Journal of Bioethical Inquiry

, Volume 13, Issue 1, pp 57–64 | Cite as

Ethical Responsibility for the Social Production of Tuberculosis

  • Seiji YamadaEmail author
  • Sheldon Riklon
  • Gregory G. Maskarinec
Symposium: Tuberculosis


Approximately one in two hundred persons in the Marshall Islands have active tuberculosis (TB). We examine the historical antecedents of this situation in order to assign ethical responsibility for the present situation. Examining the antecedents in terms of Galtung’s dialectic of personal versus structural violence, we can identify instances in the history of the Marshall Islands when individual subjects made decisions (personal violence) with large-scale ecologic, social, and health consequences. The roles of medical experimenters, military commanders, captains of the weapons industry in particular, and industrial capitalism in general (as the cause of global warming) are examined. In that, together with Lewontin, we also identify industrial capitalism as the cause of tuberculosis, we note that the distinction between personal versus structural violence is difficult to maintain. By identifying the cause of the tuberculosis in the Marshall Islands, we also identify what needs be done to treat and prevent it.


Tuberculosis Marshall Islands Pacific Islands Social determinants of health Climate change Nuclear testing Militarism 


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Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2015

Authors and Affiliations

  • Seiji Yamada
    • 1
    Email author
  • Sheldon Riklon
    • 1
  • Gregory G. Maskarinec
    • 1
  1. 1.Department of Family Medicine and Community HealthUniversity of Hawai‘iMililaniUSA

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