Drs. Brennan and Kirschner [1] are to be commended for raising important issues about medical ethics and human rights violations during and after the Iraqi occupation of Kuwait. The magnitude of human rights violations committed by the Iraqi occupation army and the persecution of Palestinians by the restored emirate may never be fully known. What is clear, however, is that tens of thousands of Iraqis were pulverized in the Arabian Desert to bring the Sabah family back to power. The systematic bombing of the Iraqi infrastructure, with the "collateral damage" to life and property, the uprising of the Kurds and Shiites spurred by our promises of material aid and democracy, the suppression of the uprising by Saddam's army, the continuing embargo on Iraq, with its debilitating effect on Iraqi life and health and especially on the children must also be considered in any discussion of human rights violations.

The authors also touch on the cultural and religious differences in the interpretation of medical ethics and comment on how Western physicians would consider "the amputation carried out by doctors enforcing Islamic law to be an unethical form of mutilation." I know of no ethical way to mutilate. The preeminent principle of any medical ethic is the preservation of life and promotion of health. This principle has been expressed throughout the documented history of medicine—whether Islamic, Western, ancient, or modern [2, 3]. That is why the medical community should not stand idly by and watch events such as the disintegration of the human family as a result of famine and civil war in the Horn of Africa or the "ethnic cleansing" taking place in the heart of Europe. No cultural, ethnic, or religious barrier should exist to the universal applicability of medical ethics and human rights. Medical ethicists should convene an international conference to arrive at a broader definition of medical ethics, delineating physicians' duties and responsibilities in relation to human rights violations in this complex world.