For the first time in human history, a lethal agent, nuclear weaponry, has the instant capacity to produce human injury, death and suffering on a vast scale, to render the environment uninhabitable and even to cause extinction of the human species. Unassailable medical research by PSR over decades has proven that medicine cannot treat the effects of even a single nuclear weapon, so that prevention of use is the only rational medical response. The only certain means of prevention is the elimination of nuclear weapons themselves. Abolition is therefore a medical issue and a medical imperative.

Today, many years since the 1991 end of the Cold War, the number of nations possessing nuclear weapons has increased to at least eight, thousands of warheads are still on hair-trigger alert, and even if all existing arms control treaties are fully implemented, there will remain many thousands of warheads - the equivalent of 200,000 Hiroshima bombs. In 2005 both North Korea and Iran are on the verge of becoming nuclear states. Nuclear states cannot maintain even the present dangerous status quo. In fact, their example and the dissemination of nuclear material, breakdown of controls, nuclear smuggling, bitter ethnic, religious and national rivalries, increasing fanatic terrorism, all make it likely that terrorists and more nations will acquire nuclear arms in the years ahead. Ultimately widespread proliferation makes it highly likely that someday nuclear weapons will be used: whether by terrorists or nations; or through accident, miscalculation, intention or madness. So-called ballistic missile defenses, even if partially effective, would be powerless to prevent the overwhelming destructive effects of offensive nuclear weapons or terrorism. There are only two real alternatives: nuclear abolition or universal proliferation and eventual use.

Abolition of nuclear arsenals is a practical and achievable goal, technically and politically, not merely an utopian dream. It would require an explicit treaty commitment by nuclear nations to elimination of weapons by time-bound actions, all undertaken with openness, verification and international enforcement. We have established a convention banning bacteriologic and chemical weapons, which provide a valuable precedent of outlawing weapons of mass destruction. The exception of nuclear weapons, the ultimate weapon of mass destruction, defies any plausible rationale.

The abolition of nuclear weapons will require a deliberate decision -- both political and moral. The voice of medicine can help propel that decision.