]]]]]]]]]]]] INTERNATIONAL PHYSICIAMS FOR [[[[[[[[[[[[[ THE PREVENTION OF NUCLEAR WAR: MESSIAHS OF THE NUCLEAR AGE? (12/14/1988) From THE LANCET (British medical journal), 18 Nov. 1988, pp.1185-6 By Jane M. Orient, MD [Freeman 85716ORIE] Leaders of the Nobel Peace Prize winning group International Physicians for the Prevention of Nuclear War (IPPNW) claim that their struggle against the nuclear threat may be "one of the significant contributions of our profession to the survival of humankind" (1). Citing their "unique knowledge and expertise" as qualifications for working for the abolition of nuclear weapons, IPPNW urges physicians to educate the public about nuclear war and to offer sound prescriptions for nuclear war prevention (1). In science, good intentions and noble sentiments do not exempt one's work from critical scrutiny. Because the advocacy of IPPNW is cloaked in scientific authority, it should be (but rarely is) subjected to the usual rigors of scientific criticism. IPPNW has indeed played a major role in educating the public about nuclear war, and consequently in gaining widespread acceptance of fallacious beliefs, some of which are repeated in the Lancet (1). For example, Lown speaks of nuclear winter as a "discovery" rather than as a hypothesis. IPPNW has pointedly ignored the criticism (2-5) of the original nuclear winter report, as well as the later, more sophisticated studies that have debunked the doomsday scenario, while not ruling out the possibility of some climatic effects (6), of which drought may be the most important (7). In referring to the Chernobyl disaster, Lown states that the odds of a meltdown were estimated to be 1 in 10,000 years, according to Soviet Life. (A mere meltdown would have been a trivial event in comparison with the graphite-fueled fire that actually occurred.) Yet American engineers recognized the danger of reactors with a positive void coefficient (like the Chernobyl reactor) as early as 1950 (8). Why did the Soviets choose an unsafe design for a reactor built quite recently? One possible explanation is that such reactors can be refueled while in operation, permitting the production of weapons-grade plutonium as a byproduct (9). At the time of the Chernobyl disaster, Soviet civil defense proved its worth as a means of saving lives, even though it was designed for a nuclear attack rather than a reactor accident. Engineers were safe in the bomb shelter while they shut down the other reactors at the site, although the outside radiation dose was up to 1000 rads per hour (10). Within 12 hours, 3000 physicians and 2400 nurses, paramedical personnel, and laboratory technicians had been transported from as far away as Moscow (11). Eventually, more than 135,000 citizens were evacuated from the surrounding area (12). The lesson drawn from the experience in the Soviet Union is that civil defense needs to be improved, especially in the area of population training (10). In the United States, on the other hand, civil defense often is what Lown calls "a butt for social satire" (1), largely because of the efforts of his own organization. The assertion that civil defense might "foster illusions but would not mitigate any of the dreadful consequences" (1) is in conflict with the data. Blast and fallout shelters have been extensively tested and proven effective (13-14). The Swiss, the Soviets, the Chinese, and the Swedes have constructed shelters on a massive scale. Spokesmen for IPPNW and Physicians for Social Responsibility do not discuss the shelter tests, but simply dismiss the concept, citing the experience of the Hamburg firestorm of 1943 as "proof" of the futility of shelters (15- 18), even though 85% of the population in the firestorm area survived, including most persons who were in minimally adequate bomb shelters (19-21). While predicting a high likelihood that nuclear war will occur (a 40% probability over the expected lifespan of today's young people (1),) IPPNW continues to promote a policy of defenselessness. This would assure the maximum number of casualties in the Western world, should IPPNW fail in its noble efforts to prevent war. (In the Soviet bloc, there is no evidence that IPPNW's ridicule of civil defense has hindered the program to the slightest degree.) IPPNW's "sound prescriptions" (by its own assessment) are all related to prevention of war through arms control. Unfortunately, the efficacy of such remedies is a matter of faith. Unlike a new drug or surgical procedure, they are not the subject of research. A study of the historical record gives little cause for optimism; however, history is apparently not among the areas of expertise claimed by IPPNW. Its spokesmen have yet to comment on the Washington Naval Treaty of 1922, the Kellogg-Briand Pact of 1928 (for which Kellogg and Briand received the Nobel Peace Prize), the Oxford Peace Resolution of 1934, the Munich Agreement of 1938, or the Molotov-Ribbentrop Pact of 1939, and on the effectiveness of these measures in preventing World War II. Nor