material-deontologia-biologica-capitulo25

Biological Ethics

Table of contents

Chapter 25. research for military purposes

N. López Moratalla and A. Monge

a) Introduction

The application of scientific knowledge to the war industry in recent years, with the consequent participation in the degree program of armaments, raises once again the serious question that the freedom of research cannot be separated from the responsibility that comes with the use of discoveries. The meaning and value of technology lies in its service to mankind, and in no way can it be presented as a service to mankind, as a search for a guarantee of peace, that unbridled degree program whose scope has exceeded the means and dimensions of struggle and destruction as never before. It is an undeniable fact that war has become more cruel with technical advances.

The magnitude of the human and material resources employed - researchers, raw materials, expenditure and land extension, and the production of ever more numerous, powerful or complex weapons - are evidence of a continuous preparation for war; and being prepared means being in a position to provoke it. The armament process makes no sense or justification, both in terms of the threat of destruction and the use of absolutely disproportionate resources for this purpose, which could and should be used in solidarity to solve pressing problems in undeveloped countries, and for promote for more humane living conditions.

Nations have the right to just defence; however, when war causes enormous and indiscriminate destruction, it is a sign that the limits of self-defence have been exceeded. After the magnitude of the disasters caused by the two world wars, and especially since the appearance of "scientific weapons" - nuclear, chemical and biological - with such an intense destructive capacity, it is necessary to show that there is no good whose defence legitimises the employment of these means, which have also been produced in disproportionate quantities. It is clear, therefore, that, if manufacturing must cease, the continuation of the research used for this purpose would not be licit; we will see some special conditions below. The ethical orientation is clear: the goal should be a general peace and the proscription of all war as a consequence of a universal respect for human rights. However, it is not easy to solve the serious and grave problem of ensuring that these forces are never used without running the risk of having to give in to the blackmail that could be exercised by those who possess them on those who renounce having or using them. Faced with this dilemma - and because it has an obligation to protect its citizens from unjust aggression - a state cannot be forced to disarm unilaterally; the Withdrawal by some countries to the right to self-defence could mean, in the current status , having to agree later to injustices such as colonisation, deprivation of their freedom, of their identity, etc.

The policy of deterrence is different from a unilateral disarmament approach. This policy, while seeking balance rather than superiority, involves enhancing degree program armament, as it seeks to obtain weapons capable of causing considerably more destruction to the opponent than the benefit that the latter could obtain by attacking first. It is, therefore, a tactic to frighten the other, while at the same time expressing the will not to use them, except in the case of being attacked. However, in today's status , with the serious risk of a global conflict, without serious arms control agreements and without bodies capable of imposing a peaceful settlement to conflicts, deterrence could be tolerable as a lesser evil, as could the research aimed at it. As John Paul II pointed out in his Letter to Scientists of 14 August 1982, "under present conditions, deterrence based on balance, certainly not as an end in itself, but as a step on the road to progressive disarmament, can still be considered morally acceptable". It is obviously one thing to tolerate the threat (with all the nuances of balance and provisionality), and quite another to legitimise the move from threat to action. Given that a nuclear war would never be justifiable, accepting any deterrence subject that would therefore include nuclear deterrence would be an excessively serious risk. Although partial, a solution to the present status should aim at progressive bilateral disarmament: halting the degree program of armaments, reducing what already exists, outlawing atomic weapons until complete disarmament. Progressive steps should be parallel and simultaneous, so that at no time is one side at an advantage over the other; and with effective controls. The latter requires a climate of trust that does not exist. Peace and the guarantee of peace require a change of mentality, leading to the recognition of the dignity of each individual and the essential equality of all; this is the foundation and the path to a solution final. It cannot be reduced to a balance of opposing forces, nor can it arise from despotic rule.

The scientist must take these principles into account in order to make a conscientious decision when he is confronted with the question of his partnership in armament work. On the other hand, in general, the responsibility of scientists in this respect is not a direct one: in other words, they are no more responsible for making decisions in this field than any other citizen who can cast a vote. However, by having access to a more complete picture of what is at stake, they can and should promote provide accurate information. Moreover, the collective effort of scientists is necessary to achieve peace and to ensure that the scientific and technical resources available in today's world are truly at the service of mankind, oriented towards development and not towards destruction.

