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 for illnesses caused by agents known to have bioweapon 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 bioweapons. 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 bioweapon facility, the Soviet medical profession would have done the world a service. It would have exposed the illegal Soviet offensive bioweapon 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 bioweapons 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 patho-genicity 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 bioweapons 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.