Ethical Choices After a Nuclear Attack-Reply

In Reply.—  I appreciate Dr Dawson's clarification that the purpose of the British Medical Association's publication of Selection of Casualties was intentionally to provoke an open public debate on the ethical issues that would face health workers and others after nuclear attack. My concern remains, however, because in the policy circles in the United States at least, and I would suppose this is also true in the United Kingdom, many people may not have such delicate ethical sensibilities and will take these plans at face value, preparing the bureaucratic machinery for the eventuality of nuclear war, which lowers the threshold for starting such a war. In the United States, there also are a few survivalists who believe that nuclear war is inevitable and whose only concern is that they survive and prevail. These people will use the British Medical Association report as a blueprint for eugenics-based triage. I find this