of a committee. Looking toward the future, Miller and his staff envisioned a Medical Follow-up Agency that would balance ongoing follow-up as in the multiple sclerosis or POW studies, cutting-edge research as in the various twin studies, and politically delicate studies such as those of Persian Gulf veterans or of atomic veterans (see Box 17).181


Since its founding in 1946, the Medical Follow-up Agency has successfully met many challenges. The agency continues to contribute to the research community because of the ingenuity and resolve of researchers such as Dr. Michael DeBakey. DeBakey and Gilbert Beebe sensed the opportunity to create a medical organization that would be a force for good in post-World War II America by channeling the experience of the war into useful medical knowledge. Beebe and

among the participants, its findings did not support the hypothesis that radiation exposure was the cause. In part as an outgrowth of the MFUA's reputation in the field of atmospheric test participant research, the Army surgeon general asked the MFUA to assemble an expert committee to review a set of proposed NATO guidelines for the exposure of soldiers to radiation doses that are well short of those that cause acute effects but that may carry the risk of subsequent cancers. The committee's interim report addressed the technical aspects of the NATO documents. In its final report the committee discussed an ethical framework for considering when to put soldiers at risk and what obligations might then follow. Although this last activity does not directly benefit the test participants, it may contribute to the military's avoidance of unnecessary radiation exposures in the future and may help to improve the decision-making and operating procedures in place to protect personnel in cases where exposure is deemed warranted.

Selected References

Institute of Medicine. A Review of the Dosimetry Data Available in the Nuclear Test Personnel Review (NTPR) Program: An Interim Letter Report of the Committee to Study the Mortality of Military Personnel Present at Atmospheric Tests of Nuclear Weapons. Washington, D.C.: National Academy Press, 1995.

Institute of Medicine. An Evaluation of Radiation Exposure Guidance for Military Operations, Interim Report. J.C. Johnson and S. Thaul (eds.). Washington, D.C.: National Academy Press, 1997.

Institute of Medicine. Potential Radiation Exposure in Military Operations: Protecting the Soldier Before, During, and After. S. Thaul and H. O'Maonaigh (eds.). Washington, D.C.: National Academy Press, 1999.

Johnson, J.C., Thaul, S., Page, W.F., Crawford, H. Mortality of Veteran Participants in the CROSSROADS Nuclear Test. Washington, D.C.: National Academy Press, 1996.

National Research Council. Mortality of Nuclear Weapons Test Participants . Washington, D.C.: National Academy Press, 1985.

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