This is where the above-mentioned reality becomes particularly clear: research, the technical applications of scientific knowledge, are inherently borderless. In itself, the research that leads to the construction of a sophisticated weapon is no different from that which leads, for example, to better equipping a hospital technically or to suppressing an epidemic. The frontiers are not of science but of consciousness.

Positive positions in this sense are those of the 18 physicists of the Göttingen Manifesto, committing themselves to seek exclusively peaceful applications of atomic energy and to work without pressure or governmental directives; or the meeting, in October 1981, of a group of specialist scientists from various countries under the leadership of Carlos Chagas, president of the Pontifical Academy of Sciences, in order to examine the consequences of the employment of nuclear weapons in terms of the survival and health of humanity. (The points discussed and approved were developed in the declaration in the Annex).

b) design and use of chemical and biological weapons

Chemistry When Frederick R. Lidell, a physician at the US Navy's high school Defence Research Chemistry commented on the "First World congress of New Compounds in Chemical and Biological Warfare" held in Ghent in May 1984, saying that it was one third science, one third politics and he failed to find out what the other third was made up of, he was putting the topic of chemical and biological weapons in a very contemporary perspective.

Special weapons, called N.B.C. (Nuclear, Biological and Chemical), began in 1915 at the battle of Ypres. In 1940, when it became known that chemical weapons were being prepared on a massive scale in Germany, a long degree program long research of organophosphorus compounds began, which even led to a certain specialization in some of them, by countries such as the USSR and the USA. The escalation has continued, and the use of defoliants in Vietnam, paralysers in Yemen or mycotoxins in Southeast Asia, are an exponent of the technical progress achieved in this field.

Chemical and biological weapons have always evoked feelings of particular concern among governments, and this explains why enormous efforts have been made to control and regulate them.

The most important of these came into being after the First World War. It is known as protocol Geneva, signed in 1925, which prohibits the use in war of asphyxiating and poisonous gases, liquids and other similar materials and devices. It also prohibits the use of bacteriological methods in warfare. A careful reading of protocol reveals that it does not prohibit the research or development of these weapons; nor does it prohibit their use against an enemy who uses them in the first place, or to settle local conflicts within the same country. Another omission B is the failure to prohibit the use of incendiary weapons such as napalm.

It seems clear that for a society concerned with doing and less with thinking, the Geneva protocol left great possibilities for action. Thus, by not preventing research or experimentation, know-how can be made available at any time, allowing these compounds to be made available to the troops of any country at any time, given their accessibility, as well as the systems for applying them. Moreover, accession to protocol has been slow and has not been ratified by some countries.

The main problem here is that the USSR does not accept verification mechanisms on manufacturing, without which any treaty is a dead letter, as these weapons can be manufactured anywhere outside the reach of espionage systems.

On the other hand, from the 1960s onwards - and mainly as a consequence of the strong impact of new knowledge from Biochemistry , biology and related sciences - there is great potential for military applications in the manufacture of insecticides, herbicides, etc. Such was the case with the defoliating agents used in Vietnam.

The development of analytical and synthetic methods has made it possible to prepare animal and plant toxins, allowing them to be used in warfare without the problems associated with the employment of micro-organisms in so-called bacteriological weapons, such as the appearance of resistance, greater localisation of effects, etc.

The problem began to be seen as extremely serious, and in 1972 the Biological Weapons Convention was concluded, which called for the destruction of stockpiles and clearly took a stand against the research and production of weapons incorporating micro-organisms and toxins. Today, the specialised press reports on the manufacture and use of chemical and biological weapons. Despite the Vietnam denunciations, there followed the yellow rain of Laos, Cambodia and Afghanistan, and then the Soviet Union's worrying installation of troops equipped with chemical weapons on the borders between the two Germanys.

In principle, the concept of a weapon Chemistry includes lethal and incapacitating chemical and biological weapons, as well as anti-plant weapons. With regard to this classification, it is necessary to establish that there is no clear distinction between the lethal and incapacitating character of these weapons, given the conditions in which wars are fought, where there will always be a population for whom all weapons will be lethal due to their physical condition, age, etc.

