The violence of September 11 has not affected me personally to the same degree that it has others. A close friend for more than 30 years, who had come cross-country to my son's wedding the week before, lives across from the south tower of the World Trade Center. I had spoken to her on the morning of the eleventh but could not get through after the tower collapsed, and spent the day calling relatives and friends who had no news of her. That night I learned she had gotten out just in time. I lived in Manhattan for almost ten years; my children were born there. I grieve with the city, but other than giving blood and money and continuing to follow the news, my life has not changed.

Three cases of anthrax to date, less than an hour's drive from me, are worrisome, but I do not feel the same loss of security that many around me obviously do. I think perhaps I had not shared a very deep feeling, perhaps illusion, of safety and security that many evidently had. I attribute that in part to living abroad in situations where terrorism is present—sabbaticals in Colombia and in Peru during the decade of Sendero Luminoso's revolutionary violence—and in part to raising two sons who have always been chronically, and often critically, ill. I have had a little taste of the sword hanging over my head, ready to drop, or not, at any moment. Many people in the world live with a much heavier sword dangling from a much thinner thread. As my Colombian friends say, "We learned to live with risk—of robbery, of kidnap and ransom, of death—and now it is your turn to learn that you live in the same world."

Popular American responses to the events of September 11 demonstrate the desperate need for comparative religious studies in this country. Traditional debates about religion in the public schools are outdated; the appropriate interlocutors are not atheists and believers, but different religionists. Comparative religious studies are cultural studies, and must be a foundational aspect of good citizenship in this nation. Comparative religious studies should be taught like any other subject, without prejudice for or against partisans. Right now Christian churches and Jewish synagogues across the nation should be inviting in Muslim scholars and clerics to educate their congregations about Islam so that more Americans understand both the ignorance and the insult in the common query: "What is it about this religion of Islam that makes them so violent and fanatic?"

For the field of healthcare ethics, there are a number of different implications. Recent events remind us of the need to understand and respect the faith cultures of all of the people within our healthcare system. Another implication is the need to assess the level of healthcare threat and the level of preparedness of our healthcare system.

Right now, we face such questions: Is it appropriate that the supply of anthrax vaccine is the exclusive property of the military, and that there is only enough for the military serving abroad? Should the training of all doctors and nurses include detection and treatment of illnesses induced by chemical and biological weapons? Should all hospitals, or only regionally designated ones, be equipped to deal with massive releases of chemical and biological weapons? Do federal or state public health authorities have obligations to install throughout the civilian population devices that detect chemical and biological releases, or is protection for the military enough? If such devices and vaccines are appropriate for the civilian population, who bears the cost? Which institutions are best equipped to monitor and address the readiness of such systems?

We face whole new areas of public health as well as the need to develop programs based on careful assessments of different levels of risk. Ethics has a critical role in the development of plans and systems for meeting the new risks.