Remembering Surgeon General C. Everett Koop (1916 – 2013)

Appointed by President Ronald Reagan, C. Everett Koop, a religious pro-life conservative, came to the office of Surgeon General in 1982 as a noted, highly respected pediatric surgeon. Despite little power, he became the most influential spokesman on many issues impacting the health of the American public by succeeding to transform the office of Surgeon General “from a minimally effective obscure role to one of the most authoritative platforms to educate the American public on health threats that became increasingly apparent.”

Although his position on a number of medical issues isolated him from his conservative base, he continued to speak out, drawing public attention by effectively exerting his expertise, equating these concerns with the question of constitutional liberties of individual rights vs governmental authority. His influence continues, reflected in the profound impact he had on the American Conscience.

No federal official before or since Dr. Koop fought a more vigorous public campaign against smoking. Once he began investigating tobacco use in preparation for the Surgeon General’s report, he openly expressed how appalled he was by the tobacco industries’ aggressive manipulative lobby in Washington. He passionately devoted his time to informing smokers and non-smokers that the dangers of tobacco directly impacted the death of 400,000 people. His reports showed “smoking caused more fatalities from heart disease than from cancer and was the major cause of illness and death from COPD (Chronic Obstructive Pulmonary Disease), while second-hand smoke presented an even greater health hazard than exposure to work place pollutants such as asbestos.” This led to a direct confrontation with the tobacco industry, and States where it’s grown, especially with the findings that tobacco was one of the most addictive drugs known to medicine.

ceverettkoop2.jpgHis tenure also coincided with the greatest public health threat of the Twentieth Century, the AIDS Epidemic. While the Reagan Administration attempted to minimize his role, he fought for getting the word out through speeches and mailing every American household his comprehensive Surgeon General’s report on AIDS, though he was continually frustrated by President Reagan not being more vocal or aggressive as the AIDS crisis began to unfold. He succeeded in transforming the debate from the politics of homosexual promiscuity, morality and drug abuse to the issues of civil rights, accessibility of medical care and the economic hardship of those suffering with HIV. His passionate public posture successfully altered the view of AIDS as a plague to “a chronic disease that can be appropriately managed by medications and behavioral change.”

When a number of high profile legal cases arose, he grappled with the rights of infants with congenital birth defects to receive medical treatment and the justification of the government “to intervene in the relationship between doctors and parents in decisions about the future of their children.” His expertise and experience as a pediatric surgeon qualified him to publicly comment from an ethical position. Although he asserted that each case should be addressed individually, “we ought to do things to give a person all the life to which he or she is entitled, but not do anything to lengthen that person’s act of dying.” However, as a physician and on moral grounds, he stated “the right of the government to override the rights of parents should extend to the protection of children with birth defects and disabilities.”

He enraged pro-life conservatives who claimed he had abandoned his anti-abortion position when asked about advising a pregnant woman with Aids about abortion, his public position was “a woman should receive advice on abortion because of the risk of transmitting the disease to her child.”

A pediatric surgeon who understood his responsibility, the political landscape and successfully navigated the balance between public awareness, personal belief and national conscience; a recipient in 1991 of the Albert Schweitzer prize for Humanitarians. A profile of a remarkable life dedicated to provoking debate on some of the most complex medical, ethical and legal issues ever to face the American Public.

Koop died on February 25th 2013.