Chemical weapons

Modern lethal chemical weapons use gases developed in the Second World War by Germany, hundreds of times more poisonous than those used in the First World War. Their effect results from being inhaled or deposited on the skin as droplets. From the evidence now available, it is known that these compounds, which have an organophosphorus structure, act by inhibiting enzymes involved in nerve functions. The enzyme normally affected is acetylcholinesterase which under normal conditions catalyses the hydrolysis of acetylcholine with consequent effects of muscle contractions. The final symptoms correspond to blockages of the central nervous system, with asphyxia and loss of vision. Reactivation of the inhibited enzymes requires phosphorus displacement by nucleophiles, e.g. pyridinium-derived oximes.

The structure Chemistry of the compounds present in these weapons sample makes it clear that any country, nuclear or not, can produce them. If this subject of weapons can be available to any nation, and not the nuclear ones, it is necessary to establish that -according to M.S. Meselson- if we compare the effect of a one megaton atomic bomb with 15 Tm of an organophosphorous agent on unprotected population, the area affected by the first will be 300 km2 and 60 km2 by the second, the time of effectiveness of seconds in the first case and minutes in the weapon Chemistry, the destruction of Structures is total in the first and null in the second. The contaminated area in the first case needs 3 to 6 months to be reused, while in the second case it can be used in a few days or weeks. The effectiveness in deaths is 90% for nuclear weapons and 50% for chemical weapons. In other words, chemical weapons are highly effective and easier to use than nuclear weapons.

More recently, in March 1984, the United Nations proved that Iran had used lethal chemical weapons, according to allegations sent in the first days of that month by the US State Department's department and by a Red Cross committee . A four-person committee was appointed to visit Tehran and the sites of the attacks between 13 and 19 March. During the visit , samples of chemical agents extracted from unexploded weapons were collected and more than 40 hospital patients in Tehran were interviewed. The samples were sent to high school National Defence Research in Umea, Sweden, and to AC Laboratories in Spiez, Switzerland. Both laboratories found Tabun (N,N-dimethyl ethyl phosphoramidate cyanide) which was manufactured in Germany in World War II. And also the so-called Sulphurmostaza (bis-2-chloroethyl sulphide) which is a lethal compound.

A second widely used chemical weapon subject is the so-called incapacitants. To this subject belong the "benzylates", which are manufactured by the US and are solids dispensed in aerosol form to be inhaled. Their effects include loss of vision and mental effects such as loss of report, disorientation and confusion lasting several days. Factors such as age, the physical condition of the sufferers, or effects specific to these compounds (such as severe alterations in water balance), can have consequences beyond what is expected.

The justification for the research of these weapons is to be found in their proposed employment exclusively for the resolution of local conflicts within the countries themselves. This at least was the claim made by US Secretary of State Dean Rusk on 24 March 1965. In the same year 100 MT were used in Vietnam, and in 1969 300 MT were used in Southeast Asia. These subject weapons are used in combination with lethal weapons in order to achieve greater effectiveness.

Biological weapons

Progress in the research of chemical weapons led unfailingly to the use of biological weapons that produce the dissemination of infectious germs over a specific area. These germs are spread by the wind and inhaled indiscriminately by the population. One widely used germ has been Bacillus anthracis. Inhalation of 50,000 spores ensures that 50% of the population acquires anthrax disease. Symptoms appear the next day, and can be mistaken for a cold, which can be fatal. Their effectiveness can be easily deduced by considering that, on low flights, 100 MT dispersed over 100 km contaminate 100,000 km2. Other examples are equine encephalitis and yellow fever viruses, cholera, etc.

Compared to nuclear weapons, in the ratio 1 megaton/10 MT of biological agent, the area affected by biological weapons is 300 times greater. The effectiveness time increases from seconds for nuclear weapons to several days for biological weapons. Unlike nuclear weapons, they do not destroy buildings, but like nuclear weapons, biological weapons can leave areas of contamination for a long time. The mortality rate in men is 50% for nuclear weapons.

