Close to the end of Casey Means’ confirmation hearing to be surgeon general Wednesday, Sen. Ed Markey, D-Mass., finally brought up the elephant in the room.

“Do you agree with the scientific research that glyphosate … is harmful to humans?” he asked Means, who has said farmers must move away from use of synthetic pesticides and toward more sustainable practices.

The question kicked off a brief back-and-forth between Markey and Means. Markey tried to get Means to condemn glyphosate, the active ingredient in Roundup, as cancer-causing. Instead, Means echoed Health and Human Services Secretary Robert F. Kennedy Jr.’s recent statement that suddenly removing glyphosate from farmers’ toolboxes would be a bad move.

Kennedy’s statement focused on the Feb. 18 executive order from President Donald Trump prompted heavy criticism from the Make America Healthy Again movement, with which Means, her brother Calley, now a White House adviser, and Kennedy are all closely associated.

“I certainly have significant concerns about many of the environmental chemicals used in our agriculture system [including] glyphosate,” Means said. “I think they need to be significantly more robustly studied so that we can understand the cumulative impact on health, and that’s a passion of mine.”

"My understanding of the executive order is the thrust of this has to do with national security," she said.  

“Our food system is dependent currently on these chemicals,” she said. However, in the Trump administration, “There is a good-faith movement toward moving our food system towards regenerative agriculture and precision application of pesticides.”

“I think there’s grave issues with these chemicals,” Means said. “We are in a very complicated moment for agriculture and food. We cannot overturn the entire agriculture system overnight; that would hurt farmers, it would hurt food prices.”

“I’m disappointed to see you back away from your efforts,” said Markey, who said he shared Means’ concerns about pesticides.

“I am not in any way backing away from this issue,” Means said sharply. “It is a core passion of my life.”

“We must as a country move away from using toxic inputs in our food supply, and we must study these chemicals more to understand their effects. I am very gravely concerned about the health impacts of these chemicals,” she said.

Means, a physician who is not currently practicing, parried many questions about specific vaccines and insisted patients should have “informed consent” with their doctor before getting any medication. Her written testimony does not mention vaccines.

She graduated from Stanford Medical School but left her surgical residency and started up a metabolic health company, Levels, which also was the subject of questions from Democrats on the panel.