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The Medical Implications of Nuclear War, Institute of Medicine. @) 1986 by the National Academy of Sciences. National Academy Press, Washington, D.C. Understanding and Preventing Nuclear War: The Expanding Role of the Scientific Community DAVID A. HAMBURG, M.D. Carnegie Corporation, New York, New York The consequences of nuclear war constitute the central facts of our age. Everything else in contemporary experience hinges on them, depends on them, follows from them. Therefore, it is exceedingly important to get the facts straight. We deal with a metric that our species has never had to deal with in the millions of years of its history-a metric involving the sudden elimination of tens or hundreds of millions of people and perhaps the deaths of billions in a matter of months. That is something we have never had to accommodate, and I am not sure we can. Grasping the meaning of these numbers is a very difficult thing to do, for it constitutes a qualitative break with the experience of the species. It is not just World War II written large. It is a fundamentally and profoundly different ex- perience. So I believe that the facts that scientists are clarifying here represent the most important facts our species has ever had to deal with. We all like to see the caring, loving, creating side of human experience. We want to believe that this side will dominate in world affairs, and perhaps it will. Indeed, an occasion like this gives some hope that it will, but let us recall George Bernard Shaw's incisive remark: "We cannot help it because we are so constituted that we always believe finally what we wish to believe. The moment we want to believe something, we suddenly see all the arguments for it and become blind to the arguments against it. The moment we want to disbelieve anything we have previously believed, we suddenly discover not only that there is a mass of evidence against, but that this evidence was staring us in the face all the time." The tendencies to wishful thinking, to complacency in the face of hard 1
2 UNDERSTANDING AND PREVENTING NUCLEAR WAR reality, to avoidance of facts, to denial of the significance of facts these are perhaps our worst enemies in the nuclear arena. There are people who believe that we can manage any kind of crisis, take any kind of risk, treat nuclear weapons like any other weapons, and still come away from every brink in good shape. Beyond the fact of the large scale of killing throughout human history, and the unprecedented scale of killing that now lies before us, is an underlying fact that deserves our serious attention. Human societies have a pervasive tendency to distinguish between apparently good and bad people, heroes and villains, or, more generally, between in-groups and out-groups. Historically, it has been easy for us to put ourselves at the center of the universe, attaching a strong positive value to ourselves and our group, while attaching a negative value to certain other people and their groups. It is prudent to assume that we are all, to some extent, susceptible to egocentric and ethnocentric tendencies. The human species is one in which individuals and groups easily learn to blame others for whatever difficulties exist, but in terms of the nuclear predicament, blam- ing is at best useless and most likely counterproductive. We have seen all too much finger-pointing between the superpowers, and for that matter, among nations throughout the world. ~C ~. .. . . . . . 1ne crux or my presentation 1S that the circumstances surrounding nu- clear war call for a new level of commitment by the scientific community to reduce the risk of nuclear war. What the world requires is really a mobilization-something akin to a wartime mobilization of the best pos- sible intellectual, technical, and moral resources over a wide range of knowledge and perspectives. We need a science-based effort to maximize the analytical capability, the objectivity, the respect for evidence that is characteristic of the scientific community worldwide, and indeed the worldwide perspective that is itself an integral part of the scientific community. These efforts should bring together scientists, scholars, and practitioners to clarify the many facets of avoiding nuclear war. To generate new options for decreasing the risk, we need analytical work by people who know the weaponry and its military uses. But that is far from enough to do the job. We also need scholars who know the superpowers in depth; people who know other nuclear powers; people who know third-world flash points; people who know international relations very broadly; people who know a lot about policy formation and implementation, especially in the super- powers; people who understand human behavior under stress, especially leadership under stress; people who understand negotiation and conflict resolution and much more. In other words, the relevant knowledge and
