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Introduction: The Knowledge Tree and Its Double Fruit William R. LaFleur Nearly two thousand years ago Marcus Aurelius articulated a standard that, if applied to the professions, held that all their members should “be upright, not be kept upright.”But this high ideal, we know by bitter experience, is unrealistic. The professions, including those of medicine, today enjoy the general public’s con¤dence in part because mechanisms have been put in place in order to keep their actions “upright.” One of these mechanisms consists of making public those actions—in both the past and the present—that violate generally agreed upon ethical standards. This was made strikingly, even shockingly, clear by what had been reported concerning some physicians serving with the American military in Iraq’s Abu Ghraib prison. The Lancet, Britain’s premier medical journal, performed a service by pointing out, “Government documents showthatthe U.S. military medical system failed to protect detainees’ human rights, sometimes collaborated with interrogators or abusive guards, and failed to properly report injuries or deaths caused by beatings” (Miles 2004, 725; now also Miles 2006). We no longer dare excuse gross lapses in professional ethics by appealing to “wartime conditions”—as if these are statistically so rare or so unusual that when they occur, ordinary standards may simply be waived. In fact, what we might wish were a sharp,clear difference between “seasons of war”and “seasons of peace” has, especially in recent centuries, been blunted by something in between , namely, seasons of rumored, anticipated, or planned-for wars. The years of what we call “the Cold War” were precisely such a season, one lasting for half a century and generating its own “culture” (Whit¤eld 1991). And medicine was caught up in the dilemma the Cold War posed—from that war’s very outset in 1945. The horrendous level of radiation poured onto two Japanese cities, we are at last beginning to see, produced a subsidiary “value” in addition to accelerating the end of World War II. And that “value” was realized because a portion of America’s medical establishment was drawn into the research producing it. While we have no direct evidence that the production of data relating to radiation and its effects was an explicit motive in dropping the bombs, the huge amount of human energy exerted by the United States into the collection, preservation, and study of data recoverable on the ground and from the bodies and body parts in Hiroshima and Nagasaki, presents us with something deeply disturbing. Even if only a “windfall” bene¤t, this hoarding of data was part of an evolving research project, one subsequently carried out by the Atomic Energy Casualty Commission but very quickly seen by many Japanese as one that had used the noncombatant citizens of Hiroshima and Nagasaki as “guinea-pigs” in a radiation test. That project’s motives seemed especially sullied when the AECC adopted a “no treatment” policy with respect to the hibakusha, persons radiated but still alive, who were suffering and desperately in need of care. Of¤cial American policy required that even American physicians in the bombed cities were expected to gather data and, correspondingly, to refuse to administer anything that would smack of therapy (Lindee 1994, 124–42). Since it is an acknowledged fact that raw data will necessarily be “contaminated” once the bodies providing such data are medicated in any way, and since the Americans were obsessed with collecting data as pure as possible, the burden of proof surely lies on those who might wish to explain away the suspicion that many, even if not all, American physicians in Hiroshima and Nagasaki let their deepest professional obligations be sidelined by the “needs” of research. Importantly, the war propelling this abrogation of professional ethics was not the war just concluded but, rather, a war then merely envisioned as occurring in the future. As Lindee notes: “The American medical teams [arriving in Japan in late September 1945] were expected to develop plans for atomic triage in a future war” (Lindee 1998, 382). And such plans required, it seems, that the data be brought home for easy access and close study. Thus, the AECC transported at least “twenty-thousand items, including photographs, autopsy records , clothing, and four thousand pieces of human remains” half a world away to Washington, D.C., where they were to remain as objects of research until being returned—on Japanese insistence—to Japan in May 1973 (Lindee 1998).1 Rationalizations initially masquerade as reasons...

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