In an interview on Radio New Zealand on the 28^th of April 2003, faced with evidence that, despite her claims to the contrary, Phuoc Tuy Province had been sprayed, Doctor McLeod responded:

I think it's been blown out of proportion, because I don't think it's the issue. I mean, whether veterans were exposed or not isn't really an issue. I mean, the issue is, did that exposure cause them harm. Did that exposure cause the health of their children to be harmed, and there doesn't seem to be any evidence that that's the case. (1)

The question of a link between Vietnam service, or the herbicides and pesticides used in Vietnam, and birth defects in the children of Vietnam veterans, has been the subject of a number of epidemiological studies. They fall into four main categories: studies of the children of Vietnam veterans; studies of the children of agricultural workers who were exposed to herbicides and pesticides; studies of populations accidentally exposed to herbicides and pesticides; and studies of children in Vietnam. The McLeod Report states that its task was to conduct "a comprehensive and critical review of all available international research on the health of Vietnam veterans children." (2) I will demonstrate that the McLeod Report's review of the studies is neither comprehensive nor critical.

The Agent Orange Scientific Task Force was assembled in the United States with the same purpose as the McLeod Report: to analyse all relevant health studies and report on the strength of the evidence for or against a link between the herbicides and pesticides used in Vietnam and birth defects. It reported in 1990.

The Task Force concluded that the evidence of a link between herbicides and birth defects is at least as strong as the evidence against such a link:

Following review of the scientific literature, it is concluded that the evidence supporting the existence of a significant statistical association between exposure to phenoxyacetic acid herbicides and/or their associated contaminants (chlorinated dioxins) and reproductive and developmental effects is at least as strong as the evidence of a lack of the association. (3)

The members of the Agent Orange Scientific Task Force carry a considerable weight of scientific expertise:

Richard W. Clapp, M.P.H., Sc.D., Director of Environmental Health Studies, JSI Research and Training Institute Inc. Boston MA.;

Barry Commoner, Ph.D., Center for the Biology of Natural Systems, Queens College, CUNY, Flushing, NY.;

John D. Constable, M.D., Associate Clinical Professor of Surgery, Harvard Medical School, Boston MA.;

Samuel S. Epstein, M.D., Professor of Occupational and Environmental Medicine, University of Illinois, Chicago, IL.;

Peter C. Kahn, Ph.D., Associate Professor of Biochemistry, Department of Biochemistry and Microbiology, Rutgers University, New Brunswick, NJ.;

James R. Olsen, Ph.D., Associate Professor, Department of Pharmacology and Therapeutics, School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo, NY.;

David M. Ozonoff, M.D., M.P.H., Professor and Chief, Environmental Health Section, Boston University School of Public Health, Boston MA.

The authors of the McLeod Report are:

Deborah McLeod, PhD, DPH;

Donna Cormack, MA;

Tai Kake, BsC (Hons1). (4)

The McLeod Reports conclusion is:

that there is no evidence that exposure to chemicals in Vietnam has affected the health of the children of New Zealand Vietnam veterans. (5)

The McLeod Report gives no indication of its reasons for disagreeing with the conclusions of the Agent Orange Scientific Task Force. In fact, the Task Force is not even mentioned, anywhere in the McLeod Report. This is inexplicable. The Internet keyword search the authors of the McLeod Report have carried out would certainly have turned up a copy of the Task Force's report. (6) The authors of the McLeod Report must surely be bound by professional ethics to report that their own conclusion is out of step with such an eminent group of medical scientists.

In the category "all birth defects", there is a discrepancy between what the McLeod Report found in its own research into the studies and what it concludes in that part of the report that is intended for public consumption.

The McLeod Report concludes that:

The risk estimates calculated for the category 'all birth defects' are remarkably consistent and overall show no increased risk for Vietnam veterans in fathering children, when all birth defects are considered. (7)

3.3.2. What the McLeod Report actually found

The longer version of the McLeod Report contains a table, which shows the results of 20 studies. (8) The table is buried deep among the technical detail that the general public is not expected to read. The McLeod Report claims that this table lists only those studies that tested for "all birth defects."

The table has a number of flaws. The most glaring is the presence of the Blatter study, which was a study of spina bifida only, and does not belong on a table of studies of "all birth defects." (9) The absence from this table of a number of studies, all of which found an increased risk for all birth defects in the children of Vietnam veterans, is also curious. These inexplicable inclusions and exclusions will be discussed in more detail later.

