The follow-up care of patients with total eblation
of the thyroid also appears inadequate.
Some had stopped

their‘medicine because of side reactions

and appear hypo-

thyroid to my eyes.
No regular follow-up has been pursued
to allow change of thyroid medication, or increase or
decrease of dosage.
A general feeling of distrust of the
Treaty Trust and Atomic Energy Commission physicians is
wide-spread among the Marshallese.
The people of the
Marshall Islands I spoke to have no-great faith in these
physicians, do not consider them devoted to their interests,
but instead representing the interests of the Atomic

Energy Commission or the Trust Treaty authorities, and
were reluctant to place their health in their hands, -although they finally did so for want of any other ade-

quate facilities supplied by the Treaty Trust Organi-

zation.
I am also impressed with the failure of the
physicians to communicate findings and prognosis to the
people of these islands.
Each patient is entitled to
have his questions answered.
He should be told the nature

of the lesion discovered, and, if he asks for it, a prognosis should be given.
The doctor should, when he can,
inform the patient of the cause of his illness.

These

basic rights of a patient have been in large part ignored
in the Marshall Islands, and I found very few Narshallese
who were acquainted with the nature of their pathology.

I reject firmly the thought that the people were too
primitive or uneducated, to absorb such information,
Since I have found this not to be true.
Among them are
educated and intelligent leaders who would be able to

digest such information and form their own conclusions
about what the islands, its vegetation, its people, and

its culture has suffered.

I have planned conversations with Americans in this

area of various expertise who would be useful in under-

standing the course of food-chain radiation and its injuries,

as well as the complex picture of fallout injury.
Some
of these conversations have been started, and some of the
correspondence is already under way.

I am writing to you instead of delivering an oral

report so that you may use this written report to demon-

-ill-

Select target paragraph3