Mike DeWine

Mr. DeWINE

Mr. DeWINE. Mr. President, the Institute of Medicine--or IOM--last Thursday released the findings of a major investigation into how America's hemophilia community came to be decimated by the HIV virus. It is a very sad and compelling story. In the early 1980's, America's blood supply was contaminated with HIV. Many Americans have become HIV-positive by transfusions of the HIV-tainted blood. One particular group of Americans has been extremely hard-hit by this [[Page S 10137]] public health disaster. There are approximately 16,000 Americans who require lifelong treatment for hemophilia, a genetic condition that impairs the ability of blood to clot effectively. In the early 1980s, more than 90 percent of the Americans suffering from severe hemophilia were infected by the HIV virus--more than 90 percent, an absolutely unbelievable figure. That is a major human tragedy. I believe we should look to the IOM report released last Thursday for answers as to the level of Federal Government culpability for this disaster. Last Wednesday, on this floor, I discussed three questions that I believed were going to be addressed in the IOM report. First, did the Federal agencies responsible for blood safety show the appropriate level of diligence in screening the blood supply? Second, did the Federal agencies move as quickly as they should have to approve blood products that were potentially safer? Third, did the Federal Government warn the hemophilia community, when the Government knew--or should have known--that there were legitimate concerns that the blood supply might not be safe? Mr. President, if the answer to any of these three key questions is no, it seems to me it should be clear that the Federal Government had not met its responsibilities in this area. As a result, the Federal Government would have a clear duty to provide some measure of relief to the people with hemophilia who have been infected with the HIV virus. Mr. President, today the report is in. The answer to each of these questions is, in fact, no. Question 1. Did the Federal agencies responsible for blood safety show the appropriate level of diligence in screening the blood supply? The report's answer is ``No.'' In January 1983, scientists from the Centers for Disease Control recommended that blood banks use donor screening and deferral to protect the blood supply. According to this report, ``it was reasonable''--based on the scientific evidence available in January 1983--``to require blood banks to implement these two screening procedures.'' The report says that ``federal authorities consistently chose the least aggressive option that was justifiable'' on donor screening and deferral. The report's conclusion is: The FDA's failure to require this is evidence that the agency did not adequately use its regulatory authority and therefore missed opportunities to protect the public health.'' By January 1983, epidemiological studies by the Centers for Disease Control strongly suggested that blood products transmitted HIV. First of all, it was becoming clear that blood recipients were getting AIDS-- even though the recipients were not members of a known high-risk group. Second, the epidemiological pattern of AIDS was similar to that of another blood-borne disease--hepatitis. According to the report, these two facts should have been enough of a tip-off to the public health authorities. As early as December 1982, the report says, (p)lasma collection agencies had begun screening potential donors and excluding those in any of the known risk groups. The report says that Federal authorities should have required blood banks to do the same. Question 2: Did the Federal agencies move as quickly as they should have to approve blood products that were potentially safer? Again, the report's answer is ``No.'' The report says that certain heat treatment processes--processes that could have prevented many cases of AIDS in the hemophilia community-- could have been developed earlier than 1980. In the interval between the decisions of early 1983 and the availability of a blood test for HIV in 1985, public health and blood industry officials became more certain that AIDS among hemophiliacs and transfused patients grew. As their knowledge grew, these officials had to decide about recall of contaminated blood products and possible implementation of a surrogate test for HIV. Meetings of the FDA's Blood Product Advisory Committee in January, February, July and December 1993 offered major opportunities to discuss, consider, and reconsider the limited tenor of the policies. I say again, Mr. President: ``Major opportunities,'' major opportunities to change the course of the government's blood-protection policies. The report continues: For a variety of reasons, neither physicians . . . nor the Public Health Service agencies actively encouraged the plasma fractionation companies to develop heat treatment measures earlier. Despite these opportunities and others to review new evidence and to reconsider earlier decisions, blood safety policies changed very little during 1983. Mr. President, I cannot avoid agreeing with the conclusion of this report: ``(T)he unwillingness of the regulatory agencies to take a lead role in the crisis'' was one of the key factors that ``resulted in a delay of more than 1 year in implementing strategies to screen donors for risk factors associated with AIDS.'' Question 3. Did the Federal Government warn the hemophilia community, when the Government knew--or should have known--that there were legitimate concerns that the blood supply might not be safe? The report's answer is ``No.'' According to the report, ``a failure of (government) leadership may have delayed effective action during the period from 1982 to 1984. This failure led to less than effective donor screening, weak regulatory actions, and''--this is the key, Mr. President--``insufficient communication to patients about the risks of AIDS.'' As a result, Mr. President, and I am again quoting from the report: ``individuals with hemophilia and transfusion recipients had little information about risks, benefits, and clinical options for their use of blood and blood products.'' The response of ``policymakers'' was ``very cautious and exposed the decision makers and their organizations to a minimum of criticism.'' In effect, Mr. President, the inertial reflex of bureaucratic caution led to a serious failure to protect the public health. That really is the bottom line. The Americans suffering from hemophilia were relying on their government to exercise due care about the safety of the blood supply. It is my view, in light of the very important report released today, that the Government failed to meet its responsibilities to the hemophilia community. It is therefore my intention to introduce, in the coming days, legislation that will offer some measure of relief to those who have been seriously harmed by this governmental failure. I have had a discussion with my colleague from Florida, Senator Graham, who has been a leader in this area, who has been working for a long time with the hemophilia community and those who have been impacted by this horrible tragedy. And I would expect to be working with him in the future in regard to legislation to be introduced. Mr. President, at this time, I yield the floor.

