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In the wake of terror: medicine and morality in a time of crisis
  1. A Borovecki

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    Edited by J D Moreno, The M I T Press, Cambridge and MA. 2003, pp 229. ISBN 0-262-13428-4

    After the events of 11 September 2001 and the anthrax letters, terrorism and bioterrorism have become the number one issue and motivation for all sorts of discussions and actions within the USA and in the rest of the world. Therefore, it is no wonder that bioterrorism and the threat of chemical weapons are prevalent issues in bioethical debates throughout the world and especially in the USA.

    In the Wake of Terror tries to give an American perspective on the most important bioethical issues connected with terrorism and bioterrorism. The book is from the series Basic Bioethics published by the MIT press. The series editors are Glenn McGee and Arthur Caplan. In the Wake of Terror is a collection of 12 essays by 16 authors with a foreword by Ford Rowan. The essays cover five topics: public health, resource allocation, healthcare workers, industry obligation, and research and genetics.

    The essays in the first part of the book by Paul A Lombardo, James G Hodge Jr, Lawrence O Gostin, George J Annas, Ronald Bayer, and James Colgrove discuss the impact of terrorism on public health. They explore in an interesting manner the history of human experiments carried out under the label of national security in the USA. This part of the book also presents different viewpoints on the Model State Emergency Health Powers Act (MSEHPA) drafted in 2001, a new public health law for controlling infectious diseases during emergencies. The essayists give a thorough explanation of the historical background, events and developments leading to the creation of this legal document and discuss its contents. Furthermore, some new issues are also highlighted on an ongoing debate—personal liberties and human rights versus the common good and national security. George J Annas presents an intriguing discussion on the debate, which is essential to any public health measure implementation scheme. His essay, more than any other contribution, gives a true bioethical flare to this part of the book.

    In the second part are two extremely interesting and well thought out essays with a strong bioethical background by James F Childress and Kenneth Kipnis. These essays discuss the issue of resource allocation, especially the triage response to a bioterrorist attack.

    The essay on the ethical obligations of emergency healthcare professionals, written by Lisa A Eckenwiler, is the first essay in the third part of the book. It highlights the major issues and possible ethical dilemmas facing emergency healthcare personnel. Griffin Trotter’s excellent essay is an interesting argument for universal access to health care in the USA in the light of the bioterrorist threats.

    The fourth part brings us views on the ethical obligations of pharmaceutical companies at a time of increasing bioterrorist threats in the world with some interesting thoughts by Evan G DeRenzo. The other essay in this part of the book written by Ann E Mills and Patricia H Werhane highlights issues in organisational ethics and continues the debate started by Griffin Trotter from another viewpoint and stresses the need for changes in the US healthcare system.

    In the final part of In the Wake of Terror is an interesting and thought provoking essay on research with victims of terror and its ethical considerations by Alan R Fleischman and Emily B Wood. The last essay by Eric M Meslin tries to discuss the ethical issues arising from the connection between genetics and bioterrorism.

    In the Wake of Terror is written mainly from the US perspective on the issues of bioethics and terrorism. However, it is interesting reading material for anyone who is dealing with these issues.