As with chemical weapons, incapacitating biological weapons have been developed, which also often have unintended effects beyond what is expected. The use of this weapon subject arises when enemy troops are concentrated in a mixture of civilian or friendly populations. International law does not distinguish between these two types of biological weapons, and neither politicians nor the military are generally in favour of the use of biological weapons, as their effects are highly questionable and public opinion is highly sensitised.

Subsequently, the use of toxins is considered. These are highly toxic compounds produced by living organisms: plants, animals or micro-organisms. And the same attention is proposed for these compounds as for biological weapons, even though the United Nations, for example, considers them to be separate because they do not have the same reproductive capacity as biological weapons.

These compounds are more effective than conventional chemical weapons, do not reproduce and can therefore be better used than biological weapons. It should be noted that the test of their use is more difficult than in the case of chemical weapons, and therefore international agreements on the use of these compounds can be violated. The most frequently used military argument in favour of their use is that because of their high potency, the weight of toxin munitions needed to cover the same area is lower area.

In recent years, toxins produced by the fungus Fusarium have been the most widely used. These compounds correspond to a structure Chemistry of Trichothecenes and are the products used and identified in the so-called yellow rain. Their use by the Vietnamese in Cambodia, by government troops in Laos and by the Soviet Union in Afghanistan is well documented, although the discussion continues as it is difficult to prove that the toxins found in the blood and urine of combatants are of unnatural origin.

The use of these weapons, in principle, violates the 1925 (Genevaprotocol ) and 1972 (Biological Weapons Convention) treaties. The Soviet Union and Vietnam are among the more than 100 nations that have signed the first agreement, but Laos, Campuchea and Afghanistan have not. According to this, technically, the Soviet Union has not violated any agreement as this circumstance occurs only if both parties to the conflict are signatories to the treaty.

Anti-plant agents were first developed in World War II. These compounds were thought to be useful for destroying enemy crops, and their use in particular in the rice fields supplying Japanese soldiers isolated on small islands in the archipelago was very close. The use of these compounds in road clearing is very common, both in military and civilian operations.

The compounds used are called Orange, White and Blue in the USA. Orange is an equimolecular mixture of n-butyl esters of 2,4-dichlorophenoxyacetic acid (2,4-D) and 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), and is mainly used in forests. Recent research - following its use in Vietnam - on the biological effects of this compound has demonstrated its teratogenicity. It should be noted that the "a posteriori" finding of unexpected effects in chemical and biological weapons is not new.

On 6 May 1984, agreement was reached to pay $180 million to veterans of the Vietnam War by seven chemical companies responsible for the production of Agent Orange (Dow Chemical, Diamond Sanrock, Hercules, Monsanto, TH Agriculture and Nutrition, Thompson Chemicals and Uniroyal) with a recommendation by Judge Weinstein that the sale of these agents in the civilian market should be carefully limited. The ruling states that "whether or not knowledge was aware of the side effects on men of this agent, or whether it was an unfortunate accident, or any other circumstance, this nation has an obligation to Vietnam veterans and their families"; the same judge, in October 1984, called this "a major step in an essential process of reconciliation among ourselves".

Blank agent is a mixture of triisopropanolamide salts of 2,4-D and 4-amino-3,4,6-trichloropicolinic acid. The agent is used by spraying its aqueous solution. It is a compound that is very resistant to biodegradation, which is very important when considering the use of these compounds, as it greatly limits their use employment. Finally, Agent Blue is an aqueous solution of sodium dimethylarsenate. It is primarily used to destroy rice crops.

The study of the effects of chemical and biological weapons cannot leave society, let alone the scientists who produce them, unmoved.

For this reason, an urgent appeal to the conscience of scientists has been made. The horror of this weaponry has been preceded by the intense work of laboratories, and just as in many cases science, with its knowledge, claims great advances for the good of humanity, it must also be held responsible for them. The relationship between science and society is becoming ever closer, both because of the ease and speed with which discoveries can be disseminated. Scientists are required to reflect deeply on the consequences of their work work, in order to actively collaborate in ensuring that their professional knowledge is applied to projects that contribute to improving the living conditions of their fellow human beings.

A recent work by Shulman reflects the fears of many biologists that the high level of funding for biological weapons at research is misplacing priorities at research .

