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Ethical Responsibility for the Social Production of 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.

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  1. Some $10 billion have been wasted on unworkable components of missile defence, including $2.2 billion on the Sea-Based X-Band Radar (SBX). The SBX, intended to detect ballistic missiles launched by enemy nations, was intended to be based in the Aleutian Islands, off Alaska. Rendered useless by its narrow field of vision, it mostly sits in Pearl Harbor.

  2. The other two, the Federated States of Micronesia and the Republic of Palau, are also in the Northern Pacific.

  3. The main population centre of the Commonwealth of the Northern Marianas Islands (CNMI), a Micronesian jurisdiction that is politically closer to the United States than the COFA Nations.

  4. This was indeed the justification for not evacuating the people of Utrik after they were exposed.


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Correspondence to Seiji Yamada.

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Yamada, S., Riklon, S. & Maskarinec, G.G. Ethical Responsibility for the Social Production of Tuberculosis. Bioethical Inquiry 13, 57–64 (2016).

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