THE EXPANDING ROLE OF THE SCIENTIFIC COMMUNITY 3 skills cut right across all the sciences physical, biological, behavioral, social. Analytical studies of this kind are likely to be much more useful if they are informed by the perspective of policymakers, and policymakers can benefit greatly from having such studies new ideas, a wider range of options, and deeper insights in other words, a continuing dynamic in- terplay between the scientific community and the world of policy. I want to refer to a few examples of the emerging generation of rather complex, serious, analytical efforts in the scientific and scholarly com- munities on the issue of avoiding nuclear war, bringing in heavy intel- lectual and technical firepower for peace, not for war. I cite examples that are primarily taking place in the United States because I am more familiar with them and have actually been involved in some. U. S. activity has been rapidly increasing in recent years, and I hope there will be similar upsurges in many countries. Now let us consider some examples of in- ternational scientific cooperation for avoiding nuclear war. Since this conference is a medical one, it is appropriate to point out the recent activity of medical organizations in this field. A serious, world- wide effort has been made to stimulate public awareness of the harsh facts of nuclear war. Many different facets of the problem have been illuminated by analytic work and education of the public on the basis of best available information. Prominent in this effort have been the Physicians for Social Responsibility, International Physicians for the Prevention of Nuclear War, World Health Organization, British Medical Association, and the Amer- ican Medical Association; others have contributed as well. The central point is that a kind of awakening has occurred in the medical community to the responsibility of addressing the immense nature of the threat to public health. The present meeting is an activity of the National Academy of Sciences, which in 1980 established the Committee on International Security and Arms Control (CISAC), chaired for several years by Marvin Goldberger and now headed by Wolfgang Panofsky, both distinguished physicists. There is a counterpart "CISAC" in the Soviet Academy of Sciences, chaired by academician E. P. Velikhov, also a physicist of note. Both committees are staffed by people with rich backgrounds in arms control and international security. CISAC's main function is to meet with its Soviet counterpart twice a year, once here and once in the Soviet Union, with a good deal of preparation between meetings. The discussions have dealt with almost all the major topics of the arms control field; in fact, CISAC has primarily been an arms control committee. These meetings have made it possible to consider in an open-minded, exploratory way a
4 UNDERSTANDING AND PREVENTING NUCI:PAR WAR variety of major issues between our two countries. There has been a minimum of boilerplate; a minimum of hostile rhetoric; and a good deal of serious, thoughtful discussion based on the facts of the awesome nuclear stockpiles: ways to reduce those stockpiles, ways to balance them, ways to increase their stability, and ways to enhance safety in their maintenance. CISAC has also had the useful function of educating the members of the National Academy of Sciences. For the past 3 years, it has conducted in-depth seminars immediately preceding the annual meeting of the Acad- emy, and hundreds of Academy members have participated in both oc- casions. The first was a broad coverage of the arms control field and the second a specific focus on strategic defense. CISAC also put together a volume called Nuclear Arms Control: Background and issues, published by the National Academy Press in 1984. Indeed, it has been altogether a constructive and stimulating body both in its activities in this country and in its interchange with Soviet counterparts over its history. And 1986 should see further extension in the range of its activities. In 1985, there was a new initiative in the National Academy of Sci- ences the creation of a Committee on the Contributions of the Behavioral and Social Sciences to Avoiding Nuclear War. This group explores in depth some of the topics that are represented in this meeting as well as others. It is an-enterprise of great potential importance and we may well find it useful to approach the Soviet Academy in due course about some counterpart group. Now let us move to another important organization in this country, the American Association for the Advancement of Science (AAAS). This is a very interesting organization because it is a kind of broad umbrella group covering all the sciences. It is deeply engaged in national science policy and is an important articulator of relationships between the scientific com- munity and the government, a useful link between that community and the society at large, and in recent years a very active participant in the arms control and national security fields. In 1981, AAAS established the Committee on Science, Arms Control and National Security to encourage its own members to become more informed on these matters and more deeply involved in them and, also, to provide links between the scientific community and the policy com- munity. It has been very effective, in my judgment, in fostering a lively interplay between scientists and policymakers on arms control and inter- national security issues. The AAAS annual meeting is a very large gathering that evokes a great deal of public interest and media coverage. AAAS also holds about 10 major symposia each year on reducing the risk of nuclear war. They cover arms control, of course, but also approaches beyond arms control, such