I have not yet worked out how to reproduce the table in this website. The table can be viewed in its original form by clicking on the following link and scrolling down to page 71:

It is worth repeating what the McLeod Report claims:

The risk estimates calculated for the category 'all birth defects' are remarkably consistent and overall show no increased risk for Vietnam veterans in fathering children, when all birth defects are considered. (10)

The McLeod Report's own chart shows that a clear majority of studies, thirteen out of the twenty listed, show an increased risk for Vietnam veterans of fathering children with birth defects. For the results to be as the McLeod Report claims, showing consistently that there is no increased risk, all of the figures must be 1.0 or lower. Clearly this is not true. Rounded to one decimal point, there is not a single figure below 1.0 in the McLeod Report's own chart. The average figure for the studies shown in the McLeod Report's own chart is 1.4. In other words, they show that Vietnam veterans have a 40% increased risk of fathering children with birth defects, when all birth defects are considered. It is not possible for the conclusion of the McLeod Report to be reconciled with the results shown in the chart.

The results are certainly remarkably consistent. They show, however, the opposite of what the McLeod Report claims. They show, with remarkable consistency, that there is an increased risk of birth defects for Vietnam veterans, when all birth defects are considered.

The chart needs a number of corrections. Some studies need to be removed, because they did not test for all birth defects, and therefore have no place in this chart. Some studies need to be added, because there is no excuse for their exclusion from the chart. The figures shown on the chart for the Wolfe study are known to have been falsified. (11) They need to be removed from the chart and the correct figures inserted in their place. Even with its errors included however, the McLeod Report's own chart provides convincing proof that the evidence does not support the conclusions of the McLeod Report.

The chart provides evidence that another assertion made by the McLeod Report is false. The McLeod Report makes the following claim:

The only study of Vietnam veterans to find an excess risk for all birth defects combined was the 1988 Centers for Disease Control (CDC) Vietnam Experience study comparing Vietnam veterans and veterans who did not serve in Vietnam. (12)

The chart clearly shows this claim to be false. Moreover, several studies that have inexplicably been excluded from the chart have also found an increased risk for all birth defects among Vietnam veterans.

The chart provides the clearest evidence yet that the McLeod Report has deliberately set out to mislead. While previous errors and false assertions in the McLeod Report may, on the most generous reading, have been the result of an appalling level of research, no such excuse can be made in this case. The McLeod Report's own chart, which shows that a clear majority of studies have indicated an increased risk, was created by the very same authors who claimed that the studies consistently showed no increased risk.

It is interesting that the chart does not appear in the short version of the McLeod Report: that is, the version that is intended to be read by the New Zealand government, Vietnam veterans and the general public.

As has already been noted, the Blatter study does not belong on the chart. The Blatter study took a group of children born with spina bifida and checked the potential for their fathers to have been exposed to a number of industrial chemicals. (13) It found that the rate of spina bifida increased with the rate of exposure to pesticides. It did not test for all birth defects.

The Erickson study (1984) is included in the McLeod Report's chart for all birth defects. The Erickson study did not test for all birth defects. The Erickson study tested "selected babies with serious structural congenital malformations." (14) In other words, many conditions, which would cause a Vietnam veteran to answer "yes" when asked if any of his children had been born with birth defects, have simply been excluded.

The Erickson study provides a measure of the standard of research in the McLeod Report. Anybody who reads only the summary of the Erickson study would be left with the impression that it was a study of all birth defects. Thorough research of the full Erickson study reveals that it was not. In addition, the Erickson study found that the risk of having a second child born with a birth defect is 2.57 times higher in Vietnam veterans than non-veterans. (15) That information does not appear in the summary of the Erickson study. It can only be found by thorough research. This information does not appear anywhere in the McLeod Report.

The Erickson study (1984) introduces another important issue, overlooked by the McLeod Report, namely deception and malpractice in some of the studies, which appear in the McLeod Report's table. In this study, Erickson claimed a result for "all birth defects", despite the fact that he did not test for all birth defects. He found an increased rate of spina bifida in the children of Vietnam veterans, but claimed this result was not important. Finally, he found that Vietnam veterans were 2.57 times more likely than non veterans to have a second child with birth defects, and he did not even report that result. (16) That is a remarkable triple deception in a single study.

