Here’s an excellent summary of the very alarming new medical study on Iraq War deaths by the BBC’s Paul Reynolds. This study indicates that some 655,000 *more* people have died in Iraq since the beginning of the war than would have died without the war.

The study has really been bothering me because if true it means the toll from the war is far, far greater than even the harshest critics of the US Iraq policies have been suggesting. If true it defies reason even for the most Machiavellian nationalist to suggest that this scale of death is justified under the circumstances. If false it shows a remarkable lack of quality in a scientific, peer reviewed research project.

Reynold’s points out the key aspect of the study that is very confusing and must be reconciled by the researchers:

That supposes a huge failing by the Iraqi health ministry, a failing the report did not hint at, because it said that death certificates were readily available for most of the reported deaths in the households surveyed.

For the study’s conclusion to be valid it seem that the death certificates they say were produced 92% of the time [I’ve also seen 80% ] *were not counted* by the health ministry. This seems highly unlikely. If they were counted and the count reflects much lower numbers (as I think it does – trying to find that out) then the study is internally inconsistent. The study cannot note 92% certificated death among those interviewed and then reject certificates as a good proxy of actual deaths.

I hope Reynolds and others with key contacts are able to follow up on the Iraq report. If true, it’s a horrific finding of great historical significance. If false, it challenges our reliance on this type of high level, academically supervised research in other sectors.

Why this matters: Ironically, many people who hold strongly held beliefs both in favor and against the Iraq war are suggesting “hey, the numbers don’t really matter”. Those supporting the war think that extremism in the defense of liberty is no vice and collateral damage is something to sweep under the rug. Those against the war seem to feel that USA should pull out without much regard to the fate of Iraq or to the potentially catastrophic civil war that could follow a US withdrawl.

The death toll is hard to review but it is arguably the best measure of the costs of a war. Ignoring death as a key measure is fundamentally immoral.Also, suggestions to make decisions without taking count of the death toll are not only naive and irrational, they dangerously support the status quo of making decisions without enough information. The world is complex and many life and death decisions must be made every second. Precious lives and resources are being deployed daily to build hospitals, fight wars, teach, drill wells, etc.

Sadly, these allocation decisions are almost always made politically and emotionally rather than being rooted in a careful examination of the costs and the benefits of various courses of action. It’s human to make this mistake, but it’s algo tragic, and results in millions of unnecessary deaths, especially due to the lack of rational allocations in favor of health care in developing world.

Update:  This is an outstanding analysis by the Iraq Body Count, an organization very unsympathetic to the war, of why the findings must be viewed with skepticism.  If the Lancet and the study are to maintain credibility I would hope these concerns will be addressed.

Related links:

Iraq Body Count

BBC on Iraq Body Count project counts

Some Iraq Health Ministry Numbers. Lower than the new study would suggest.

USA Today: Iraq Health Ministry told to stop counting deaths in December 2003 but it appears they started again after this controversial decision which came after they were coming up with counts that are consistent with other studies but do not appear to support the huge tolls in the new study.