THE EXPANDING ROLE OF THE SCIENTIFIC COMMUNE s as crisis prevention, about which I will say more later. The official journal of the AAAS, Science, has increasingly given ex- tended coverage to the issues under discussion at this meeting and related ones. Under its new editor, Daniel Koshland, there is a commitment to increase even further the coverage of subjects pertinent to the avoidance of nuclear war. In November 1985, AAAS's magazine for the lay reader, Science 85, had a special issue on science, technology, and peace. Co- inciding with its publication was a symposium for journalists based on this issue. AAAS also sponsors seminars for members of Congress and their staffs. The most recent one centered on crisis prevention and nuclear risk re- duction. This year, for the first time, AAAS will have a highly visible and very-high-quality meeting that will be the first of an annual series of national colloquia on avoiding nuclear war, bringing together the scientific and scholarly communities with a wide cross-section of national leaders and the public at large. Now I turn to another organization, the American Academy of Arts and Sciences, based in Cambridge, Massachusetts. Its Committee on Inter- national Security Studies (CISS) has just completed a major study of weapons in space, reported in the most recent issue of Daedfalus. A book based on this project is forthcoming. CISS is also completing a project on Crisis, Stability and Nuclear War, conducted jointly with Cornell Uni- versity, that looks particularly at crisis management issues, command and control communication questions for both U. S . and Soviet nuclear forces, delegation of authority in time of crisis, and the very dangerous interplay of military alerts between the superpowers. The American Academy will soon be publishing a volume that analyzes whether the superpowers place too much emphasis on the technical aspects of weaponry and not enough on underlying political and psychological factors that exacerbate conflict. It aims to illuminate underlying factors in the U.S.-Soviet relationship that make the weapons so dangerous. The American Academy is actively supporting Pugwash. Pugwash, of course, was the pioneering international forum in this field. Active interest continues, and one phenomenon of the American participation is a growing involvement of young scholars. Pugwash is dealing with critical issues: conventional deterrence in Europe, regional conflicts that can lead to nuclear war, and the ramifications for Europe of strategic defense. The American Academy is also trying to enlarge the role of U.S. universities and colleges in addressing nuclear issues. It has started a Kistiakowsky visiting scholar program honoring the late scientist who was the President's Science Adviser in the Eisenhower administration. In this program, distinguished scholars visit smaller colleges and universities that
6 UNDERSTANDING AND PREVENTING NUCLEAR WAR are starting courses and other activities in this field. Perhaps the most striking of the American Academy's outreach efforts occurred some months ago in a meeting held jointly with the Planetary Society and with the cooperation of the National Academy of Sciences. The meeting was de- voted to ballistic missile defense (BMD) and antisatellite (ASAT) matters, including effects of the BMD and ASAT programs on U. S . -Soviet political relations, on the superpowers' strategic stability, and on civilian uses of space. This meeting was covered extensively by the national news media in this country. Finally, in connection with the American Academy's Weapons in Space Project, there is a U. S.-Soviet activity led on the Soviet side by academicians Velikhov and Segdaev, together with Professor Frank Long of Cornell University. Let me now mention a set of studies being supported by the Carnegie Corporation of New York on different facets of strategic defense and to some extent dealing also with the way the Strategic Defense Initiative (SDI) impinges on other security uses of space and on civilian uses of space. This is, after all, an exceedingly complex area: technical feasibility, economic considerations, strategic considerations, international relations; there are so many facets affected by SDI that it is important to have a set of objective, analytical, science-based, independent studies. These studies are open to full critique, will be published, and should be useful to gov- ernments and the public. I have already sketched the American Academy of Arts and Sciences study. There is another being done in the University of California system headed by Professor Herbert York and involving various campuses of the university, as well as the special laboratories associated with the University of California. The American Physical So- ciety is also conducting a study with the cooperation of the U.S. De- partment of Defense. And the Johns Hopkins School of Advanced International Studies, headed by the former Secretary of Defense, Dr. Harold Brown, and the United Nations Association of the United States are each conducting their own studies. The earliest such study came from Stanford University, with Drell and Parley as the principal authors. More recently, the Stanford group completed a report on a specific space defense research program that would be consistent with the Anti-Ballistic Missile (ABM) Treaty and with improved U.S.-Soviet relations. The crisis prevention approach deserves mention here. In essence, it is an antidote to complacency in the spirit of science: raising questions, challenging assumptions in seeking ways to reduce the risk of the use of nuclear weapons, looking at factors that influence the use of these weap- ons. Basically it is preoccupied with the prevalence of error and mis- judgment in human affairs.
