| The activities of scientific expert advisory committees are among the most visible aspects of the federal government's regulation and promotion of pharmaceuticals, vaccines, medical devices, and related technologies. The substantial attention given to the deliberations and judgments of these groups belies their official roles limited to providing only non-binding recommendations. To the contrary, advisory committee recommendations so frequently mirror subsequent government decisions that those seldom cases in which health agencies do not follow the guidance of their advisors often result in public scrutiny, concern, and allegations of political interference in science.;This dissertation traces the work, visibility, and influence of expert advisory committees in public health regulation and policy through an examination of the history of these activities within health agencies of the U.S. federal government. Focusing on the Food and Drug Administration, Centers for Disease Control and Prevention, and National Institutes of Health since the early 1960s, it explores the development of a model for decision-making that created formal mechanisms for ongoing contributions from outside scientific and medical experts in the day-to-day work of government agencies evaluating specific biomedical products and practices.;Through their creation, design, and use, expert advisory committees have been profoundly significant venues through which federal health officials have negotiated and strengthened their relationships with professional and lay communities. Expert advice has also been thought by its proponents to enhance the credibility and legitimacy of federal agency activities, leading to greater support for agency decisions. It established a more open deliberative process to which professional communities, patients, and the public had greater visibility and access, in part a procedural solution to the unavoidable subjectivity associated with government decision-making.;External Factors: Advisory Committees, Regulation, and American Public Health, 1962-1999 reveals how scientific expert advice in public health regulation and policy grew in three decades from an experiment to an institution. This history of the technical advisory committee system illuminates transformations in biomedical research, medical practice, and public health, offering new perspectives on the changing but ever-critical relationships between the federal government and physicians, scientists, manufacturers, patients, and consumers in the past, present, and future. |
