Urban Survival Secrets for Terrorist Attacks

Urban Survival Guide

Discover How You Can Easily Have A Survival Plan Staying Right Where You Currently Live That's Better Than Having. A Fully Stocked Rural Retreat That You Can't Get To! Finally Revealed: Urban Survival Secrets For Surviving Terrorist Attacks, Natural Disasters And Pandemics! In The Real World, Most People Don't Have A Fully Stocked Retreat They Can Escape To. Even If You've Planned Ahead And You Do, There's No Guarantee That You'll Leave In Time Or That You'll Be Able To Make It There. Your First Plan Must Be To Survive In Place.

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Patterns of Torture and Terrorism

The punitive destruction of a major joint by gunshot wound was originally thought to be the signature injury of certain criminal elements in the United States. More recently, it has been seen as an act of terrorism in other parts of the world, especially Fig. 23. Neurogenic destruction in the ankle and hindfoot of a 7-yr-old female with congenital insensitivity to pain. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press. Fig. 23. Neurogenic destruction in the ankle and hindfoot of a 7-yr-old female with congenital insensitivity to pain. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press.

Agroterrorism

Agroterrorism is the willful, unlawful threatened or actual destruction of property or people through the agricultural and food industry to achieve the perpetrator's ends, usually political. The ultimate target may be food consumers. Agroterrorism (or any other form of terrorism) is a tool of choice in asymmetric power situations, where the perpetrator perceives an inability to achieve ends through conventional political, market, judicial, or educational channels. Terrorist threats and acts are a form of propaganda designed to achieve a political end by striking fear in people. Among the many forms of agroterrorism, random killing of many innocent people is especially effective in striking widespread fear. Because everyone eats every day, some experts conclude that the agricultural and food industry is an attractive venue through which the general population can be terrorized. The following paragraphs outline the threat and means to counter it. Agroterrorists have been home grown....

Bioterrorism

The issues associated with bioterrorism are as broad in their scope and as challenging in their complexity as any in bioethics. These issues engage the resources of basic sciences, history, political philosophy, sociology, healthcare administration, and public health, as well as clinical medicine. In some instances they present unique concerns, in others they are variations on more familiar bioethical problems. In providing a sound bioethical account of these problems this entry will presuppose that the terrorist threat in question is morally unjustifiable either because the cause it represents or the means used to advance this cause cannot be rationally defended.

New Points of Emphasis

The third edition includes a wide array of new titles ranging from Bioterrorism, Holocaust, and Immigration, Ethical and Health Issues of, to Artificial Nutrition and Hydration, Cancer, Ethical Issues Related to Diagnosis and Treatment, Dementia, Dialysis, Kidney, DNR Do Not Resuscitate, and sets of articles under Cloning and Pediatrics. Topic areas such as Reproduction and Fertility, Organ and Tissue Transplantation, Death and Dying, Ethical Theory, Law and Bioethics, Mental Health, Genetics, Religion and Ethics, and alike have been thoroughly redesigned, and are essentially new. As mentioned in the Preface, half of the third edition is entirely new, while half consists of deeply revised and updated articles from the earlier edition. There isn't a single article that was not thoroughly updated, even if only at the level of bibliographies, unless it is designated as classic.

Mass Disaster Victim Identification Utilizing Biology Technology And Genetics

Forensic DNA laboratories may be called upon to assist in victim identification following mass disasters such as airplane crashes or terrorist attacks. Situations where remains are highly fragmented prevent the use of fingerprints or dental records to rapidly determine the identity of each victim and DNA analysis often becomes the only method to bring closure to the chaos of such an event. To recognize the increasing role that DNA information is playing in mass disaster victim identification, we discuss here the application of STRs, mitochondrial DNA, and single nucleotide polymorphisms in the identification of individuals who died in the terrorist attacks of 11 September 2001 at the World Trade Center twin towers, the Pentagon, and Shanksville, Pennsylvania. The original information from the first edition on the Waco Branch Davidian fire (April 1993) and the airline crash of Swissair Flight 111 (September 1998) are retained to provide historical perspective.

