The commonly-held belief that science provides us with undeniable facts not marred by any sort of bias dates back at least hundreds of years. Prominent physicist and philosopher Galileo stated that “the conclusions of natural science are true and necessary and the judgment of man has nothing to do with them”. ² This objectivity has often made scientific data the golden standard of evidence in political, legal, and general public discourse; in the case of Agent Orange, it is particularly relevant to understand the ongoing use of the supposed objectivity of science to determine—and later, justify—policy decisions related to veteran health. Because the reliance of health policy on science is accepted to the point of being considered necessary, it is not generally seen as especially problematic. However, when scientists are unable to provide strong, conclusive evidence about a politically relevant topic, standard methods of truth verification break down. More specifically, when policymakers were not able to confirm with any degree of certainty the causal relationship between Agent Orange and the wide range of diseases being presented by Vietnam veterans, Congress and the Veterans Administration (VA) were effectively stranded. The burden of determining what course of action to take was passed back and forth between the three institutions we generally look to in defining illness and disease causality: the courts, the government, and biomedical researchers.

George Pratt, a Federal District judge overseeing a suit against Dow and the other chemical companies that had produced Agent Orange, released a decision in July 1979 concluding that in cases of “allegedly serious environmental hazards,” the Environmental Protection Agency—and not the courts—should have “primary jurisdiction”. ³ Government agencies, however, simply shifted responsibility back onto the researchers, using the assumption of scientific objectivity to justify their inaction. In his opening statement at a February 1980 hearing before the Committee on Veterans’ Affairs, Chairman David Satterfield reiterated that “the question of cause and effect really is not one for this committee to determine;” he went on to add that such a determination “requires scientific and medical expertise which this committee does not possess”.4 Researchers, however, were not necessarily willing to bear this largely policy-oriented responsibility. During a heated conversation later in the same 1980 congressional hearing, Joan Bernstein, a researcher at the Department of Health, Education, and Welfare, tried to explain that it may not be possible to definitively support or reject the connection between Agent Orange and disease. When asked by a representative about what, given this uncertainty, would be an appropriate course of action, Bernstein gave a brief but articulate response that addressed many of the central questions in toxic tort litigation (cases involving personal injury caused by a chemical): “There are solutions other than scientific solutions. There are legislative solutions. There are administrative or policy-type solutions in which one simply makes the judgment that there is enough association”. ⁴ In other words, someone within the governmental or judicial systems—and not from the scientific community—needed to recognize the impossibility of technical certainty and take the initiative to make a well-informed decision with the available information.

Same Data, Different Conclusions

Regardless of which group was best qualified to make the determination of causality, this back-and-forth resulted in bureaucratic and ideological confusion over whose responsibility it was to ultimately establish whether the veterans presenting with Agent Orange-related illnesses deserved some sort of compensation. Unfortunately, allowing scientific evidence to be evaluated by all three groups is likely to be troublesome since the training people in each of these professions receive on how to reach sound conclusions is in many ways fundamentally contradictory. In standard research, scientists generally attempt to either confirm or reject the null hypothesis as a way to make legitimate analyses. Because studies are structured around the notion that the negative claim has a greater probability of being correct, proving (or more accurately, making a case for) the opposite theory is inherently difficult. Courts, on the other hand, have a far more subjective method of determining the truth that lowers the standard of proof: the body of evidence presented is split up into statements that support the defendant’s claim and statements that support the plaintiff; whichever side comes up even slightly on top is the winner. According to Wilbur Scott, a sociologist who has written extensively on the politics of Agent Orange, this method is supposed to ensure that a wrong decision is “as likely to favor an undeserving plaintiff as an undeserving defendant”. ⁵

Inconsistencies in the standards of proof may lead to varying conclusions based on the same evidence. While the chemical companies, government agencies, and the veteran organizations were looking at effectively the same time type of results, disagreements over whether dioxin exposure had negative consequences still existed. Referring to the Veteran Administration’s practice of denying treatment for the vast majority of veterans claiming damage from Agent Orange, Senator Tom Daschle admitted, “I would wager that in a court of law, out of 10,000 cases, that there would be better than two wins”. ⁴ If science is in fact as objective as the media tends to assume and people tend to believe, this sort of discrepancy between rulings of the court and scientific conclusions would not be possible.

