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Case Story: Special Project--Bioterror and the Physician

NCJ Number
Date Published
January 2006
2 pages
This article describes model plans designed to facilitate any interactions an attending physician might have with law enforcement, public health agencies, and patients during instances of possible biocrime or bioterror.
The goals of the plan address the needs of the patient, explain a physician’s primary duty, and create a body of evidence for later use in the identification and prosecution of responsible parties. Modeled after the more familiar documentation procedures utilized in sexual assault and child abuse cases, the first step of the plan determines the legal responsibility of the physician, both locally and nationally, to report a possible incident of biocrime or bioterror to law enforcement and/or a public health agency by attempting to obtain the patient's consent to release the information. Physicians must discuss with the patient the importance of reporting the information to governmental authorities and the consequences of not reporting the incident. The next step involves physicians collecting early and often any evidence that could identify the origin of the infection, and the preservation of the collected evidence for later legal and medical use. Microbial forensic processes for the collected evidence include the full scope of forensic evidence and lab analysis that uses molecular sequencing, microbiological cultures, biochemistry, electron microscopy, crystallography, and mass spectrometry. This procedure also establishes and secures a verifiable chain of custody. A second model practice was developed after the 2003 SARS outbreak in Toronto where physicians successfully contained the outbreak. Key factors crucial to controlling any mass infection were identified; a principle component to the containment of SARS was the stringent quarantine requirements imposed on infected individuals in Ontario. The strategy used could also reasonably serve as a model plan of action for future infectious disease outbreaks and includes: educating the public and health care workers about steps they could take to reduce the likelihood of infection; controlling and tracking the movement of patient transfers, staff, and visitors; and controlling when and how hospital equipment was used by medical facilities. References

Date Published: January 1, 2006