The bulk of these biological research funds that the US Defence department . The bulk of these funds - amounting to $73.2 million in 1987 - are directed primarily to development vaccines against exotic and lethal diseases in connection with biological weapons. It has sparked fierce controversy, with critics claiming that the line between offensive and defensive biological weapons is blurred and that increased spending threatens to escalate the degree program of these weapons. Some 4,000 scientists have called for a halt to military research.

c) Ethical mastery of the research warfare

It seems obvious that the status produced by the application of technology to warfare cannot continue to advance in the same direction; if technology is not guided by ethics it is a blind power that threatens and frightens man. Max Born, the founder of the atomic theory, with which a new scientific conception of the universe was elaborated, refers1 to how his generation, which devoted itself to science for science's sake and believed that it would only bring goods, was awakened by world events; "even those who were enjoying a deeper sleep had to wake up when, in August 1945, the first atomic bombs were dropped on Japanese cities.

Since then we have realised that because of the results of our work we are irrevocably involved in the Economics and in politics, in the internal social struggles of countries and in the power struggles between nations, and that all this places a great responsibility on us.

We would like to defend here the view that the atomic bomb was only the last link in a long, foreseeable development , which is now dragging us towards a crisis, possibly a catastrophe final and devastating. The hope of averting it can only be based on an understanding of the path that has led us to the present status ".

The path that Max Born points out, based on his own experience, is a progressive dehumanisation where the decisive factor is not man and life, but the technical superiority, industrial power and inventiveness of the rearguard. "I myself was a tiny part of this machine, as a member of a military unit in Berlin, where I worked, together with other physicists, on the so-called 'phenometricprocedure '. Its purpose was to locate the location of the most important nuclear reactors in the world. Its purpose was to locate enemy batteries by measuring the time it took for the sound of the bomb explosion to reach different observation posts. The precise time-measuring instruments that we requested for the procedure to be effective were refused by higher bodies, because the industry did not have the time, the manpower or the materials for such 'trifles'.... Even then it seemed to me profoundly immoral and inhuman, and I began to understand that in modern warfare it is not heroism but technology that makes the difference guideline ".

But technique is meaningless without ethics. The do's and don'ts must always mark the limit of what can be done. Max Born tells how he became aware of the need for a moral limit; quotation is long, but worthwhile: "Many of my colleagues were involved in the war, including men with very strong ethical convictions. For them, as for Haber, the defence of the fatherland was the first commandment. Even then, I was confronted with a case of conscience. It was not a question of whether gas grenades were more inhumane than shrapnel grenades, but whether poison, which has been regarded since time immemorial as the instrument of the cowardly murderer, could be permitted as a weapon of war, because if no limit was set to what was permitted, everything would soon be lawful. But it was only much later, after Hiroshima, that I began to see clearly. Had this not been the case, the awareness of the scientist's responsibility would have seeped into my teaching activities, and perhaps not so many of my students would have volunteered to collaborate on the atomic bomb.

An event that happened to me in 1933, when I arrived in Cambridge (England) as an émigré, showed me that I was not the only one who harboured such doubts even in the First World War. I was warmly welcomed in Cambridge, but Haber, who despite his already mentioned merits during the First World War had also been forced to emigrate, found a certain civil service examination. Lord Rutherford, the founder of nuclear physics and one of the greatest physicists of our time, refused to accept an invitation to my house together with Haber, as he did not want to shake hands with the inventor of gas warfare.

And yet Rutherford had taken an active part in the technical defence of his country and was by no means a pacifist, but he had set himself a limit, beyond which no means of extermination should be permitted as a weapon. I think he would have justified his argument on the grounds that without a moral limit to the use of weapons it is impossible for there to be a limit to annihilation, with the consequent danger of ending civilised life".