In a case as politically-charged as this one, it is also important to consider how an understanding of a certain conclusion’s sociopolitical ramifications could affect a scientist’s methodologies and data analyses. For instance, if scientists agreed that Agent Orange was not a threat, veterans would be denied additional treatment and compensation, people who continued to worry about other substances would be considered misinformed, and trust in the military, the chemical companies, and the government’s regulatory legislature would rise. On the other hand, if scientists presented strong evidence that Agent Orange was a health hazard, the list of potential repercussions would be equally long: Vietnam veterans would be entitled to more respect, the idea of the environment being a source of disease would be further cemented, and suspicions of the Department of Defense’s defoliation policy, along with pressure on both the industry to change and on the government to issue tighter regulations would grow. ² In a letter to a colleague in Canada, Dow’s toxicology director stated that if it became known that Agent Orange caused chloracne, a condition of the skin, the entire industry would be “hard hit” and “restrictive legislation, either barring the material or putting very rigid controls upon it” would be likely. At the end of the letter, he added an obvious warning that suggests an intentional cover-up: “I trust you will be very judicious in your use of this information”. ⁶ Since most people at the time—including scientists—would have likely had their sympathies leaning to one side of the controversial debate or the other, it is easy to imagine these value biases influencing their research.

While an individual scientist’s preferred result may subconsciously (or even consciously) shape their study, scientist working within the government, were subject to tighter regulations as politicians’ agendas transformed their methodologies. At first, it appeared that the government looked to scientists to guide their policy simply by convention and not because of any ulterior motives. However, as evidence of the dioxin’s harmful effects on humans continued to surface, the White House undoubtedly became fearful that they would be responsible for the incredibly expensive compensation of Vietnam veterans who had been exposed to Agent Orange. ⁷ It is at this point that the VA, the Centers for Disease Control, and other governmental agencies implemented an intricate operation designed to use the guise of scientific objectivity to conceal the increasingly likely association between Agent Orange and a myriad of diseases. In June 1980, the VA began soliciting applications for a scientist who could write up a thorough proposal for their officially mandated study on the effects of dioxin. They claimed to be looking for someone with “political sensitivity…who is able to be objective in the face of political pressure” but ultimately chose Dr. Gary Spivey, a professor of public health from California whose track record did not fit those criteria. ⁷ Having testified against a bill intended to provide outreach to Vietnam veterans with illnesses potentially brought on by exposure to Agent Orange, Spivey had made it public that he thought the herbicide was harmless. Immediately, veteran organizations were suspicious of Spivey and questioned the credibility of a study carried out by a man whose expectations of the research were so one-sided. ⁷ Whether or not this appointment was deliberate on the part of the VA, it foreshadowed an increasingly blurry relationship between science and policy that developed around the government’s notably biased investigations of Agent Orange until the early nineties.

When Policy Influences Science and Science Influences
Policy

In some cases, the government simply censored scientific reports. Major General John Murray reviewed the ongoing work of a CDC-funded study and wrote to the White House explaining that since the project would probably not yield significantly conclusive evidence, the government should use the money set aside to complete the study on veteran compensation. His letter was never made public. ⁷ Later, doctors working for the VA were told to avoid including statements that referenced a connection to Agent Orange in their medical reports. ⁴ And finally, the administration’s growing concern over Agent Orange became even more obvious in a series of memos sent from the White House’s Office of Management and Budget to various high-ranking officials throughout the eighties. One such memo sent to the CDC on July 18, 1986 stated that “it is important that testimony and other public comments not associate the measurement of dioxin in blood with causation”. ⁷

The Air Force’s Ranch Hand Study provides yet another clear example of both the way in which preconceived notions of the truth can alter the methodology used in a study and the government’s ability to shape research in a way that affects the conclusions reached. Initially designed in response to growing public attention to the possible negative health effects of dioxin exposure, the goal of the study was to compare and analyze the differences in morbidity rates of Ranch Hands and other pilots who served in Vietnam but did not spray the chemical. The study had multiple issues, but the fact that there were only 1,200 subjects was of primary concern. If, as in the case of many cancers and other diseases associated with exposure to the herbicides, the illness had an incidence of less than one in 1,200, it may have not been detected at all. Additionally, since dioxin can be harmful in minute concentrations, perhaps even the veterans who had only flown in Vietnam were sufficiently exposed. The Air Force, however, did not see any problems in the study’s design, approving the first draft. ⁷ The null hypothesis used by its researchers was that Agent Orange does not lead to higher rates of disease. So, as discussed previously, proving the opposite theory—that Agent Orange is harmful to human health—would be far more difficult than simply supporting the null hypothesis.

