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Letters From Our Members

Letter from our members regarding the crisis in Ukraine

Dear Friend of Greater Boston PSR,

Those of us working in healthcare have joined the rest of the world in shock and horror watching the Russian military’s attacks on civilians and civilian infrastructure, including a maternity ward and children’s hospital in Mariupol last week. Physicians who study the effects of conflict on public health have long described the ripple effect that these kinds of attacks have. As food, water, transportation, and sewage and waste infrastructure fail, a larger wave of sickness and death will follow the initial bombings, as civilians face food insecurity, infectious disease, and exacerbations of chronic medical conditions.

The disaster currently unfolding would be multiplied to unimaginable proportions if the current conflict escalated to involve nuclear weapons. The approximately 12,000 nuclear weapons in Russian and NATO arsenals today include many strategic weapons which are orders of magnitude more powerful than the bombs that destroyed Hiroshima and Nagasaki. An exchange of these weapons would not only kill millions of people, but collapse the global economy and spread radioactive fallout. Climate models show that such an exchange on population centers would inject enough soot into the atmosphere to disrupt the climate, dropping global temperatures by as much as 10° C (18° F), causing widespread crop failures and likely the starvation of billions of people.


The impossible needle that Western leaders must thread in this moment is how to protect and help Ukrainian civilians without escalating the conflict to the point of nuclear war. Cable news is full of cheerleading for a no-fly zone over Ukraine. A YouGov poll from March 5th-8th showed that 40% of US citizens felt that a no-fly zone was a good idea (and 30% a bad idea), but when the question was rephrased to ask if the US military should “shoot down Russian military planes flying over Ukraine,” the number fell to 30%, with 46% opposing. This is a critical distinction which the Biden administration must clearly draw in its communication. Given the dangers of a nuclear exchange, the administration’s steadfastness in not escalating to direct conflict with Russia, and its insistence in setting up direct lines of communication with the Russian military, deserve praise.

If the world survives this conflict, we will need to regard it as a wake-up call to dismantle the system of global security that keeps us all in danger of extinction. As members of International Physicians for the Prevention of Nuclear War (IPPNW) and its US affiliate, Physicians for Social Responsibility (PSR), we are carrying on this work which was started early in the Cold War. Our current system of nuclear deterrence makes many false assumptions: that all actors in geopolitics are states, that those states act rationally in their own interest, and that our nuclear command and control systems are secure. History has shown us otherwise. Whether by accident – so called “broken arrow” incidents, such as the recent near-miss of a mistakenly fired cruise missile from India at Pakistan – or threats of intentional use, the world has narrowly escaped destruction numerous times.

Our organizations are involved in efforts to educate physicians and the public about nuclear weapons. We lobby for sane nuclear policies, such as a “No First Use” commitment and the end to sole presidential control of nuclear weapons. We have passed resolutions in favor of our policy platform, known as Back from the Brink, in the legislatures of four states and numerous municipalities. We maintain relationships with a network of allied doctors and medical trainees across the world, including in Russia. And we have worked in the United Nations to support the Treaty on the Prohibition of Nuclear Weapons, which passed the UN General Assembly in 2017 and was ratified last year, and provides an international legal framework for nuclear abolition. As the events of recent weeks show, individual states do not always follow international law. We must continue the work of strengthening the inspections capacity, oversight, and enforcement capabilities of international bodies.

Nuclear weapons have faded from the public consciousness since the end of the Cold War, but as the current conflict shows, their existence remains a threat to ours. We must find a way, as impossible as it seems, to peacefully resolve this conflict, as President Zelensky himself said in an interview last week. And then we must turn our attention to the existential threat that these weapons pose.


Dr. Joseph Hodgkin is a hospitalist at Massachusetts General Hospital
Dr. Philip Lederer practices internal medicine at Upham’s Corner Health Center