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W O R L D
H E A L T H
O R G A N I S A T I O N
H E A D C H A I R
L A U R A S A B R O S A
C H A I R
S T E L L A B O I C E N C O
RIO DE JANEIRO MIDDLE SCHOOL
MODEL UNITED NATIONS
STUDY GUIDE
WHO STUDY GUIDE
R J M S M U N
CONTENTS
Introduction to the committee
Letter from Dais/Chair…………………………………………………………….2
Committee Information……………………………………………………………3
Topic A: Discussing the use of euthanasia in diseased patients……...……………...4
Background Information…………………...……………………………………..5
Current Situation…………………………………………………………………..8
Bloc Positions……………………………………………………………………...9
Timeline of Events…………………………………………..…………………...11
Definition of Key Terms………………………………………….……………...13
Guiding Questions……………………………………….……………………...15
Bibliography…………………………………….………………………………..16
Topic B: Addressing bioterrorism threats………………………………………….…..18
Background Information………………………………..……………………….19
Current Situation ………….…………………………………………………….21
Bloc Positions……………………………………………………………..……..23
Timeline of Events…………………………………………………………..…..24
Definition of Key Terms………………………………………..………………. 26
Guiding Questions………………………………………………..……………..27
Bibliography……………………………………………………………………..28
2
WHO STUDY GUIDE
R J M S M U N
LETTER FROM DAIS
Dear delegates,
Welcome to the first edition, of hopefully many, of the RJMSMUN! As two
aspiring doctors and MUN enthusiasts, we couldn’t be more honoured to be
serving as your chairs for the World Health Organization. We are immensely
delighted to help you to develop your debate skills through the discussion of
such pertinent topics. One of our main goals is to make this conference, not
only as intellectually enlightening as possible, yet also a fun experience,,
which will hopefully engender lifetime memories and inspire the start of your
MUN careers.
Topic A addresses the legality of euthanasia in diseased patients, currently
permitted in countries such as the Netherlands, Belgium, Luxemburg and
Colombia; a treatment which has increasingly been requested by terminally
ill patients. Whereas some regard this controversial procedure as the 'right to
die by ending suffering', others view it as murder.
Topic B tackles the issue of security and protection against biological weapons
and bioterrorism, which are viruses and bacteria used purposely against
humans, animals and plants. The consequences of bioterrorism can result in
epidemics and pandemics, which in turn bring a lot of deaths., however, not
all countries have the infrastructure to protect their population against it.
Looking forward to fruitful debate, we have produced this guide to provide
you with key information to enhance your knowledge on both topics. . We
hope that our efforts can lead into engaging debates and passionate
speeches! If you have any doubts or concerns, feel free to contact any of us
through our email lmsabrosa@gmail.com & stellagcb@gmail.com. Surprise us!
3
WHO STUDY GUIDE
R J M S M U N
COMMITTEE INFORMATION
The World Health Organization was created in 1948 and is a
Specialized Agency of the United Nations responsible for global
health. Counting with 194 member states, the organization's main
role is to serve as the “authority for health within the United Nations
system”, and to provide “leadership on global health matters.”
Headquartered in Geneva, Switzerland the WHO's objectives are
based on a Six-Point Agenda aimed at responding to the rising
problems of global health. These points are: (1) promoting
development; (2) fostering health security; (3) strengthening health
systems; (4) harnessing research, information and evidence; (5)
enhancing partnerships; and (6) improving performance.
The World Health Assembly is the decision-making body of the
WHO, which is attended by delegations of the Member States to
discuss and determine policies of the WHO, proposing program
budgets, and drafting resolutions, following an agenda prepared by
the Executive Board. That said, this Special Committee will feature
the World Health Assembly (except the part of electing the
Director-General and the financial policies), which abides by
traditional MUN procedure –– please check RJMSMUN's procedure
guide for more information.
4
WHO STUDY GUIDE
R J M S M U N
TOPIC A: Discussing the use of
euthanasia in diseased patients
The literal translation of euthanasia from Old Greek is “good death”
however, by some, this is seen as one of the most terrible forms of
murder.
5
WHO STUDY GUIDE
R J M S M U N
BACKGROUND INFORMATION
Overview
6
Euthanasia is properly defined as the hastening of death of a patient to prevent further
suffering, be it from an incurable and/or painful disease or an irreversible coma. In 2016,
JAMA, a peer-reviewed medical journal, reported that around “0.3% to 4.6% of all deaths
are reported as euthanasia or physician-assisted suicide in jurisdictions where they are
legal.”1 All of these acts are performed under people who suffer some type of incurable
pain and illness. Studies throughout various years showed that the illnesses which account
for the most acts of euthanasia are as follows: tumors (or/and cancers), multiple
pathologies, disease of the nervous system, diseases of the circulatory system, mental and
behavioral disorders, and diseases of the respiratory system.2
The group of drugs most commonly used to end life is called barbiturates, which slow
down the activity of the brain and nervous system. They are usually used alone or in
combination for euthanasia, usually as the form of lethal injections, and are the preferred
drugs in the Netherlands, Belgium, Switzerland and some USA states where euthanasia is
legal. Other options also exist, but have limited evidence of use in euthanasia. Such
alternative and rare types of euthanasia drugs cause excessive muscle relaxation; fatally
lower blood sugar levels; heart attacks; or paralysis and respiratory distress which can end
life, as can some painkillers commonly used in palliative care. With that in mind, it is up to
the domestic policy of each of the aforementioned countries where euthanasia is legal in
order to decides their preference type of drugs and the way it will be administered into a
person’s body.
Furthermore, there are other classifications which need to be taken into consideration
with the performance of euthanasia. Euthanasia can be voluntary or non-voluntary,
passive or active. During voluntary euthanasia, a person is totally aware of their decision
and is not in an unconscious state of mind, whereas in the case of voluntary euthanasia,
the patient could be unconscious and hence, their appointed legal responsible decides
their final fate. Additionally, while passive euthanasia involves suspending medications
which keeps people lives going, active euthanasia is when death is brought about swiftly
by an act, be it an overdose of pain-killers or a lethal injection.
1 - McGee, A. 2019
2 - Statista, 2018
WHO STUDY GUIDE
R J M S M U N
Countries are more prone to allowing liberal in regards to passive and voluntary euthanasia
than active and non-voluntary euthanasia. For example, countries which are semi-liberal, such
as like India and US states, only allow passive euthanasia to be performed.
In 2002, Netherlands and Belgium became the first countries to legally adopt euthanasia as an
alternative for terminally ill patients; further, in 2008, this was mirrored by Luxembourg.
Additionally, the first non-European to authorize the application of euthanasia was Colombia,
in 2015, subsequently followed by Canada and The Australian state of Victoria in 2016 and
2017 respectively. Despite the efforts of many countries to introduce laws that make at least
some type of euthanasia legal, there are still many barriers to its holistic legalization.
Besides the usage of euthanasia, another very similar practice is common: assisted suicide.
Overall, whereas euthanasia describes the situation where the unnatural death of a person is
caused by a second individual (e.g.: injecting a lethal drug) the person who is asking for the
act has someone else take the action that leads to their unnatural death (like injecting a lethal
drug), assisted suicide is when the person is prescribed drugs by a professional, and yet, their
death is caused by their ownselves. that they must take themselves in order to die. More
technically, euthanasia is when the physician, takes an action with the singular intention of
causing a patient’s death. Assisted suicide is when a suicide is intentionally aided by the
physician and the person self-administers the medication. That is, the medical practitioner will
prescribe a lethal drug which the patient will usually take orally. Many believe assisted suicide
is more ethically correct than euthanasia, as the doctor who once swore not to cause the death
of one individual in the Hippocratic Oath is not involved directly in the death of the person as
they would otherwise be he is with euthanasia.
7
Legality of Euthanasia
WHO STUDY GUIDE
R J M S M U N 8
While euthanasia may be believed to be new, only modern methods have come to rise
nowadays. Euthanasia was practiced in both Ancient Greece and Rome, and was seen to be
supported by Socrates, Plato and other major philosophers. Hippocrates appears to be one of
the only ones who at the time spoke against it according to his oath "I will not give a lethal
drug to anyone if I am asked, nor will I advise such a plan"3 (there is some debate about
whether or not this was intended to encompass euthanasia).
The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th
century, to refer to an easy, painless, happy death, during which it was a "physician's
responsibility to alleviate the 'physical sufferings' of the body." As the Judeo-Christian
influence grew around the world, these practices began to be more frequently opposed.
Instead, it is argued that euthanasia grew more and more, especially with the Age of
Enlightment, given the burgeoning opposition to the Church.
