interested in bio-weapons. The attraction is simple, bio-weapons are inexpensive to make, require materials, equipment, and expertise that are easy to procure (some of the information is even on the Internet), and, for the most part, involve biological agents that are readily available. As an added feature, bio-weapons are the best weapons of mass destruction for covert use.
The effects of their release take many hours or even days to materialize, giving the perpetrators time to escape.
Adding to this unfortunate circumstance of the rising threat of bio-weapons is the current social, economic, and political reality of the world. With mounting religious fundamentalism in some countries, thwarted nationalistic goals in others, economic deprivation in many, and, in the industrialized west, the increased desperation of violent farright groups whose agenda has stalled in an era of increased globalization, there has been a worldwide rise of terrorism in general.
The combination of this increase with a heightened appreciation of the evil attractiveness of bio-weapons is what makes the current situation so critical.
In Vector, medical examiners were the first to confront an occurrence of bioterrorism in the form of a single case of anthrax. Lamentably, since there was a simple but unverified explanation for the case in the story, the doctors' index of suspicion of bioterrorism was not adequate for them to insist on proper follow-up. If they had, the event as it unfolded could possibly have been prevented. This is an important lesson. Leaving fiction for the real world, there is a high probability that the medical profession would be the first group of professionals to interface with a bioterrorism event, and that distinct possibility must be part of medical thinking these days. This is particularly true involving illnesses caused by agents known to have bio-weapon potential.
Yet the medical profession's responsibility with regard to bioterrorism goes beyond detecting an episode and treating its victims. The medical profession has an ethical duty to continue to institutionalize the opprobrium currently associated with the use of bio-weapons. Members of the medical profession of all countries must insist on investigating any suspicious disease incidents within their borders and report such circumstances to the world forum. If that had happened in Sverdlovsk in 1979 following the anthrax leak from a Biopreparat bio-weapon facility, the Soviet medical profession would have done the world a service. It would have exposed the illegal Soviet offensive bio-weapon program.
Instead, the world was treated to elaborate KGB disinformation, and Biopreparat continued its illegal and ethically repulsive secret work for another ten years.
Another reason the medical profession has an ethical role to play in relation to bio-weapons is that this technology represents the ultimate perversion of biomedical research. Indeed, with the help of the burgeoning field of bioengineering, the possibility exists of constructing new doomsday organisms.
Experts shudder at the thought of combining the contagiousness of the common cold or even smallpox with the pathogenicity of Ebola.
As is the case with the nuclear threat, the public feels it can do little to thwart the development or deployment of bio-weapons. But that is not entirely true. The public can play a role in this worsening biological nightmare by being cognizant of the threat bio-weapons pose.
Counterintelligence is the only way to actually prevent occurrences, and the public should be suspicious and vigilant. Since it is true that small labs and production facilities can be made in private locations like basements or spare rooms, it is important to be on the alert for tip-offs, like fermenting odors or the sound of constant, circulating fans. These should be reported to the authorities. Any unexpected traffic or theft involving microorganisms, microbiological equipment, microbrewery fermenters, biocontainment gear, or pest control spraying devices should also be brought to the attention of law enforcement.
With everything else there is to worry about these days between AIDS, famine, economic woes, civil war, ethnic cleansing, and global warming, it seems there is hardly room for the specter of bioterrorism.
Yet few threats have the capability of killing so many so fast. For years we lived under the fear of nuclear winter annihilating the human race.
Now there is a similar threat from biology.
Finally, on a more positive note, governments and local authorities, particularly in the United States, have started to consider seriously the menace of bioterrorism and have begun to act. Money has been appropriated. The Department of Defense and the FBI have formed specialized response units. Major cities like New York have tasked their emergency management organizations with the problem. There have been efforts at training on the local level and exercises to mimic real events. Still, the results to date are equivocal. It may take an actual bioterrorist strike to harden government initiative, but by then, for many, it will be too late. Much needs to be done, and we all have to contribute. Let's not wait for an incident like the planned one in Vector to solidify our resolve.
Robin Cook, M. D. Naples, Florida December 1998
1. Davis, Lorraine,
This is a thoroughgoing, textbook treatise.
2. Falkenrath, Newman, and Thayer, America's Achilles Heel, Nuclear, Biological, and Chemical Terrorism and Covertattact. Cambridge, MA, M.
I. T. Press, 1998.
This is the best general book on the subject that I found. It focuses directly on policy implications.
3. Hamm, Mark, American Stinheads, The Criminology and Control of Hate Crime. Westport, Conn. Praeger, 1993.
I didn't know the difference between skinheads, punks, and rockers until I read this book. I found it fascinating, particularly in relating these movements to rock music.
4. Laqueur, Walter, Fascism, Past, Present, Future. New York, Oxford University Press, 1996.
This is an extraordinarily readable book about a movement that most of us thought had been defeated in World War II. I found it inordinately stimulating, particularly in relation to the current economic and social turmoil in Russia.
5. Lundberg, George, Journal of the American Medical Association (JAMA).
Chicago, Vol. 278, No. 5, August 6, 1997.
This entire issue of JAMA was devoted to the issues of bio-weapons, biowarfare, and bioterrorism. It is written from the point of view of the health-care provider.
the end.