Mr. DeWINE

Mr. DeWINE. Mr. President, I ask unanimous consent to proceed as in morning business.

Mr. DeWINE. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. DeWINE

Mr. DeWINE. Mr. President, tomorrow the Institute of Medicine will release the findings of a major investigation into how America's hemophilia community came to be decimated by the HIV virus. Even before this report is released, some of the tragic facts are very well [[Page S 9793]] known. In the early 1980's, America's blood supply was contaminated by HIV-infected donors. Many Americans have become HIV positive by transfusions of the HIV-tainted blood. Mr. President, Americans who contract HIV through a single blood transfusion know they can point to the specific blood supplier and therefore seek redress. But this is not the case with people who suffer from hemophilia. Those individuals have to undergo blood treatment too often and receive blood products from too many sources for this recourse to be open to them. They simply cannot identify the blood supplier that is culpable. Mr. President, this community has been extremely hard hit by the spread of HIV. Mr. President, this story is one of the great tragedies of the last decade. It is a sad, tragic, and shocking story. Mr. President, today there are approximately 20,000 Americans who require lifelong treatment for hemophilia, a genetic condition that impairs the ability of blood to clot effectively. In the early 1980's, more than 90 percent of the Americans suffering from severe hemophilia were infected by the HIV virus. Think of it--more than 90 percent. I think everyone knows someone who suffers from hemophilia. Mr. President, 90 percent of those individuals in this entire country have been affected by HIV. Mr. President, people with hemophilia have to receive treatment on a regular basis, treatment that requires the use of blood products from many sources. The danger to this population is and was immense. Their ability to get health insurance and life insurance has been severely limited. They also have very little chance of legal redress for the tainted blood they have received. Mr. President, in America's past, a challenge of some public health disasters, disasters in which the Federal Government has played a contributing role, has, in fact, been met with a Federal response. I believe, Mr. President, that the U.S. Senate needs to tackle the question of whether the Federal Government should play a similar role in the crisis now taking place in America's hemophilia communities. The report scheduled to be released tomorrow will be very helpful, as we discuss this problem. It is my hope, it is my expectation, that the report will address three very important questions: First, did the Federal agencies responsible for blood safety show the appropriate level of diligence in screening the blood supply? Second, did the Federal agencies move as quickly as they should have to approve blood products that were potentially safer? Third, did the Federal Government fail to warn the hemophilia community when the government knew or should have known that there were legitimate concerns that the blood supply might not be safe? Said in another way, what did the government know? When did it know it? What did it do about it? Whom did it inform? Mr. President, if the answer to any of these three questions is no, it is clear to me, and I would hope to other Americans, that the Federal Government has not met its responsibility--has simply not met its responsibility in this area. As a result, the Federal Government would have a clear duty to provide some measure of relief to the people with hemophilia who have been infected with the HIV virus. Mr. President, there is reason to suspect that the answer to all three of these questions is, tragically, ``No.'' No to each of the questions. Beginning in 1982, an investigation by the Centers for Disease Control suggested that aids was being transferred by blood-borne agents, but the public health service of this country did not call for precautionary measures to protect the blood supply until March 1983. Mr. President, on January 4, 1983, the Centers for Disease Control recommended the testing of new viral inactivation methodologies-- essentially, new strategies to stop the spread of HIV virus in the blood supply. The public health service did not--I repeat, did not--act on this recommendation. Neither, Mr. President, did the Food and Drug Administration. Furthermore, we know that Federal agencies assured the American people that it was safe to go ahead and use these blood products. Now we know the products were, in fact, not safe. Mr. President, I will be examining this report that will be issued tomorrow with great care, as I think all Americans should. I believe the story this report is going to tell will not be a reassuring story, that the picture that this story will paint will not be a pretty one. Therefore, I expect to come back to this floor before this Senate to discuss appropriate steps for the Congress to take in response to this very great human tragedy. I thank the Chair. I yield the floor.

Mr. DeWINE

Mr. DeWINE. Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

Mr. DeWINE. Mr. President, I ask unanimous consent that I be allowed to proceed as in morning business.