does IPPNW acknowledge the fact that their current prescription, the cessation of all nuclear explosions (1), was tried in late 1958, and lasted until the Soviet Union surprised the U.S. with an extensive, well-planned series of tests, even as a formal treaty was being negotiated (8). Like their prescriptions, the rationale given by IPPNW has a historical precedent. Sir Norman Angell (also a Nobel Peace Prize winner), in his 1910 best-seller entitled The Great Illusion, showed that war had become so terrible and expensive as to be unthinkable. The concept of "destruction before detonation" was not discovered by Victor Sidel (22), but was previously enunciated by Neville Chamberlain, who warned his Cabinet about the heavy bills for armaments: "even the present Programmes were placing a heavy strain upon our resources" (23). IPPNW does not represent a consensus among physicians. Most physicians recognize that their medical skills do not necessarily qualify them as experts in nuclear weapons effects, climate modeling, reactor safety, and diplomacy. Furthermore, even those who agree with IPPNW about the desirability of arms control treaties might question the antidefense part of the prescription. Psychic numbing, denial, and "missile envy" (24) are some of the diagnoses applied by IPPNW members to those who differ with them. However, for the threats facing the world, IPPNW does not entertain a differential diagnosis, nor admit the slightest doubt about the efficacy of their prescription, if only the world will follow it. So certain are they of their ability to save us from war that these physicians seem willing to bet the lives of millions who might be saved by defensive measures if a nuclear attack is ever launched. Is this an omnipotence fantasy? REFERENCES 1. Lown B. Looking back, seeing ahead. Lancet 1988;ii:203- 204. 2. Penner JE. Uncertainties in the smoke source term for "nuclear winter" studies. Nature 1986;324:222-226. 3. Seitz R. Siberian fire as "nuclear winter" guide. Nature 1986;323:116-117. 4. Seitz R. In from the cold: "nuclear winter" melts down. National Interest 1986;2(1):3-17. 5. Chester CV, Kornegay FC, Perry AM. A preliminary review of the TTAPS nuclear winter scenario. Oak Ridge, TN: Oak Ridge National Laboratory, 1984 (ORNL/TM-9223). 6. Thompson SL, Schneider SH. Nuclear winter reappraised. Foreign Affairs 1986;64:981-1005. 7. Chester CV, Perry AM, Hobbs BF. Nuclear winter: implications for civil defense. Presented at the annual meeting of The American Civil Defense Association, Mobile, AL, November 8, 1987. 8. Teller E. Better a shield than a sword: perspectives on defense and technology. New York: Free Press, 1987. 9. Cohen BL: The nuclear reactor accident at Chernobyl, USSR. Am J Phys 1987;55:1076-1083. 10. Goure L. Comparison of Soviet and United States civil defense programs. Presented at the National Emergency Training Center, Professional Development Series Capstone Seminar, Emmitsburg, MD, May 17, 1988. 11. Lushbaugh CC. What we have learned from Chernobyl. West J Med 1988;148:76-77. 12. Wilson R. A visit to Chernobyl. Science 1987;236:1636- 1640. 13. Beck C (ed). Nuclear weapons effects tests of blast type shelters--a documentary compendium of test reports. Washington, DC, US Atomic Energy Commission, June 1969 (CEX- 68.3). 14. Chester, CV, Zimmerman, GP. Civil Defense Shelters: a State-of-the-Art Assessment -- 1986. Washington, DC, National Technical Information Service, 1987 (ORNL-6252). 15. Ervin FR, Glazier JB, Aronow S. et al. I. Human and ecologic effects in Massachusetts of an assumed thermonuclear attack on the United States. N Engl J Med 1962;266:1127-1137. 16. Leaf A. New perspectives on the medical consequences of nuclear war. N Engl J Med 1986;315:905-912. 17. Geiger HJ. Illusion of survival. In: Adams A and Cullen S, eds. The final epidemic: physicians and scientists on nuclear war. Chicago: Educational Foundation for Nuclear Science, 1981:173-181. 18. Leaning J: Star Wars revives civil defense. Bulletin of the Atomic Scientists 1987 (May);vol 43(4):42-46. 19. US Strategic Bombing Survey, No. 154: Public Air Raid Shelters in Germany. 20. Earp KA: Deaths from Fire in Large Scale Air Attack -- with Special Reference to the Hamburg Fire Storm. Whitehall, Home Office Scientific Advisory Branch (Report CD/SA 28), April, 1953. 21. Kehrl: Bericht des Polizeiprsidenten in Hamburg als rtlicher Luftschutzleiter ber die schweren Grossluftangriffe auf Hamburg im Juli/August 1943. Hamburg, Dec 1, 1943. 22. Sidel VW. Destruction before detonation: the impact of the arms race on health and health care. Lancet 1985;ii:1287- 1289. 23. Minutes of the British Cabinet meeting, February 3, 1937. Quoted in Fuchser, LW. Neville Chamberlain and Appeasement: a Study in the Politics of History. WW Norton, New York, 1982. 24. Caldicott H. Missile envy: the arms race and nuclear war. New York: William Morrow, 1984. Jane M. Orient, MD 1601 N. Tucson Blvd. Suite 9 Tucson, AZ 85716 USA * * *
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