Ethical Responsibility for the Social Production of Tuberculosis.

Approximately one in two hundred persons in the Marshall Islands have active tuberculosis (TB). We examine the historical antecedents of this situation in order to assign ethical responsibility for the present situation. Examining the antecedents in terms of Galtung's dialectic of personal versus structural violence, we can identify instances in the history of the Marshall Islands when individual subjects made decisions (personal violence) with large-scale ecologic, social, and health consequences. The roles of medical experimenters, military commanders, captains of the weapons industry in particular, and industrial capitalism in general (as the cause of global warming) are examined. In that, together with Lewontin, we also identify industrial capitalism as the cause of tuberculosis, we note that the distinction between personal versus structural violence is difficult to maintain. By identifying the cause of the tuberculosis in the Marshall Islands, we also identify what needs be done to treat and prevent it.

The art of misunderstanding moral bioenhancement.

In our book Unfit for the Future and a number of papers, we have argued that there is a dangerous mismatch between, on the one hand, the tremendous power of scientific technology, which has created societies with millions of citizens, and, on the other hand, our moral capacities, which have been shaped by evolution for life in small, close-knit societies with primitive technology. To overcome this mismatch before it results in the downfall of human civilization, human beings stand in acute need of moral enhancement, not only by traditional means but also by biomedical means, should this turn out to be possible. After summarizing this argument, we respond to two critics, Michael Hauskeller and Robert Sparrow.

Vertical nuclear proliferation.

All the nuclear-weapon states are working to develop new nuclear-weapon systems and upgrade their existing ones. Although the US Congress has recently blocked further development of small nuclear weapons and earth-penetrating nuclear weapons, the United States is planning a range of new warheads under the Reliable Replacement Warhead programme, and renewing its nuclear weapons infrastructure. The United Kingdom is spending 1 billion pounds sterling on updating the Atomic Weapons Establishment at Aldermaston, and about 20 billion pounds sterling on replacing its Vanguard submarines and maintaining its Trident warhead stockpile. The US has withdrawn from the Anti-Ballistic Missile Treaty and plans to install missile defence systems in Poland and the Czech Republic; Russia threatens to upgrade its nuclear countermeasures. The nuclear-weapon states should comply with their obligations under Article VI of the Non-Proliferation Treaty, as summarised in the 13-point plan agreed at the 2000 NPT Review Conference, and they should negotiate a Nuclear Weapons Convention.

The continuing risk of nuclear war.

Climate change and nuclear war are currently the most dangerous challenges to human civilisation and survival. The effects of climate change are now sufficient to persuade many governments to take effective measures to reduce greenhouse gas emissions. Today there are about 27,000 nuclear warheads, many at least ten times more powerful than the Hiroshima and Nagasaki bombs, and a meaningful medical response to a nuclear attack is impossible. Nevertheless, the threat of nuclear war does not raise public concern, and indeed the nuclear-weapon states are upgrading their capability. The only effective preventive measure is the abolition of nuclear weapons. Steps towards this include: a Fissile Material Cut-off Treaty, for the nuclear weapon states to observe their obligations under the Nuclear Non-Proliferation Treaty, and for the Comprehensive Test Ban Treaty to enter into force. The ultimate need is for a Nuclear Weapons Convention; International Physicians for the Prevention of Nuclear War have launched an International Campaign to Abolish Nuclear weapons (ICAN) to promote a NWC.

Proliferation dangers associated with nuclear medicine: getting weapons-grade uranium out of radiopharmaceutical production.

Abolishing the threat of nuclear war requires the outlawing of nuclear weapons and dismantling current nuclear weapon stockpiles, but also depends on eliminating access to fissile material (nuclear weapon fuel). The near-universal use of weapons-grade, highly enriched uranium (HEU) to produce radiopharmaceuticals is a significant proliferation hazard. Health professionals have a strategic opportunity and obligation to progress the elimination of medically-related commerce in HEU, closing one of the most vulnerable pathways to the much-feared 'terrorist bomb'.