Thus, by not imposing a limit, gas warfare was a moral disaster for mankind, as was the fact that the principle that a state can only fight against the military might of its enemies, but not against a defenceless civilian population, ceased to be valid - as it was until the 19th century - and was no longer respected in the Second World War because of the development of aviation. Two British scientists, Tizard and Lindemann, were the leading figures in the decision on the bombing of cities; Born continues: "Here it was already a question of killing from a distance, without direct intervention staff and therefore without responsibility, i.e. a purely technical war, the 'push-button war. Nuclear weapons have sharpened this development, putting it on display for the whole world to see. Nothing can be blamed on those men who, outside Germany (1939-1945), worked on nuclear fission and its technical and military applications, because the finding of uranium fission came from 'Hitler's Germany', and it was to be expected that the National Socialists would do everything in their power to make a weapon out of it against which there would be no defence. It was therefore necessary to get ahead of the game. And in the face of the need to forge ahead, only the immediate military advantages were considered; and when the satisfaction of demonstrating to the world the power that had been discovered was added to the equation, the ethical limit of self-defence was definitely crossed. Only a true image of man, of his dignity, value and rights, can show that peace is a much greater good than personal or political interests. Hence, the ethical limits that Born speaks of - in themselves insufficient - are valid insofar as they demonstrate a conviction in certain limits: respect for human dignity, human life and human values.

It was precisely the consideration that there is no boundary to what can be technically done that made Oppenheiner the "father of the atomic bomb"; he only cared about the dynamics of the technological process itself, as he stated in the impressive cross-examination of the three-week trial that began on 12 April 1954: "...I would have done anything that was demanded of me, including bombs of every conceivable kind, provided I had considered them technically possible"2.

Notes

(1) BORN, M. "Hope that all men will understand the importance of the atomic menace". In Science and Conscience in the Atomic Age. Alliance publishing house. Madrid, 1971. pp. 186-197.

(2) From the interrogation at the Oppenheiner trial quoted in "Brighter than a Thousand Suns", Robert Junk, p. 285. Robert Junk, p. 285. Ed. Argos. Barcelona, 1959.

 

Annex: Against the employment of nuclear weapons*.

1. Recent statements that a nuclear war can be won and even survived err on the side of an incorrect assessment of medical reality. The reality is that any nuclear war would inevitably spread death, disease and suffering on a gigantic scale and scale and without any possibility of effective medical intervention. This leads us to the same conclusion that physicians have reached about the deadly epidemics that history has known: only prevention can master status.

Despite widespread belief, we now have a good idea knowledge of the extent of the catastrophe that would follow the employment of nuclear weapons. And we also know exactly the limits of the medical attendance . If this knowledge were made clear to people and their leaders throughout the world, it could help to stop the degree program of armaments and thus prevent what could well be the last epidemic of our civilisation.

The devastation caused by atomic weapons in Hiroshima and Nagasaki provides us with direct evidence of the consequences of a nuclear war. But there is also no shortage of theoretical estimates to rely on. Two years ago, a serious official agency published the results of an estimate and described the effects of a nuclear attack on cities of about two million inhabitants. If a nuclear weapon weighing one million tons were to explode in the centre of such a city (the Hiroshima bomb had a yield of approximately 15,000 tons of TNT), the result would, according to the calculations, result in devastation over an area of 180 km, 250,000 dead and 500,000 seriously injured. These would include those suffering from atomic blast injuries such as fractures and severe soft tissue injuries, superficial or retinal injuries, respiratory injuries and radiation injuries, with acute syndromes and delayed effects.

Even with the best conditions, the medical care that would have to be provided for these wounded would be an unimaginable effort. The study estimated that if there were 18,000 hospital beds in or around one of these cities, only 5,000 would be fit for use. Thus, no more than one per cent of the wounded could be hospitalised; but it should also be noted that no one would be in a position to provide the medical service needed by only a few individuals with severe burns or victims of radiation or landslides.

The impotence of the medical attendance is particularly evident when one considers all that is required for the seriously injured. A case in point is that of a 20-year-old man with severe burns following a car accident in which his petrol tank had exploded. During his hospitalisation at department for severe burns at Boston Hospital, he received 140 litres of plasma and 147 litres of red blood cells, both freshly frozen, 180 millilitres of platelets and 180 millilitres of albumin. He underwent six operations to close the wounds, which covered 85% of the surface of his body, with different types of grafts, including artificial skin grafts. During his stay in hospital, he had to be kept on life support. Despite these and other exceptional procedures, which drew on all the resources of one of the most comprehensive medical institutions in the world, the patient died after 33 days of hospitalisation. The doctor manager compared his injuries to those described by many Hiroshima victims. If forty patients from that subject were to present themselves at the same time in all the hospitals in Boston, the medical capacity of the city would not be sufficient to care for them. Imagine now what would happen if, in addition to thousands of injured people, most of the emergency medical facilities were destroyed.