Mr. DeWINE

Mr. DeWINE. Mr. President, I rise today in strong support of this budget resolution. With this budget, we begin to deliver on the promises that were made to the American people last November. This Congress will do what prior Congresses have not done. It will pass a realistic budget for the U.S. Government. The current direction of the United States budget policy is simply not sustainable. Congress has already amassed a $4.7 trillion national debt that our children and our grandchildren are going to have to pay off. We are already paying over $235 billion a year just in interest on the national debt. By the year 2002, just 8 years from now, spending on entitlements and interest will exceed 70 percent of our entire budget. Take out defense, that leaves just 15 percent of the budget for all the discretionary spending on domestic needs--that is 15 percent of the whole budget: 15 percent, for education, for job training, for Women, Infants, and Children programs; just 15 percent for all of these domestic needs. That is just if we stay on our present course. Really, it does not get any better after the year 2003. By the year 2012, just 17 years from today, there will be nothing left in the budget for these social needs--zero. No money for our children. Every last penny in the Federal budget will go for entitlements and interest payments. That is the future, bankruptcy on top of a breathtakingly high mountain of debt. When my parents graduated from high school in the early 1940's, the debt on each child who graduated that year was $360. By the time my wife Fran and I graduated in the mid-1960's, it was up to $1,600 on each child. When our older children, Patrick and Becky and Jill, graduated in the mid-1980's, that figure stood at $9,000. If we continue to go the way we have been going, by the year 2012--just 1 year after our grandson Albert graduates from high school, and just 1 year after our daughter Anna enters college--by that year, 2012, that figure will be $25,000. That will be $25,000 in debt for each person in this country and no money at all to pay for urgent national needs. I believe this is much more than a budget question. It is much more than a question of accounting and bookkeeping. It is a fundamental moral question about the kind of people we, as Americans, really are. I believe we do not have the right--I do not think we have the right to leave our children a bankrupt America. They deserve a lot better from us than that. Another way of looking at it, when my parents were growing up, back in the 1930's, each family in this country had to work until about March 8 to pay for their taxes. By the time I was growing up in the 1960's, a typical family had to work until April 16. Today, 1995, American families have to work up until May 6, to pay their taxes. We have gone from March 8 to April 16 to May 8. That is simply going in the wrong direction. Last November, the American people decided they were sick and tired of this. They demanded a fundamental change of course, and they are right. I believe today, with what I hope will be the passage of this budget, we begin to bring about the change the people of this country voted for last November. This budget is based on a simple idea. First, we cut Government spending. Then we have a sensible, realistic tax cut. Because two things are necessary if we want to ensure America's prosperity as we move into the 21st century. First, we have to make sure Congress does not spend more than it takes in. Second, we have to give some tax relief to American families. We have to let [[Page S 9386]] families keep more of their own resources so they can save for their own future and invest in America's future. In conclusion, this conference report I believe is in fact a realistic blueprint for an American future we can be proud to leave our children. I congratulate Chairman Domenici and Chairman Kasich for their outstanding work. I intend to vote ``yes'' on this conference report, and I yield the floor.

Mr. DeWINE

Mr. DeWINE. Mr. President, I ask unanimous consent to proceed as in morning business.

