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Source: JAMA, The Journal of the American Medical Association, Jan 6, 1999
v281 i1 p36(1).

Title: Abolishing Nuclear Weapons.(Letter to the Editor)
Author: David W. Fouts and Bernard Lown

Full Text COPYRIGHT 1999 American Medical Association. All Rights Reserved.

To the Editor While it is important to condemn the irresponsible behavior of Pakistani and Indian leaders for testing nuclear weapons, thereby increasing the risk of nuclear war, as Dr Lown and colleagues [1] point out, the real blame for this unhappy state of affairs rests squarely on the shoulders of the United States and the other nations with nuclear weapons Over the last 50 years, these nations have sent the world mixed messages For instance, the United States has promoted nuclear abstinence for others while continuing its own unilateral nuclear arms race, even 7 years after the end of the Cold War The prestige and power associated with possessing nuclear weapons have not gone unnoticed by other countries.

As the one world superpower and the first country to develop and use nuclear weapons, the United States should take the lead in bringing them under control before their distribution becomes even more widespread In his recent book, Jonathan Schell [2] records interviews with civilian leaders, scientists, and retired high-level military officers from the United States, Russia, and Europe who are convinced that the time is ripe for the world to eliminate nuclear weapons If this opportunity is missed, it is likely that these terrible weapons will eventually be possessed by "rogue" states and terrorist groups who could and likely would use them to cause destruction beyond imagination The United States is not exempt from this threat We have only to consider the World Trade Center and Oklahoma City bombings to get an idea how this might happen

As guardians of the health of society, physicians can support the process of nuclear weapon abolition by speaking out to their friends, patients, and congressional representatives Saving the world from nuclear destruction should be our number one public health priority

David W Fouts, MD

Lutherville, Md

1. Lown B, Chazov El, Foege WH, UI-Majeed 5, Reddy RJ An appeal for nuclear sanity an open letter to Prime Minister Atal Behari Vajpayee of India, Prime Minister Nawaz Sharif of India JAMA 1998,280 467

2. Schell J The Gift of Time The Case for Abolishing Nuclear Weapons New York, NY Henry Holt, 1998

In Reply Nuclear weapons are instruments of genocide Their possession is a crime against humanity No reason of state can ever justify their use, which would inflict indiscriminate mass murder, injure generations yet unborn, and despoil an already degraded environment We have defeated Hitler, yet have succumbed to his vicious philosophy In going nuclear, India and Pakistan have extended the reach of barbarism.

Dr Fouts is completely on target. The nidus of the pathology is among the permanent members of the UN Security Council and especially in Washington, DC, which has initiated and been a key player in shaping the atomic age. The concept of nonproliferation was flawed from the outset. The superpowers retained the right to keep testing and modernizing weapons notwithstanding their huge arsenals and their qualitative and quantitative dominance. At the same time, the nonweapons states were expected permanently to forswear any intent of acquiring nuclear military capabilities. Such a double standard could not be permanently enforced. The options were 2 either eradicate the malignant virus, nuclearism, or witness its spread. The events in South Asia confirm the bankruptcy of nuclear apartheid policies.

From the vantage point of our long-range national security, nuclear weapons offer nothing except a dire threat. With the United States the strongest nation on earth by every conceivable military, economic, and scientific measure, legitimization of nuclear weapons detracts rather than bolsters our safety. They are potential equalizers, enabling the weak to inflict unacceptable damage on the strong. Nuclear know-how is everywhere Terrorists are aware that a nuclear bomb affords the cheapest and biggest hang for the buck "No blackmail would be as compelling as holding an entire city hostage. Few societies are more susceptible to their malevolent consequences than the rich, urbanized, highly developed, industrialized North, foremost the United States. It is already the object of growing global resentment and envy. One may surmise that it will increasingly be the target for terrorist acts.

Physicians for Social Responsibility and the International Physicians for the Prevention of Nuclear War have long argued that nuclear abolition is a "number one public health priority" Political leaders respond not to historic imperatives but to the clamor of their constituencies. Only an upsurge of public opinion in favor of nuclear abolition will sway Washington to reconsider a flawed, immoral, and dangerous course.

Bernard Lown, MD

Harvard School of Public Health

Brookline, Mass

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