Moreover, morphine was introduced to the world in the 1800s as an analgesic, followed by
chloroform to replace it as a less toxic substance. The debate between ethics of euthanasia
spread around scientific journals after Samuel Williams, a non physician, stated that euthanasia
was a right everyone should have and the use of morphine’s could be used to do so. This led to
outrage in science and medical conferences, magazines and journals, seen as many
professionals believed that not even the use of aesthetics should be used, as pain is a natural
process of life.
Morphine ended up becoming some of the main mechanisms for euthanasia. In 1936, King
George V of Britain was given a fatal dose of morphine and cocaine to hasten his death. At the
time he was suffering from a cardio-respiratory failure, and the decision to end his life was
made by his physician. This event was kept a secret for over 50 years, however it coincided
with proposed legislation in the parliament to legalise voluntary euthanasia for inividuals above
21 years of age.. That said, the rise of these drugs also allowed many US states to develop bills
to legalise euthanasia.
Historical Information
3 - N A T I O N A L L I B R A R Y O F M E D I C I N E , 2 0 0 2
Recently, more countries are looking to renew their laws on euthanasia, be it to legalize it or to
reinforce the laws dealing with its illegal use. Portugal, for example, has opened Parliament
votes to legalize euthanasia practice in the country. The same goes for South Africa, Spain,
Germany and New Zealand, where the court is to decide the legality of this practice. Not only
that, but in countries where euthanasia are considered to be legal, be it passive or active, cases
have been soaring. The Vienna-based Institute for Medical Anthropology and Bioethics
(IMABE) noted on Feb. 12 that cases had increased in Belgium from just 24 in 2002 to 2,656
in 2019. In the same period, cases had surged in the Netherlands from 1,882 to 6,361. 4
Views on eutahansia have also started to dissect (and thus polarize) the world, leading to
huge protests where some affirm that the “right to die” is a human right, and others classify
euthanasia as suicide or an heinous crime.. The Vatican has recently publicly stated that both
euthanasia and assisted suicide are “intrinsically evil,”.5
WHO STUDY GUIDE
R J M S M U N 9
4 - C N A S T A F F , 2 0 2 1
5 - W I N F I E L D , N . 2 0 2 0
CURRENT SITUATION
Current legality of euthanasia around the world
Euthanasia has also given the rise to what is called suicide tourism, or euthanasia tourism. This
happens when potential euthanasia candidates travel to countries where the practice is legal in
order to gain their “peaceful death”. There's a notable increase in the number of patients
travelling to Belgium, known as the “world’s euthanasia capital”, where assisted dying has been
legal since 2002, mostly from the other 27 European Union member nations as well as from
other continents where euthanasia is barred.
WHO STUDY GUIDE
R J M S M U N
BLOC POSITIONS
The Belgian parliament legalised euthanasia on 28 May 2002. There have been about 1,400
cases a year since the law was introduced, and a record 1,807 cases were recorded in 2013. 6
In December 2003, the Belgian Senate voted in favour of extending its euthanasia law to
terminally ill children. A psychologist must also determine the patient's maturity to make the
decision.
1 0
Belgium
Switzerland
All forms of euthanasia are illegal in the country, however it is known to be the world’s capital of
assisted suicide with the largest rates of assisted suicide. There are no age requirements, illness
diagnosis, or symptom state for the act to be performed, however assisted suicide is considered a
crime if the reason behind it is selfish. The assistance doesn’t need to come from a physician.
United States of America
Active euthanasia is illegal throughout the United States. Patients retain the rights to refuse
medical treatment and to receive appropriate management of pain at their request (passive
euthanasia), and burdensome treatments, such as life-support machines, may be withdrawn
under specified circumstances. Assisted suicide is legal in Colorado, Oregon, Hawaii, Washington,
Vermont, Maine, New Jersey, California, the District of Columbia, one county in New Mexico, and
in Montana.
United Kingdom
Euthanasia remains illegal in the country and considered murder under the law, however a poll
from 2019 sugegsted that over 90% 7 of the population believes euthanasia should be legalised
for those suffering from temrinal illnesses.
6 - A S S O C I A T E D P R E S S , 2 0 1 4 A N D P O R T E R , T . 2 0 1 5
7 - B O W C O T T , O . 2 0 1 9
WHO STUDY GUIDE
R J M S M U N
TIMELINE OF EVENTS
4th Century B.C.
The Hippocratic Oath states that any doctor that
swear under the oath should be prohibited from
supplying 'a deadly drug to anybody, not even if
asked for, 8
1870
Use of morphine as an analgesic (pain-relieving
agent) grows and Samuel Williams, a
nonphysician, begins to advocate the use of these
drugs not only to alleviate terminal pain, but to
intentionally end a patient’s life.
1935
Voluntary Euthanasia Legalisation Society is
founded
1950
World Medical Association condemns euthanasia.
1952
Groups petition the United Nations to amend the
Declaration of Human Rights to include "the right
of incurable sufferers to euthanasia or merciful
death”. However, Eleanor Roosevelt, the
Chairperson of the Committee, did not present
the petition to the Commission.
1957
The Vatican proclaims that passive euthanasia is
acceptable.
1 1
8 - N A T I O N A L L I B R A R Y O F M E D I C I N E , 2 0 0 2
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R J M S M U N
2001
Netherlands becomes the first country to legalize
euthanasia.
2nd March 2014
Belgium legalizes euthanasia for terminally and
incurably ill children, becoming the first coutnry to
lift all age restrictions on euthanasia.
29th November 2017
Victoria becomes the first Australian state to
legalize limited euthanasia.
29th January 2021
Portugal’s parliament votes in favour of
euthanasia in terminally ill patients.
1 2
WHO STUDY GUIDE
R J M S M U N
DEFINITION OF KEY TERMS
1 3
Active Euthanasia
Active euthanasia occurs when the doctor purposely gives someone a lethal dose of a sedative or
injection.
Analgesic
A pain reliever substance, but also often used as anesthesia.
Assisted Suicide
The act of intentionally helping a person’s death by providing lethal drugs for self-administration,
at that person’s voluntary request.
Involuntary Euthanasia
When euthanasia is performed on a person against their own will, and they are able to provide
informed consent.
Non-voluntary Euthanasia
Involves someone else making the decision to end someone’s life and the explicit consent of the
individual addressed is unavailable, close family members usually make the decision. This is
generally done when someone is completely unconscious or permanently incapacitated.
Palliative Care
A method by which a doctor or nurse tries to soothe the pain of a patient without taking their
lives
WHO STUDY GUIDE
R J M S M U N 1 4
Palliative Sedation
Procedure which entails a request to be deeply sedated until death.
Passive Euthanasia
Passive euthanasia is the act by which life-sustaining treatments are withdrawn allowing a
person’s death to come more quickly.
Voluntary Euthanasia
Voluntary euthansia occurs when a physician administers a lethal dose of a drug to a patient
upon the patient’s specific request.
WHO STUDY GUIDE
R J M S M U N
GUIDING QUESTIONS
1 5
How can euthanasia be properly regulated in countries that
have legalized it? Which forms can be better controlled and to
whom should they be given?
In countries where euthanasia is legalized, should doctors
continue to swear under the Hippocratic Oath even if it clearly
states that a doctor should “not give a lethal drug to anyone”?
By what means can the legalization of euthanasia be used to
solve other problems present in modern world, such as
overpopulation and lack of organ donation?
In regards to the Universal Declaration Of Human Rights,
shouldn’t euthanasia - “right to die” - be included in the
document?
To what extent is it hypocritical to legalize assisted suicide and
maintain euthanasia pratice illegal?