Mr. DeWINE

Mr. DeWINE. Mr. President, this Congress and the American people are now engaged in a historic debate about welfare. I would like to talk this afternoon about the people we need to focus on in that debate. Mr. President, when I was in Youngstown, OH, a couple of months ago, I visited a church that ran a program for what is termed ``at-risk youth.'' The kids that I saw that evening were seated in a circle talking about their lives, talking about their problems. One of the teenagers was asked this question: ``Why do you get up in the morning?'' That is a simple question. This young man responded: ``Because I don't want to be dead.'' Mr. President, people that were there that evening thought he might have missed the meaning of the question and misunderstood it. So they asked him his goals for the rest of the day. He said, again, that he did not want to die. That was his objective for an average day. Mr. President, that teenager, that young man, is growing up in a different country from most of the rest of us--a country most of us would have a very difficult time recognizing. Now, the sociologists call that teenager at risk. That is kind of a strange term. As parents, we know that, in a sense, all children are at risk at all times. But these children are at risk in a different sense, in a different way. They are in grave danger of living very sad, very unhappy, very tragic lives. By the term ``at-risk,'' we mean children who are not learning the skills they need to really participate at all in society; children who are more than a grade behind in school; children who drop out; children who are abused, assaulted and live in constant danger of violent crime; children who are homeless or who run away from home. By at-risk, we mean children who are having children, children who are juvenile offenders themselves, already experiencing the justice system because of the crimes that they have committed. By at-risk, we mean children who live in neighborhoods where work is more the exception than the rule, children who do not have any responsible adults playing a meaningful role in their lives--no role models, no one to look up to, no one to trust. These young people are growing up so far outside the mainstream that they are going to have really very little chance of ever joining what you and I know as the American community. They will certainly have very little chance to ever participate in the American dream. Mr. President, these young people do not share in the values of America. It is not so much that they reject our values. It is not that they are protesting against our values. Rather, they never learned these values to begin with. This group of young people is, unfortunately, tragically, growing. Since 1965, the juvenile arrest rate for violent crime has tripled. Children are the fastest growing segment of the criminal population. Mr. President, since 1975, homelessness has been on the rise, and it has increased faster among families with children than among any other group. Every year, nearly one million young people between the age of 12 and 19 are themselves victims of violent crime. Mr. President, too many young people are not getting the education they need either. Since 1960, we have spent 200 percent more on public schools, in real dollars. But the quality of education is not improving. A 1988 study found that of all the nations tested, the United States finished dead last in science. In my home State, the State of Ohio, the Ohio Department of Education says that they really do not have complete statistics on graduation. But the statistics they do have suggest that of the children who enter Ohio high schools, only 75 percent graduate 4 years later. But that statistic really sugarcoats the much more dismal reality in many of our cities. In Youngstown, OH, for example, the reported figure is that only 46 percent graduate after 4 years; in Columbus, only 44 percent; and in Toledo, only 37 percent. I suspect that these figures would not be different in any major city in this country today. Mr. President, these children are really not being educated. We all know what not educating a young person leads to. According to the educational testing service, half of the heads of households on welfare are dropouts. That should not be a surprise. The Ohio Department of Rehabilitation and Corrections--our State prison system--reports that at least 25 percent of the inmates in Ohio prisons are dropouts. I would say, Mr. President, based on my own experience as Lieutenant Governor in Ohio and being in charge of our prison system and working with the Governor in this area, that figure is probably a lot higher than that. Mr. President, these young people are falling behind every day. They are falling behind too far and too fast. Almost 5 million children are growing up in neighborhoods where the majority of men are unemployed for most of the year. And certainly too many children are having children. Since 1960, the rate of unmarried teenagers having children has increased almost 200 percent. Since 1960, the percentage of families headed by single parents has also tripled. You hear a lot, of course, about single-parent families. But I feel that too many people really are missing the point. They are missing the point about why this is really an important issue and what all of the ramifications really are. Let me point out for the Senate, Mr. President, one reason why that statistic, that figure, is so very important. It is important because children growing up in single-parent families are poorer than children, on the average, who live with two parents. Children who do not have fathers around are five times more likely to be poor. They are also 10 times more likely to be extremely poor, to live in the kind of grinding poverty which is very hard to escape. Mr. President, it is hard to escape this poverty because it is more than economic poverty. It is a poverty, really, of the spirit, the poverty especially of young men who are growing up with no role models. It is a basic fact of human existence that when boys grow up without fathers, they become men without knowing what mature manhood really is supposed to be. That is really what fatherhood is all about, giving young people an adult male, a role model, to learn from. Young people need to have strong adult role models around if they are going to break out of the cycle of dysfunctional behavior. All the social pathologies I talk about in this speech really reinforce each other. Only the involvement of strong, caring adults in children's lives can ever truly break this vicious cycle. Consider another fact: 54 percent of all females who drop out of school are either pregnant at the time or already have children. Mr. President, the early, decisive intervention of a strong adult role model can certainly prevent a lot of problems. The young people I am talking about many times lack fathers. They lack role models, they lack education, they lack hope. That is why America today is losing these young people. The class of young people I am talking about who are seriously at risk is growing, and it is heading toward an explosion, right in the middle of what is and what should remain the richest, greatest, the most powerful country in the world. Mr. President, that is simply wrong. We, as a society, cannot afford to lose more and more young people to social trends that hurt people and destroy lives. We simply cannot let this problem continue to grow. We have to do everything we can to roll back that tide of what really is a social collapse. Now, this is not going to be an easy tack. It will be an extremely difficult task. It will take a lot more than Government programs to get America through what amounts to a full-scale social crisis. We need churches, businesses, labor groups, and, indeed, all of American society to reach