THE EXPANDING ROLE OF THE SCIENTIFIC COMMUNITY 7 Crisis prevention simply says that it is too dangerous to think that we can manage nuclear confrontations like the Cuban Missile Crisis time after time and get away with it. There are too many sources of both human and mechanical error and, above all, the interaction between human and mechanical error that is enormously exacerbated in time of crisis. It is appropriate in this medical meeting to reflect on the wider signif- icance of the growing research literature on iatrogenic illness. For those of you not close to medicine, the term refers to medically induced illness. Most of the studies indicating the serious nature of this problem are coming out of our very finest hospitals. Even with splendid institutions, a science- based profession, and highly disciplined teams of workers, tragic mistakes are made. Our power is greater than ever before, both for better and for worse, and not just in medicine. It has been my personal good fortune to relate to leaders in government, science, technology, medicine, and busi- ness. They have earned my respect. Yet I have witnessed serious mistakes in each of these spheres. In the nuclear war arena, we have only one mistake to make. This is the first time in history that we really cannot afford one serious mistake. Over the long term it is vanishingly improbable that, in this field where the stakes are much higher than any other, we could operate indefinitely in an error-free environment. That is what the crisis prevention approach addresses. It involves a variety of strategies and techniques. One fundamental point of crisis prevention is to avoid subjecting either superpower to any threatening surprises. The upgrading of the Hotline is a useful step in that direction. Another idea of crisis prevention is to reach agreements that deal effectively with situations that are predictably sen- sitive and potentially explosive; perhaps the best case in point involves the rules of sea agreement between the U.S. and Soviet navies. It is highly probable that, during the course of this meeting, somewhere on the high seas U.S. and Soviet naval vessels or naval aircraft have encountered each other. They might have had a very nasty, unpleasant, dangerous exchange if not for the fact that the rules for such encounters are well established, codified in books on the ships at sea, and updated and clarified every year at a high-level conference between the two navies. All this is done in a professional, low-key manner that has survived political vicissitudes be- tween the two nations. Similarly we had a recent agreement on nuclear terrorism, a very ap- propriate subject to worry about between the U.S. and Soviet governments. It is only a start, but a step in the right direction. This year, too, we have had systematic regional consultations where we tried to clarify vital in- terests in touchy situations. It may not mean anything more than informal
8 UNDERSTANDING AND PREVENTING NUCLEAR WAR understandings about what are crucial interests, but it too is a step in the right direction. Finally, in this crisis prevention approach, one needs institutional mechanisms that provide a professional exchange of infor- mation and ideas on a regular basis about matters that could become highly dangerous. In this domain, the best example is the Standing Consultative Commission (SCC). The SCC has worked well for more than a decade. Various suggestions about risk reduction centers in Washington and Mos- cow are now under active consideration; they build on the SCC experience and could provide a useful long-term mechanism for crisis prevention. Crisis prevention endeavors go beyond arms control. They do not make assumptions about the levels of stockpiles or the hostility between the two nations, only hope that both will change for the better. That would be a highly desirable therapeutic outcome, but the question is, what do we do until the doctor comes? Until that fundamental change in the relationship occurs, can we alter the circumstances surrounding the likelihood of use of nuclear weapons? We in the scientific community are beginning to give the problem the attention it deserves. There is so much more to be done. When we leave this meeting, I fervently hope that