Identity of the Victim

The forensic neuropathologist is not often asked to establish identity, a task usually left to the expertise of the medical examiner or forensic pathologist. The forensic neuropathologist can however be asked to determine whether a mix-up has occurred in surgical or biopsy material from a neurological or neurosurgical clinic or from an institute of pathology The identity of a biopsy specimen can be established by DNA analysis of the specimen by a molecular biologist. Only rarely must brain tissue be identified, following train accidents for example, or massive explosions with multiple casualties (the result of industrial accidents or terrorist attacks). Sometimes brain tissue can provide evidence that violent injury has indeed occurred (Oehmichen et al. 1984). In all such cases DNA analysis is now the investigative method of choice.

Emerging Approaches To Finding And Identifying Contaminants

The advance of genetic-based identification DNA fingerprinting (100) may come to aid the resolution of sterility-test failure ambiguity in that genomic characterization makes it possible, in theory, to determine the origin of contaminants (i.e., a true product contaminant or an artifact of testing) based on an organism's genetic relatedness to environmental isolates, either of production or lab origin. Genetic methods are being developed for analogous epidemiological purposes in other disciplines including diagnosing, identifying, and tracking the origin and progress of infectious agents (101) and food-borne disease without the concomitant need for microbial enrichment (102), in some cases supplanting traditional, culture dependent serotyping (103) tracking antibiotic resistance genes (104) and tracking the origin of organisms used for bioterrorism (i.e., anthrax) (105,106). This latter field has been referred to as microbial forensics (107).

Biological Evidence At Crime Scenes

Postal Service began using electron-beam irradiation of mail (for some ZIP postal codes in Washington, DC) as a protective measure against terrorism with biological agents following the anthrax attacks on the Senate Office Building in October 2001. The irradiation is performed at levels demonstrated to cleave microbial DNA and prevent passage of harmful materials such as anthrax.

Using Biological Systems

The use of biological systems in environmental engineering relate to the nature of the substances needing to be removed or treated and to the localised environmental conditions pertaining to the particular situation itself. Thus, in respect of the former, the intended target of the bioprocessing must generally be both susceptible and available to biological attack, in aqueous solution, or at least in contact with water, and within a low to medium toxicity range. Generally, the local environmental conditions required would ideally offer a temperature of 20-30 C but a range of 0-50 C will be tolerated in most cases, while an optimum pH lies in the range 6.5-7.5, but again a wider tolerance of 5.0-9.0 may be acceptable, dependent on the precise organism involved. For land-based applications, especially in the remediation of contamination or as a component of integrated pollution control measures, there is an additional common constraint on the substrate. Typically the soil types best...

Change in Attitudes Beliefs and Practices Regarding Gender

Increases in population, out-migration, communication, and transportation throughout the 20th century have drawn rural people into more relationships with the rest of the world. The Bolivian and Peruvian Aymara were as affected as their compatriots by the political and economic turmoil of the late 20th century. Terrorism in Peru, the growing, trading, and processing of coca and cocaine in the Bolivian lowlands and its trade through Peru, dizzying rates of inflation, and many changes in governments have affected many aspects of Aymara life including gender roles.

Public Health and Civil Liberties

Whether the political element is in itself sufficient justification for permitting the state to have greater latitude in the abrogation of civil liberties than it would in a naturally occurring public health emergency is an issue that may be raised. One might argue that the intentionality of a terrorist act, expressed through a biological attack, is liable to sow panic in a fashion that differs from the psychological effects of a naturally occurring epidemic. Whether that is the case or not is an empirical matter, and whether it is sufficient justification for a more aggressive response is a matter of political philosophy. Not all agree that more stringent restrictions on civil liberties may be required by a bioterrorism event. Some oppose abrogating the right to refuse treatment and any requirement that doctors treat patients against their will. These critics also question the practicality and effectiveness of large-scale quarantine. All these actions tend to undermine the most...

The Obligations of Emergency Health Workers

In the context of terrorism the society under threat should also provide the material support required for emergency healthcare workers to do their job, particularly as there is an expectation that their personal welfare is at somewhat greater risk than that of other health professionals (Eckenwiler). The failure to provide suitable support is not an excuse for the healthcare worker to abandon his or her post. Rather it reflects the reciprocity that skilled professionals may fairly expect considering the physical and psychological stresses to which they are exposed.