A Japanese doctor, Professor M. Ichimaru, an eyewitness to the effects of the Nagasaki bomb, has published his own testimony. He says: "I tried to go to my medical school in Urakami, 500 metres from the hypocentre. I found many people returning from Urakami. Their clothes were in tatters and pieces of skin were hanging from their bodies. They looked like ghosts with empty eyes. The next day I was able to walk into Urakami and everything I knew was gone. All that remained were the concrete and steel frames of the buildings. Dead bodies were everywhere. On every corner there were water tanks to put out the fires after the air raids. In one of these small vats, barely big enough for one person, lay the body of a man who had been desperately searching for some fresh water. Foam was foaming at the mouth, but he was no longer alive. I was haunted by the wailing of women in the devastated fields. As I approached the school I saw blackened, charred corpses, white bones sticking out of arms and legs. When I arrived there were some survivors. They were unable to move. The strongest were so weakened that they lay on the ground. I spoke to them and they thought they would recover, but they all eventually died over the next two weeks. I will never forget the way they looked at me and I will always hear their voices...".

3. It should be recalled that the bomb dropped on Nagasaki had a yield equivalent to 20,000 tonnes of TNT, slightly larger than the so-called "tactical bombs" intended for the battlefield.

But even such visions of horror are inadequate to describe the human disaster that would result from an attack on a country with today's nuclear weapons arsenals, containing thousands of bombs with a yield of a million tonnes of TNT and more.

The suffering of the surviving population would be unparalleled. Communications, food and water supplies would be completely disrupted. Only in the first few days could people venture out of buildings to provide relief without the danger of deadly radiation. The social disintegration following such an attack would be unimaginable.

The exhibition to large doses of radiation would decrease resistance to bacteria and viruses and could therefore pave the way for widespread infections. In addition, radiation could cause irreversible brain damage and mental deficiencies in the foetuses of mothers exposed to radiation. Among survivors, the incidence of many types of cancer would increase significantly. And genetic impairment would be passed on to future generations, should they exist.

In addition, large areas of soil and forest, as well as livestock, would be contaminated, which would reduce food resources. Many other biological and even geophysical consequences are to be expected, but the current state of knowledge does not allow us to predict with certainty what they would be.

Even a nuclear strike directed exclusively against military facilities would be devastating for the entire country, because these facilities are dispersed and not concentrated in certain areas. Thus, many nuclear weapons would explode. On the other hand, radiation would spread due to natural winds and atmospheric mixing, killing many people and contaminating vast regions. Medical facilities in any country would be inadequate to care for the survivors. goal An analysis of the status medical-health after a nuclear war leads to only one conclusion: our only resource is to prevent it.

Of course, the consequences of a nuclear war are not only health-related. But they force us to heed the stern lesson of modern medicine: when treatment of a given disease is ineffective or when the costs are too high, efforts should be directed towards prevention. Both conditions apply to nuclear warfare. Can a stronger case be made for a preventive strategy?

The prevention of any disease requires an effective prescription. We admit that such a prescription must at the same time prevent nuclear war and safeguard security. Our scientific and medical knowledge and credentials do not, of course, allow us to deal authoritatively with security issues. However, if political and military leaders have based their strategic organisation on erroneous assumptions concerning the medical aspects of a world war, we feel that we have a responsibility in this regard. We must inform the whole world about what the overall clinical picture would be after a nuclear attack and about the powerlessness of the medical community to provide a valid response.

If we remain silent, we risk betraying ourselves and our civilisation.

* E. Arnaldi, Rome; N. Bochkov, Moscow; L. Caldas, Rio de Janeiro; C. Chagas, Rio de Janeiro; H. Hiatt, Boston; R. Latarjet, Paris; A. Leaf, Boston; J. Lejeune, Paris; L. Leprince-Ringuet, Paris; G.B. Marini-Bettolo, and V. Weisshopf, Cambridge, USA.

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