out to these young people in a way that is truly effective. This past Wednesday, the Labor and Human Resources Committee reported out the Work Force Development Act. This is, of course, the Senate's job training bill. Mr. President, as we shift responsibility for job training to the States, because I think we should, there will be a temptation to focus the job training effort to a relatively--I say ``relatively''--easier task, like assisting the skilled and educated workers who are temporarily out of work. They certainly need help. I think that our Nation must have a different primary focus. I believe we must target America's No. 1 problem and tackle it head on. There are millions of young people in this country who are growing up in an environment that really all but guarantees their failure. If our job training legislation does not make a difference in the lives of these young people, we will be sacrificing not just an entire generation, but because these kids are having kids, we will be sacrificing the generation to follow. We will sacrifice more than that, really, because this is an issue not just about these children's future, it is about who we are as a people. These young people are really not strangers among us. They are us. We will not be able to rest until we have brought the young people back into the American mainstream--a mainstream of work, a mainstream of responsibility, and a mainstream of opportunity. That is why, Mr. President, during Wednesday's hearing, I proposed an amendment that would establish, as part of the Senate job training block grant, a $2.1 billion fund for programs to help these threatened young people. My amendment passed the committee by a vote of 12 to 4. I believe that our committee's intent could really not be more clear. We must have a national focus on at-risk youth. Mr. President, I held a job training field hearing in Ohio a few weeks ago. I heard from people on the front lines, the people who get up every morning and try to make a difference by helping train some of these young people. I also heard at that hearing from some of these young people themselves. It is pretty clear from what we heard that their needs are not being met by our current system. In fact, State job training programs many times simply do not focus on this very difficult but crucial task. If we, as Americans, want to do something about this problem, I believe that we have to have a national commitment. Now, it remains as true as ever that Federal mandates are not--let me repeat, are not--an effective way to tackle social problems. That is why it is essential we not try to prescribe particular solutions from Washington, DC. We do not need more micromanagement out of this Capitol. However, I do believe what we should do is make a national commitment to target this at-risk youth population. At the same time we make this national commitment, we must match that national commitment and a national setting of priorities with a commitment to give the States the maximum amount of flexibility to design their own programs to target this group of our young people. Mr. President, the history of the last 30 years proves that the Federal Government does not have the answers. We have to give the States the funding and the flexibility they need to design and support programs that will, in fact, work. I also believe we must, as a nation, as a people, say that the saving of this group of young people is, in fact, a national priority. Even now, as we speak today, a number of communities are pointing the way to possible solutions. They are doing it with programs that may be partially federally funded, may not be federally funded at all, may have some State money in them, or some of the programs I have seen have no government money. A number of the communities I have visited are really leading and pointing the way. The Youngstown church, for example, which I mentioned earlier at the beginning of my remarks, is a place where kids can go between the end of school, when they get out of school, and bedtime. It is a place where they have things to do and a place where they are safe. Being safe from physical violence is a good start. In Cleveland, OH, Charles Ballard started a program 13 years ago that helped teach these young people how to be fathers. His organization, the Institute for Responsible Fatherhood, is making a big difference; 2,700 men have participated so far, and 97 percent of the program's graduates are, in fact, supporting their own children. Last week, Mr. Ballard announced he will be expanding his program to five new cities. I had the opportunity to see him last week when he stopped by my office here in Washington. In San Jose, CA, there is a project called CET that provides 3 to 6 months of vocational training to disadvantaged young people and adults. A study of this local San Jose program indicates that the young people who participate in it end up doing substantially better many years into the future. Their annual earnings increase by more than $3,000 a year. That is one of the best results ever achieved by such a youth training program. Their success in San Jose is really because the program is tied closely--very closely, intimately--to the local labor market. The CET program's staff keeps in close touch with local employers so they know what jobs really exist in the community, so that they are training people for jobs that really exist. CET emphasizes practical job training over more rigid, classroom-focused instruction. Mr. President, Cleveland, OH, has a program called Cleveland Works. This program provides training, day care, and health care for welfare recipients. Each welfare recipient receives some 400 or 500 hours of training, and then gets placed with one of the 630 employers who participate in that area in the program. These workers get full-time wages and health care benefits for themselves and for their families. Cleveland Works has tracked all of its clients over the last 9 years and about 80 percent of them --80 percent--never go back on welfare. Cleveland Works breaks down the barrier between the two cultures of work and welfare. It can be done. Cleveland Works is a success story that is already being replicated by dedicated people in six other American cities. At the other end of the State is Cincinnati. In Cincinnati's Over- the-Rhine district there is a program called Jobs Plus, which I personally visited, which gives intensive training and counseling to at-risk individuals. All Jobs Plus clients are enrolled in a 90-day program, a crash course in the values and skills that are required in the working world. But the Jobs Plus program does not stop when the client gets a job. The client is then encouraged to join the Jobs Plus Club, to get moral support for what can be a very tough transition to a life of work and responsibility. Should we mandate any of these programs nationally? No. I do not think so. But they look like good programs, and I think it would be wise for local communities across the country who are concerned about their at-risk youth to consider programs such as these. The bottom line is that we have to keep on looking for the answers. There is no one right answer. We have to keep the focus on this problem. We have to keep the focus on this challenge. We have to do that. We have to keep reminding ourselves about the problem because there is simply too much of an incentive for us to forget these kids. There is a wall between these children and the rest of America, a wall every bit as real as if it were the stone wall of a prison or a jailhouse. We need to bring that wall down. That is why, as we discuss the job training legislation and the welfare reform bill that will certainly follow, we must not lose sight of these particular children who have simply been forgotten for too long. Mr. President, I yield the floor.