BIBLIOGRAPHY
Ashford, J. 28/08/19, ​‘​Countries where euthanasia is legal’, ​The Week, Online, Accessed
08/02/21
https://www.theweek.co.uk/102978/countries-where-euthanasia-is-legal
Associated Press, 16/09/14, ‘​Belgian convicted killer with 'incurable' psychiatric condition
granted right to die’, ​The Guardian, Online, Accessed 01/03/21
https://www.theguardian.com/world/2014/sep/16/belgium-convict-granted-right-to-die
Associated Press, 24/09/20, ​‘Vatican declares euthanasia and assisted suicide ‘intrinsically
evil’’, ​Independent, Online, Accsessed 11/02/21
https://www.independent.co.uk/news/world/vatican-euthanasia-assisted-suicide-catholicism-p
ope-francis-b559321.html
Bomford. A. & Doyle, E. 30/01/19​, ‘Wanting to die at 'five to midnight' - before dementia
takes over’, ​BBC, Online, Accessed 24/02/21
https://www.bbc.com/news/stories-47047579
Bowcott, O. 03/03/19, ‘​Legalise assisted dying for terminally ill, say 90% of people in UK’,
The Guardian, Online, Accessed 23/02/21
https://www.theguardian.com/society/2019/mar/03/legalise-assisted-dying-for-terminally-ill-s
ay-90-per-cent-of-people-in-uk
Brazier, Y. 17/12/18, ​‘What are euthanasia and assisted suicide?’, ​Medical News Today,
Online, Accessed 08/02/21
https://www.medicalnewstoday.com/articles/182951
Broughton, T. 14/02/21, ‘​Court to decide on euthanasia and right to die in South Africa’,
Bussiness Tech, Online, Accessed 22/02/21
https://businesstech.co.za/news/lifestyle/466997/court-to-decide-on-euthanasia-and-right-to-d
ie-in-south-africa/
Cardinal Seper, F, 05/05/1980, ‘​DECLARATION ON EUTHANASIA’, ​La Santa Sede, Online,
Accessed 01/03/21
http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_1980
0505_euthanasia_en.html
Chaar B. & Isaac, S. 20/10/17​, ‘Euthanasia drugs: What is needed from medications for
assisted deaths?’, ​ABC​, ​Online, Accessed 24/02/21
https://www.abc.net.au/news/2017-10-20/assisted-dying-what-is-need-from-drugs-for-volunt
ary-euthanasia/9069896
CNA ​Staff, 16/02/21, ​‘Belgium and the Netherlands see rapid rise in euthanasia and assisted
suicide cases’, ​Catholic News Agency (CNA), Online, Accessed 21/02/21
https://www.catholicnewsagency.com/news/belgium-and-the-netherlands-see-rapid-rise-in-eu
thanasia-and-assisted-suicide-cases-68714
Davis, N. 15/07/19, ‘Euthanasia and assisted dying rates are soaring. But where are they
legal?’, ​The Guardian, Online, Accessed 08/02/21
https://www.theguardian.com/news/2019/jul/15/euthanasia-and-assisted-dying-rates-are-soari
ng-but-where-are-they-legal
Hiatt, A. 06/01/16, ‘​The History of the Euthanasia Movement’, ​Jstor​, ​Online, Accessed
23/02/21
https://daily.jstor.org/history-euthanasia-movement/
McGeem A. 27/02/19, ‘​In places where it’s legal, how many people are ending their lives
using euthanasia?’, ​The Conversation, Online, Accessed 10/02/21
https://theconversation.com/in-places-where-its-legal-how-many-people-are-ending-their-live
s-using-euthanasia-73755
Mcmurtry, A. 29/01/21, ‘​Portugal’s Parliament votes to legalize euthanasia’, ​Anadolu
Agency, Online, Accessed 22/02/21
https://www.aa.com.tr/en/europe/portugal-s-parliament-votes-to-legalize-euthanasia/2127744
National Library Of Medicine, 2002, ‘​The Hippocratic Oath’, ​National Library Of Medicine,
Online, Accessed 01/03/21
https://www.nlm.nih.gov/hmd/greek/greek_oath.html
NBC News, 13/02/2014, ‘Belgium Becomes First Country To Allow Euthanasia For Dying
Children’, ​NBC News, Online, Accessed 14/02/21
https://www.nbcnews.com/nehttps://www.statista.com/statistics/1098051/number-of-euthana
sia-instances-registered-in-belgium/ws/europe/belgium-becomes-first-country-allow-euthanas
ia-dying-children-n29441
Porter, T. 03/01/15, ‘​Belgian serial rapist and murderer Frank Van Den Bleeken 'to be
euthanised' in January’, ​International Business Times, Online, Accessed 01/03/21
https://www.ibtimes.co.uk/belgian-serial-rapist-murderer-frank-van-den-bleeken-be-euthanis
ed-january-1481742
1 
Pro​Con, 19/10/20, ​“History of Euthanasia and Physician-Assisted Suicide”. ​ProCon, Online,
14/02/21
https://euthanasia.procon.org/historical-timeline/
Rodriguez, C. 17/03/19, ‘​Euthanasia Tourism: Is The E.U. Encouraging Its Growth?’,
Forbes, Online, Accessed 23/02/21
https://www.forbes.com/sites/ceciliarodriguez/2019/03/17/euthanasia-tourism-is-the-e-u-enco
uraging-its-growth/?sh=30ac7931229b
Statista, 02/19, ‘​Share of officially performed euthanizations in Belgium by illness leading to
the demand in 2018’, ​Statista​, ​Online, Accessed 12/02/21
https://www.statista.com/statistics/1098074/share-of-euthanized-patients-by-illness-belgium/
Van Dalen, D. 28/04/20, ‘​What is the difference between euthanasia and assisted suicide?’,
Maxim Institute, Online, Accessed 09/02/21
https://www.maxim.org.nz/faq-1/
 
2 
TOPIC B: Addressing the threat of
biological weapons and
bioterrorism
WHO STUDY GUIDE
R J M S M U N
Troops train in order to use or be protected in a scenario of
biological warfare. This is a photo from the US Navy
1 9
Overview
Biological weapons are microorganisms such as bacteria, viruses, fungi or other toxins. Bioterrorism is the
production and the release of these biological agents to infect and kill humans, plants and animals. The
means of transmission usually include water and food supplies, animals such as cattle and insects, aerosols,
or infected individuals. Biological weapons fall in the category of weapons of mass destruction, given that
agents cause many deaths in a short period of time, and are challenging to contain, hence resulting in
epidemics and pandemics. Biological Weapons programs date back to the 1930s, when Canada and the
United Kingdom developed schemes focused on crops and cattles, researching anthrax respectively.
Further, with the escalated tensions in WWII, Japan concentrated its efforts on "Unit 731", the center of its
expansive biological program, consisting of 150 buildings and 3000 scientists. 9 They was responsible for the
death of 10,000 prisoners 10, a third of them being war prisoners from an array of nations including the US,
the USSR and the UK. Simultaneously, the American Biological Program was secretly initiated at Fort Detrick
in Maryland. At its peak, the program involved about 3400 people 11 and produced a range of agents. Some
cities were used as laboratories; organisms were released to study the effects of solar radiation and climatic
conditions on the viability of the pathogens. Public health concerns were brought up after an outbreak of
urinary tract infections.
Despite ratifying the Biological Weapons Convention (BWC) in 1975, the Soviet Union continued its biological
weapons program through a secret organization called Biopreparat, opening eight facilities for large-scale
production of BW. There were open-air testings of BW agents on the island of Vozrozhdeniye. At its peak, the
facility counted 60,000 people in 40-50 facilities. 12
WHO STUDY GUIDE
R J M S M U N
BACKGROUND INFORMATION
2 0
9- Riedel, 2004
10- Riedel, 2004
11- Roffey, 2002
12- Roffey, 2002
Japanese troops conducting experiments on a Chinese
person
The usage of anthrax as a weapon of mass destruction began in WWI, when Germany
shipped horses infected with anthrax to infect the population in the Allied Powers. People get
infected with anthrax through spores, which can be put in powders, sprays, food and water.
Perhaps one of the most notably bioterrorism attacks took place in the US , shortly after the
terrorist attack on the 9th of September 2001. Four anonymous letters laced with anthrax
spores were sent out to media outlets and the offices of two US senators. In total, 17 people
were contaminated and 5 died.13 The Washington and New Jersey facilities were closed,
however, contaminated distribution centers in Connecticut, Florida, and New York City
remained open. After the attack, the National Institute of Health tracked 7 of the survivors, 2
which inhaled anthrax and the rest were exposed via contact with the skin 14. Another
analysis by the Centers for Disease Control and Prevention showed that 8 people out of the 17
survivors did not go back to their jobs, all of them were receiving psychiatric assistance.
WHO STUDY GUIDE
R J M S M U N 2 1
Anthrax, Ricin & T-2 mycotoxin
E v i d e n c e o f o n e o f t h e a n t h r a x l e t t e r s , r e c o v e r e d b y t h e F B I
13- FBI, 2021
14- Nuclear Threat Initiative, 2011
Also, bioterrorism attacks were done and attempted using ricin which can be made into a
powder, a mist or pallet, and dispersed through food, water or air.. In 1991, four people were
arrested because they were planning to poison a US Marshal. They planned on mixing ricin
with another chemical to coat the handle of the US’s Marshal car, in the hope it would be
absorbed by the skin. Then, in 2003, ricin was found in the White House mailroom, and four
months later, found in Senate Majority Leader Bill Frist’s mailrooms. Luckily, no casualties were
resultant of either incident.
During the Cold War, after the communist victory in Southeast Asia, 1975, Vietnam and Laos
launched attacks against the Hmong tribes in the north of Laos. Refugees began to report
aircrafts, from Laos, that were dropping an oily yellow liquid, which they called “yellow-rain”.
Exposure to this liquid caused symptoms such as bleeding in the nose and gums, tremors,
blindness, seizures and in the worst case, death. Similar cases were reported from the Khmer
tribes in Cambodia, and anti-Soviet resistance groups in Afghanistan. The US accused the
Soviet Union of having provided their allies in Laos and Vietnam with T-2 mycotoxin which
was associated to be what caused the “yellow-rain”.
