Lethal predators: psychopathic, sadistic, and sane.

The violent criminals defined in this article are a small, exceptionally dangerous group of offenders designated by the authors as "lethal predators." They have a history of sexual predation, have killed at least once, and are mentally abnormal but legally sane. They are highly likely to keep killing as long as they are free. Laws permitting civil commitment of dangerous and mentally abnormal sexual predators after they have completed criminal prison sentences have been upheld by the U.S. Supreme Court. Such laws can provide a legal means of keeping these highly dangerous killers confined so they cannot kill again.

Psychological challenges of bioterror: containing contagion.

In this article, we have introduced the concept of shielding as a public mental health intervention. Shielding addresses the core elements of bioterrorism when we consider that bioterrorism is best understood as terrorism, i.e., psychological warefare, which merely employs biologic agents, not to kill, but to terrorize. It is, therefore, to some degree dependent upon widespread contagion. Shielding is not a panacea. It is one aspect of an overall response plan. Nevertheless, it represents a potentially useful "antidote" for the bioterrorist assault. Perhaps most significant among its putative mechanisms of action appears to be controlling contagion, both physical and psychological. In the final analysis, in the wake of a terrorist attack, physicians can physically immunize and treat those who require such attention. Engineers can reconstruct buildings and roads. But who rebuilds the essence of humanity which has been violently ripped away from those who suffered the terrorist attack? How do we reconstruct a belief in justice and safety in the wake of a mass terrorist attack? Without attention to mental health, i.e., the "psychological side of terrorism," we run the risk of rebuilding a nation without a spirit, without a vitality, without a sense of humanity.