Civil defense in the United States: evolution and regression.

Thirty years ago, physicians were exhorted to assume a leadership role in preparedness for national emergency, including war. At that time, a system evolved to prevent certain types of casualties (due to blast and radiation), and to meet the medical challenges that would result from disaster. In recent years the system has regressed, and physicians are often leaders of the opposition to its improvement. Funding has been cut drastically, and many programs have been all but abandoned. Because this change in philosophy could cost millions of lives, the underlying assumption that all efforts would be futile in the face of modern warfare needs to be critically reexamined.