The Erickson study actually found that the rate of spina bifida increased with the father's score on an Agent Orange exposure index. In other words, those fathers more likely to have been exposed to Agent Orange had a higher risk of fathering a child with spina bifida. The same applied to cleft lip, with or without cleft palate. Fathers with higher exposure ratings also had higher risks for fathering babies with tumours classified as "other neoplasms," including teratomas, neuroblastomas, hamartomas, dermoid cysts, lipomas, central nervous system tumours, Wilms tumour, and miscellaneous benign tumours. (17)

Here is what the Erickson study reported:

The most important conclusion to be drawn from this study is that the data collected contain no evidence to indicate that Vietnam veterans have had a greater risk than other men for fathering babies with defects when all types of serious structural birth defects are combined. (18)

The McLeod Report makes no comment on the discrepancy between what the Erickson study actually found and what it reported. This is a significant omission.

The records of 4,002 abnormal births in Saigon Children's Hospital from 1959 to 1968 show a sudden rise in two forms of defect after the start of heavy spraying in 1966. These are cleft palate and a spinal deformity known as spina bifida. (19)

The source of the story was Dr. Matthew S. Meselson, Professor of Biology at Harvard University. The Erickson study found an increased rate of the same birth defects in the children of exposed Vietnam veterans, with the rate increasing with the level of exposure. That is what Erickson should have reported as "the most important conclusion to be drawn from this study." Instead, Erickson chose to bury the cleft lip and spina bifida information in the detail of his report. He completely failed to note the similarity with the results of the Meselson study. He failed to report his finding that Vietnam veterans were at a greater risk of fathering a second child with birth defects. He chose to publicize only the finding that there was no increase in all birth defects.

Erickson himself stated at a congressional hearing in 1997 that:

it was interesting that both CDC studies had some potentially suggestive, albeit highly equivocal, findings relative to spina bifida. (20)

This belated acknowledgement by Erickson of the significance of his spina bifida findings came only after congressional inquiries had uncovered serious misconduct involving his studies.

Erickson was still in charge at the CDC when falsification of results and political interference in the CDC studies became the subject of a congressional hearing in the United States House of Representatives on the 11^th of July 1989. The Washington Post reported the testimony of statistician Dennis M. Smith, who had worked on the CDC studies, that:

CDC administration changed the design of studies so often and switched variables so frequently that the results were meaningless. 'Researchers sometimes made up data to fill in gaps in the records', he said, so that 'at one point people lost track of what was true and what was false.' (21)

At the hearing, after questioning Dr. Vernon Houk, Director of the Center for Environmental Health and Injury Control at the CDC, Congressman Weiss commented:

Well, I must say that so far the testimony to me has been shocking. We've heard that the CDC study was at best flawed, and that the CDC did not know how to use military records or didn't want to use them, that its estimation of the half life of dioxin was based on assumptions which may not be valid and that CDC has downplayed or disregarded highly significant health findings regarding Vietnam veterans. Perhaps worst of all, the documents and the testimony show that it was politicians at the White House, and not CDC scientists, who canceled the study. (22)

Dr. Philip Landrigan, Director of the Division of Environmental and Occupational Medicine at Mount Sinai School of Medicine, New York, testified:

It's clear that something went very wrong down there in regard to this study whatever the motives. As numerous witnesses have said before me, I believe science was ill-served and I believe the American veterans who served in Vietnam were ill-served by the series of events that took place at CDC. (23)

The "series of events" to which Dr. Landrigan refers include political interference from the White House Office of Management and Budget (OMB), whose officials, possessing no scientific qualifications, "interfered with and second-guessed the professional judgements of agency scientists and multidisciplinary panels of outside peer review experts." (24) The Zumwalt Report found several examples of political interference in the CDC studies. Each of these interventions was aimed at diluting the studies, so that they would be unable to produce any meaningful results. Admiral Zumwalt explained:

This "dilution effect" is considered the classic flaw in epidemiological study design. Most epidemiologists would try to optimize the chances of observing an effect by including, rather than excluding, the subjects who are most likely to have been exposed to the suspected disease causing agent. This statistical ability to observe an effect if one is present is generally referred to as the "statistical power" of a given study.

When the CDC chose to generalize exposure to Agent Orange to groups of veterans who were less likely, rather than more likely, to be exposed, the power of the study was diluted. (25)

It should be noted that there was no party politics in this criticism of political interference. Admiral Zumwalt was reporting to Mr. Ed Derwinski, Secretary for Veterans Affairs in the Republican administration of George Bush Senior. The political interference in the CDC studies came from another Republican administration, that of Ronald Reagan.

