A central premise of the Bush administration’s recently published Nuclear Posture Review is that nuclear dangers have grown since Sept. 11. No one disagrees. Moreover, there is also widespread agreement that it is a prime responsibility of the president to protect Americans from the risk of nuclear attack.

So how best to proceed?

Some would say that the best defense is a good offense. That appears to be the course that President Bush and his advisers are taking us down. This is an approach that may work in conventional military strategy, but it only creates greater risks when it comes to nuclear weapons policy.

Let’s look at a realistic threat assessment, the major elements of Bush administration nuclear policies, and some alternative approaches.

Since Sept. 11 most security analysts rank nuclear threats in something like the following order, from most likely to least likely:

. Attack on a nuclear power plant, using a plane or conventional explosives.

. Terrorists smuggling in a so-called “dirty bomb,” which would use conventional explosives packed with radioactive waste.

. Terrorists smuggling in a small nuclear weapon, perhaps stolen from the former Soviet Union or built elsewhere using stolen nuclear material.

. A distant last on the list is attack by a nuclear missile.

Common sense dictates that we must respond to the threats in that order. In sharp contrast, the Nuclear Posture Review reveals that this administration is instead now fully engaged in resurrecting old Cold War plans and in formulating new, even more provocative and dangerous schemes to use nuclear weapons for the first time since we destroyed Hiroshima and Nagasaki almost 57 years ago – all completely unrelated to responding to the three most likely nuclear threats.

The Bush administration proposes spending billions on National Missile Defense and development of new smaller, more “usable” nuclear weapons. Most ominously, they threaten to actually use our nuclear arsenal against other nuclear and non-nuclear countries. This radical policy shift is in direct violation of the Nuclear Non-Proliferation Treaty.

Such plans send exactly the wrong message to other nuclear powers and nuclear want-to-be’s, essentially challenging them to a new arms race. These policies are a recipe for promoting nuclear proliferation and increasing the risks of the three most likely kinds of terrorist nuclear attacks against us.

Some suggest that we should be pleased with the recent Nuclear Posture Review and that more credit should be given to President Bush’s proposed reductions in the absolute numbers. The problem is that this part of his shift in nuclear policy is not intended to decrease reliance on nuclear weapons. Rather the intent is to shift emphasis from those older weapons that no one believes are actually usable to new nuclear weapons that he mistakenly believes could actually be used for some beneficial purpose in conventional war.

The tragic reality is that use of smaller nukes would still inflict devastating environmental and health effects on tens of thousands, perhaps millions, of innocent civilians beyond those enemy soldiers who might be targeted. Moreover, once we develop these new weapons, it is inevitable that future adversaries will eventually get their hands on the same kinds of weapons, increasing the likelihood of them being used against us.

Rather than taking us down this potentially catastrophic path, the United States must live up to its finest traditions of preserving life, liberty and the pursuit of happiness, and lead the world away from using weapons of mass destruction. To contain the three most likely nuclear threats, our policies should all be geared toward decreasing production, deployment and threatened use of nuclear weapons. Instead of wasting billions on National Missile Defense and developing new nuclear weapons, we should:

. Strengthen security at our seaports, airports, passenger rail terminals and at our borders.

. Fully fund the Nunn-Lugar program to help secure Russian nuclear materials.

. Enhance the effectiveness of the Immigration and Naturalization Service.

. Improve our public health system’s capacity to respond to attacks with weapons of mass destruction.

Some state outright that it is unpatriotic to question this administration at this time. Exactly the opposite is true – if we care about the survival of our country and our planet, we must debate these questions and convey back to our elected leaders that we want them to reduce nuclear dangers, not increase them.

Peter Wilk, M.D. is president of Physicians for Social Responsibility/Maine