like “evidence-based” or “science-based”, the phrase that is deemed acceptable is “CDC bases its recommendations on science in consideration with community standards and wishes”. In other words, a corruption on scientific standards of evidence by political ideology. For the other terms, no proposed alternative was immediately available.

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Other words CDC is banned from using

In addition to banning the words “evidence-based” and “science-based”, the Trump administration has also banned the CDC from using five other words: fetus, entitlement, diversity, transgender and fetus.

Fetus

On April 13, 2017, Trump signed a law that removed federal funding for any group that, as part of their activities, perform or fund abortions. This included Planned Parenthood, even though only 3% of Planned Parenthood services are abortions and there was already a ban for using federal money for abortions. The April 13 funding removal was aggravated by also blocking funding for any other organization in the world that performs or promotes abortions. This expansion harms hundreds of health care providers involved in fighting many dangerous infections around the world, including research on Zika.

Thus, banning the word ‘fetus’ is very much in line with their anti-abortion ideology. The reason they did not use abortion is likely because the CDC is a research institution and not an abortion provider and because it can serve to crack down more broadly about research related to pregnancy and other issues related to reproductive health for women.

Transgender

In July, 2017, Trump announced that he wanted to ban transgender individuals from serving in the military. His primary arguments were that transgender individuals somehow could cause “tremendous medical costs and disruption”. A study by RAND corporation disproves both of these claims and showed that transgender people do not cause disruptions of unit cohesion and the medical costs is just a tiny sliver of the total health care costs for the military. The report concluded that including transgender people “have minimal impact on readiness and health care costs”. It is thus obvious that banning the word transgender is part of the anti-trans hostility that the Trump administration has shown towards transgender people. Like fetus, this is a decision based on political ideology unsupported by scientific evidence.

There is also a more sinister consequence of banning the word transgender. Because transgender people face discrimination and other forms of unfair treatment when it comes to housing, employment, health care, school harassment, hate crimes and so on, cracking down on CDC research on transgender people and their experiences risks sweeping these issues under the rug.

Diversity

Diversity is a term that in this context refers to being more inclusive when it comes to e. g. recruitment or media portrayal. Wanting to ban this word is predictable from the dismissive attitude towards equality efforts, but it fails to take into account that diversity is a scientific term used in biology and medicine. For instance, diversity can refer to genetic diversity of pathogens or hosts. It is also a fact that inequalities exists in health care and other issues, so it is a direct attack on the efforts and practices of the CDC.

Vulnerable

In many regards, the word vulnerable also relates to the fact that not everyone is on the same footing when it comes to health care. Some people are more likely to get certain infectious and chronic diseases, physical injuries, more susceptible to diseases and complications, more likely to be hospitalized, worse access to health care and more vulnerable to different forms of discrimination.

Entitlement

This word is likely included for similar reasons as diversity and vulnerable. It relates to social and medical inequalities and the Trump administration wants to cut funding and de-emphasize these issues. Perhaps it is also a way to reduce available information of government entitlements that are available for people.

Conclusion

This is yet another troubling example of how the current U. S. administration is hard at work undermining scientific research and the institutions of science. First they scrubbed climate science and now they are coming after biomedical research. More shockingly, they have even banned generic scientific terms such as “evidence-based” and “science-based” in an all-out assault on scientific research carried out by the CDC under the disguise of cracking down on alleged politicized science on transgender people, diversity and vulnerability. This is unacceptable.

Hopefully the CDC management and subject matter experts will speak out against this kind of political oppression of science. Some will probably resign. What ever happens, the scientific community should not take this attack lying down.

Updates:

On 17 December, CDC Director Dr. Brenda Fitzgerald denied (cached, cached) that words were being banned at the CDC on Twitter. However, the issue revolves discouraging the use of certain words in the budget documents, not banning words at the CDC. (Note added 2017-12-17 17:24 UTC+01:00).

As new information has become available, it now looks like this is a matter of internal self-censoring that has apparently been already in process for about a year. A Science Magazine investigation reveal a sharp drop in the usage.

Notice the drop from 125 to 38 for evidence-based and almost total elimination of the word transgender. Thus, this is worse than we feared, as it is already happening. The CDC is likely self-censoring to make it easier for them to get their budget passed (Note added 2017-12-20 22:13 UTC+01:00).

The title and excerpt has been updated with more accurate information (Note added 2017-12-21 20:53 UTC+01:00).

On December 19, the heads of several medical organizations wrote a letter (cached) to the acting director of Health and Human Services. These were

Douglas E. Henley, MD, FAAFP
Executive Vice President and Chief Executive Officer
American Academy of Family Physicians

Karen Remley, MD, MBA, MPH, FAAP
Chief Executive Officer and Executive Vice President
American Academy of Pediatrics

Hal C. Lawrence III, MD
Executive Vice President and Chief Executive Officer
American College of Obstetricians and Gynecologists

Darilyn V. Moyer, MD, FACP
Executive Vice President and Chief Executive Officer
American College of Physicians

Saul M. Levin, MD, MPA, FRCP-E
Chief Executive Officer and Medical Director
American Psychiatric Association

On December 21, another letter (cached) on the same topic signed by hundreds of health organizations was sent to the same government official. A CNN article has some more details (Note added 2017-12-23 00:19 UTC+01:00).