Perhaps the most inexplicable exclusion from the McLeod Report's chart is the comprehensive survey of the health of Australian Vietnam veterans and their children, conducted for the Department of Veterans Affairs by the Australian Institute of Health and Welfare (the AIHW study). This study concluded, "the reported number of abnormalities is considerably above expected for all abnormalities. This is a very disturbing finding." (26)

Also excluded is Michalek, Rahe, et al, (1998). This is a Ranch Hand study, which compared the rate of birth defects among the children of Ranch Hand personnel born before and after their service in Vietnam. The rate in children born after Vietnam service was found to be more than double the rate of those born before Vietnam service. (27)

The study released by Richard Albanese in 1988 compared the rate of all birth defects in Ranch Hand veterans with the comparison group, before and after Vietnam service. Children born to Ranch Hand veterans before they served in Vietnam had 15% fewer birth defects than the children of the comparison group. Children born to Ranch Hand veterans after they served in Vietnam had 39% more birth defects than the comparison group. (28)

The figures quoted by the McLeod Report for the study named in the table as "Wolfe" are not correct. As the authors of the McLeod Report must surely know, or could easily have discovered, a United States congressional inquiry heard evidence that those figures had been falsified. (29) The real figure contained in the Wolfe study report is 1.5. That is, a 50% increase in the risk of birth defects in the Ranch Hand veterans compared with the comparison group. (30)

In 1979, the United States Air Force began a 25-year study of the health of the veterans who had participated in Operation Ranch Hand during the Vietnam War. These were the men who had loaded herbicides onto the aircraft, flown the herbicide missions, and unloaded and cleaned the aircraft after the missions. With only a year to go until the scheduled completion of the Ranch Hand study, approximately two hundred million US dollars have been spent on the project. All funding has been provided by US taxpayers, and allocated by the Congress.

The Ranch Hand study gathered figures on birth defects in 1984. It did not report them until 1992. The following figures appear in the 1992 report, under the heading:

Table 1-16

Baseline Counts of Reported Live Births by Reported Defect, Time of Birth Relative to the Father's Duty in SEA and the Father's Group Membership. (31)

The figures show that, prior to service in Vietnam, the Ranch Hand group suffered 78 birth defects from 1487 live births. That is a rate of 52.4 per 1000 births. The comparison group had 80 birth defects from 1258 births, or 63.6 per 1000 births. The ratio of birth defects between Ranch Hand veterans and the comparison group was 0.815. In other words, the Ranch Hand group had nearly 20% fewer birth defects among children born before Vietnam service.

In children born since Vietnam service, the Ranch Hand group suffered 76 birth defects from 833 births. That is 91.2 per 1000, an increase of 74% compared with those born before Vietnam service. The comparison group suffered 44 birth defects from 682 births. That is 64.5 per 1000, or only a 1% increase compared with pre-Vietnam births.

The ratio of birth defects in the Ranch Hand group compared with the comparison group was 1.456, which rounds up to a 50% increased risk of birth defects for the Ranch Hand group for children born after Vietnam service.

That figure does not appear anywhere in the executive summary of the study. Nor does it appear anywhere in the McLeod Report. This leads to the conclusion that the authors of the McLeod Report, who claim to have conducted a comprehensive and critical analysis, have only read the executive summary, not the whole study.

The March 2000 congressional inquiry into the Ranch Hand study heard startling evidence about falsification of figures, and interference by senior Air Force officers in the work of the study. Some of the most serious evidence came from Dr. Richard Albanese, a senior medical researcher in the United States Air Force. Dr. Albanese had been a principal investigator on the Ranch Hand study from 1978 until 1984. He reported to the inquiry that the Ranch Hand study had found a 50% increase in birth defects in the Ranch Hand veterans compared with their control group, but that this figure had been suppressed. The Inquiry chairman asked Dr. Albanese to explain how this was done. Dr. Albanese replied:

Yes, sir. When you compare the Ranch Hand sprayers with their control group, there's a more than 50 percent excess in the group that has sprayed. Now that birth defects excess, using current analytical techniques, does not regress linearly on dioxin. But that group difference exists. I am one of four authors of that protocol. The purpose of this study was to determine whether Agent Orange is associated with problems. There's also a portion in the protocol which says we're concerned about the Vietnam experience. We have sitting on the table a greater than 50 percent increase in the birth defects. And because it doesn't have a linear regression with dioxin, which is not the only dangerous contaminant in Agent Orange, we've ruled it out. (32)