WHO STUDY GUIDE
R J M S M U N 2 2
Nowadays, the greatest concern regarding BW is the fact that several countries are not
prepared for a biological weapon attack and bioterrorism. The developing world is more
vulnerable, as they lack basic healthcare for their population. The supply of healthcare is very
scarce due to a lack of resources. The amount of money invested in healthcare is way below
the amount required to provide essential health services. Where healthcare services are
available, the quality is usually deficient, which in summary, if there were to be a biological
attack, the healthcare system in developing countries would not be able to help the population
and most probably collapse.
Countries that are in war are also very vulnerable to biological threats. Syria, which is in the
middle of a civil war, has lost several healthcare facilities. More than 590 facilities and
personnel have been assaulted 15. The government deliberately stopped water treatment,
withheld vaccinations, surgical items, and emergency kits, and criminalized healthcare workers.
As a result, there were epidemics of waterborne diseases, the return of the poliovirus, and due
to irregular antibiotics, unsterile underground hospitals, and unsafe water, “superbugs” began
to emerge and penetrate through wounds caused by the war.
WHO STUDY GUIDE
R J M S M U N 2 3
1 5 - P H Y S I C I A N S F O R H U M A N R I G H T S , 2 0 2 1
CURRENT SITUATION
Syrian map showing the location of the attacks on health facilities
Moreover, simulations of bioterrorism in the past of the US have shown how government
officials had lack of communication, flaws in the command structure and decision making,
insufficient containment, and inadequate supplies or handling of supplies. Not to mention, that
the exercise also proved that the healthcare system would be incredibly overwhelmed due to
the increased patient demand. There are also concerns about the improvement of surveillance
on the use of biological agents including when used through water or food.
Additionally, there are ethical implications concerning clinical trials. Traditional clinical trials are
conducted by testing medication on patients that are currently infected with the disease being
investigated. However, in the US for example, the Food and Drug Administration requires
clinical trials that are safe and effective, and it would be considered ethically unacceptable to
use biological weapons to infect patients for the research.
WHO STUDY GUIDE
R J M S M U N 2 4
WHO STUDY GUIDE
R J M S M U N
BLOC POSITIONS
The US was in compliance with the BWC even before formally ratifying it in 1975. Furthermore,
the US is the biggest contributor to the G8 Global Partnership against the Spread of Weapons
and Materials of Mass Destruction, and has contributed in the improvement of biosecurity against
BW and bioterrorism, preventing illegal trafficking of BW and further international non
proliferation cooperation.
2 5
United States
Russia
Russia has ratified the BWC in 1975, when it was still the Soviet Union and has implemented
export regulations on BW materials. However, there have been several concerns raised due to
the fact that the USSR has continued BW activities after the ratification of the BWC for more than
15 years.
Iran
Iran ratified the BWC on the 22nd of August of 1973 and has publicly denounced all types of
mass destruction weapons. Iran considers the acquisition, development and use of weapons of
mass destruction to be immoral. However, the country did not upload any documentation part of
the Confidence Building Measures (CBMs), which is required for all submitters of the BWC to
reduce suspicions, until 10 years after the BWC took place. Several accusations have been done
on Iran for secretly having BWs, but there has been no evidence found to support that.
Israel
Israel has not signed the BWC and has never made a public statement about its current situation
regarding BW. Israel has very advanced research in biological agents such as anthrax, plague,
and others, and the Israel Institute for Biological Research has about 170 technicians.
Speculations about an offensive BW weapon program continue till today. Israel is also very
concerned about “Islamic terrorist groups” and has made much improvement in security around
their laboratories and regulations of exports.
WHO STUDY GUIDE
R J M S M U N
TIMELINE OF EVENTS
WW1
Germany ships anthrax infected horses to France,
the US, Spain, Romania, and others.
1925
The Geneva Protocol, which prohibited poisonous
or other gases, and bacteriological methods of
warfare is established and signed by 108 nations.
1975
The Biological Weapons Convention (BWC) is
implemented, banning the acquisition and
production of biological and toxin weapons,
including 183 state-parties. 16
1979
Anthrax epidemic in Russia affects people living
near a microbiology facility.
1952
Groups petition the United Nations to amend the
Declaration of Human Rights to include "the right
of incurable sufferers to euthanasia or merciful
death”. However, Eleanor Roosevelt, the
Chairperson of the Committee, did not present
the petition to the Commission.
2001
Anonymous letters filled with anthrax spores are
sent to new media offices and two US Senators,
Patrick Leahy, President of the US Senate, and
Senate Minority Leader, Tom Daschle.
2 6
1 6 - D A V E N P O R T , 2 0 2 0
WHO STUDY GUIDE
R J M S M U N
2002
The launching of G8 Global Partnership Against
the Spread of Weapons and Materials of Mass
Destruction. This is a 10-year framework that
focuses on preventing bioterrorists and states that
support them.
2004
The US implements the BioShied project, focusing
on purchase of vaccines to be used in case of a
bioterrorism attack.
2011
Four men are arrested for planning to disperse
ricin in Atlanta and other places in the US.
2013
Russia’s Prime Minister Dmitry Rogozin announces
the beginning of a rearmament program that
would include the development of new kinds of
weapons.
2019
The US makes a report saying that Iran has not
abandoned its BW program for offensive
purposes.
2 7
WHO STUDY GUIDE
R J M S M U N
DEFINITION OF KEY TERMS
2 8
Toxins
Hazardous and poisonous substances released by different living organisms that can be harmful
when it enters your body.
Pathogen
A living organism that causes disease to a host. This can include viruses, bacteria and others.
Anthrax
An infection caused by bacteria that affects both animals and humans. It can affect the skin, lung
and intestine and can be deadly.
Ricin
It is a toxin part of the left-over waste of when castor beans are processed to make castor oil.
Ricin poisoning can kill cells and cause death. It also has no antidote for it.
T-2 mycotoxin
A highly toxin released by fungi and can be extremely dangerous when inhaled. It can cause
vomiting, diarrhea, skin irritation, rash, blisters and others.
Dual-Use
The character of being either used for peaceful purposes, such as medication and vaccination, or
for warfare purposes.
Confidence Building Measures (CBM)
Reports submitted by countries to reduce suspicions and improve international cooperation in
peaceful biological weapons activities.
WHO STUDY GUIDE
R J M S M U N
GUIDING QUESTIONS
2 9
To what extent is the BWC effective, taking into account the
sovereignty of each country, and their responsibility as
members of the UN and international community?
What measures should be taken if a country does not comply
with the BWC, having ratified it, and what is the responsibility
of your delegation in case this happens?
How can countries prevent terrorist attacks, and what is the
role of developed countries in biosecurity compared to
developing countries?
How can the fiscalization of the different countries, in terms of
possessions of BW, be improved and legitimate, taking into
account each countries’ sovereignty?
BIBLIOGRAPHY
2011, ​Many Anthrax Mailings Survivors Still Suffering, ​NTI, accessed 27/02/2021,
http://nti.org/22569GSN
2004, ​U.S. Health Officials Underestimated Anthrax Risks During 2001 Mail Attacks, GAO
Finds​, NTI, accessed 21/02/2021, ​http://nti.org/3223GSN
2016, ​Amerithrax or Anthrax Investigation, ​accessed 27/02/2021,
https://www.fbi.gov/history/famous-cases/amerithrax-or-anthrax-investigation
Courtney Madeus, 2013,
2020, ​The Threat of an Anthrax Attack, ​accessed 02/03/2021,
https://www.cdc.gov/anthrax/bioterrorism/threat.html#:~:text=Anthrax%20makes%20a%20g
ood%20weapon,used%20as%20a%20weapon%20before​.
