lowed the disclosures of federally fund-summations), and there are sur - PDF document

lowed the disclosures of federally fund-summations), and there are surely more, hid--across a broad ethical spectrum, from med-touch" [2], lacking any diagnostic or thera-and by Congressional committees are con- The Cold W hundreds of thousands of unknowing or mis-exposed to radioactive fallout from atmos- 33 Medicine & Global Survival 1994; Vol. 1, No. 1Medicine, Public Health, and Ethics of the Cold War H. Jack Geiger, MD ꤀Copyright 1994 Medicine & Global Survival tivity into the air, soil, or groundwater fromnuclear weapons plants and laboratories, The Hanford Case: One Example rads, mostly from drinking radioactively con- The Soviet Equivalent Soviet nuclear weapons production site atChelyabinsk -- have revealed a bitter sym ofthe cold war and confirmed that arrogance,ignorance, and obsessive secrecy know nonational borders. By all accounts, massiverisks to the health of civilians, nuclearweapons workers, and soldiers were evenworse, apparently by orders of magnitude, inthe Soviet Union. A report by Sharov [6] in this issue,describing Soviet soldiers ordered to marchthrough ground zero shortly after a nuclearairburst during war games in the test areanear Totsk, in the southern Urals, is typical.Additional details of this event were reportedby Igor Stadnik in an article in the weeklyMoscow News in 1992: A well-equipped infantry corpswas moved from Byelorussia toKazakhstan. It was divided into thedefending "Blue" side and the advanc-ing "Red" side. The bomb was explod-ed in the space between the two...Thearea was saturated with radioactivedust: the bomb was exploded 350metres above the sun-scorched steppe,which was then pounded for twohours by artillery guns...Troops werenot always told about the effects ofnuclear radiation during the prepara- Medicine, Public Health, and EthicsGeiger 34 Releases of radioactivity at the Tomsk-7 mili- The Unanswered Questions The American and Soviet disclosuressuggest the first of a long series of urgent andunanswered questions. How much remainsto be disclosed from the U.S. Department ofEnergy files, at least 32 million pages ofrecords (some of them, ironically, literallycontaminated with plutonium and otherradioactive materials) that are still classified?How much nuclear experimentation lies hid-den in the records of other U.S. agencies -- theDepartment of Defense, the CentralCIACIAAeronautic and Space Administration andthe Veterans Administration? How many ofthem refer, in addition, to the production andtesting of chemical and biological weapons --individual, like the CIA's tests of LSD andother psychotropic agents, or populationbased, as in the government's release ofbut not quitebut not quitein a half dozen cities? Each of these questions,clearly, must be asked of the former SovietUnion as well. And what of the other nuclear powers?How much is hidden behind the highlyrestrictive Official Secrets Act in the UnitedKingdom? Does France have dosimetric andepidemiologic data on the South Pacific pop-ulations exposed to fallout from its atmos-pheric nuclear tests in the South Pacific?What are the records -- of medical experi-ments, population exposures, worker healthand safety, and environmental contamination-- of China, India, South Africa, and Israel?Partial answers have been provided byIPPNW [10], but no truly global accountingwill be possible until the international cultureof secrecy -- it is not just an American phe-nomenon -- is undone. The Ethical Question: What Took the focus of intense discussion among physi--time, if informed consent was sought at all, a"community standard" prevailed; the physi-cian was required only to disclose as much toexperimental subjects as other physiciansdid. (One "informed consent" example of thisperiod consists in its entirety of a statementwritten and signed by the mother on behalfof her three-year-old child: "The doctors havetold me everything I need to know." Personalcommunication, February 8, 1994, ChristineK. Cassel.) Many researchers now offer thesepractices as an ethical frame of reference,arguing that their experiments met "the stan-What happened? It seems that the ethi- 35 Medicine & Global Survival 1994; Vol. 1, No. 1Medicine, Public Health, and Ethics Next Time? threat? What will happen when new cate- References 1. McCally M, Cassel C, Kimball DG. US government-sponsored radiation research onhumans 1945-1975. M&GS 1994;1;3-18. 2. Allen S, Kong D. '50 memo warned radiationtests would suggest Nazism. boston Globe,December 28, 1993;1. 3. Geiger HJ. Generations of poison and lies.New York Times, August 5, 1990;E19. 4. Stone R. Scientists study "cold war" fallout.Science 1993;262:1968. 5. Kossenko MM, Degteva, MP, PetrushovaNA. Estimates of the risk of leukemia to resi-dents exposed to radiation as a result of anuclear accident in the southern Urals. PSRQuarterly 1992;2:187-197. 6. Sharov VB. The secrecy of the southern Uralnuclear accidents and its results. M&GS1994;1:37. 7. Stadnik 1. Survivors of the Soviet atomicbomb program. Moscow News, No. 26, 1992;11. 8. Epstein PR, Clapp RW. Soviet nuclearmishaps pre-Chernobyl. Lancet 1993;341:346. 9. Yemelyanenkov A, Propov V. The atomdeclassified. Berlin: H & P Druck: 1992. 10. Hu H, et al. Plutonium: deadly gold of thenuclear age. Cambridge, MA: InternationalPhysicians Press; 1992. 11. Beecher HK. Ethics and clinical research.New Engl J Med 1966; 274:1354-1360. 12. Geiger HJ, Rush D, et al. Dead Reckoning: Acritical review of the Department of Energy'sepidemiological research. Washington, DC:Physicians for Social Responsibility, 1992. Medicine, Public Health, and EthicsGeiger 36