Leaders of one of the nation's most esteemed medical-advisory associations are considering whether to alter the membership of a new committee assigned to scrutinize scientific studies on Gulf War illness.
"We are exploring options for expanding the committee," Institute of Medicine spokeswoman Jennifer Walsh said. "We plan to have the committee finalized by our next public session at the end of January."
The Institute of Medicine committee met for the first time in Washington, D.C., Wednesday, but its membership has yet to be formally approved.
The committee's lineup could have a profound effect on its eventual findings, according to Phoenix resident and Gulf War illness researcher James H. Binns.
The Department of Veterans Affairs commissioned the Institute of Medicine to conduct the review, and the committee's report is expected to help lay the foundation for future treatments and benefits for thousands of Gulf War veterans.
The VA previously determined approximately 250,000 U.S. troops who deployed to Kuwait and Iraq in 1990 and 1991 suffer from Gulf War illness, a collection of symptoms that often includes gastritis, irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia.
The committee's membership became a flashpoint when Binns, a former Department of Defense policy official, and four colleagues charged that the Institute of Medicine's new committee lacks a broad spectrum of perspectives.
The focal point of the matter is the question of what causes Gulf War illness: psychiatric triggers, such as post-traumatic stress disorder, or environmental triggers, such as exposure to toxins from chemical weapons and smoke from oil-well fires.
Eight of the 16 proposed members of the committee already are on record supporting the idea that Gulf War illness is caused by psychiatric triggers, according to an analysis by Binns and his colleagues, who are current or former members of a VA advisory committee on Gulf War illness.
The other eight members of the Institute of Medicine committee are neutral, according to their analysis.
"Conspicuously absent from the committee are any doctors or scientists who have studied Gulf War health in the past decade," they wrote to Institute of Medicine President Victor Dzau on Nov. 28.
The committee also lacks anyone who has studied or treated other groups, such as farmers, who have been subjected to neurotoxin exposures, or anyone who has studied the effects of Gulf War exposure on animals, they wrote.
Binns and his colleagues believe the toxic-exposure connection is well established by existing scientific research. They believe the psychiatric connection is tied to outdated theories intended to keep veterans off the VA's rolls, they wrote.
Institute of Medicine executives screen potential committee members to ensure balance, Walsh said.
"Committee members are expected to have points of view, and the National Academies attempt to balance these points of view on a committee and to include members on a committee with the specific expertise and experience needed to address the study's statement of task," she said in an email.
The Institute of Medicine is part of the National Academy of Sciences, which positions itself as a nonpartisan and independent adviser to government policymakers on scientific matters.
Binns' group, which is aligned with representatives of six veterans organizations, is prepared to bring the matter to members of Congress if the committee's membership remains unchanged, he said.
Phoenix resident Matthew Key said he and other Gulf War veterans are monitoring the matter closely.
Key, a former Navy corpsman who advanced with the Marines during the Gulf War invasion, is certain toxic exposures are the root of his medical ailments. He said he's losing function of his hands, knees and shoulders.
"Chemicals from over there are eating up all my joints," he said.
The makeup of the Institute of Medicine panel is concerning, Key, 46, said. "I sure hope they get somebody who's in for the vets," he said.

Paul Giblin is a Pulitzer Prize-winning reporter covering government policies and efficiency, and how they affect consumers of government.
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