The Role of Private Sector Institutions

Many of the human and material resources that may be required in catastrophic circumstances are in the private sector, especially pharmaceutical manufacturers and managed care organizations. Nonpublic entities are generally agreed to have some responsibilities to the society that provides a stable framework for their business activities, responsibilities that must only increase in the event of social emergency. The contours of these corporate social responsibilities assume a special character in the context of bioterrorism. Managed care organizations (MCOs) have concentrated a large portion of the highly skilled healthcare work force in the private sector. Not limited to bioterrorism, this arrangement raises questions about the relationship between corporate responsibilities and threats to the public health. Controlling of costs while also providing excellent healthcare has proven to be a significant challenge to the industry, and quality improvement efforts have proven disappointing...

Research Ethics and National Security

Like the other bioethical issues associated with bioterrorism, the development of ethical standards for the involvement of human beings in national security experiments requires the resources of several disciplines. Still more challenging, is the application of these standards, which requires a level of engagement with the political system that clearly identifies bioethics as a practical moral activity.

Development Role And Methodologies

Development of a number of new areas of concern, including physician-assisted suicide (Battin, Rhodes, and Silvers), palliative care (Barnard et al.), medical mistakes (Rubin and Zoloth Institute ofMedicine), ethics and genetics (Juengst), and even bioterrorism (Gostin).

Phylum Firmicutes The low GC Grampositive bacteria

Bacillus species are aerobes or facultative anaerobes. They are chemoheterotrophs and usually motile by means of peritrichous flagella. Only a few species of Bacillus are pathogenic in humans, notably B. anthracis, the causative agent of anthrax. This is seen by many as a potential agent of bioterrorism, and here again the relative indestructibility of its spores is a crucial factor. Other species, conversely, are positively beneficial to humans antibiotics such as bacitracin and polymixin are produced by Bacillus species, whilst the toxin from B. thuringiensis has been used as a natural insecticide (see Chapter 12).

Third Country Resettlement

Many Western countries are of victims, powerless against rebel forces fighting for or against the incumbent government, of living conditions within refugee camps that harbor diseases long eradicated or unknown in developed societies, and of miserable and malnourished children (Mares, 2001). These refugees are perceived as people who are vulnerable and reliant on the goodwill of the receiving nation (McMaster, 2001c). Also featured in the media are people taking perilous journeys to cross national borders without legal documentation people taking the initiative to seek out peace and stability instead of waiting on the benevolence of wealthier countries through an established process that is nonetheless protracted and not necessarily equitable.2 Further images present similar looking people responsible for terrorist attacks on civilian populations. The overall picture drawn from these representations is important to the perception and reception of refugees and asylum seekers. The power...

Strategies toward the Elimination of FGC Does Meaning Matter

Adopting a universalist stance, some activists argued that FGM should be subject to condemnation, and, in certain instances, punishment through legislative force. Legal scholar Bashir, for example, argues that criminalization will assist in deterring the practice by fostering an environment that is clearly intolerant to FGM (Bashir, 1996, p. 13). This view is receiving increasing support from Western nations, whose influence through economic means is perceived to threaten countries that do not outlaw or formally denounce all forms of genital cutting. There have been rumors, both on the ground in Africa and in U.S. media, of U.S. legislation tying international aid conditionally to a nation's steps to criminalize and combat FGM, much as with conditions tied to, for example, drug trafficking, terrorism, or forced abortions.5 Although

Sources Of Assistance

Search Team (NEST), Radiological Assistance Program (RAP), and Radiation Emergency Assistance Center Training Site (REACTS). These assets provide expert technical support throughout the U.S. in response to radiation accidents, nuclear weapons incidents, lost or stolen radioactive materials, or acts of nuclear terrorism.

Summary And Future Directions

Perhaps most important, and especially so in light of the terrorist attacks on New York and Washington on September 11, 2001, is the need for understanding how to prevent PTSD. Efforts by mental health professionals and public health professionals to deliver psychological interventions in the aftermath of trauma exposures are in their nascent stage of development. Needed now are creative efforts to intervene when mass disaster or tragedy occurs. At this point there are preliminary data available to suggest that CBT can prevent PTSD. The questions remaining are who can deliver the interventions, who in particular needs these interventions, when after the traumatic event is the best time to intervene, and how do we provide the interventions. Given the enormity of the tragedy of 9 1l and the enormity of most war-related traumatic events, the use of the Internet and large-group formats may well be the future of preventive efforts for PTSD.

