Andrew Sullivan’s open letter to President Bush (“Dear President Bush,” October Atlantic) is an eloquent expression of the deep moral ramifications of torture. The question is not whether the United States deliberately tortured its prisoners, and thereby committed war crimes; the questions now are What does it mean that we did so? and What should we do about it? Sullivan contends that Bush’s authorization of “harsh interrogation” was an aberration from a man who is fundamentally honorable because he, at various times in the past, has condemned torture, proclaimed that America is above all “a nation of law and justice,” called evil by its name, and professed adherence to a Christian faith that recognizes the inherent dignity of all God’s children, no matter how great their sins. But the article, perhaps unintentionally, makes clear that Bush’s embrace of the abuses is a natural outcome of the Decider mentality: I’ll decide what is torture and what is not; I’ll decide what is legal and what is not; I’ll decide what is evil and what is not; and I’ll decide in whom dignity inheres and in whom it does not. In the world of hypotheticals, Bush may indeed be the ideal figure to help heal the damage done. In reality, the improbability that Bush will now decide to acknowledge any mistakes whatsoever, much less take full responsibility for the torture he knowingly authorized, means that unless we as a country are resigned to live with the stain of dishonor Sullivan so compellingly describes, it will be left to someone else to demand atonement for this ignoble legacy.
Andrew Sullivan says, “It would be too damaging and polarizing to the American polity to launch legal prosecutions against” President Bush. I absolutely disagree. Our nation has deep reservoirs of strength. We are a great and noble people, and we were dragged into the sewers by the Bush administration. I want to know what happened, who ordered it, and who did it, and I want the guilty punished. We have survived far greater crises. We can survive this.
With the statement “You are not known for Clintonian parsings of moral truths,” Andrew Sullivan demonstrates that at one level he himself fails to understand President Bush’s actions. His entire article is predicated on exactly that: the parsings of moral truths. Mr. Bush and his cadre of advisers parsed the moral truths embedded in the Constitution, in the Geneva Conventions, in the Universal Declaration of Human Rights, and in common sense, to arrive at justifications for these morally unjustifiable and reprehensible acts. Mr. Clinton may have tried to dance around on the head of a pin with his question as to the meaning of is, but his actions and prevarications only damaged his standing among some; they did not undermine decades of unassailable moral leadership on the international stage. So although I join Mr. Sullivan in his plea to Mr. Bush to take responsibility for the torture promulgated in our name, I would lay the blame on Mr. Bush for precisely his parsings of moral truths.
When I spoke to Jeanne Lenzer, the co-author of “Shots in the Dark” (November Atlantic), about influenza vaccine, my answer to the question “Does the vaccine matter?” was (and is) “Most definitely yes.” Unfortunately, you would never know that from reading the article.
Lenzer is certainly entitled to her own opinions on the uses and efficacy of influenza vaccines. When she and I discussed my research on the uses of nonpharmaceutical interventions (NPIs) for pandemic mitigation, I clearly stated that hand-washing and social distancing alone would not protect the majority of Americans from a severe influenza pandemic. And when she brought up stocking canned goods, I averred that although storing food and water is a reasonable thing to do when preparing for any crisis, it hardly protects against influenza.
What the writers chose not to include from my comments (and what Atlantic readers need to know) is that NPIs serve only to slow or blunt a pandemic for a short period of time, at best. They do little to contain, let alone prevent, it. This is because you still have a huge population susceptible to the novel influenza strain, and once it does spread, as it always seems to, millions of people will get sick from it.
Socially disruptive measures like quarantines, public-gathering bans, or school closures would be a consideration in 21st-century America only in the event of a highly lethal and widespread flu pandemic (like the disastrous 1918 flu pandemic). If employed, the aim would be to buy a little extra time until mass amounts of vaccine could be produced and distributed, and reduce the rush of patients to hospitals. Fortunately, the hospitalization and death rates being seen for H1N1 simply do not support the use of more draconian measures like NPIs.
Allow me to state my unfiltered medical opinion based on 25 years of experience as a pediatrician and historian of epidemic diseases and epidemiology: the best and safest way individuals can protect themselves against seasonal or H1N1 influenza is to roll up their sleeves and get a flu vaccine.
Howard Markel, M.D., Ph.D.
The University of Michigan
Jeanne Lenzer and Shannon Brownlee reply:
We appreciate Howard Markel’s desire to clarify his personal position on flu. As the article says, many experts believe flu vaccine is effective; some believe it is not. The point of the story is that we really don’t know one way or the other: our public health policy is built on a very thin base of evidence.