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The physician and national security.

The Physician and National Security

The appropriate extent of political activism by physicians is controversial. Public health threats, including environmental pollution, seat belt use, occupational health hazards, or social violence such as child abuse have often been considered to require political involvement of physicians. Similarly, the work of physicians in the prevention of nuclear war has been justified within the context of the "public health model." Nuclear war would be "the final epidemic" for which there could be no efficacious medical response; use of nuclear weapons, therefore, must be prevented. The activities of Physicians for Social Responsibility (PSR) have focused a lively debate on the extent of medical authority and responsibility in the arena of national security.

In the early 1980s, PSR achieved a great deal of visibility through its public symposia and publications describing the medical effects of nuclear weapons explosions. As a response to the then new Reagan Administration's commitment to building newer and more destabilizing nuclear weapon systems and its disconcerting rhetoric about the Soviet Union, PSR's efforts vividly brought the reality of nuclear war and its unsurvivability home to the public. Public education on the nuclear issue from 1980-85 by PSR and other organizations helped to shift public opinion drastically: A majority of Americans no longer believe that nuclear war can be survived or that systems of self-defense provide effective protection, but instead see the threat of nuclear war as real and the promise of the Strategic Defense Initiative ("Star Wars") as illusory.

Though relations between the superpowers have improved considerably since the early part of the decade, long-term professional, moral, and policy challenges continue to inform the work of PSR. While the recently-signed INF agreement is a symbolically important first step toward reductions in nuclear weapons arsenals, it has not appreciably decreased the threat of nuclear war: More weapons have been produced since the treaty was first initialed in December 1987 than will be dismantled in the entire three years of its implementation. PSR, now the tenth largest national medical organization with 45,000 members and supporters, remains involved in the quest for weapons reduction, because without active public pressure nuclear arsenals will continue to grow.

The organization intends to move beyond "diagnosis" of what would happen in the event of nuclear war to "prescription" of what citizens and informed professionals can do to urge government to reduce the threat of nuclear war. At a practical level, it has sponsored a growing number of exchange visits of Soviet and American physicians and medical students to increase professional dialogue on the nuclear issue as well as to lay the groundwork for better understanding between the two countries.

The most important concrete policy step envisioned by PSR is a comprehensive nuclear test ban. Members of 155 PSR chapters in the U.S. are joining with other physicians' groups worldwide in protesting continued testing of nuclear weapons by the U.S. and the U.S.S.R.

Philosophically, PSR is committed to a positive conception of "national security" that depends as much upon the economic productivity and health of the American people as it does upon military hardware. The responsible use of scientific and economic resources will continue to be addressed by PSR physicians in the years to come as the organization seeks to meet the ongoing need for education about the threat of nuclear war and to cultivate the role of responsible professional activism by physicians and health professionals.
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Author:Cassel, Christine K.
Publication:The Hastings Center Report
Date:Dec 1, 1988
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