each of us will ask, What more can I do? Who can I enlist in the effort? How can I widen that network? What tasks are being neglected? What organizations and institutions am I familiar with that could do more useful work in this field? One more point and a vital one: the scientific community must address the sources of conflict; it must go beyond the manifestations of conflict or the weapons that make so much damage possible. What is there in human nature and human interaction that increases the risk of hatred and destruction, and what can be done to resolve conflicts? Scientific study of human conflict is only beginning to expand. It is being stimulated now by the deep concerns that we all share at this meeting, and yet the status accorded this field of inquiry has been low, the support has been minimal, and the institutional arrangements have often been inadequate. I regard it as one of the greatest challenges of science policy in the remainder of this century to find ways to understand the nature and sources of human conflict and, above all, to develop effective ways of resolving it short of disaster. The world is now, as it has been for a long time, awash in a sea of ethnocentrism, prejudice, and violent conflict. The historical record is full of every sort of slaughter based on invidious distinctions pertaining to religion, race, nationality, and so on. The human species seems to have a virtuoso capacity for making invidious distinctions and for justifying violence on whatever scale the current technology permits.
THE EXPANDING ROLE OF THE SCIENTIFIC COMMUNITY 9 That is old; but what is new indeed, very new and very threatening- is the destructive power of our weaponry; not only nuclear but enhanced conventional, chemical, and biological. What else is new is the worldwide spread of technical capability. Thus, it is possible almost everywhere to make or at least to use effectively the weapons of high technology. What is also new is the miniaturization of weapons, which opens up all kinds of dangerous possibilities for terrorism. And the technology that permits the widely broadcast justifications for violence is new, too. Moreover, there is an upsurge of fanatical behavior. Taken together, these devel- opments provide a set of conditions that give us a growing capacity to make life everywhere absolutely miserable and disastrous, even aside from the fact that two nations probably have the capacity to render human life extinct. In this kind of world, the scientific community must pull together in a reasonably unified way so that the physical, biological, behavioral, and social sciences can address these profound and pervasive problems. This will require cooperative engagement over a wide range of scientific activity and will necessitate overcoming some of our own internal barriers within the scientific community. There is one final feature about the scientific community that is worth bearing in mind. I think it is fair to say that the scientific community is the closest approximation we now have to a truly international community, sharing certain fundamental interests, values, and standards, as well as certain fundamental curiosities about the nature of matter, life, behavior, . . and the universe. The shared quest for understanding is one that knows no national boundaries, has no inherent prejudices, no necessary ethno- centrism, and no barriers to the free play of information and ideas. So, to some extent the scientific community can provide a model for human relations that might transcend some of the biases and dogmatisms that have torn us apart throughout our history and have recently become so much more dangerous than ever before. Science can contribute greatly to a better future through its ideals and its processes as well as through the specific content of its research and all these need to be brought to bear now on the problem of human conflict. As I see it, the essential scientific outlook flows from some very old and cardinal features of human adaptation through our long history as a species. The evolution that is distinctively human centers around our increasing capacity for learning, for communication chiefly by language, for cooperative problem solving, for complex social organization, and for advanced toolmaking and tool using. These attributes have gotten us here by enormously enhancing our capabilities, not only to adapt to the widest variety of habitats, but also
