title: Ethical Responsibility for the Social Production of Tuberculosis.
abstract: 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.
authors.affiliation: Department of Family Medicine and Community Health, University of Hawai'i, 95-390 Kuahelani Avenue, Mililani, HI, 96789, USA. seiji@hawaii.edu.
authors.forename: Seiji
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Family Medicine and Community Health, University of Hawai'i, 95-390 Kuahelani Avenue, Mililani, HI, 96789, USA.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Riklon
authors.affiliation: Department of Family Medicine and Community Health, University of Hawai'i, 95-390 Kuahelani Avenue, Mililani, HI, 96789, USA.
authors.forename: Gregory G
authors.initials: GG
authors.lastname: Maskarinec
mesh_terms: D030861:Capitalism; D057231:Climate Change; D003226:Congresses as Topic; D017281:Cost of Illness; D003441:Crowding; D003920:Diabetes Mellitus / Q000453:epidemiology*; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D058872:Epidemics; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D038622:Internationality; D066192:Manufacturing Industry / Q000941:ethics; D008849:Micronesia / Q000453:epidemiology; D008889:Military Personnel; D054043:Nuclear Weapons / Q000941:ethics / Q000266:history; D011634:Public Health / Q000941:ethics* / Q000639:trends; D011851:Radioactivity; D012307:Risk Factors; D064890:Social Determinants of Health / Q000941:ethics / Q000639:trends; D012941:Social Responsibility; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control / Q000635:transmission; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000209:etiology; D014481:United States / Q000453:epidemiology
keywords: Climate change; Marshall Islands; Militarism; Nuclear testing; Pacific Islands; Social determinants of health; Tuberculosis