Mr. DeWINE

Mr. DeWINE. Mr. President, I rise today to discuss the nomination of Dr. Henry Foster to be Surgeon General of the United States. The role of the Surgeon General is to be a public advocate--to persuade Americans to change their private behavior and lead healthier lives. That is why the credibility of the Surgeon General--his or her ability to communicate with the American people--is vital to his success in that job. The Surgeon General has to be able to connect with the general public in a truly personal way. To do this, the Surgeon General has to be sensitive to people's real concerns. He cannot be someone who appears to shrug off important issues. That is why Dr. Foster's record on the very important issue of sterilizations is so troubling. What are the facts? The facts are that in the early 1970's, it was becoming increasingly clear, to a broad public, to the medical profession, that mentally retarded individuals needed special protections--to prevent abuses of the practice of sterilization. In 1970, the American College of Obstetricians and Gynecologists issued the following statement of policy: If an operation to accomplish sterilization is recommended by the physician for medical indications, the recorded opinion of a knowledgeable consultant should be obtained. Four years later, in 1974, Dr. Foster wrote an article in which he said--and I quote: ``Recently, I have begun to use hysterectomy in patients with severe mental retardation.'' The operative words are ``recently'' and ``begun.'' ``I have recently begun''. In a written inquiry, I asked Dr. Foster whether he had obtained the recorded opinion of a consultant prior to performing those hysterectomies. His answer was--and I quote--``I do not believe I obtained the recorded opinion of a consultant.'' But he adds: I believed that * * * the manner in which they were performed was fully consistent with prevailing rules governing informed consent. Dr. Foster is now--and was then--a member of the American College of Obstetricians and Gynecologists. But in response to my question, Dr. Foster said he believes that the policies of the American College of Obstetricians and Gynecologists simply are not binding. I have a problem with that. I think that the position of the American College of Obstetricians and Gynecologists--their insistence on a recorded opinion from a consultant--should not be dismissed so cavalierly. Indeed, the whole trend of history was moving toward protecting the rights of the mentally retarded, and away from Dr. Foster's position, at the time he wrote that article. Let me add a few more comments to put it into really historic context. In 1972, a Federal district court--in the case of Wyatt versus Stickney--had placed Alabama's institutions for the mentally ill and mentally retarded under sweeping and detailed court orders forbidding experimental research and certain kinds of treatment without express and informed consent. In June 1973, two girls--ages 12 and 14--were surgically sterilized in Montgomery, AL. Without going into all the details, it was an absolutely shocking set of facts. When the sterilizations came to light, there was immediate public reaction--and a move toward nationwide reform. By the end of that same month--June 1973--there was already a lawsuit filed. In the following month--July 1973--Senator Edward Kennedy held hearings on this controversy. The Secretary of HEW announced that new regulations on the use of Federal funds for sterilizations would be published within weeks. And the regulations were published. They sought to protect the rights of all persons--including the mentally retarded--with respect to federally funded sterilizations. These regulations never took effect, because in 1974 a Federal district court found--in the case of Relf versus Weinberger--that HEW had no authority to perform any nonconsensual--that is what we are talking about, nonconsensual--sterilizations whatsoever. On January 8, 1974--the very beginning of 1974--Federal District Judge Frank M. Johnson, Jr., issued an order that specified the procedures that would have to be followed in cases of the sterilization of institutionalized mentally handicapped individuals. Judge Johnson required that any sterilization would have to be approved by the director of the institution, a review committee, and the court. That was January 1974. That tells us a little bit about what the climate was. That was the moral and legal climate in which Dr. Foster was justifying and defending the practice of sterilizing mentally handicapped women. In the summer of that same year--months after the decision by Judge Frank Johnson, and a year after the Kennedy hearings--Dr. Foster made his statement that he had ``recently * * * begun to use hysterectomy in patients with severe mental retardation.'' The physician--even more than the average citizen--owes what our Declaration of Independence calls ``a decent respect to the opinions of mankind.'' That is way Dr. Foster's responses on the issue of sterilization gives cause to me for grave concern. They lead one to believe that Dr. Foster can be tone deaf to some very important issues. It is one thing to have a controversial position on some issue. It is something else entirely when someone chooses to remain totally indifferent to the moral controversies of his time. If you are going to be Surgeon General, you have to be able to reach people. You have to be sensitive to them. You have to care about what is going in their hearts and their fundamental moral sensibilities. Dr. Foster, as I have said on several different occasions, Mr. President, is a good man. He is a caring person. He is a loving human being. That is not the issue. I believe, based upon the hearings, on my own conversations with him, on his responses to my written questions, that Dr. Foster simply cannot adequately perform this job; that he cannot use the job of the Surgeon General of the United States to its fullest capability; that he cannot use it as the bully pulpit that it should be used as; that he cannot maximize the great potential that office has. That is why I will again today vote no on his nomination. I yield the floor.

Mr. DeWINE

Mr. DeWINE. My colleague would make the point of States rights, and my colleague from Oklahoma made the point about States rights. For this Senator, it is a balancing test, as I think most things are in Congress, most things are in the Senate. It is a balancing test of how much we send back to the States, how much we need to have some national uniformity. I think what we are doing in this amendment is, in fact, a balancing test. It is not a question of do we know best here? Do people know best in Columbus or Indianapolis? I think it is simply a balancing test. That would be my response to my friend. I yield the floor. Unanimous-Consent Agreement

Mr. DeWINE. I am happy to yield to the Senator.

