Dr. Charles "C" Everett Koop, the former surgeon general of the United States, died on Monday in his New Hampshire home at the age of 96. Koop was perhaps the most well-known and influential person to ever serve as the "nation’s doctor." According to the Associated Press, "Koop was the only surgeon general to become a household name". Although Koop had a lifetime of achievements as a physician, his most enduring legacy will be as a public official that was able to separate his personal beliefs from his duty as a public servant. Koop’s tenure as an appointed elected official is a case study for how to administer and serve as a socially conservative government official. Koop demonstrated an exemplary model of governing that all politicians, but especially social conservatives, need to heed.
Koop was appointed surgeon general by President Reagan in 1981. He served for eight years, and according to the Washington Post, "used the bully pulpit to fight for Americans' health." Koop was an evangelical Christian who never let his own moral code interfere in his ability to govern. He came to Reagan’s attention not only because of his ground-breaking work as a pediatric surgeon, but because of his pro-life stance. Because of his pro-life position and conservative views, liberals strongly opposed his nomination; however, once he was confirmed, the nation quickly saw that he understood the concept of separation of church and state. Contrary to today’s social conservative, Koop put public service above personal moral code and began a campaign to educate the nation and make it healthier.
Known for his distinctive Lincolnesque beard and uniform, Koop became a social activist for public health. Although he was pro-life, he refused to use his office to support anti-abortion legislation. The Reagan administration wanted Koop to prepare a report stating that abortion was psychologically harmful to women; instead, Koop refused, saying that abortion was a personal matter, not a public health issue.
Compare that to the hundreds of anti-abortion laws that have been authored by socially conservative elected officials throughout the country. Koop said abortion was a moral issue, and as such, his office had no say in the matter. Koop refused to bow to political pressure and issue a report stating that abortion was psychologically harmful to women. Koop commissioned his office to research the matter and found no conclusive scientific evidence to support the assertion. That is in staunch contrast to the number of elected social conservatives who are passing legislation that have no scientific basis (e.g. transvaginal ultrasounds) in their attempt to criminalize abortion.
Koop was an advocate of what we would today call "the nanny state." He was one of the first high-profile government officials to promote the dangers of secondhand smoke, and in 1984, launched a campaign to make America smoke-free by the year 2000. He noted that cigarettes were as addictive heroin or cocaine and the "most important individual health risk in this country." As surgeon general, he released eight reports on the health consequences of tobacco use, including the first report on the health consequences of involuntary tobacco smoke exposure. In 1984, Congress passed legislation providing for new, rotated health warning labels on cigarette packs and required advertising to include the labels. Those labels remain unchanged today and his efforts to create a smoke-free environment have been adopted by elected officials throughout the United States.
Perhaps Koop’s most enduring legacy will be his work to prevent the spread of AIDS. Because of his socially conservative Christian background, few people thought he would use his office to talk about homosexuality, anal intercourse, condoms, and intravenous drug use. Koop was personally anti-gay and opposed to pre-marital sex, but he used his public office to send a seven-page brochure, Understanding AIDS, to all 107 million households in the country. At a time when there was widespread fear about HIV and a tremendous backlash against the gay community, Koop felt that information was the most useful weapon against HIV and used his office to serve the public in that stead. As the AIDS epidemic spread and conservative and evangelical groups attacked the gay community, Koop released a report that advocated for the use of condoms and promoted sex education for children. Koop was attacked for his decision, but stood steadfast. He felt that the government could have done more but people "placed conservative ideology far above saving human lives." As per The New York Times, Koop said that "Our first public health priority, to stop the further transmission of the AIDS virus, became needlessly mired in the homosexual politics of the early 1980s. We lost a great deal of precious time because of this, and I suspect we lost some lives as well." Chances are that Koop would not have been invited to speak at the social conservative-dominated CPAC.
Despite his controversial positions on abortion, AIDS, and tobacco, Reagan never tried to silence Koop. The Associated Press reports that Koop angered conservatives, got static from White House staff, and Reagan was pressured to fire him. To his credit, Reagan stood by the renowned surgeon, something that is in stark contrast today as conservatives who do not support the social conservative agenda are often ostracized within the party. Is there any doubt that today social conservatives and others would be questioning his conservative values? Wouldn’t he be considered a RINO (but then again wouldn’t Reagan)?
Dr. Koop spent a lifetime as a public servant. In 1995 President Clinton awarded him the Presidential Medal of Freedom. He was a pioneer in the field of pediatric surgery, where he established the first neonatal surgical intensive care unit and became an expert in the separation of conjoined twins, including separating twin babies joined at the heart. As a public official he epitomized the essential difference between being informed and influenced by personal beliefs and legislating personal beliefs.
When he retired, The New York Times wrote "The skeptics and cynics, this page included, were wrong to fear that Surgeon General C. Everett Koop would use his office only as a pulpit for his anti-abortion views. He has put medical integrity above personal value judgments and has been, indeed, the nation's First Doctor."
Furthermore, the Times notes that Koop "consistently eschewed ideology for responsible discussion." What a concept! Responsible discussion trumping personal ideology: This is a lesson that today's politicians need to take to heart. Koop was a socially conservative, evangelical Christian that understood there is a difference between private life and public service.