What Dr. Albanese is saying is that, faced with an extraordinarily high and politically sensitive number of birth defects in the Ranch Hand veterans, the Ranch Hand researchers looked for ways to hide this information, in clear breach of the study protocol. They decided to divide the Ranch Hand veterans into three sub-groups, according to the level of dioxin in their blood. The study protocol, passed by Congress in order to allocate funding to the study, and therefore a legal document, gave them no authority to do this.

In a further breach of the study protocol, the study leaders dispersed the birth defects statistics from the Ranch Hand group into the three subgroups. Each subgroup was compared with the total number of birth defects in the comparison group. The comparison group was not subdivided.

The greatest number of birth defects was found in the medium category. This is what Dr. Albanese meant when he referred to a linear regression. A linear regression to dioxin, according to the Ranch Hand researchers, could only be demonstrated if the highest number of birth defects was found in the sub-group with the highest dioxin level.

The study leaders used this lack of a linear regression, obtained by breaching the study protocol, as a reason to change their method of reporting. Instead of reporting their findings on birth defect numbers, they now only reported the link between dioxin levels and birth defects. They were able to report that there was no significant dioxin-related increase in the birth defect rate in the Ranch Hand group. Thus a 50% increase in the rate of birth defects was effectively hidden.

Dr. Albanese was one of the authors of the protocols for the Ranch Hand Study. He testified that to fail to report an increase in birth defects simply because it did not have a linear regression with dioxin was strictly against the protocol. This was a clear case of falsification of the results of the Ranch Hand study.

Dr. Albanese was asked to comment on the level of confidence that could be placed in the increased birth defects rate found in the Ranch Hand veterans. He told the inquiry:

I think it's beyond a reasonable doubt that there is a birth defects excess in the Ranch Hand group. I think the preponderance of the evidence is that there has been an excess of cancer. I think it's beyond a reasonable doubt that there are some neurological effects. And I think there's a preponderance of the evidence that there are endocrinological effects in the Ranch Hand group. (33)

The choice of words is important. The chairman of the subcommittee was looking for guidance regarding the level of proof that should be sufficient for the Department of Veterans Affairs to be satisfied that it should provide benefits to veterans or their children for Agent Orange related illnesses. Dr. Albanese replied by stating the results of the Ranch Hand study in terms of the highest possible level of proof, "beyond reasonable doubt."

The McLeod Report sums up the Ranch Hand study results as follows:

The authors concluded that the results provide 'no definitive evidence that paternal dioxin exposure causes birth defects or any of the other adverse reproductive outcomes' studied. (34)

This is an outrageously misleading conclusion to draw from a study that clearly found an extraordinarily high level of birth defects in the children of the Ranch Hand veterans. The Agent Orange Scientific Task Force found:

a statistically significant increase in reported birth defects in the Ranch Hand group. Defects reported in the Ranch Hand group included skin defects, neural tube defects, heart defects, oral clefts, and kidney defects. (35)

The authors of the McLeod Report claim to have conducted a critical analysis of the epidemiological studies, including the Ranch Hand study. However, nowhere in the McLeod Report is there any mention of the key finding of the Ranch Hand study, that the children of Ranch Hand veterans have an increased incidence of all birth defects. Failure to report this key finding can only be interpreted as a misrepresentation of the Ranch Hand results.

The McLeod Report's ignorance of the Ranch Hand congressional inquiry is all the more inexplicable, since the longer version of the McLeod Report lists, among experts it has consulted, Dr. David Butler, of the US National Academy of Sciences, Institute of Medicine. (36) Dr. Butler gave evidence at the inquiry. (37) It is not likely that Dr. Butler has forgotten his appearance at the inquiry. His unwillingness to answer the simplest of questions prompted the inquiry's leader, Congressman Christopher Shays, to exclaim:

I am going to ask it again and we will have a long time here, because it is really a simple question and it is a waste of time for you to be here if you are not going to answer basic simple questions. It is a yes or no. (38)

The United States General Accounting Office (GAO) produced a scathing report on the operation of the Ranch Hand study in December 1999. Aside from its criticisms however, the GAO found that there had been one positive outcome from the Ranch Hand study after 20 years and 150 million United States dollars. The Ranch Hand figures had contributed to a decision by the Department of Veterans Affairs to allow compensation to children of Vietnam veterans born with spina bifida. (39) The McLeod Report's analysis of the Ranch Hand study does not even mention spina bifida.