2021, ​T-2 mycotoxin, ​accessed 02/03/2021,
https://en.wikipedia.org/wiki/T-2_mycotoxin#Toxicity
Yellow rain, Britannica, accessed
27/92/2021,​https://www.britannica.com/science/yellow-rain
Riedel, ​Biological warfare and bioterrorism: a historical review, ​accessed 27/02/2021,
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1200679/
Roffey, et al, 2014, ​Biological warfare in a historical perspective, ​accessed
27/02/2021,​https://www.sciencedirect.com/science/article/pii/S1198743X14626343#bbib3
Susan Borowski, ​From beans to weapon: The discovery of ricin, ​accessed
27/02/2021,​https://www.aaas.org/beans-weapon-discovery-ricin#:~:text=The%20substance%
20can%20be%20made,food%2C%20water%2C%20or%20air.&text=The%20United%20Stat
es%20looked%20at,be%20inhaled%20by%20the%20enemy
Fact Sheets & Briefs, ​accessed 27/02/2021,​https://www.armscontrol.org/factsheets/cbwprolif
A Map of Attacks on Health Care in Syria, ​accessed 27/02/2021,​https://syriamap.phr.org/#/en
Annie Sparrow, 2018, ​Bashar al-Assad Is Waging Biological War-By Neglect, ​accessed
27/02/2021,
https://foreignpolicy.com/2018/10/24/bashar-al-assad-is-waging-biological-war-by-neglect/
O’Donnell, ​Access to health care in developing countries: breaking down demand side
barriers, ​accessed
27/02/2021,​https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-311X200700120
0003
Biological weapons, ​accessed 27/02/2021,
https://www.who.int/health-topics/biological-weapons#tab=tab_2
Dudley and McFee, 2005, ​Preparedness for Biological Terrorism in the United States:
Project BioShield and Beyond​, accessed
27/02/2021,​https://jaoa.org/article.aspx?articleid=2093182
Iran, ​accessed 27/02/2021, ​https://www.nti.org/learn/countries/iran/biological/
United States, ​accessed 27/02/2021,
https://www.nti.org/learn/countries/united-states/biological/
Russia, ​accessed 27/02/2021, ​https://www.nti.org/learn/countries/russia/
Israel, ​accessed 27/02/2021,
https://www.nti.org/learn/countries/israel/
Toxins of Biological Origin​, accessed 27/02/2021,
https://www.ehs.ufl.edu/programs/bio/toxins/#:~:text=Biological%20toxins%20are%20hazar
dous%20substances,ingested%2C%20injected%2C%20or%20absorbed​.
Armstrong et al., 1993, ​Q&A: What is a pathogen? A question that begs the point,
27/02/2021,
https://bmcbiol.biomedcentral.com/articles/10.1186/1741-7007-10-6#:~:text=A%20pathogen
%20is%20usually%20defined,cause%20damage%20in%20a%20host​.
Fact Sheet: U.S. Participation in the Global Partnership Against the Spread of Weapons and
Materials of Mass Destruction, ​27/02/2021,
https://obamawhitehouse.archives.gov/the-press-office/2016/04/01/fact-sheet-us-participation
-global-partnership-against-spread-weapons#:~:text=of%20Mass%20Destruction-,The%20Gl
obal%20Partnership%20Against%20the%20Spread%20of%20Weapons%20and%20Material
s,developing%20weapons%20of%20mass%20destruction​.
2015,​Guide to Participating in the Confidence Building Measures of the Biological Weapons
Convention aids States Parties with agreed-to reporting requirements – UNODA​,
27/02/2021,
https://www.un.org/disarmament/update/guide-to-participating-in-the-confidence-building-m
easures-of-the-biological-weapons-convention-aids-states-parties-with-agreed-to-reporting-re
quirements/#:~:text=In%201986%2C%20the%20Second%20Review,operation%20in%20the
%20field%20of
 
 
1 

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World Health Organisation Study Guide

  • 1. W O R L D H E A L T H O R G A N I S A T I O N H E A D C H A I R L A U R A S A B R O S A C H A I R S T E L L A B O I C E N C O RIO DE JANEIRO MIDDLE SCHOOL MODEL UNITED NATIONS STUDY GUIDE
  • 2. WHO STUDY GUIDE R J M S M U N CONTENTS Introduction to the committee Letter from Dais/Chair…………………………………………………………….2 Committee Information……………………………………………………………3 Topic A: Discussing the use of euthanasia in diseased patients……...……………...4 Background Information…………………...……………………………………..5 Current Situation…………………………………………………………………..8 Bloc Positions……………………………………………………………………...9 Timeline of Events…………………………………………..…………………...11 Definition of Key Terms………………………………………….……………...13 Guiding Questions……………………………………….……………………...15 Bibliography…………………………………….………………………………..16 Topic B: Addressing bioterrorism threats………………………………………….…..18 Background Information………………………………..……………………….19 Current Situation ………….…………………………………………………….21 Bloc Positions……………………………………………………………..……..23 Timeline of Events…………………………………………………………..…..24 Definition of Key Terms………………………………………..………………. 26 Guiding Questions………………………………………………..……………..27 Bibliography……………………………………………………………………..28 2
  • 3. WHO STUDY GUIDE R J M S M U N LETTER FROM DAIS Dear delegates, Welcome to the first edition, of hopefully many, of the RJMSMUN! As two aspiring doctors and MUN enthusiasts, we couldn’t be more honoured to be serving as your chairs for the World Health Organization. We are immensely delighted to help you to develop your debate skills through the discussion of such pertinent topics. One of our main goals is to make this conference, not only as intellectually enlightening as possible, yet also a fun experience,, which will hopefully engender lifetime memories and inspire the start of your MUN careers. Topic A addresses the legality of euthanasia in diseased patients, currently permitted in countries such as the Netherlands, Belgium, Luxemburg and Colombia; a treatment which has increasingly been requested by terminally ill patients. Whereas some regard this controversial procedure as the 'right to die by ending suffering', others view it as murder. Topic B tackles the issue of security and protection against biological weapons and bioterrorism, which are viruses and bacteria used purposely against humans, animals and plants. The consequences of bioterrorism can result in epidemics and pandemics, which in turn bring a lot of deaths., however, not all countries have the infrastructure to protect their population against it. Looking forward to fruitful debate, we have produced this guide to provide you with key information to enhance your knowledge on both topics. . We hope that our efforts can lead into engaging debates and passionate speeches! If you have any doubts or concerns, feel free to contact any of us through our email lmsabrosa@gmail.com & stellagcb@gmail.com. Surprise us! 3
  • 4. WHO STUDY GUIDE R J M S M U N COMMITTEE INFORMATION The World Health Organization was created in 1948 and is a Specialized Agency of the United Nations responsible for global health. Counting with 194 member states, the organization's main role is to serve as the “authority for health within the United Nations system”, and to provide “leadership on global health matters.” Headquartered in Geneva, Switzerland the WHO's objectives are based on a Six-Point Agenda aimed at responding to the rising problems of global health. These points are: (1) promoting development; (2) fostering health security; (3) strengthening health systems; (4) harnessing research, information and evidence; (5) enhancing partnerships; and (6) improving performance. The World Health Assembly is the decision-making body of the WHO, which is attended by delegations of the Member States to discuss and determine policies of the WHO, proposing program budgets, and drafting resolutions, following an agenda prepared by the Executive Board. That said, this Special Committee will feature the World Health Assembly (except the part of electing the Director-General and the financial policies), which abides by traditional MUN procedure –– please check RJMSMUN's procedure guide for more information. 4
  • 5. WHO STUDY GUIDE R J M S M U N TOPIC A: Discussing the use of euthanasia in diseased patients The literal translation of euthanasia from Old Greek is “good death” however, by some, this is seen as one of the most terrible forms of murder. 5
  • 6. WHO STUDY GUIDE R J M S M U N BACKGROUND INFORMATION Overview 6 Euthanasia is properly defined as the hastening of death of a patient to prevent further suffering, be it from an incurable and/or painful disease or an irreversible coma. In 2016, JAMA, a peer-reviewed medical journal, reported that around “0.3% to 4.6% of all deaths are reported as euthanasia or physician-assisted suicide in jurisdictions where they are legal.”1 All of these acts are performed under people who suffer some type of incurable pain and illness. Studies throughout various years showed that the illnesses which account for the most acts of euthanasia are as follows: tumors (or/and cancers), multiple pathologies, disease of the nervous system, diseases of the circulatory system, mental and behavioral disorders, and diseases of the respiratory system.2 The group of drugs most commonly used to end life is called barbiturates, which slow down the activity of the brain and nervous system. They are usually used alone or in combination for euthanasia, usually as the form of lethal injections, and are the preferred drugs in the Netherlands, Belgium, Switzerland and some USA states where euthanasia is legal. Other options also exist, but have limited evidence of use in euthanasia. Such alternative and rare types of euthanasia drugs cause excessive muscle relaxation; fatally lower blood sugar levels; heart attacks; or paralysis and respiratory distress which can end life, as can some painkillers commonly used in palliative care. With that in mind, it is up to the domestic policy of each of the aforementioned countries where euthanasia is legal in order to decides their preference type of drugs and the way it will be administered into a person’s body. Furthermore, there are other classifications which need to be taken into consideration with the performance of euthanasia. Euthanasia can be voluntary or non-voluntary, passive or active. During voluntary euthanasia, a person is totally aware of their decision and is not in an unconscious state of mind, whereas in the case of voluntary euthanasia, the patient could be unconscious and hence, their appointed legal responsible decides their final fate. Additionally, while passive euthanasia involves suspending medications which keeps people lives going, active euthanasia is when death is brought about swiftly by an act, be it an overdose of pain-killers or a lethal injection. 1 - McGee, A. 2019 2 - Statista, 2018
