primary prevention appears to be a post hoc rationalization introduced half-way through the study process to relieve the committee of contentious debates about specific policies of primary prevention—for example, prenatal testing and abortion, gun control, national health insurance, and drug abuse programs. I say this because almost all of the recommendations that concern infrastructure are totally undocumented, and an examination of the body of the report shows that the committee spent no time collecting and analyzing information about infrastructural components. For example:

  • Recommendation 2 calls for an "enhanced role for the private sector," including advocacy groups, the media, voluntary agencies, philanthropies, and business. Nowhere does the report describe or analyze the current role of media, voluntary agencies, or philanthropies. Advocacy groups are mentioned a few times, notably the National Council on Disability, which cosponsored this study, but there is certainly no analysis in the report of the number, range of activities, or effectiveness of advocacy groups in preventing disability. The report mentions a few private employment programs for people with disabilities as good examples, but there is no inquiry into the scope of these programs, how many people they employ, whether they are cost-effective, and whether they have lasting effects.

  • Recommendation 15 calls for establishing a major, university-based training program for disability research. The report itself provides no information or analysis of the nature and scope of existing disability research and training programs.

  • Recommendations 23 and 24 call for upgrading medical education and training of physicians and allied professionals, but the committee made no inventory of existing training programs and curricula and the report provides no documentation that there is anything wrong with them. In several chapters, there are categorical statements to the effect that there is a shortage of personnel or programs, but no data are provided.

These recommendations (and others calling for more research and grants) easily found their way into the report's conclusions, not because they emerged from reasoned inquiry but because they offend no one. One might even say they benefit primarily the people who wrote them. In response to a previous draft of this dissent, a staff member replied:

Indeed, the Committee did not undertake a systematic review of all the disability research training programs. Rather, among the Committee members there are several who are major figures in disability research training in the U.S. Their testimony on this subject was thought by the Committee to be well informed and adequate.

This attitude is emblematic of what was wrong with the whole committee process. Instead of engaging in genuine empirical inquiry, the committee



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