Mr. DeWINE. Mr. President, let me try briefly to respond to the very eloquent comments of my colleague from Oklahoma. My friend talks about the fact that our forefathers would be shocked at amendments such as this. I think our forefathers would be shocked by the Interstate Highway System. I think they would be shocked by over 40,000 deaths every single year. So I am not sure that that really has, at least from this Senator's perspective, a great deal of validity. The Senator talked about the figures that were cited--that I cited, that my colleague from New Jersey cited. Those were not our figures. They were national experts, respected, who gave those figures. He talked about those arguments and figures being hogwash, ludicrous. Let me assure him that I am not attempting on this floor today to extrapolate or speculate or predict in any way, shape or form the number of auto fatalities that there will be. I think it is important to cite what the experts tell us. I am not pretending to project that. I would ask my friend from Oklahoma to find me one expert--one expert--in this whole country on highway safety who will say that there is not a direct relationship between speed and number of fatalities. It is an accepted fact. If we want to talk to the real experts, go to any State in the Union and talk to the law enforcement officers who literally have to scrape people up off the roads. The law enforcement officers who study this, the law enforcement officers who have to deal with it every day, and have to talk to the families, and ask them if, in their opinion, speed does not matter, and speed does not kill. It does. That is what we are saying. It is all we are saying. But I think it is a lot to say. I agree with my colleague from New Jersey. No one is saying that anybody on this floor does not care about human life and does not care about the welfare of people. I think the evidence is abundantly clear what will happen if, in fact, this bill as written is passed without this amendment. The evidence is clear. We saw the statistics in 1973 and 1974. We saw what happened when this Congress allowed more flexibility at the State level. We saw what happened. We saw that the States did jump in. We saw the tremendous pressure. We saw the fact that speed limits were increased. Then we saw the auto fatality rate change. We saw it go up from what it should have been and was expected to be. I do not think it is too big of a step of the imagination--I think, the opposite. The evidence is abundantly clear what will happen. That is, that speed limits will, in fact, be increased. It is true that this bill does not do it directly. It will do it indirectly. The consequences are very clear. I want to assure my colleague from Oklahoma I am not saying that we can predict exactly how many people will die, how many families will be crushed. But we can pretty well predict this: more will be--with this bill as it is written--than would be if the amendment were passed. I think that is very, very, significant. I know there are other Members on the floor who would like to talk. I would end by saying that this is a compromise. I think it is a rational compromise. It is rational that when you drive on the Interstate Highway System there be uniformity. But it is also rational, as we turn power back to the States, as we are sensitive as we should be to where the enforcement should take place and who has to really do the job every day, that we not try to micromanage things from Washington, and not tell the States how to enforce the law, allow the States the flexibility to do that. That is what this bill does. It eliminates the reporting. It eliminates the looking over the shoulder. What it does say is that there is still a national standard.

Mr. DeWINE. I thought he yielded the floor.

Mr. DeWINE. Will the Senator yield?

Mr. DeWINE. Mr. President, let me talk for a moment about the enforcement issue. Enforcement has always been local enforcement and State enforcement. What this amendment is going to do is say, while we have a national standard, Congress is no longer--Washington is no longer--micromanaging the enforcement of it. This has always been local, and it will remain local. Predictions: I have only one prediction that I will make. While we cannot guess how many lives will be lost, the prediction is this: If this amendment does not pass, and if the bill goes into effect as written, the speed limits will go up and more people will die. That is what the facts are. That is what the evidence shows us. That is what history shows us. That is the bottom line of this bill. I yield the floor.

Mr. DeWINE

Mr. DeWINE. Does the Senator believe this amendment--I do not think he would have offered the amendment, though, if he did not think there would be some consequence to it? That there would be a change by the States?