  • 7. WHO STUDY GUIDE R J M S M U N Countries are more prone to allowing liberal in regards to passive and voluntary euthanasia than active and non-voluntary euthanasia. For example, countries which are semi-liberal, such as like India and US states, only allow passive euthanasia to be performed. In 2002, Netherlands and Belgium became the first countries to legally adopt euthanasia as an alternative for terminally ill patients; further, in 2008, this was mirrored by Luxembourg. Additionally, the first non-European to authorize the application of euthanasia was Colombia, in 2015, subsequently followed by Canada and The Australian state of Victoria in 2016 and 2017 respectively. Despite the efforts of many countries to introduce laws that make at least some type of euthanasia legal, there are still many barriers to its holistic legalization. Besides the usage of euthanasia, another very similar practice is common: assisted suicide. Overall, whereas euthanasia describes the situation where the unnatural death of a person is caused by a second individual (e.g.: injecting a lethal drug) the person who is asking for the act has someone else take the action that leads to their unnatural death (like injecting a lethal drug), assisted suicide is when the person is prescribed drugs by a professional, and yet, their death is caused by their ownselves. that they must take themselves in order to die. More technically, euthanasia is when the physician, takes an action with the singular intention of causing a patient’s death. Assisted suicide is when a suicide is intentionally aided by the physician and the person self-administers the medication. That is, the medical practitioner will prescribe a lethal drug which the patient will usually take orally. Many believe assisted suicide is more ethically correct than euthanasia, as the doctor who once swore not to cause the death of one individual in the Hippocratic Oath is not involved directly in the death of the person as they would otherwise be he is with euthanasia. 7 Legality of Euthanasia
  • 8. WHO STUDY GUIDE R J M S M U N 8 While euthanasia may be believed to be new, only modern methods have come to rise nowadays. Euthanasia was practiced in both Ancient Greece and Rome, and was seen to be supported by Socrates, Plato and other major philosophers. Hippocrates appears to be one of the only ones who at the time spoke against it according to his oath "I will not give a lethal drug to anyone if I am asked, nor will I advise such a plan"3 (there is some debate about whether or not this was intended to encompass euthanasia). The word "euthanasia" was first used in a medical context by Francis Bacon in the 17th century, to refer to an easy, painless, happy death, during which it was a "physician's responsibility to alleviate the 'physical sufferings' of the body." As the Judeo-Christian influence grew around the world, these practices began to be more frequently opposed. Instead, it is argued that euthanasia grew more and more, especially with the Age of Enlightment, given the burgeoning opposition to the Church. Moreover, morphine was introduced to the world in the 1800s as an analgesic, followed by chloroform to replace it as a less toxic substance. The debate between ethics of euthanasia spread around scientific journals after Samuel Williams, a non physician, stated that euthanasia was a right everyone should have and the use of morphine’s could be used to do so. This led to outrage in science and medical conferences, magazines and journals, seen as many professionals believed that not even the use of aesthetics should be used, as pain is a natural process of life. Morphine ended up becoming some of the main mechanisms for euthanasia. In 1936, King George V of Britain was given a fatal dose of morphine and cocaine to hasten his death. At the time he was suffering from a cardio-respiratory failure, and the decision to end his life was made by his physician. This event was kept a secret for over 50 years, however it coincided with proposed legislation in the parliament to legalise voluntary euthanasia for inividuals above 21 years of age.. That said, the rise of these drugs also allowed many US states to develop bills to legalise euthanasia. Historical Information 3 - N A T I O N A L L I B R A R Y O F M E D I C I N E , 2 0 0 2
  • 9. Recently, more countries are looking to renew their laws on euthanasia, be it to legalize it or to reinforce the laws dealing with its illegal use. Portugal, for example, has opened Parliament votes to legalize euthanasia practice in the country. The same goes for South Africa, Spain, Germany and New Zealand, where the court is to decide the legality of this practice. Not only that, but in countries where euthanasia are considered to be legal, be it passive or active, cases have been soaring. The Vienna-based Institute for Medical Anthropology and Bioethics (IMABE) noted on Feb. 12 that cases had increased in Belgium from just 24 in 2002 to 2,656 in 2019. In the same period, cases had surged in the Netherlands from 1,882 to 6,361. 4 Views on eutahansia have also started to dissect (and thus polarize) the world, leading to huge protests where some affirm that the “right to die” is a human right, and others classify euthanasia as suicide or an heinous crime.. The Vatican has recently publicly stated that both euthanasia and assisted suicide are “intrinsically evil,”.5 WHO STUDY GUIDE R J M S M U N 9 4 - C N A S T A F F , 2 0 2 1 5 - W I N F I E L D , N . 2 0 2 0 CURRENT SITUATION Current legality of euthanasia around the world Euthanasia has also given the rise to what is called suicide tourism, or euthanasia tourism. This happens when potential euthanasia candidates travel to countries where the practice is legal in order to gain their “peaceful death”. There's a notable increase in the number of patients travelling to Belgium, known as the “world’s euthanasia capital”, where assisted dying has been legal since 2002, mostly from the other 27 European Union member nations as well as from other continents where euthanasia is barred.
  • 10. WHO STUDY GUIDE R J M S M U N BLOC POSITIONS The Belgian parliament legalised euthanasia on 28 May 2002. There have been about 1,400 cases a year since the law was introduced, and a record 1,807 cases were recorded in 2013. 6 In December 2003, the Belgian Senate voted in favour of extending its euthanasia law to terminally ill children. A psychologist must also determine the patient's maturity to make the decision. 1 0 Belgium Switzerland All forms of euthanasia are illegal in the country, however it is known to be the world’s capital of assisted suicide with the largest rates of assisted suicide. There are no age requirements, illness diagnosis, or symptom state for the act to be performed, however assisted suicide is considered a crime if the reason behind it is selfish. The assistance doesn’t need to come from a physician. United States of America Active euthanasia is illegal throughout the United States. Patients retain the rights to refuse medical treatment and to receive appropriate management of pain at their request (passive euthanasia), and burdensome treatments, such as life-support machines, may be withdrawn under specified circumstances. Assisted suicide is legal in Colorado, Oregon, Hawaii, Washington, Vermont, Maine, New Jersey, California, the District of Columbia, one county in New Mexico, and in Montana. United Kingdom Euthanasia remains illegal in the country and considered murder under the law, however a poll from 2019 sugegsted that over 90% 7 of the population believes euthanasia should be legalised for those suffering from temrinal illnesses. 6 - A S S O C I A T E D P R E S S , 2 0 1 4 A N D P O R T E R , T . 2 0 1 5 7 - B O W C O T T , O . 2 0 1 9
  • 11. WHO STUDY GUIDE R J M S M U N TIMELINE OF EVENTS 4th Century B.C. The Hippocratic Oath states that any doctor that swear under the oath should be prohibited from supplying 'a deadly drug to anybody, not even if asked for, 8 1870 Use of morphine as an analgesic (pain-relieving agent) grows and Samuel Williams, a nonphysician, begins to advocate the use of these drugs not only to alleviate terminal pain, but to intentionally end a patient’s life. 1935 Voluntary Euthanasia Legalisation Society is founded 1950 World Medical Association condemns euthanasia. 1952 Groups petition the United Nations to amend the Declaration of Human Rights to include "the right of incurable sufferers to euthanasia or merciful death”. However, Eleanor Roosevelt, the Chairperson of the Committee, did not present the petition to the Commission. 1957 The Vatican proclaims that passive euthanasia is acceptable. 1 1 8 - N A T I O N A L L I B R A R Y O F M E D I C I N E , 2 0 0 2
  • 12. WHO STUDY GUIDE R J M S M U N 2001 Netherlands becomes the first country to legalize euthanasia. 2nd March 2014 Belgium legalizes euthanasia for terminally and incurably ill children, becoming the first coutnry to lift all age restrictions on euthanasia. 29th November 2017 Victoria becomes the first Australian state to legalize limited euthanasia. 29th January 2021 Portugal’s parliament votes in favour of euthanasia in terminally ill patients. 1 2
  • 13. WHO STUDY GUIDE R J M S M U N DEFINITION OF KEY TERMS 1 3 Active Euthanasia Active euthanasia occurs when the doctor purposely gives someone a lethal dose of a sedative or injection. Analgesic A pain reliever substance, but also often used as anesthesia. Assisted Suicide The act of intentionally helping a person’s death by providing lethal drugs for self-administration, at that person’s voluntary request. Involuntary Euthanasia When euthanasia is performed on a person against their own will, and they are able to provide informed consent. Non-voluntary Euthanasia Involves someone else making the decision to end someone’s life and the explicit consent of the individual addressed is unavailable, close family members usually make the decision. This is generally done when someone is completely unconscious or permanently incapacitated. Palliative Care A method by which a doctor or nurse tries to soothe the pain of a patient without taking their lives
  • 14. WHO STUDY GUIDE R J M S M U N 1 4 Palliative Sedation Procedure which entails a request to be deeply sedated until death. Passive Euthanasia Passive euthanasia is the act by which life-sustaining treatments are withdrawn allowing a person’s death to come more quickly. Voluntary Euthanasia Voluntary euthansia occurs when a physician administers a lethal dose of a drug to a patient upon the patient’s specific request.
