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American Journal Of Psychiatry: Preventing Genocide: Practical Steps

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  • American Journal Of Psychiatry: Preventing Genocide: Practical Steps

    PREVENTING GENOCIDE: PRACTICAL STEPS TOWARD EARLY DETECTION AND EFFECTIVE ACTION

    American Psychiatric Association
    http://ajp.psychiatryonline.org/cgi/content/full/168/9/992
    September 2011

    "Out of the crooked timber of humanity," as Kant and Isaiah Berlin
    powerfully assert, "nothing entirely straight can be made."

    Is it possible to understand, confront, and even prevent genocide?

    Has much been learned and done? Can we, as psychiatrists and
    citizens, do anything about it? David Hamburg-for many decades one
    of the world's most thoughtful and distinguished psychiatrists and
    a significant figure in international thinking about mass violence,
    war, and genocide-marshals a rather staggering array of evidence and
    ideas from many disciplines in his current book, which is an updated
    and revised version of a 2008 book with the same title.

    Dr. Hamburg, for those unfamiliar with his life, is a psychiatrist
    with a public health background who has been a professor at Stanford
    and at Harvard and is now a Distinguished Scholar at Weill/Cornell.

    He has been President of the Institute of Medicine, the National
    Academy of Science, and the American Association for the Advancement
    of Science. His many awards include the U.S. Presidential Medal of
    Freedom. He was president of the Carnegie Corporation for 14 years and
    has served on and/or chaired countless major national and international
    advisory boards. His books include Learning To Live Together, No More
    Killing Fields, and Today's Children.

    History, politics, economics, diplomacy, war, psychology and
    psychiatry, sociology, anthropology, and biology are all relevant to
    Dr. Hamburg's tasks in the current book, which stresses public policy
    and prevention. His sources, quotations, references, and interactions
    are heavy with names from academia but also names from differently
    powerful worlds, such as Annan, Carter, Gorbachev, Tutu, Solana,
    Vance, Mandela, Nunn, Sachs, Sen, and Urquhart as well as Armenia,
    Nazi Germany, the Soviet Union, Yugoslavia, Cambodia, Rwanda/Burundi,
    and Darfur.

    Dr. Hamburg reminds us that genocide is old, not new, even if mankind's
    weapons have become on the whole more lethal, and that genocide usually
    follows years of clear warning signs. After a general overview, he
    devotes a full chapter to each of several notable and much-studied
    illustrative 19th and 20th century examples, including what led up
    to them and what was and was not done: Turkey/Armenia, Nazi Germany,
    and Burundi/Rwanda/Tutsi/Hutu. He then devotes a more hopeful full
    chapter to a place and recent time where genocide might well have
    happened but did not: South Africa at the end of Apartheid.

    Dr. Hamburg has a patient, tenacious, and hopeful interest in
    prevention on a grand scale. That he is so widely informed and
    reasonable may make anyone, such as the current reviewer, who is a bit
    more pessimistic than Dr. Hamburg appears to be about these issues,
    feel a bit wrong or even churlish. I would like to be as optimistic
    as Dr. Hamburg is in this book, but my psychiatric views about
    individual biopsychosocial people and the primitive and destructive
    impulses of our species, including mankind's capacity for creating,
    ignoring, tolerating, and even enjoying savagery, violence, war,
    and genocide, may be darker than Dr. Hamburg's view of them. I
    also read some of the political evidence in a darker light than
    I think Dr. Hamburg does. That area includes perennial spoken and
    unspoken, hugely conflicting demands within the realms of politics
    and economics; the continuing usefulness, to far too many leaders,
    of war and of scapegoating; people's deep openness to propaganda and
    demagoguery; what governments did and did not do before, during, and
    after Turkey/Armenia, Nazi Germany, and Rwanda/Burundi; and the recent
    efforts and successes by governments in narrowing the definition of
    genocide for their perceived national convenience and in avoiding
    calling genocide genocide, lest they be pressed to act.

    That the book largely leaves out, as a likely potential agent for
    change, the United States, with its current reductionist business
    model as a substitute for government, seems to me to be notable and
    probably realistic.

    In his introduction, Dr. Hamburg emphasizes proactive help to
    countries in trouble. He recommends the formulation and dissemination
    of specific response options to deal with early warning signs. He
    draws together tools and strategies to prevent mass violence. He
    clarifies what international organizations can do and emphasizes the
    roles of democracies. He looks at preventive uses of cooperation,
    conflict resolution, and democratic socioeconomic development. He
    suggests developing two large cooperating international centers
    for prevention of genocide, as well as many smaller contributory
    structures. He suggests tasks for the next decade (e.g., in expanding
    linkage). And he urges encouraging leaders by molding a constituency
    for prevention by public education. He is concerned with education,
    or training, for hatred as one reason to insist on education for
    social and civic strength. All these goals would seem to many of us
    reasonable and admirable.

    He has a section called Pillars of Prevention, with chapters on
    preventive diplomacy, democracy and prevention of mass violence,
    equitable socioeconomic development, education for survival, human
    rights abuses and international justice, and restraints on weaponry.

    He supplements that with a list of what he considers a few recent
    advances in preventing mass violence, such as Kofi Annan's work in
    Kenya in 2008, and some restructuring of the United Nations.

    He is an expert on relevant institutions and organizations, and this
    becomes the focus of the third major section of the book, which
    looks at the United Nations, the European Union, the Organization
    for Security and Cooperation in Europe, NATO, and many smaller
    potential contributors, several of which he has helped to build and/or
    strengthen. He does several times note-without, in my judgment, fully
    acknowledging the power of-obstacles and limitations and conflicting
    aims in those organizations.

    It is an impressive book, painted on a large canvas. One might
    wish that the next edition be a bit more tightly edited to reduce
    repetitiveness and perhaps to leave room for further development of
    thought, or books, on some unwieldy areas only briefly touched on, such
    as religion, the psychology of ideologies, nationalism and tribalism,
    the sociobiology of aggression, and perhaps even the implications of
    climate change. Overall, however, this book will usefully challenge
    some of any reader's basic values and assumptions.

    It is a hopeful, widely informed, widely thoughtful, and quite readable
    one-man multidisciplinary survey of an unpleasant and important topic
    that makes many of us angry and most of us sad and uncomfortable.

    Footnotes

    The author reports no financial relationships with commercial
    interests.

    Book review accepted for publication March 2011.

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