Current and Future Controversies

The abortion issue remains among the most politically explosive and unresolved issues in bioethics. Provision of abortion services has endangered funding for other family planning services and endangered the lives of providers and consumers alike. Concerns of political conservatives and anti-abortion groups have affected policy debates as diverse as end of life decision-making in New York State and Federal regulation of embryonic stem cell research. In August of 2002, George Bush revealed his decision on stem cell research. Had it not been for the terrorist attacks that occurred shortly thereafter, stem cells might have been the defining issue of his presidency. Bush allowed future work with stem cell lines already produced, but his policy did not allow for the development of additional cell lines. By sitting on the fence, Bush did not satisfy either side in the debate. Anti-abortion forces were not happy that the existing cell lines, obtained from aborted fetuses, would still be...

Characteristics of Terrorist Related Blast Injuries

Trauma casualties (Kluger 2003 Kluger et al. 2004 Pe-leg et al. 2003). According to these studies, the maj ority of terrorist-related victims were relatively young, half of them in their 20s, since crowded public places such as malls, pubs, and buses are frequently crowded by young people (Kluger 2003 Kluger et al. 2004). It is noteworthy that children, especially adolescents, are frequently injured in terrorist attacks and the injury severity, as well as the subsequent morbidity and mortality, is exceptionally high among children injured by explosions (Aharonson-Daniel et al. 2003 Amir et al. 2005 DePalma et al. 2005).

Supersymmetry Principle

Revisionist models of belief) and subadditivity is more pronounced for probability judgments than for frequency judgments and is enhanced (enhancement effect) by compatible evidence. The background rationale of support theory is that the study of intuitive probability judgment shows that people often do not follow the ex-tensional logic of probability theory (e.g., the suggestion that 1,000 people will die in an earthquake may appear to be more likely than a more inclusive event, such as 1,000 people will die in a natural disaster). The nonexten-sional support theory of belief attaches subjective probability not to events (as in other models), but to descriptions of events, called hypotheses. According to support theory, each hypothesis (A) has a support value s(A) , corresponding to the strength of the evidence for this hypothesis. The judged probability p(A,B) that hypothesis A rather than B holds, assuming that one and only one of them obtains, is given by p(A,B) s(A) s(A)+s(B)....

Mechanisms of Injury and Specific Urological Injuries in Mass Casualty Events

Buildings and bridges collapses, earthquakes, floods, and tsunamis, train collisions and aircraft catastrophes tend to be associated with an inconceivably high number of victims and carry the potential of becoming mass casualty scenarios. However, such extreme situations often carry such a high fatality rate that they do not necessarily respond to the definition of a mass casualty event that can overwhelm the medical facilities available (Caro 1974 Cooper et al. 1983). Unfortunately, mass casualty events in recent history are frequently associated with civilian terrorism and are most often the result of explosions. Shootings rarely result in a large number of injuries to become a mass casualty event and other possible mechanisms, such as chemical or biological attacks, will not be discussed in the present chapter because there are no specific urological aspects of their resultant injuries. The secondary injury is produced by debris and projectiles set in motion by the explosion. In...

Burkholderia pseudomallei

Because of its pathogenicity and also its potential as a tool for bioterrorism, Holden et al. (2004b) sequenced the genome of B. pseudomallei. Holden et al. (2004b) detected evidence for the pervasive effect of horizontal acquisitions of genomic islands in the evolution of B. pseudomallei. In particular, they noted that this bacterium possessed a large genome relative to other prokaryotes and had numerous genomic islands with characteristics reflective of recent lateral exchange events (e.g. G+C anomalies and the presence of gene sequences related to mobile elements). Furthermore, Holden et al. (2004b)

Anticipating Estimating And Communicating Accurate Lead Times

When an excipient distributor is sourcing a material for a user for the first time or even for subsequent orders on a nonstock item, a key element of information that must be communicated to the user is the availability of the excipient and the time it will take between when an order is placed and when the excipient is actually delivered to the user site. The definition of availability can be variable, especially if the distributor happens to represent international excipient makers, who may have the material in stock overseas, requiring additional lead times of anywhere from two to eight weeks, depending on the service of the supplier and customs, and, now as a result of the Bioterrorism Act, FDA intervention with entry into the United States.