  • 15. WHO STUDY GUIDE R J M S M U N GUIDING QUESTIONS 1 5 How can euthanasia be properly regulated in countries that have legalized it? Which forms can be better controlled and to whom should they be given? In countries where euthanasia is legalized, should doctors continue to swear under the Hippocratic Oath even if it clearly states that a doctor should “not give a lethal drug to anyone”? By what means can the legalization of euthanasia be used to solve other problems present in modern world, such as overpopulation and lack of organ donation? In regards to the Universal Declaration Of Human Rights, shouldn’t euthanasia - “right to die” - be included in the document? To what extent is it hypocritical to legalize assisted suicide and maintain euthanasia pratice illegal?
  • 16. BIBLIOGRAPHY Ashford, J. 28/08/19, ​‘​Countries where euthanasia is legal’, ​The Week, Online, Accessed 08/02/21 https://www.theweek.co.uk/102978/countries-where-euthanasia-is-legal Associated Press, 16/09/14, ‘​Belgian convicted killer with 'incurable' psychiatric condition granted right to die’, ​The Guardian, Online, Accessed 01/03/21 https://www.theguardian.com/world/2014/sep/16/belgium-convict-granted-right-to-die Associated Press, 24/09/20, ​‘Vatican declares euthanasia and assisted suicide ‘intrinsically evil’’, ​Independent, Online, Accsessed 11/02/21 https://www.independent.co.uk/news/world/vatican-euthanasia-assisted-suicide-catholicism-p ope-francis-b559321.html Bomford. A. & Doyle, E. 30/01/19​, ‘Wanting to die at 'five to midnight' - before dementia takes over’, ​BBC, Online, Accessed 24/02/21 https://www.bbc.com/news/stories-47047579 Bowcott, O. 03/03/19, ‘​Legalise assisted dying for terminally ill, say 90% of people in UK’, The Guardian, Online, Accessed 23/02/21 https://www.theguardian.com/society/2019/mar/03/legalise-assisted-dying-for-terminally-ill-s ay-90-per-cent-of-people-in-uk Brazier, Y. 17/12/18, ​‘What are euthanasia and assisted suicide?’, ​Medical News Today, Online, Accessed 08/02/21 https://www.medicalnewstoday.com/articles/182951 Broughton, T. 14/02/21, ‘​Court to decide on euthanasia and right to die in South Africa’, Bussiness Tech, Online, Accessed 22/02/21 https://businesstech.co.za/news/lifestyle/466997/court-to-decide-on-euthanasia-and-right-to-d ie-in-south-africa/ Cardinal Seper, F, 05/05/1980, ‘​DECLARATION ON EUTHANASIA’, ​La Santa Sede, Online, Accessed 01/03/21 http://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_1980 0505_euthanasia_en.html Chaar B. & Isaac, S. 20/10/17​, ‘Euthanasia drugs: What is needed from medications for assisted deaths?’, ​ABC​, ​Online, Accessed 24/02/21
  • 17. https://www.abc.net.au/news/2017-10-20/assisted-dying-what-is-need-from-drugs-for-volunt ary-euthanasia/9069896 CNA ​Staff, 16/02/21, ​‘Belgium and the Netherlands see rapid rise in euthanasia and assisted suicide cases’, ​Catholic News Agency (CNA), Online, Accessed 21/02/21 https://www.catholicnewsagency.com/news/belgium-and-the-netherlands-see-rapid-rise-in-eu thanasia-and-assisted-suicide-cases-68714 Davis, N. 15/07/19, ‘Euthanasia and assisted dying rates are soaring. But where are they legal?’, ​The Guardian, Online, Accessed 08/02/21 https://www.theguardian.com/news/2019/jul/15/euthanasia-and-assisted-dying-rates-are-soari ng-but-where-are-they-legal Hiatt, A. 06/01/16, ‘​The History of the Euthanasia Movement’, ​Jstor​, ​Online, Accessed 23/02/21 https://daily.jstor.org/history-euthanasia-movement/ McGeem A. 27/02/19, ‘​In places where it’s legal, how many people are ending their lives using euthanasia?’, ​The Conversation, Online, Accessed 10/02/21 https://theconversation.com/in-places-where-its-legal-how-many-people-are-ending-their-live s-using-euthanasia-73755 Mcmurtry, A. 29/01/21, ‘​Portugal’s Parliament votes to legalize euthanasia’, ​Anadolu Agency, Online, Accessed 22/02/21 https://www.aa.com.tr/en/europe/portugal-s-parliament-votes-to-legalize-euthanasia/2127744 National Library Of Medicine, 2002, ‘​The Hippocratic Oath’, ​National Library Of Medicine, Online, Accessed 01/03/21 https://www.nlm.nih.gov/hmd/greek/greek_oath.html NBC News, 13/02/2014, ‘Belgium Becomes First Country To Allow Euthanasia For Dying Children’, ​NBC News, Online, Accessed 14/02/21 https://www.nbcnews.com/nehttps://www.statista.com/statistics/1098051/number-of-euthana sia-instances-registered-in-belgium/ws/europe/belgium-becomes-first-country-allow-euthanas ia-dying-children-n29441 Porter, T. 03/01/15, ‘​Belgian serial rapist and murderer Frank Van Den Bleeken 'to be euthanised' in January’, ​International Business Times, Online, Accessed 01/03/21 https://www.ibtimes.co.uk/belgian-serial-rapist-murderer-frank-van-den-bleeken-be-euthanis ed-january-1481742 1 
  • 18. Pro​Con, 19/10/20, ​“History of Euthanasia and Physician-Assisted Suicide”. ​ProCon, Online, 14/02/21 https://euthanasia.procon.org/historical-timeline/ Rodriguez, C. 17/03/19, ‘​Euthanasia Tourism: Is The E.U. Encouraging Its Growth?’, Forbes, Online, Accessed 23/02/21 https://www.forbes.com/sites/ceciliarodriguez/2019/03/17/euthanasia-tourism-is-the-e-u-enco uraging-its-growth/?sh=30ac7931229b Statista, 02/19, ‘​Share of officially performed euthanizations in Belgium by illness leading to the demand in 2018’, ​Statista​, ​Online, Accessed 12/02/21 https://www.statista.com/statistics/1098074/share-of-euthanized-patients-by-illness-belgium/ Van Dalen, D. 28/04/20, ‘​What is the difference between euthanasia and assisted suicide?’, Maxim Institute, Online, Accessed 09/02/21 https://www.maxim.org.nz/faq-1/   2 
  • 19. TOPIC B: Addressing the threat of biological weapons and bioterrorism WHO STUDY GUIDE R J M S M U N Troops train in order to use or be protected in a scenario of biological warfare. This is a photo from the US Navy 1 9
  • 20. Overview Biological weapons are microorganisms such as bacteria, viruses, fungi or other toxins. Bioterrorism is the production and the release of these biological agents to infect and kill humans, plants and animals. The means of transmission usually include water and food supplies, animals such as cattle and insects, aerosols, or infected individuals. Biological weapons fall in the category of weapons of mass destruction, given that agents cause many deaths in a short period of time, and are challenging to contain, hence resulting in epidemics and pandemics. Biological Weapons programs date back to the 1930s, when Canada and the United Kingdom developed schemes focused on crops and cattles, researching anthrax respectively. Further, with the escalated tensions in WWII, Japan concentrated its efforts on "Unit 731", the center of its expansive biological program, consisting of 150 buildings and 3000 scientists. 9 They was responsible for the death of 10,000 prisoners 10, a third of them being war prisoners from an array of nations including the US, the USSR and the UK. Simultaneously, the American Biological Program was secretly initiated at Fort Detrick in Maryland. At its peak, the program involved about 3400 people 11 and produced a range of agents. Some cities were used as laboratories; organisms were released to study the effects of solar radiation and climatic conditions on the viability of the pathogens. Public health concerns were brought up after an outbreak of urinary tract infections. Despite ratifying the Biological Weapons Convention (BWC) in 1975, the Soviet Union continued its biological weapons program through a secret organization called Biopreparat, opening eight facilities for large-scale production of BW. There were open-air testings of BW agents on the island of Vozrozhdeniye. At its peak, the facility counted 60,000 people in 40-50 facilities. 12 WHO STUDY GUIDE R J M S M U N BACKGROUND INFORMATION 2 0 9- Riedel, 2004 10- Riedel, 2004 11- Roffey, 2002 12- Roffey, 2002 Japanese troops conducting experiments on a Chinese person
  • 21. The usage of anthrax as a weapon of mass destruction began in WWI, when Germany shipped horses infected with anthrax to infect the population in the Allied Powers. People get infected with anthrax through spores, which can be put in powders, sprays, food and water. Perhaps one of the most notably bioterrorism attacks took place in the US , shortly after the terrorist attack on the 9th of September 2001. Four anonymous letters laced with anthrax spores were sent out to media outlets and the offices of two US senators. In total, 17 people were contaminated and 5 died.13 The Washington and New Jersey facilities were closed, however, contaminated distribution centers in Connecticut, Florida, and New York City remained open. After the attack, the National Institute of Health tracked 7 of the survivors, 2 which inhaled anthrax and the rest were exposed via contact with the skin 14. Another analysis by the Centers for Disease Control and Prevention showed that 8 people out of the 17 survivors did not go back to their jobs, all of them were receiving psychiatric assistance. WHO STUDY GUIDE R J M S M U N 2 1 Anthrax, Ricin & T-2 mycotoxin E v i d e n c e o f o n e o f t h e a n t h r a x l e t t e r s , r e c o v e r e d b y t h e F B I 13- FBI, 2021 14- Nuclear Threat Initiative, 2011
