Bandy X. Lee M.D., M.Div.

Psychiatry in Society

Nuclear Violence as Madness

A massive structure of violence needs reconsideration for societal health.

Posted Sep 04, 2018

I appeal as a human being to human beings; remember your humanity, and forget the rest. If you can do so, the way lies open to a new Paradise; if you cannot, nothing lies before you but universal death.” – Bertrand Russell

What is the current likelihood of dying from a thermonuclear world war? This may seem an odd question, but an American professor emeritus of engineering at Stanford University has sought precisely to answer this question. Applying risk analysis to a potential failure of nuclear deterrence, Martin Hellman claims that the risk of a child born today suffering an early death due to nuclear war is at least 10 percent (Blackman, 2009).

Just as manufacturers assess the risk of injury to drivers, and engineers assess potential risks of a new nuclear power plant, we can assess the risk of nuclear war based on our current arms strategy. While almost everyone agrees that thermonuclear weapons cannot be used to advantage because using them would be annihilation, the policy of nuclear deterrence requires that those weapons always be ready for use, and many of them on “launch-on-warning” hair-trigger ready. We are therefore playing a gamble that makes our children more likely to die of a nuclear war than of a car crash.

Probability theory is the branch of mathematics that measures the probability of something by expressing it through a set of axioms or premises, and is the logical way to evaluate the nuclear gamble. Consider a game in which A repeatedly tosses a coin and B calls heads or tails each time. The game continues until B guesses incorrectly, at which point B is shot. The chance of surviving thirty tosses is roughly one in one billion. What does pistol roulette have to do with nuclear war? During the Cuban Missile Crisis, Kennedy estimated that the odds of a nuclear war were “somewhere between one out of three and even.” Thus, the Cuban Missile Crisis would be equivalent to nuclear roulette, a version of pistol roulette in which the entire world is at stake, with a two- or three-chambered revolver. Every “small war” pulls the trigger in nuclear roulette (Hellman, 1986).

When nuclear tensions between the U.S. and the former Soviet Union ran high, the risk of nuclear inadvertence was much greater than had generally been recognized; the Union of Concerned Scientists (2015) lists many dozens of “close calls” involving nuclear warheads in the U.S. alone, and estimates many more that have not been made public. The end of the Cold War and the Treaty on the Non-Proliferation of Nuclear Weapons (1968) did not bring the nuclear standoff to an end, but the two countries continued to develop and modernize weapons, while seven other nations around the world joined in (Busch, 2015).

This situation prompted the Treaty on the Prohibition of Nuclear Weapons (2017), but meanwhile, the U.S. just committed a 1.25 trillion-dollar, thirty-year budget to modernize its nuclear arsenal. The president pledges major increases in nuclear weapons and has articulated nuclear-weapons policies that include unprecedented plans to use nuclear weapons in response to nonnuclear threats (U.S. Department of Defense, 2018). At the same time, Russia boasts of its new and “invincible” nuclear weapons, signaling a renewal of a nuclear arms race. The possibility of a nuclear strike due to computer malfunction, human or technical error, or military escalation has thus vastly increased (Forrow, Ruff, and Thurlow, 2018).

A poll of 50 experts concluded that there is a 6.8 percent chance of catastrophic nuclear war in the next twenty years, killing more people than World War II. This survey brought out which cities are most likely targets. India versus Pakistan was by far the most likely conflict with a 40 percent chance of war and a 9 percent chance of nuclear exchange (Project for the Study of the 21st Century, 2017). Cities in the Middle East may be more vulnerable. Despite the nuclear deal between Iran and the world’s major powers at the time of the poll, experts still saw a 27 percent risk of some kind of conflict between Tehran and its enemies—and now with the nuclear deal withdrawn, the chances are even worse.

More than a quarter of a century after the fall of the Berlin Wall, Russia and the U.S., which have an estimated 1950 and 1650 active strategic nuclear weapons respectively, still together possess more than 90 percent of the world’s nuclear arsenals. The survey estimated a 21 percent chance of NATO and Russia fighting at least a limited conventional war in the next twenty years, and a 4 percent chance it might go nuclear. The risk of the U.S. fighting China is 12 percent, with a 2 percent chance of going nuclear. Japan does not currently have a nuclear-weapons program, but experts say it could probably build one in a hurry if it believed it needed it (Apps, 2015). Since the survey, the possibility that the U.S. and Russia may jointly attack another nation, such as Iran, is no longer inconceivable. But there is yet another uncomfortable reality: the erratic and unstable presentation of our commander-in-chief, whose mental capacity to handle these arsenals has not been proven.

The immediate consequences of a single thermonuclear-weapon explosion are well known: fireball radiation, prompt neutrons, and gamma rays, blasts, and fires. The kind of firestorms that are likely would block the sun’s rays to create massive global cooling and disrupt food production in ways that would put more than two billion people at risk of dying from starvation (Helfand, Haines, Ruff, Kristensen, Lewis, and Mian, 2016).

The Hiroshima bomb that killed an estimated 200,000 people is now considered a small, “usable” nuclear bomb. We can see that the current policy of “Mutually Assured Destruction” (aptly abbreviated “MAD”), or a doctrine that ensures the full-scale use of nuclear weapons against any nuclear attack, is not purely military strategy but truly a characteristic of insanity (being blind to one’s own destruction). The only possible conclusion is that the way to survive this pistol roulette is to put the gun down—and the question is whether we are healthy enough to do it.


Apps, P. (2015). Which cities are at greatest risk of nuclear war? City Metric, November 13. Retrievable at:

Blackman, C. (2009). Chance of nuclear war is greater than you think: Stanford engineer makes risk analysis. Phys, July 20. Retrievable at:

Busch, N. E. (2015). No End in Sight: The Continuing Menace of Nuclear Proliferation. Lexington, KY: University Press of Kentucky.

Forrow, L., Ruff, T., and Thurlow, S. (2018). The 2017 Nobel Peace Prize and the Doomsday Clock—The end of Nuclear Weapons or the end of us? New England Journal of Medicine, 378(24), 2258-2261.

Helfand, I., Haines, A., Ruff, T., Kristensen, H., Lewis, P., and Mian, Z. (2016). The growing threat of nuclear war and the role of the health community. World Medical Journal, 62(3), 86-94.

Hellman, M. E. (1986). Nuclear War: Inevitable or Preventable? Vancouver, British Columbia: University of British Columbia.

Project for the Study of the 21st Century (2017). PS21 Survey: Experts see Increased Risk of Nuclear War. London, U.K.: Project for the Study of the 21st Century. Retrievable at:

Treaty on the Non-Proliferation of Nuclear Weapons (1968). Retrievable at:

Treaty on the Prohibition of Nuclear Weapons (2017). Retrievable at:

U.S. Department of Defense (2018). Nuclear Posture Review. Arlington, VA: U.S. Department of Defense.

Union of Concerned Scientists (2015). Close Calls with Nuclear Weapons. Boston, MA: Union of Concerned Scientists.