Their Nature and Extent

Sexual Aggression in Warfare and Religious and Ethnic Conflicts. The most public rapes occur in wars and ethnic conflicts. In Against Our Will, Brownmiller (1975) writes of the use of rape as terrorism and spoil of war citing Christian pilgrims' rape of The Threat of Sexual Violence. The threat of sexual violence limits the freedoms of likely victims and gives an edge of terrorism to likely perpetrators. Men on Rape (Beneke, 1982) looks at the effects of the threat of sexual violence on women. Talking to women, Beneke found that the threat of rape alters the meaning and feel of the night and nature, with women fearful of walking late at night or alone in the country or wooded areas. Limiting mobility at night, the threat of rape limits where and when one works, making it harder for women to earn money. It makes solitude less possible and women more dependent on men and other women. It inhibits expressiveness, making women fearful of seeming too friendly or sexy. It inhibits freedom of...

Nonhuman Dna Testing And Microbial Forensics

While the vast majority of forensic DNA typing performed for criminal investigations involves human DNA, it is not the only source of DNA that may be useful in demonstrating the guilt or innocence of an individual suspected of a crime (Sensabaugh and Kaye 1998). Domestic animals such as cats and dogs live in human habitats and deposit hair that may be used to place a suspect at the crime scene. Demonstration that a botanical specimen came from a particular plant can aid the linkage of a crime to a suspect or help demonstrate that the body of a deceased victim may have been moved from the murder site. DNA testing can now be used to link sources of marijuana. A large area of future application for forensic DNA typing involves identification of bio-terrorism materials such as anthrax. This chapter will briefly discuss each of these topics and the value of non-human DNA testing in forensic casework. Unfortunately microbial forensics will likely become a larger part of DNA testing in the...

Urological Aspects of Terrorist Related Injuries

Blast injury causes injuries to the torso in 38 only one-third of them are isolated, whereas the others are abdominal injuries combined with head, chest, or extremity injuries (Peleg et al. 2003). Gas-containing organs are the most vulnerable to primary blast effect, though injuries to solid organs such as the kidneys are also encountered as a result of acceleration and deceleration forces. At exploration, this injury usually takes the form of hemorrhage beneath the visceral peritoneum that extends into the mesentery, possibly associated with perforation of the bowel or rupture, infarction, ischemia, or hemorrhage of solid organs, including the genitourinary system (Centers for Disease Control 2006 DePalma et al. 2005 Stein and Hirshberg 1999). During warfare, the proportion of the abdominal injury with involvement of the kidneys and ureters is quite varied in different series because of the different characteristics of the conflict and the medical management. During World War II,...

Public versus Private Control

All governments have some degree of involvement in healthcare because essentially all countries have a centrally funded agency that is concerned with public health issues. The proportion of healthcare expenditures spent on public health tends to be higher in low-income countries, although the level of effort varies greatly from country to country. Government involvement usually includes surveillance of communicable diseases and interventions to prevent or curtail epidemics. Some countries have more extensive government involvement through direct delivery of services (e.g., immunizations, well-child care, screening for developmental disabilities, and treatment of communicable diseases) and programs of health promotion. Public health efforts in the United States are fragmented but have begun to receive more attention as the costs of personal, disease-oriented healthcare and concerns about bioterrorism have increased.

Profiling of Community Health Performance Indicators Case

The field of public and community health is growing and expanding. There is great potential to combine the fields of health and medical informatics, community health care, epidemiology, biostatistics, health management, and policy research. This confluence of disciplines could improve our understanding of how best to prepare the public, particularly at the community level, to deal with everyday threats, including HIV AIDS, obesity, cancer, congestive heart failure, diabetes, and other chronic and infectious diseases, as well as potential threats from bioterrorism and other emerging challenges, including new or mutated contagious diseases. The first step is learning how to track and monitor community health performance data electronically, which is the focus of the case example discussed here.