  • 22. Also, bioterrorism attacks were done and attempted using ricin which can be made into a powder, a mist or pallet, and dispersed through food, water or air.. In 1991, four people were arrested because they were planning to poison a US Marshal. They planned on mixing ricin with another chemical to coat the handle of the US’s Marshal car, in the hope it would be absorbed by the skin. Then, in 2003, ricin was found in the White House mailroom, and four months later, found in Senate Majority Leader Bill Frist’s mailrooms. Luckily, no casualties were resultant of either incident. During the Cold War, after the communist victory in Southeast Asia, 1975, Vietnam and Laos launched attacks against the Hmong tribes in the north of Laos. Refugees began to report aircrafts, from Laos, that were dropping an oily yellow liquid, which they called “yellow-rain”. Exposure to this liquid caused symptoms such as bleeding in the nose and gums, tremors, blindness, seizures and in the worst case, death. Similar cases were reported from the Khmer tribes in Cambodia, and anti-Soviet resistance groups in Afghanistan. The US accused the Soviet Union of having provided their allies in Laos and Vietnam with T-2 mycotoxin which was associated to be what caused the “yellow-rain”. WHO STUDY GUIDE R J M S M U N 2 2
  • 23. Nowadays, the greatest concern regarding BW is the fact that several countries are not prepared for a biological weapon attack and bioterrorism. The developing world is more vulnerable, as they lack basic healthcare for their population. The supply of healthcare is very scarce due to a lack of resources. The amount of money invested in healthcare is way below the amount required to provide essential health services. Where healthcare services are available, the quality is usually deficient, which in summary, if there were to be a biological attack, the healthcare system in developing countries would not be able to help the population and most probably collapse. Countries that are in war are also very vulnerable to biological threats. Syria, which is in the middle of a civil war, has lost several healthcare facilities. More than 590 facilities and personnel have been assaulted 15. The government deliberately stopped water treatment, withheld vaccinations, surgical items, and emergency kits, and criminalized healthcare workers. As a result, there were epidemics of waterborne diseases, the return of the poliovirus, and due to irregular antibiotics, unsterile underground hospitals, and unsafe water, “superbugs” began to emerge and penetrate through wounds caused by the war. WHO STUDY GUIDE R J M S M U N 2 3 1 5 - P H Y S I C I A N S F O R H U M A N R I G H T S , 2 0 2 1 CURRENT SITUATION Syrian map showing the location of the attacks on health facilities
  • 24. Moreover, simulations of bioterrorism in the past of the US have shown how government officials had lack of communication, flaws in the command structure and decision making, insufficient containment, and inadequate supplies or handling of supplies. Not to mention, that the exercise also proved that the healthcare system would be incredibly overwhelmed due to the increased patient demand. There are also concerns about the improvement of surveillance on the use of biological agents including when used through water or food. Additionally, there are ethical implications concerning clinical trials. Traditional clinical trials are conducted by testing medication on patients that are currently infected with the disease being investigated. However, in the US for example, the Food and Drug Administration requires clinical trials that are safe and effective, and it would be considered ethically unacceptable to use biological weapons to infect patients for the research. WHO STUDY GUIDE R J M S M U N 2 4
  • 25. WHO STUDY GUIDE R J M S M U N BLOC POSITIONS The US was in compliance with the BWC even before formally ratifying it in 1975. Furthermore, the US is the biggest contributor to the G8 Global Partnership against the Spread of Weapons and Materials of Mass Destruction, and has contributed in the improvement of biosecurity against BW and bioterrorism, preventing illegal trafficking of BW and further international non proliferation cooperation. 2 5 United States Russia Russia has ratified the BWC in 1975, when it was still the Soviet Union and has implemented export regulations on BW materials. However, there have been several concerns raised due to the fact that the USSR has continued BW activities after the ratification of the BWC for more than 15 years. Iran Iran ratified the BWC on the 22nd of August of 1973 and has publicly denounced all types of mass destruction weapons. Iran considers the acquisition, development and use of weapons of mass destruction to be immoral. However, the country did not upload any documentation part of the Confidence Building Measures (CBMs), which is required for all submitters of the BWC to reduce suspicions, until 10 years after the BWC took place. Several accusations have been done on Iran for secretly having BWs, but there has been no evidence found to support that. Israel Israel has not signed the BWC and has never made a public statement about its current situation regarding BW. Israel has very advanced research in biological agents such as anthrax, plague, and others, and the Israel Institute for Biological Research has about 170 technicians. Speculations about an offensive BW weapon program continue till today. Israel is also very concerned about “Islamic terrorist groups” and has made much improvement in security around their laboratories and regulations of exports.
  • 26. WHO STUDY GUIDE R J M S M U N TIMELINE OF EVENTS WW1 Germany ships anthrax infected horses to France, the US, Spain, Romania, and others. 1925 The Geneva Protocol, which prohibited poisonous or other gases, and bacteriological methods of warfare is established and signed by 108 nations. 1975 The Biological Weapons Convention (BWC) is implemented, banning the acquisition and production of biological and toxin weapons, including 183 state-parties. 16 1979 Anthrax epidemic in Russia affects people living near a microbiology facility. 1952 Groups petition the United Nations to amend the Declaration of Human Rights to include "the right of incurable sufferers to euthanasia or merciful death”. However, Eleanor Roosevelt, the Chairperson of the Committee, did not present the petition to the Commission. 2001 Anonymous letters filled with anthrax spores are sent to new media offices and two US Senators, Patrick Leahy, President of the US Senate, and Senate Minority Leader, Tom Daschle. 2 6 1 6 - D A V E N P O R T , 2 0 2 0
  • 27. WHO STUDY GUIDE R J M S M U N 2002 The launching of G8 Global Partnership Against the Spread of Weapons and Materials of Mass Destruction. This is a 10-year framework that focuses on preventing bioterrorists and states that support them. 2004 The US implements the BioShied project, focusing on purchase of vaccines to be used in case of a bioterrorism attack. 2011 Four men are arrested for planning to disperse ricin in Atlanta and other places in the US. 2013 Russia’s Prime Minister Dmitry Rogozin announces the beginning of a rearmament program that would include the development of new kinds of weapons. 2019 The US makes a report saying that Iran has not abandoned its BW program for offensive purposes. 2 7
  • 28. WHO STUDY GUIDE R J M S M U N DEFINITION OF KEY TERMS 2 8 Toxins Hazardous and poisonous substances released by different living organisms that can be harmful when it enters your body. Pathogen A living organism that causes disease to a host. This can include viruses, bacteria and others. Anthrax An infection caused by bacteria that affects both animals and humans. It can affect the skin, lung and intestine and can be deadly. Ricin It is a toxin part of the left-over waste of when castor beans are processed to make castor oil. Ricin poisoning can kill cells and cause death. It also has no antidote for it. T-2 mycotoxin A highly toxin released by fungi and can be extremely dangerous when inhaled. It can cause vomiting, diarrhea, skin irritation, rash, blisters and others. Dual-Use The character of being either used for peaceful purposes, such as medication and vaccination, or for warfare purposes. Confidence Building Measures (CBM) Reports submitted by countries to reduce suspicions and improve international cooperation in peaceful biological weapons activities.
  • 29. WHO STUDY GUIDE R J M S M U N GUIDING QUESTIONS 2 9 To what extent is the BWC effective, taking into account the sovereignty of each country, and their responsibility as members of the UN and international community? What measures should be taken if a country does not comply with the BWC, having ratified it, and what is the responsibility of your delegation in case this happens? How can countries prevent terrorist attacks, and what is the role of developed countries in biosecurity compared to developing countries? How can the fiscalization of the different countries, in terms of possessions of BW, be improved and legitimate, taking into account each countries’ sovereignty?
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