Mr. DeWINE. Mr. President, I rise in strong opposition to this amendment. I understand the philosophical argument, the States rights argument that [[Page S 8673]] has been made on this floor. I think it has, certainly, some validity. It's a philosophical argument. It is an argument about what the Federal Government should do and what the States should do. But as I concede to the other side on this issue, I hope they would also understand that does not tell the full story. This is not an abstract debate about States rights. As I said this morning in the debate, what we do in this Chamber has consequences. There is no greater example than what we are about today. There will be consequences, and they are not just philosophical. They are not just abstract. They are practical, life and death consequences based on what we do today. So let us not just say it is a philosophical debate and you are either for States rights or you are against States rights. I do not think too many people would look at my record over the years and say I am against the States. I spent over half of my career at the county level and State level, not here in Washington. But I think this debate is about a lot more than just philosophy and a lot more than just States rights. I think it is about lives. We debated earlier today my amendment and the amendment of Senator Lautenberg that we offered to deal with speed. We lost that amendment. Basically what this Senate said, what the will of the Senate was this morning--and I certainly respect that--is the Federal Government is going to back off. The green light is out. We no longer have any national interest in the issue of speed on interstate highways. I respect that. I disagree with the decision by the Senate, but I certainly respect that. Now we are back on the floor with an amendment that says the Federal Government has no interest, we have no interest as a nation, in the issue of seatbelts. I really cannot believe we are here talking about this. I was not going to become involved in this debate. I thought enough this morning was enough. But as I listened to the debate on the floor, I frankly felt compelled to come over here and talk, and talk about an issue I feel very, very deeply about. Do we really want the legacy, or one of the legacies of this Congress, of this Senate, to be for the first time in years we will say we do not care about seatbelts, who wears them and who does not? We do not care about speed? I think that would be a sorry legacy for this Congress. It may occur, but it will not occur with this Senator's vote. I mentioned I have spent over half of my career at the county level and State level. One of my elected positions over the last 20 years was as Lieutenant Governor of the State of Ohio. My job as Lieutenant Governor was to oversee our anticrime and our antidrug efforts. I had at various times five or six different agencies that reported directly to me on behalf of the Governor. One of the departments that reported directly to me was the department of highway safety. So I have been intimately involved with this issue over the last 4 years. Prior to that time I was a State senator in Ohio. I wrote our drunk driving law. So I have lived with this. We used to say, when we went around and talked about highway safety when I was Lieutenant Governor and when we tried to institute programs--we used to say there were three things that caused auto fatalities. This was kind of an oversimplification, but I think it did not miss it by far. There were three things: use of seatbelts, drinking and driving, and speeding. You can just about categorize every single auto fatality into one of those categories. So, if you are trying to cut down on auto fatalities, you have to deal with those three issues. We have already said we do not care about the issue of speed. Now we are preparing, possibly, to say we do not care about the issue of seatbelts. I think that would be a tragic mistake. I understand that my colleagues, for whom I have a great deal of respect, the Senator from New Hampshire, the Senator from Maine --their argument is really that is not what we are saying. We are not, by this action today, repealing any seatbelt law. We are not by this action today repealing any speed laws. Mr. President, that is technically true. That is true. But that does not tell the entire story, and I think it misleads a little bit to only say that, because I think we know what the consequences of our actions are. Is there anyone in this Chamber who believes that virtually every State in the Union would have passed seatbelt laws when they did but for the action of the National Congress? I do not think anybody here would claim that. Just as I do not think there is anybody here who would stand up here with a straight face and say that with the action we took this morning, the action we may take this afternoon, the action with speed, the action with seatbelts, that some States will not change what they are doing. They clearly will. We will have a retrenchment. We will have a retrenchment in two areas that every expert that I have ever heard from, anybody I have ever talked to who knows anything about this issue, has said: These are key--speed, seatbelts--you will save lives. Cut down the speed and if people wear seatbelts, you will save lives. I have yet to hear in the debate today anybody come up and cite an expert who says that is wrong. So I think this would be a sad legacy for this Congress. I think for those who say it is a philosophical debate, I again emphasize it is more than a philosophical debate. It is a question of lives. For those who say we are really not repealing the speed limit, we are really not repealing seat belt laws--yes, that is technically true. But, no, it does not tell the full story. So the action we take today will affect lives. As I said this morning when we talked about speed--and I will say the same thing again about seatbelts--if you have less use of seatbelts, if you have higher speed, more people will die. And that is the natural consequence of what we appear to be about ready to do. So, I will in a moment yield the floor. But I believe this is a debate of great significance. I have been a States rights supporter for years. I do not think anyone would look at my record and argue with that. But that is not the entire debate today. The entire debate today has to look at what works and what does not work; what makes a difference and what does not make a difference. Let me say the evidence is absolutely overwhelming, the jury has returned. The jury is back. Seatbelt use makes a difference, and that is why I oppose the amendment of my colleague, Senator Smith. I yield the floor.

Mr. DeWINE. If the Senator will continue to yield for just a moment?

Mr. DeWINE. The States will take no--no actions will be changed at all?

Mr. DeWINE. I am sorry?

Mr. DeWINE. Will the Senator yield on that?

Mr. DeWINE. Ten minutes.

Mr. DeWINE. I have not talked to the Governor about this issue.

Mr. DeWINE. If the Senator will yield, I was directly involved in the spending of that $9 million. That money was, in fact, as the Senator can tell by the legislation, used on highway safety issues. Many people in Ohio were very upset about that, obviously, and have been upset about it. My only point in asking the question is a statement was made, basically, we are not telling anybody what to do. I understand that. My only point though is that there are consequences to what we do. There are consequences to what we do not do. My point is pretty simple. My point is that there will be a change in the use of seatbelts. There will be a change in what States do, just as there will be a change in regard to when we took the red light off and put the green light on this morning on speed limits. We are going to see a change. Because you will see that change, there will be other changes, and the other changes, I believe--the evidence is absolutely overwhelming--means that more people are going to die. There is no doubt about it.