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Biological Warfare and the ‘Hiroshima' Issue of JAMA
To the Editor.—One interesting sidebar to the biological warfare story was not mentioned in the Editorial by Dr Lederberg.1 At the same time that the United States participated in the Biological and Toxin Weapons Convention of 1972, President Nixon and Congress were shaping the "War on Cancer," which was signed into law in December 1972. This concatenation provided the Department of Health, Education, and Welfare with the unique opportunity of petitioning the White House to permit, for the first time, the National Institutes of Health to expand beyond its Bethesda campus by opening the laboratories at Fort Detrick to cancer research by the National Cancer Institute.
Using the "swords to plowshares" argument, we persuaded the administration to do just that. Indeed, our first step was not only to open (the formerly top secret) Fort Detrick to public view, but we invited the Russian Minister of Health, Dr Boris Petrovsky, to lead the public tour on August 3, 1972.
Merlin K. Du Val, MD
Phoenix, Ariz
1. Lederberg J. Infectious disease and biological weapons: prophylaxis and mitigation. JAMA. 1997;278:435-436.
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To the Editor.—Based on the Biological Agents as Weapons issue of JAMA,1 it appears that American medicine had been sold to the Pentagon in a most bizarre presentation of the problems of chemical and biological warfare. Checking the issue date, August 6, 1997, I found, to my total disbelief, that I was reading an anticommemorative to Hiroshima—the wholesale massacre of civilians in Hiroshima and Nagasaki on August 6 and 9, 1945, respectively.
The entire issue assiduously avoids Hiroshima and the choice of date surely seems intentional. From the Editorial by Dr Lederberg1 to the articles from the Defense Department and several military physicians, the focus on the usual "terrorists" and "rogue State" leaders like Mr Hussein as a great threat to unleash biological and chemical weapons on civilian populations is disingenuous and covers a hidden agenda. Standing alone, Lederberg's article appears credible, but, just as he cites the "strange bedfellows" the United States chose to side with in the Cold War, he forgets to look at the bedfellows he is ushering into our medical bedroom—ie, the overall gestalt of this entire issue of THE JOURNAL is dominated by the military and its assumptions.
Even issues such as the rights of gays to be in the military or the protection of women soldiers from harassment and sexual abuse pale in comparison to the chemical and biological warfare conspiracies that have been promulgated by this democratic government against its own citizens—Gulf War veterans, atomic veterans, the people of St George, Utah, the secret bacteriological warfare fogging experiments against the population of the San Francisco Bay area, and the nonconsensual exposure of patients with cancer to radiation by the Defense Department. These episodes are not the rantings of conspiracy theorists but are the public record and are virtually always collaborated by physicians.
For these victims, the adage that time heals is not working. The victims of St George die off and disappear, yet the demands for vindication, compensation, and candor grow louder and the government stands exposed as nothing less than callously inhumane and steadfastly cynical and undemocratic. Now in commemoration of 130000 Japanese noncombatants, who were dead, wounded, and writhing in pain with radiation sickness, comes not just the usual silence, but a plea for cooperation with the military against the scourge of biological and chemical terrorism.
Today, we are ill-prepared to respond to dangers presented by the most highly organized and cynical governments (including our own, not just Mr Hussein's). How can there be a technical or military solution to this problem? What is required is a much deeper look into where we are now, how we have arrived at this moment, and into what future we intend that our species shall go. We may not have much time left to recognize the impact on the human spirit when medicine remembers one of the worst crimes against humanity, and one for which we share some collective responsibility, by urging that physicians attend to the need to cooperate in military preparedness.
AUTHOR INFORMATION
These letters were shown to Dr Lederberg, who declined to reply.—ED.
Marc Sapir, MD, MPH
Center for Elders Independence Inc
Oakland, Calif
1. Lederberg J. Infectious disease and biological weapons: prophylaxis and mitigation. JAMA. 1997;278:435-436.
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In Reply.—In 1983, JAMA began publishing an annual issue the first week of August to commemorate the bombing of Hiroshima for the specific purpose of preventing nuclear war. For many years, these annual issues focused on nuclear warfare, preventing the proliferation and use of nuclear weapons, and the biology of radiation exposure. Following the collapse of the Soviet Union and the end of the Cold War, other war-related threats to public health became major concerns: civil wars and conflicts with civilians, not combatants, comprising the casualties; massive populations of refugees and displaced persons; terrorism; and state-sponsored human torture. These coupled with a reemergence of chemical and biological agents as real tools of war served as the impetus to broaden the editorial focus of the annual Hiroshima issue. The 1997 issue was devoted to the threat of biological warfare, which like nuclear warfare uses a weapon of mass destruction to harm or kill civilians.
Dr Sapir asks: where are we now, how have we arrived at this moment, and into what future do we intend to go? The biological warfare issue of JAMA addresses each of these questions. For example, articles written by physicians, scientists, historians, and policy experts describe the historical role of the US military and government in covert biological weapons development, our current underdeveloped detection and response capabilities in the event of a biological or chemical weapons attack, and acts of biological terrorism that have actually occurred during the last decade in the United States and Japan. A review article delineates the major biological agents most likely to be used in such attacks with a practical emphasis on clinical diagnosis and management. The message for the future is clear—it is time for openness, shared responsibility, and collaborative planning among physicians and other health professionals, scientists, national and local government agencies, and the military to develop effective detection and response capabilities, as well as prevention strategies, to protect society from all weapons of mass destruction.
Annette Flanagin, RN, MA
Associate Senior Editor, JAMA
George D. Lundberg, MD
Editor, JAMA
Edited by Margaret A. Winker, MD, Senior Editor, and Phil B. Fontanarosa, MD, Senior Editor.
JAMA. 1998;279:274-275.
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