Interactions

Plans for medical care must proceed simultaneously along interdisciplinary and intradisciplinary lines. Coordination with fire, rescue, and hazardous materials teams public health departments and law enforcement agencies and or security providers is essential. What law enforcement agency and officials are responsible for precautions against terrorism and the coordinated response to it What agency and officials are responsible for the jurisdictional disaster or multicasualty incident (MCI) plan What is the communications path to officials responsible for initiating execution of the plan and what intravenue officials are in the decision tree to trigger the request

Conclusions

Molecular methodologies have been used successfully to address a number of problems in identification of plant pathogenic fungi. Not all of the molecular identification methods have been fully utilized, but this will probably change in the future. Practical application of molecular methodologies is increasing as the instruments become less expensive and the protocols less complex. The demand for rapid, accurate identification of plant pathogens is growing. In addition to the need for such methods in field diagnosis and import export issues, the threat of plant pathogens as potential bioterrorist weapons has added impetus to the need for rapid identification. The lack of a universally applicable technique that would differentiate all fungi makes rapid identification difficult unless preliminary morphological or physiological information is available. New methods are being developed (Schaad et al. 2002) which hold great promise for rapid identification of many plant pathogens.

Life Cycle

When environmental conditions are harsh, some species (including members of the genus Clostridium) can form a special resistive structure within themselves called an endospore. The endospore contains DNA, ribo-somes, and other structures needed for life, but is metabolically inactive. It has a protective outer coat and very low water content, which help it survive heating, freezing, radiation, and chemical attack. Endospores are known to have survived for several thousand years, and may be capable of surviving for much longer, possibly millions of years. When exposed to the right conditions (presence of warmth and nutrients), the endospore quickly undergoes conversion back into an active bacterial cell.

The Contributors

Ed Hsu, Ph.D., is assistant professor of health management and policy at the University of North Texas School of Public Health. He teaches health information systems and coordinates the Master of Public Health in Health Informatics program. Hsu has published in the area of spatial analysis of health and income disparities and is currently working on two projects that apply geographical information systems (GIS) in bioterrorism needs assessment training. He served as a programmer for a GIS-enabled community health information system to support his doctoral training. He received his Ph.D., (management and policy sciences), M.S. (health informatics) and M.P.H. (health services organization) from the University of Texas Health Science Center at Houston.

Empowerment

E-consumers can also benefit from being informed of breakthroughs in dealing with public health problems as well as potential symptoms arising from unknown exposures to hazardous bacteria, other dangerous biological agents, or threats due to bioterrorism (for example, anthrax). Medical problems that are on the minds of a growing number of both Americans and Canadians include AIDS HIV, SARS, West Nile virus, mad cow disease, and avian flu. Many people turn to the Internet and other media for authoritative information about these life-threatening diseases. Knowing as much as possible about the vectors, symptoms, and treatment of these potentially threatening ailments is the best medicine knowledge is power, and access to information may eventually offer some protection or, when no protection is available, at least the comfort of understanding the scope of the problem.

Background

The United States in general and cities such as Detroit in particular face a formidable challenge in delivering and promoting health services efficiently and equitably in the face of competing resource demands from sources that include bioterrorism and homeland security, natural calamities, environmental concerns and global warming effects, K-12 education and higher learning, and, on the federal level, international relations and foreign affairs. During this era of shrinking resources paired with information and knowledge explosion, several major federal and national initiatives indicate that government agencies, health care providers, and consumers expect information technology, particularly e-technology and Web-based services, to contribute to meeting this challenge. People are looking to information technology to facilitate increased clinical expert consultations, rapid health information access, equity in health care delivery, and increased comprehensiveness and accountability of...

