Modernized versions of the physicians' oath, which are used in the vast majority of American medical schools these days, do not stop with expurgating specific proscriptions (as against abortion, euthanasia, and ``all intentional ill-doing and all seduction of patients''). The word ``harm'' has disappeared. The word ``society'' has been added. The concept of individual responsibility-that the physician must be guided by his own judgment-has been replaced with a vaguely defined social responsibility. (For the wording of the oaths and a comparison, see www.aapsonline.org .)
A shift in emphasis from the care of the sick to prevention and ``health maintenance''-with the sick having to compete with the vast majority of healthy people in the allocation of ``scarce resources''-is the corollary to the fundamental change in ethics.
One result is opposition to civil defense. To prevent nuclear war, ``social responsibility'' prescribes the sacrifice of the millions who could be saved by shelters, radiation monitoring, food storage, etc., if war occurs-as if total vulnerability were a deterrent rather than an invitation to attack.
Another result is ``global immunization for the 21st century'' (Science 284:587, 1999): ``Millennial winds are blowing through the field of global vaccinology.'' An alliance of key U.N. agencies, leaders of the vaccine industry, major foundations, and independent academics has an agenda: ``a new global [public- private] partnership designed to save 40 million lives over the next 10 years at a cost that could approach $3 billion per year'' [a mere $1300 per hypothetical life saved]. This requires building ``a vaccine infrastructure.'' (In the U.S., this infrastructure includes networked computer data bases that could also serve as the basis for a womb-to-tomb tracking of all citizens or subjects.)
A sovereign nation might prefer a different agenda, emphasizing sanitation, more plants to generate electricity along with other industrial infrastructure, or DDT and other vector control measures. This could save many more lives, which are now threatened by all the diseases of poverty, not just those that might be lost to rubella or other diseases for which a vaccine happens to exist. The vaccine partnership could exert leverage by tying certain loan agreements to immunization outcomes. (Denial of funds for building a bridge might, of course, be a less harmful measure than bombing a bridge that already exists.)
The global agenda is already affecting policy in the U.S. The push to immunize American newborns against hepatitis B is part of a global campaign to eradicate a disease that is far more prevalent in Third World countries. The rationale for immunizing a baby is not just to help that baby (which would require an individual risk:benefit calculation), but to control hepatitis B in the U.S. and the world.
Somehow, it is acceptable to have children with active AIDS attend class without anyone's knowledge of their status-yet children who have not been immunized against hepatitis B may not be allowed in a classroom even if they do not carry the disease, and even if the entire school is free of the disease!
The opinion of a group of elite experts, who have close ties with an industry that stands to make enormous profits from mandatory vaccines, while it is shielded from product liability, is so far being allowed to trump the opinion of the patient's attending physician and override the usual procedure for genuinely informed consent.
Occasionally, people ask for the DDP list of suggested medical supplies to store. While still available, the list has not been updated. Recent suggestions are found in a new book entitled Plain-Talk Medicine for Uncertain Times and Places by Robert S. Berry, M.D. This spiral-bound, 117-page volume contains much good advice from an experienced emergency room physician. It also reviews a number of other medical textbooks and self-help manuals. It can be ordered for $19.95 from y2kdoc, P.O. Box 336, Greeneville, TN 37743 (and see www.y2kdoc.com).
Dr. Berry notes that the U.S. is vulnerable to an interruption in medical supplies-whether due to a Y2K computer glitch or other factors. According to a February U.S. Senate report on Y2K, 80% of the basic ingredients for pharmaceutical products come from outside the U.S. Denmark is the source of 70% of the world's insulin. Instead of the large wholesale drug warehouses of the past, the U.S. now relies on a (generally) more efficient computerized just-in-time (JIT) inventory process. One pharmaceutical distributor states that there already are shortages of some products. Dr. Berry suggests that physicians and patients keep extra supplies.
This generally helpful book contains at least one serious error: the oral rehydration formula calls for salt substitute (potassium iodide). Salt substitute, such as Morton's Lite Salt, contains potassium chloride. Do NOT use the KI from your thyroid blocking kit for this purpose!
A very limited supply of CD-ROMs from the 1992-1997 annual meetings is available at fire-sale prices: $2 each for a minimum order of 5. An updated CD-ROM, including audio presentations from the 1998 and 1999 meetings, should be available in a few months. Audiotapes can be order from the enclosed 1999 meeting program: please note some last-minute changes in the program.
A 3-hour workshop on weapons of mass destruction was presented at the Pima County Medical Society in Tucson, April 24. A videotape containing talks on nuclear weapons by Dr. Jane Orient, chemical weapons by Dr. John Sullivan, and biological weapons by Dr. Sheldon Marks is available for $20 post-paid from DDP at 1601 N. Tucson Blvd. Suite 9, Tucson, AZ 85716.
James R. Dunn, Ph.D., writes: [Concerning] my paper ``Can the Greens Destroy Nature?'', I agree with your comment that nature will not actually be destroyed [as a result of green policies] because after the demise of (most) humans, nature will rejuvenate. However, before that occurs, we in the eastern two-thirds of America will see our forests and wildlife depleted. We may permanently lose some species along with vast amounts of soil. Of course, this is contingent on the Luddites winning and actually turning back the technologic clock. Powerful though they may be, their victory would seem improbable.
On Audubon's list of the 20th century's greatest environmentalists, I could not find a single person who contributed to the environmental miracle in which we live. The new forests, the hugely expanded wildlife, and the vastly reduced soil erosion are all products of our system. The real environmental heroes are John Deere, McCormack, Ford, Dow Chemical, and Union Pacific.
Incidentally, the best indicator species in New York is the white-tailed deer, simply because we have so much data. Current puzzle: why has the deer population increased by a factor of 2 to 5 since 1970 in areas adjacent to our upstate metropolitan areas? It appears to coincide with ``suburbanization.'' Again, ``conservationists'' cannot take the credit.''
DDP, 1601 N. Tucson Blvd. Suite 9, Tucson, AZ 85716, (520)325-2680