In his confirmation hearings to lead the National Institutes of Health, Jay Bhattacharya pledged his openness to views that might conflict with his own. “Dissent, he said, ”is the very essence of science.” That commitment is now being put to the test. On Monday, scores of scientists at the agency sent their Trump-appointed leader a letter entitled the Bethesda Declaration. It is a frontal challenge to “policies that undermine the NIH mission, waste our public resources, and harm the health of Americans and people across the globe.” It says: "We dissent." In a capital where insiders often insist on anonymity to say such things publicly, more than 90 NIH researchers, program directors, branch chiefs and scientific review officers put their signatures on the letter — and their careers on the line. They went public in the face of a “culture of fear and suppression” that they say President Donald Trump's administration has spread through the federal civil service. “We are compelled to speak up when our leadership prioritizes political momentum over human safety and faithful stewardship of public resources,” the declaration says.