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A Proposed Universal Medical and Public Health Definition of Terrorism

Published online by Cambridge University Press:  28 June 2012

Jeffrey L. Arnold*
Affiliation:
Office of Emergency Preparedness, Yale New Haven Center for Emergency and Terrorism Preparedness, Yale New Haven Health System, New Haven, Connecticut, USA
Per Örtenwall
Affiliation:
Beredskapsenheten, Goteborg, Sweden
Marvin L. Birnbaum
Affiliation:
Emergency Medical Services Program, University of Wisconsin-Madison, Madison, Wisconsin, USA
Knut Ole Sundnes
Affiliation:
Office for War Surgery and Emergency Medicine, Joint Medical Command, Norwegian Defense Forces, Sessvollmoen, Norway
Anil Aggrawal
Affiliation:
Professor of Forensic Medicine, Maulana Azad Medical College, New Delhi, India
V. Arantharaman
Affiliation:
Department of Emergency Medicine, Singapore General Hospital, Singapore
Abdul Wahab Al Musleh
Affiliation:
Chairman of Accident and Emergency and EMS, Assistant Medical Director, Director of Hamad International Training Center, Hamad General Hospital, Doha, Qatar
Yasufumi Asai
Affiliation:
Chairman, Department of Traumatology and Critical Care Medicine, Sapporo Medical University, Sapporo, Japan
Frederick M. Burkle Jr.
Affiliation:
The Center for International Emergency, Disaster and Refugee Studies, The Schools of Public Health and Medicine, Johns Hopkins University Medical Institutions, Baltimore, USA
Jae Myung Chung
Affiliation:
Chairman and Professor, Department of Emergency Medicine, Kyungpook National University Hospital, Taegu, South Korea
Felipe Cruz Vega
Affiliation:
Disaster Division Head, Mexican Social Security Institute, Mexico City, Mexico
Michel Debacker
Affiliation:
Senior Lecturer in Disaster Medicine, Free University Brussels and Catholic, University of Leuven, Belgium
Francesco Della Corte
Affiliation:
Department of Anesthesiology and Intensive Care, Università del Piemonte Orientale, Novara, Italy
Herman Delooz
Affiliation:
Department of Emergency Medicine, Free University of Brussels, Belgium
Garth Dickinson
Affiliation:
Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
Timothy Hodgetts
Affiliation:
Royal Centre for Defence Medicine, Selly Oak Hospital, Birmingham, United Kingdom
C. James Holliman
Affiliation:
Department of Emergency Medicine, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, Pennsylvania, USA
Campbell MacFarlane
Affiliation:
Head of EMS Training, Gauteng Provincial Government, South Africa and Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa
Ulkumen Rodoplu
Affiliation:
Emergency Medicine Association of Turkey, Izmir, Turkey
Edita Stok
Affiliation:
Ministry of Health, Ljubljana, Slovenia
Ming-Che Tsai
Affiliation:
Department of Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan Republic of China
*
Medical Director Yale New Haven Center for Emergency and Terrorism Preparedness, 1 Church Street, 5th floor, New Haven, CT 06510 USA, E-mail: arnoldmdcs@cs.com

Abstract

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it.

In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters.

We propose the following universal medical and public definition of terrorism: The intentional use of violence — real or threatened — against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

Type
Theoretical Discussion
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2003

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References

1. Council on Foreign Relations: Terrorism: An introduction. Council on Foreign Relations. Web site. Available at www.terrorismanswers.com Accessed 01 June 2003.Google Scholar
2. Malik, O: Enough of the Definition of Terrorism. London: Royal Institute of International Affairs, 2000, pp 166.Google Scholar
3. Altran, S: Genesis of suicide terrorism. Science 2003; 299:15341539.CrossRefGoogle Scholar
4. Commission of the European Communities: Proposal for a Council Framework Decision on Combating Terrorism. The European Union On-Line Web site. Available at http://europa.eu.int/eur-lex/en/com/pdf/2001/en_501PC0521.pdf. Accessed 20 June 2003.Google Scholar
5. Department of Justice, Canada: Royal Assent of Bill C-36, The Anti-Terrorism Act. Department of Justice Web site. Available at http://canada.justice.gc.ca/en/news/nr/2001/doc_28217.html. Accessed 20 June 2003.Google Scholar
6. Federal Bureau of Investigation: Terrorism in the United States 1999. Federal Bureau of Investigation Web site. Available at www.fbi.gov. Accessed 01 June 2003.Google Scholar
7. Ganor, B: Defining terrorism: Is one man's terrorist another man's freedom fighter? The International Policy Institute for Counter-Terrorism Web site. Available at www.ict.org.il. Accessed 01 June 2003.Google Scholar
8. National Center for Health Statistics: Classification of death and injury resulting from terrorism. Centers for Disease Control Web site. Available at www.cdc.gov/nchs/about/otheract/icd9/terrorism_code.htm. Accessed 01 June 2003.Google Scholar
9. United Kingdom Parliament: Terrorism Act 2000. HMSOnline Web site. Available at www.legislation.hmso.gov.uk/acts/acts2000/00011--b.htm#1. Accessed 20 June 2003.Google Scholar
10. United Nations Office on Drug and Crime: Definitions of terrorism. United Nations Office on Drug and Crime. Web site. Available at www.undcp.org/odccp/terrorism_definitions.html. Accessed 01 June 2003.Google Scholar
11. Beaton, R, Murphy, S: Psychosocial responses to biological and chemical terrorist threats and events. Implications for the workplace. AAOHN Journal 2002; 50: 182189.CrossRefGoogle ScholarPubMed
12. Centers for Disease Control and Prevention: New classification for deaths and injuries involving terrorism. MMWR 2002; 51(special issue):1819.Google Scholar
13. The Oxford English Dictionary (CD-ROM, version 3.0) 2nd ed. New York, NY: Oxford University Press; 2002.Google Scholar
14. Brown, L (ed): The New Shorter Oxford English Dictionary on Historical Principles. 4th ed. New York: Oxford University Press, 1999, pp 13801.Google Scholar
15. Krug, EG, Dahlberg, LL, Mercy, JA, Zwi, AB, Lozano, R (eds): World Report on Violence and Health. Geneva: World Health Organization, 2002, p 5.Google ScholarPubMed
16. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p 100) and entered into force on 07 April 1948.Google Scholar
17. Friel, JP (ed): Dorland's Illustrated Medical Dictionary. 26th ed. Philadelphia: WB. Saunders Company, 1981, p 583.Google Scholar
18. Price-Smith, AT. Wilson's bridge: A Consilient Methodology for Analysis of Complex Biological-Political Relationships. Program on Health and Global Affairs (PHEGA), University of Toronto: Center for International Studies working paper 1998–8. November 1998. pp 243.Google Scholar
19. Burkle, FM: Mass casualty management of a large-scale bioterrorist event: An epidemiological approach that shapes triage decisions. Emerg Med Clin N Am 2002; 20: 409436.CrossRefGoogle ScholarPubMed
20. Zwi, A, Uglade, A: Political violence in the third world: A public health issue. Health Policy and Planning 1991; 6: 203217.CrossRefGoogle Scholar
21. International Committee of the Red Cross: International Humanitarian Law. Answers to Your Questions. Geneva: International Committee of the Red Cross, 2002, p 35.Google Scholar