Members of the congressional inquiry into the Ranch Hand study expressed concern over certain aspects of its methodology. Firstly, there was concern over the very suggestion that Air Force veterans who had taken part in Operation Ranch Hand could possibly be considered to have been a suitable group for a study of this kind. After all, it is simple common sense that those who flew above the herbicide spray could not possibly be a model for the health problems suffered by those who lived and worked on the ground below the spray. (40) Secondly, although the aim of the exercise is to determine whether the health of Vietnam veterans and their children is different from that of the general population, the Ranch Hand study actually compares one group of Vietnam veterans with another group of Vietnam veterans. (41) The comparison group in the Ranch Hand study is a group of US Air Force veterans who served in Southeast Asia, including Vietnam, but were not employed on Operation Ranch Hand. This is obviously a flawed methodology.

3.3.8.6. Conflict of interest concerns in Ranch Hand study

Vietnam veterans, and the funding authorities for this project in the US congress, have always held serious concerns about the suitability of the Ranch Hand study being in the hands of the US Air Force. The congressional inquiry expressed the same concerns. (42)

The Ranch Hand study has serious implications for the US Air Force. If the study finds that Ranch Hand veterans have a greater incidence of health problems, or a greater risk of fathering children with birth defects, then the Air Force will be forced to admit that it poisoned its own army, the armies of its allies, and the people of Vietnam. That hardly makes the Air Force a suitable body to conduct the study. The way the Air Force falsified the birth defects figures only adds to this concern.

It is extraordinary that the McLeod Report's analysis of the Ranch Hand study has completely failed to mention the falsification of figures, methodology and conflict of interest concerns, which so outraged American authorities that a congressional inquiry was ordered. The McLeod Report also fails to mention the high incidence of birth defects found in the Ranch Hand study, or the fact that the Ranch Hand study contributed to US DVA recognition of a link between Vietnam service and spina bifida. Another notable omission from the McLeod Report is an acknowledgment that its analysis of the Ranch Hand study is out of step with the Agent Orange Scientific Task Force.

The McLeod Report's table displays two figures for CDC studies. The first is labeled as "CDC: Self-report", the second as "CDC: validated". The first has a figure of 1.3 (30% more birth defects in the Vietnam veteran group). The second has a figure of 1.0 (no difference in the birth defect rates between Vietnam veterans and controls). This labeling of the two studies gives the impression that the second study is a validation, and therefore a more credible version, of the first. This is simply false. The second CDC study is an entirely different study, on a different subject group, with completely different methodology. (43) The first study compared more than 7,000 Vietnam veterans with a similar number of non-veterans. The second study analysed a subset, not of veterans, but of approximately 1,000 children, from the first study. (44) The CDC group gives no indication of the criteria used for selecting out children from the first study.

Clearly, a comparison of Vietnam veterans and non-veterans and the number of their children born with birth defects is completely different from a study that works backwards from a selected group of children to their fathers. For example, a Vietnam veteran who has fathered three children with birth defects would have considerable statistical weight in the first study. In the second study, one, two or three of his children could be selected out. Those who remained in the second study would be counted as individual children with birth defects, each with a single Vietnam veteran father. Thus the Vietnam veteran father with multiple children born with birth defects loses his statistical weight. This is an example of dilution of a study, something with which a US congressional inquiry found Erickson and the CDC to be all too familiar. (45)

For the McLeod Report to label this second CDC study as a validation of the first is breathtakingly misleading.

There is a hint of "Orientalism" in the McLeod Report's treatment of Vietnamese studies, when compared with its treatment of American studies. Orientalism is a term coined by Edward Said in his book of the same name. (46) It refers to Eurocentric assumptions of superiority over Asian nations and peoples. The McLeod Report appears to assume that a study conducted by medical scientists in an Asian country, especially a communist country such as Vietnam, could not possibly have the same validity as a similar study in an economically advanced nation such as the United States. This bias is not a provable fact. It is only a perception. It is, however, a perception the McLeod Report brings upon itself by its apparent willingness to dismiss Vietnamese studies, (47) while at the same time accepting falsified American studies without criticism.