In science, there are two types of error: type I, which is rejection of a true hypothesis and type II, which is failure to reject a false hypothesis. In general, it is seen as less problematic (and thus more desirable and prudent) to commit a type II error. In the case of the Ranch Hand Study, for instance, if questionable and potentially flawed data revealed that Agent Orange was toxic, it would be the more likely that a scientist would reject the data and stick with the originally assigned null hypothesis until more conclusive evidence was reached. And that is exactly what happened. Although the preliminary report did not find death rates to vary significantly between the two groups, a second progress report in 1985 said that statistically significant increases in skin cancer, liver ailments, and leg circulation problems had been recorded. The report, however, attributed these observations to factors other than dioxin exposure, saying the jump in skin cancer, for instance, was due to sun exposure. Regardless, the White House’s Agent Orange Working Group removed a sentence in the text that said the herbicide could neither be dismissed nor supported as a causative agent, replacing it with a statement that the study’s findings should be seen as “reassuring”. ⁷

In an effort to avoid compensating veterans, the VA moved farther and farther away from the legal standards of proof instituted by the 1955 Bradley Commission Report (officially, the Commission on Veterans’ Pension), which stated that in cases where an injury could not be service-connected with complete certainty, veterans must be given the benefit of the doubt and compensated for medical care. Instead, the VA maintained an unreasonably high burden of proof, hiding behind “a façade of scientific prudence” and benefiting from the fact that different fields have different methods of truth verification.^8^ By January 30, 1980, 1,624 claims had been made for Agent Orange-related injuries but only 21 had been approved by the VA—and even these were not officially connected to the herbicide, only to combat duty in general. ⁴ The House of Representatives Subcommittee on Medical Facilities and Benefits continued to give the impression that they were waiting until scientists could offer indisputable facts and make the job of policy-making more clear-cut, a development that would have never unfolded. “We want to get at [the truth] as soon as is reasonably possible on an objective, thoroughly scientific basis. Nothing less will satisfy this committee”. ⁴

All of these examples of censorship and government interference made Vernon Houk’s subtle statement at a Congress hearing on Agent Orange seem quite ironic. In response to an inquiry about one of his staff members who questioned the efficacy of their study, the high-ranking CDC official said, “They are scientists and can state their own opinions freely”. ⁷ Perhaps things would’ve turned out differently if that were indeed the case.

According to philosopher Neven Sesardić, hiding or obscuring scientific findings for any reason (whether that be political, personal, or something else), is detrimental: “There is something deeply wrong with the whole idea of making the decision to disclose scientific information dependent on its expected impact on society”.^9^ He continues to argue that the availability of all circulating ideas is critical not only to the function of science but also to society. Additionally, although scientists should not absolve themselves of all social responsibility, Sesardić posits that it is “simply incoherent” for scientists to be working towards the truth and at the same time, being required to constantly examine the potential consequences of publicizing their findings. ⁹ These considerations are entirely unrelated to the actual determination of truth and should not be considered in research, a reality that was not possible for scientists who were being overseen by government agencies with specific intentions in the Agent Orange controversy.

In Sesardic’s opinion, the politicization of science, which was certainly an issue in the post-Vietnam years, commonly results in an ideological dilemma. By allowing scientists to play such a central role in the process of policy-making, a government forces itself to make a tough decision: if it agrees with the scientists, it is effectively giving this group of citizens “special authority” in politics; if, however, it chooses to ignore or go against the scientific conclusions, it is giving itself and society the right determine which theories can and can’t be accepted. ⁹ Aside from the incredible precedent such a decision would set for the interaction between government and science, it allows for two groups (the researchers and the policymakers, in this case) to arrive at two separate conclusions based on the same set of data. This discrepancy, as was apparent in earlier Agent Orange discussions, leads to further controversy and unproductive debate.

Legal Intervention and Conclusions

Given all of the foot-dragging and cover-ups that occurred during the late seventies and eighties, passage of the Agent Orange Act in 1991 was a welcomed departure from the norm. In a 48-page decision issued on July 3, 1989, Judge Thelton Henderson of the California Northern District Court ruled that the standards of proof required by the VA to establish a service connection for Agent Orange-related illnesses were “impermissibly demanding” and thus set the tone for the subsequent act. ⁷ He invalidated the VA’s insistence on scientific evidence and instead suggested a return to the more legal form of truth verification: balancing claims in favor and against the service connection and choosing the side with more evidence; if the two sides of the argument could be equally supported, Henderson said veterans should be given the benefit of the doubt, as stipulated in earlier legislature. The Agent Orange Act made the compensation requirements more reasonable by asking that only association—and not causality—be demonstrated. ¹⁰ It also gathered a group of independent scientists who had never worked on Agent Orange-related cases and asked them to design a new study to test the effects of dioxin. Although not a perfect method, this provision ensured that the scientists, overall, came in with less of their own bias. Effectively, the Act implied that it was appropriate to make decisions on a lower scientific standard in toxic tort cases, signaling an important shift in standards of proof. It also stressed the impossibility of achieving certainty in science, a fact that pushed the policy-making burden back onto the government. Daschle praised the bill, saying “intelligent policy need not wait for perfect science”. ¹⁰

