BMJ -- Press Releases
Releases Saturday 12 April 2003
No 7393 Volume 326

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(Letter: Medical journals may have had a role in
justifying war)

Medical journals may have played an important part in
providing the political justification for attacking Iraq,
argues a public health expert in this week's BMJ.

Professor Ian Roberts believes that most people in the
United States and the United Kingdom would have
preferred not to launch a military attack on the people of
Iraq. To persuade them to do so, they need to believe
that they are being attacked.

Medical journals have (unwittingly) had an important
propaganda role in persuading the public that it is being
attached, he writes.

To illustrate this point, he compared the number of
articles on bioterrorism published in five major medical
journals between 1999 and 2002 with the number of
articles published on road traffic crashes (which kill
about 3,000 people and disable about 30,000 each day

Articles on bioterrorism outnumbered articles on road
traffic crashes in both 2001 and 2002. Of the 124
articles on bioterrorism, 63% originated in the United
States and the rest in the United Kingdom. JAMA
published the largest proportion (47%), followed by the
BMJ (21%), the Lancet (16%), and the New England
Journal of Medicine (15%).

Compared with a health problem that kills 3,000 people
per day, the public health importance of bioterrorism has
been over emphasised in the leading medical journals, he

"I am not implying that this is a deliberate attempt to
alarm the population, but nevertheless it may have had
this effect. As a result, medical journals may have
unwittingly played an important political part in justifying
war in Iraq," he concludes.


Ian Roberts, Professor of Epidemiology and Public
Health, London School of Hygiene and Tropical
Medicine, London, UK
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(Editorial: Images of war and medical ethics)

Graphic media images of Iraqi civilian casualties raise
questions about the boundaries of media ethics and,
more importantly, medical ethics, according to an
editorial in this week's BMJ.

Law lecturer, Jerome Singh, and television news
reporter, Tania DePellegrin, believe that doctors owe
patients basic duties of care that should not be
suspended during times of war.

Any decision that affects a patient should be motivated
by what is in the patient's best interest and should be
supported explicitly by that individual. If this cannot be
achieved then cameras should not be permitted into a
hospital room. "Doctors who permit footage to be
captured fail in their legal and ethical duty to protect their
patients," they write.

Doctors should be mindful that during a war patients can
be used as propaganda tools. Governments and the
media should refrain from using doctors and patients to
further their own agendas, they add.

Publishing or broadcasting images of prisoners of war is
illegal under international law, yet the same protection is
not afforded to civilian casualties of war. Addressing this
shortcoming would provide explicit guidance to doctors
faced with scenarios such as those being experienced by
the Iraqi doctors. Ethics should not be lost in the war,
they conclude.


Tania DePellegrin, Television News Reporter, Toronto,
Email:  [log in to unmask]

Jerome Singh, Senior Lecturer, Howard College School
of Law, University of Natal, Durban, South Africa
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