Contemplating a one child world

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7035.907 (Published 06 April 1996) Cite this as: BMJ 1996;312:907

Fundamental rethinking is needed

  1. Colin Butler
  1. General practitioner 4 Queen Street, Campbell Town, Tas 7210, Australia

    EDITOR,—A one child world1 may just be possible in China, a country of coercion, abortion, and neglect of orphans; it may also be achievable soon in Catholic Italy and Ireland. For most countries, though, the switch from demographic transition (average families of 2.1 children) to ecological transition (a one child world) is at least a generation away, and in countries threatened by or already experiencing demographic entrapment this will take much longer. The resurgence of nationalism also complicates this objective, as many ethnic groups will insist that a one child family should not apply to them.

    If human survival on a global level is possible, families urgently need to adopt not only a one child world but one in which the destructive ecological effect of each person is as small as possible.2 3 The issues of demographic and ecological entrapment must become central to the debate over scientific and public health policy; the taboos that hamper this must be dropped. Fundamental rethinking is needed. This is especially true in the industrialised countries in the North, where the ecological effect of one person easily outweighs that of 50 in the non-industrialised South.

    Improved surveillance of, and response to, the catastrophic public health threats that the North now faces is not an adequate solution.4 The explosion of the consumption bomb threatens populations in both the North and the South.5 To defuse it, fundamental rethinking is needed; along with the nuclear and population bombs this is the greatest threat to public health that we currently face.


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