Since 1991, the VA has done a marginally better job of medical compensation for Agent Orange-related conditions, creating a list of “presumptive illnesses” that make veterans eligible for care. However, they have not made substantial efforts to educate ex-Ranch Hands on their increased health risks; additionally, bureaucratic inefficiencies routinely result in two-year delays in claims processing. ^11,12 Although the VA no longer denies a connection between Agent Orange and human health, they are very slow in attaching new diseases to the list of those eligible for compensation. The VA’s perpetual tendency to justify inaction under the pretense of scientific objectivity has led many veterans to believe that the agency is simply waiting for them to die. ¹² Whether or not that is the case, it serves as a reminder that different arenas have varying methods of truth verification that often to lead to different conclusions, something that “claims makers” can use to their advantage. ⁷ Furthermore, it highlights the inseparable connection that continues to exist between policy and supposedly undeniable scientific facts.

REFERENCES

1. Raloff, Janet. “Agent Orange: What Isn’t Settled.” Science News 125 (1984): 314-317.
2. Tesh, Sylvia N. Hidden Arguments: Political Ideology and Disease Prevention Policy. New Brunswick: Rutgers University Press, 1988.
3. “Judgments on Herbicides Viewed As Job of Environmental Agency.” New York Times, August 16, 1979.
4. U.S. Congress. House. 1980. Committee on Veterans’ Affairs. Subcommittee on Medical Facilities and Benefits. Oversight Hearing to Receive Testimony on Agent Orange. 96th Cong., 2nd sess., February 25, 1980.
5. Scott, Wilbur J. “Competing Paradigms in the Assessment of Latent Disorders: The Case of Agent Orange.” Social Problems
35.2 (1988): 145-161.
6. Blumenthal, Ralph. “Files Show Dioxin Makers Knew of Hazards.” New York Times, July 6, 1983.
7. Scott, Wilbur J. Vietnam Veterans Since the War: The Politics of PTSD, Agent Orange, and the National Memorial. Norman: University of Oklahoma Press, 2004.
8. U.S. Congress. House. 1980. Committee on Interstate and Foreign Commerce. Subcommittee on Oversight and Investigations. Agent Orange: Exposure of Vietnam Veterans. 96th Cong., 2nd sess., September 25, 1980.
9. Sesardić, Neven. “Science and Politics: Dangerous Liaisons.” Journal for General Philosophy of Science 23 (1992): 129-151.
10 Tickner, Joel A. “Developing Scientific and Policy Methods that Support Precautionary Action in the Face of
Uncertainty—The Institute of Medicine Committee on Agent Orange.” Public Health Reports 117 (2002): 534-545.
11. Cone, Marla. “Veteran Vets Face Dangers Decades Later.” Environmental Health News, September 15, 2008.
12. Grotto, Jason and Tim Jones. “For U.S., A Record of Neglect.” Chicago Tribune, December 4, 2009.

For further reading on the topic of Agent Orange and its health effects, check out the following sources:

“Coalition to Study Effect of Agent Orange on G.I.’s.” New York Times, July 17, 1979. Fumento, Michael. Science Under Siege: Balancing Technology and the Environment. New York: William Morrow and Company, Inc., 1993.
Grotto, Jason. “Birth Defects Plague Vietnam, U.S. Slow to Help.” Chicago Tribune, December 8, 2009.
Grotto, Jason. “At Former U.S. Bases in Vietnam, A Potent Poison is Clear and Present Danger.” Chicago Tribune, December
9, 2009. Grotto, Jason and Tim Jones. “Defoliants More Dangerous Than They Had to Be.” Chicago Tribune, December 17, 2009.
Hill, Gladwin. “A Chemical in the Balance.” New York Times, March 12, 1979.
Jones, Tim. “For Vietnam War Veterans, Injustice Follows Injury.” Chicago Tribune, December 6, 2009.
“Presumption of Illness.” Minnesota Medicine, February 2005.
Severo, Richard. “House Study Assails Herbicide Actions.” New York Times, March 29, 1981.
Stone, Richard. “Agent Orange’s Bitter Harvest.” Science 315 (2007):176-179.
U.S. Congress. House. 2008. Committee on Foreign Affairs. Subcommittee on Asia, the Pacific and the Global Environment. Our Forgotten Responsibility: What Can We Do to Help the Victims of Agent Orange?. 110th Cong., 2nd sess., May 15,
2008.
U.S. Congress. House. 2009. Committee on Foreign Affairs. Subcommittee on Asia, the Pacific and the Global Environment. Agent Orange: What Efforts Are Being made to Address the Continuing Impact of Dioxin in Vietnam. 111th Cong., 1st sess.,
June 4, 2009.