Dr. Nurhussein is correct that the effects of the Gulf War, especially on the children and ethnic minorities of Iraq, must be considered in any discussion of human rights violations. Physicians for Human Rights (PHR) has sent several missions to Iraq, Iraqi Kurdistan, and Kurdish refugee camps in Turkey to draw public attention to the enormous dimensions of this problem [1, 2].

We agree that the principles of medical ethics cross national and cultural boundaries and cannot be abrogated by civilian or religious law. Physicians are obliged to speak out on behalf of colleagues living in countries where physicians are being intimidated or coerced into participating in torture or other human rights abuses and to condemn those who willingly participate in such activities. At the same time, as Dr. Nurhussein points out, the medical community must not remain passive while civil war, famine, and "ethnic cleansing" strike at the human family. Physicians are increasingly involved in international human rights activities. Physicians for Human Rights works closely with major human rights organizations worldwide. The American College of Physicians has an active human rights committee, and other medical organizations are also becoming more active in this area.

Medical ethicists as a group, however, have concentrated mainly on First World ethics (for example, organ transplantation and care of the terminally ill) and have given less attention to the international human rights violations cited by Dr. Nurhussein. Still, there is no need for an international conference to establish broader definitions of medical ethics or to create new international codes. What is needed are procedures for implementing, monitoring, and enforcing existing standards and codes, as well as an increased awareness by the medical community of its human rights obligations. The best way to achieve this would be to make "medicine and human rights" a significant part of the ethics curriculum in medical and public health schools.