sustained the only known adverse medical effect up to this time. We intend that the phrase “such people as resided on Rongelap and Utirik on March 1, 1954" to include those then in utero. The restriction to residence in the Marshalls is a pralttical one. We know of no Rongelapese or Utirikese permanently residing beyond the Marshalls, but if any chose to do so, we believe it would be almost impossible as a practical matter to extend the program to them. The Secretary of the Interior would provide an identification system that would permit the people of Rongelap and Utirik to receive the special medical care while within the Marshalls but away from their home islands. 2. Medical conditions covered. Section 102 currently requires that the program provide medical care "for any injury, illness, or condition which may be the result directly or indirectly of such nuclear weapons testing program."' While there is no unanimity on the point, most of the advice received by the Interior Department is that it is usually impossible to know whether a given injury results from the testing program or from some other cause. Moreover, even if cause could be established, there remains the ethical and practical problem referred to above: can or should a doctor refuse to treat an illness, when he is otherwise equipped to do so, if he concludes that it is not nuclear-related? Our conclusion, reflected in section 1 of the proposed bill, is that the distinction should not be attempted. Accordingly, the bill provides for medical care and treatment to meet any health problea, not just nuclear-related problems. 3. "Integrated". Section 102 requires that the health program be "an integrated, comprehensive health care program." We construe the term to mean that the special health care program contemplated would be "integrated" to the maximm extent feasible with the programs provided elsewhere in the Marshall Islands Government. That construction would continue under the proposed bill. As an example, treatment of a Rongelapese with a broken arm could be provided at local medical facilities, for example at the Majuro Hospital, which is and would remain the responsibility of the Marshall Islands Government, but the cost of the treatment would be met by the United States. * * * We recognize that if our proposed bill is enacted, the benefits of the special medical program, as visualized by the law, would be confined to those explicitly named in it. We also recognize, however, that there have been contentions from the Government of the Marshall Islands and others that radiation effects have been experienced by Marshallese people not associated with the four atolls specified in the current law. Allegations have been made that there have been thyroid illnesses, birth abnormalities, and other medical irregularities on certain islands and atolls -- particularly Likiep -- that may be the result of the testing program. Although the Department of Energy has been willing to perform studies on Likiep, it has been unable to outline a study program that is satisfactory to the Marshall Islands Government, and Likiep and its people are thus far unexamined.