Should we advocate for an end to nuclear power?

Long a subject of heavy controversy, the recent meltdowns at the Fukushima Daiichi nuclear plant have brought the issue of nuclear safety to the forefront of public discussion around the globe. In Germany 250,000 protesters took to the streets 2 weeks after the disaster, demanding an end to their country's nuclear plants. Two months later, in an abrupt reversal in policy, chancellor Angela Merkel vowed to accomplish this goal by 2022.

Concerns over the safety of nuclear power have likewise led a number of physicians to speak out and advocate for its abandonment. They argue that nuclear catastrophes are unavoidable and send radioactive materials across the planet and through food chains, making any such accident "local." Frequently cited as a standard for comparison, the 1986 meltdown at Chernobyl is said to have directly resulted in over a million deaths, according to a 2010 report by the New York Academy of Sciences.

One prominent critic is Dr. Helen Caldicott, an Australian-born physician and co-founder of Physicians for Social Responsibility, a group advocating an end to nuclear weapons and nuclear power.

Please take 10 minutes to read some of her arguments here:

http://www.helencaldicott.com/2011/05/unsafe-at-any-dose/#more-285

However, despite advocacy from physicians worldwide, many proponents of nuclear power are skeptical of the true long-term effects of radiation from nuclear accidents. Furthermore they argue that nuclear is in fact the safest form of energy, citing statistics on deaths associated with other means of energy production for comparison. Dr. Barry Brook, a professor of Earth and Environment Sciences at the University of Adelaide, argues that opposition to nuclear power on safety grounds is irrational. He favors comparing accidents such as that at Fukushima to high-speed rail accidents, asking why we are not, by the same logic, crying out for an end to high-speed rail.

His views can be found on his blog, BraveNewClimate.com. This site contains detailed info on numerous pro-nuclear power arguments. If you're short on time, the basic idea of the relative safety of nuclear energy can be had from this article:

http://transitionvoice.com/2011/03/nukes-are-scary-but-dont-forget-coal/

As physicians should we advocate against nuclear power? Have we considered all of the evidence? What evidence can we trust and how do we access it? Even if nuclear is dangerous, are there less dangerous options that can realistically meet global energy demands?

Join us for an open discussion of these and related issues on Wednesday, November 30 at 7 PM in the Haynes Hall seminar room.

Voluntourism followup

Hi everyone,

Thanks for the great discussion at the last QSM session! I hope everyone was challenged on the issues around medical volunteerism and voluntourism.

As promised, here's a great article that encompasses many of the issues we discussed:

GLOBAL HEALTH ETHICS FOR STUDENTS
ANDREW D. PINTO AND ROSS E.G. UPSHUR

http://www.ncbi.nlm.nih.gov/pubmed/19302567

Abstract
As a result of increased interest in global health, more and more medical students and trainees from the ‘developed world’ are working and studying in the ‘developing world’. However, while opportunities to do this important work increase, there has been insufficient development of ethical guidelines for students. It is often assumed that ethics training in developed world situations is applicable to health experiences globally. However, fundamental differences in both clinical and research settings necessitate an alternative paradigm of analysis. This article is intended for teachers who are responsible for preparing students prior to such experiences. A review of major ethical issues is presented, how they pertain to students, and a framework is outlined to help guide students in their work.

Voluntourism

International health experiences, and more broadly, any type of overseas volunteerism in the the developing world has become increasingly popular. Amoungst medical students in the US, 5.8% completed such an experience in 1978. In 2003 it jumped to more than 1 in 5; 22.4%.

However, in the midst of this growth many tough questions around the ethics and implications of these experience for host communities have been short changed. For example, what are our own intentions when undertaking these experiences? What are the consequences for the local community, good and bad? What are the overarching goals of these experiences?


If you have 5 minutes:

To Hell with Good Intentions - Ivan Illich

Written in 1968, but still relevant today, Illich turns the idea of ‘mission-vacations’ on its head, arguing that these projects are irredeemably mired in hypocrisy. Using his experience with 'voluntourists' in Latin America, he argues:

- Good intentions are meaningless when the result is a ‘do-gooder’ army that offends many Mexicans.

- Volunteers are ultimately selling an American value system and ‘seducing’ the ‘underdeveloped’ with the benefits of their way of life. This value system is a product of American consumerism with little in common with the local community.

- Ultimately, volunteers have no ability for a meaningful dialogue with those they are ‘helping’. Their only meaningful exchanges can be with Latin American versions of themselves, the educated and middle class elite.

Finally Illich urges the volunteers to stay at home and work for change in their own communities, where their work can be understood and have meaningful consequences.

If you have 10 minutes:

Read the full article. Much more powerful then our bullet points and worth the time:
http://www.swaraj.org/illich_hell.htm

For a medical perspective, read this short piece from the BMJ: Medical tourism can do harm
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1117889/

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If you have 5 minutes:

Watch this 4 minute video from Free the Children. If extolls the virtues of the type of experience Illich rails against.

http://www.youtube.com/v/0J9ZqW5KyDE?autoplay=1


As physicians where does this leave us? There are clear inequities in health and health care in Canada and overseas. Do we have a role in addressing them? If so, how do we do so responsibly and respect the principle of 'do no 'harm?' If not, what is our role in dealing with health disparities?

After our discussion, we'll post an article that addresses these issues in it's own way.

Fast food, fat profits: Obesity in America (& Canada?)

As a follow-up to our discussion, here's another take on industry influence on the way we eat. Josh Rushing of Al-Jazeera explores the world of cheap food for those living at the margins. What opportunities do people have to eat healthy? Who is responsible for food deserts and processed food in schools? Rushing finds food revolutions taking place and speaks with the people that are fighting back.