New Challenges

A biotechnology that by its very definition causes harm is bioterrorism, especially when genetic manipulation is used to augment the killing power of a naturally occurring pathogen. Bioterrorism dates back to the Middle Ages, when Tartan warriors hurled plague-ridden corpses over city walls to kill the inhabitants. The British used a similar approach in the eighteenth century, when they intentionally gave Native Americans blankets that carried smallpox virus. Efforts in the former Soviet Union to create bio-weapons

Confidentiality

There is an ethical and common law duty on the doctor to maintain the confidentiality of anything that is discovered about a patient in the course of the consultation unless the patient gives consent to disclosure. Problems can arise when the doctor's duty to the patient of confidentiality comes into conflict with an overriding duty to society or even duty to another patient. A patient may be found to be suffering from an inherited but treatable disorder. If the patient refuses to allow his relatives to be informed so that they can be screened and treated, the doctor may have a duty to break the patient's confidentiality. There may be a legal obligation on the doctor to breach confidentiality such as the statutory duty to notify specified infectious diseases, or when called upon to do so by a Court Order. Certain Acts of Parliament (e.g. Road Traffic Act 1972, Prevention of Terrorism Act 1984 and Police and Criminal Evidence Act 1984) specifically lay down that access to medical...

Oina M Fusco

The world's recent traumatic events have introduced the term crisis not only to working clinicians but also to the mass public. Crisis conjures not only images related to individuals experiencing psychological distress, but also images related to the broadly based and broad impact of the traumatic events of September 11th, war, and terrorism. Society has become more knowledgeable about trauma, stress reactions, and crisis

Cultural Sensitivity

Third, cross-cultural criticism seems to be important and even obligatory when one considers cultures that engage in terrorism, war, torture, mass rape, infanticide, and slavery, and so people should be able to criticize female genital cutting on the same basis. Otherwise, people would be led to the very problematic view that any act is right if it has cultural approval even if it is a culturally endorsed act of war, oppression, enslavement, aggression, rape exploitation, racism, or torture. In this view the disapproval of other cultures is irrelevant in determining whether acts are right or wrong. Even if this version of ethical relativism is defended consistently, its plausibility is eroded by its conclusion that the disapproval of people in other cultures, even victims of war, oppression, enslavement, aggression, exploitation, rape, racism, or torture, is irrelevant in deciding what is wrong in the aggressor culture (Kopelman, 1994, 1997).

Positioning

Cross Table Lateral

Metaphyseal cupping secondary to epiphyseal injury which blights the growth process. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press. Fig. 46. Metaphyseal cupping secondary to epiphyseal injury which blights the growth process. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press. Fig. 47. Subluxation of the left femoral epiphysis due to intracapsular blood or effusion. This child had massive trauma elsewhere and was probably swung by this extremity. Compare with the right hip to see the widened joint. Reprinted from Brogdon BG, Vogel H, McDowell JD, eds. A radiologic atlas of abuse, torture, terrorism, and inflicted trauma (2003) with permission from CRC Press. Fig. 47. Subluxation of the left femoral epiphysis due to intracapsular blood or effusion. This...

Identification

Identification of the victims of mass disasters, such as the terrorist attacks of 11 September 2001 on the World Trade Center twin towers, can require application of innovative biology, technology, and genetics. Indeed, as will be described in this chapter, the New York City Office of the Chief Medical Examiner brought to bear new DNA markers (autosomal single nucleotide polymorphisms SNPs ), new technology (mini short tandem repeat STR assays, high-throughput mitochondrial DNA mtDNA sequencing, TrueAllele), and new genetic analysis (software for kinship analysis and remains association) to help in identifying many of the remains of the World Trade Center victims that would have otherwise been unidentifiable. The power of forensic DNA typing is at its finest hour when applied to identification of victims of mass disasters.

Equity Issues

Another issue related to intergenerational equity is what sort of criteria might justify irreversible damage to the environment, such as that caused by deep-well storage of high-level nuclear waste. On the one hand, irreversible management schemes for nuclear waste, because they are premised on the nonretrievability of the waste, theoretically impose fewer management burdens on later generations, but they also preempt future choices about how to deal with the hazards. On the other hand, schemes that are reversible allow for wider choices for future generations, but they also impose greater management burdens. If we cannot do both, is it ethically desirable to maximize future freedom or to minimize future burdens The technical problems associated with storing long-lived hazardous waste for centuries are forcing us to take a great gamble that our descendants will not breach the waste repositories through war, terrorism, or drilling for minerals that groundwater will not leach out and...