10 UNDERSTANDING AND PREVENTING NUCLEAR WAR to modify our habitats profoundly in ways that suit our purposes. Now we are challenged as never before to find ways in which these unique capacities can be used to prevent us from destroying ourselves and especially to prevent the final epidemic; to prevent that will make possible the search for a decent quality of life for everyone on the planet. If we have lost our sense of purpose in the modern world, perhaps this per- spective can help us regain it. BIBLIOGRAPHY Some Recent Books Published by Scientific Organizations Concerned with Nuclear War Adams, R., and S. Cullen, eds. 1981. The Final Epidemic: Physicians and Scientists on Nuclear War (Physicians for Social Responsibility). Chicago, Ill.: University of Chicago Press. American Psychiatric Association. 1982. Psychosocial Aspects of Nuclear Developments (APA Task Force Report No. 20). Washington, D.C.: American Psychiatric Association. British Medical Association. 1983. The Medical Effects of Nuclear War. New York and Chichester: John Wiley & Sons. Cassel, C., M. McCally, H. Abraham. 1984. Nuclear Weapons and Nuclear War: A Source Book for Health Professionals (Physicians for Social Responsibility). New York: Praeger. Chivian, E., S. Chivian, R. J. Lifton, and J. E. Mack, eds. 1982. Last Aid: The Medical Dimensions of Nuclear War (International Physicians for the Prevention of Nuclear War). San Francisco, Calif.: W. H. Freeman and Company. The Committee for the Compilation of Materials on Damage Caused by the Atomic Bombs in Hiroshima and Nagasaki. 1981. Hiroshima and Nagasaki: The Physical, Medical, and Social Effects of the Atomic Bombings. New York: Basic Books. (Translated by Eisei Ishikawa and David L. Swain.) Ehrlich, P., C. Sagan, D. Kennedy, W. O. Roberts. 1984. The Cold and the Dark: The World After Nuclear War (Center on the Consequences of Nuclear War). New York: W. W. Norton. Griffiths, F., and J. Polanyi, eds. 1979. The Dangers of Nuclear War (A Pugwash Sym- posium). Toronto: University of Toronto Press. Harwell, M. A., and T. C. Hutchinson, with W. P. Cropper, Jr., C. C. Harwell, and H. D. Grover, eds. 1986. Environmental Consequences of Nuclear War. Volume II: Ecological and Agricultural Effects. SCOPE 28 (Scientific Committee on Problems of the Environment, International Council of Scientific Unions). New York and Chichester: John Wiley & Sons. Leaning, J., and L. Keyes, eds. 1984. The Counterfeit Ark: Crisis Relocation for Nuclear War (Physicians for Social Responsibility). Cambridge: Ballinger. London, J., and G. F. White, eds. 1984. The Environmental Effects of Nuclear War (American Association for the Advancement of Science Selected Symposium No. 98). Boulder, Colo.: Westview Press. Long, F. A., D. Hafner, and J. J. Boutwell, eds. 1986. Weapons in Space (American Academy of Arts and Sciences). New York: W. W. Norton.
THE EXPANDING ROLE OF THE SCIENTIFIC COMMUNITY 11 National Academy of Sciences, Committee on International Security and Arms Control. 1985. Nuclear Anns Control: Background and Issues. Washington, D.C.: National Acad- emy Press. National Research Council. 1985. The Effects on the Atmosphere of a Major Nuclear Exchange. Washington, D.C.: National Academy Press. Peterson, Jeanne, ed. 1983. The Aftermath: The Human and Ecological Consequences of Nuclear War (Royal Swedish Academy of Sciences). New York: Pantheon Books. Pittock, A. B., T. P. Ackerman, P. J. Crutzen, M. C. MacCracken, C. S. Shapiro, and R. P. Turco, eds. 1986. Environmental Consequences of Nuclear War. Volume I: Phys- ical Atmospheric Effects. SCOPE 28 (Scientific Committee On Problems of the Envi- ronment, International Council of Scientific Unions). New York and Chichester: John Wiley & Sons. Thompson, James. 1985. Psychological Aspects of Nuclear War (The British Psychological Society). New York and Chichester: John Wiley & Sons. World Health Organization. 1984. Effects of Nuclear War on Health and Health Services: Report of the International Committee of Experts in Medical Services and Public Health. WHO Pub. A36.12. Geneva: World Health Organization.