The Patient as Victim and Vector: Ethics and Infectious Disease
Margaret P. Battin, Leslie P. Francis, Jay A. Jacobson, and Charles B. Smith
Abstract
Bioethics emerged at a time when infectious disease was not a major concern, and thus never developed a normative framework sensitive to disease transmission. This book develops the “patient as victim and vector” view to explore issues in clinical medicine, research, public health, and health policy. The central idea of this book is that a patient with a communicable infectious disease should be understood both as a victim of that disease and also as a potential vector—both a person who is ill and may die but who also may transmit an illness that could sicken or kill others. Bioethics has in g ... More
Bioethics emerged at a time when infectious disease was not a major concern, and thus never developed a normative framework sensitive to disease transmission. This book develops the “patient as victim and vector” view to explore issues in clinical medicine, research, public health, and health policy. The central idea of this book is that a patient with a communicable infectious disease should be understood both as a victim of that disease and also as a potential vector—both a person who is ill and may die but who also may transmit an illness that could sicken or kill others. Bioethics has in general failed to see one part of this duality, and public health the other: that the patient is both victim and vector at one and the same time. Part I of the book shows why patient-centered concepts like autonomy and informed consent need to change in the context of communicable infectious diseases; Part II develops a normative theory for doing so. Part III examines traditional and new issues: the ethics of quarantine and isolation, research, disease screening, rapid testing, antibiotic use, and immunization, in contexts like multi-drug-resistant tuberculosis, syphilis, hepatitis, HIV/AIDS, and HPV. Part IV begins with a controversial thought experiment to consider constraints in the control of infectious disease, including pandemics, and Part V “thinks big” about global efforts to prevent, treat, or eradicate infectious disease.
Keywords:
bioethics,
communicability,
public health,
health law,
constraint,
pandemic,
global health
Bibliographic Information
| Print publication date: 2009 |
Print ISBN-13: 9780195335842 |
| Published to Oxford Scholarship Online: May 2009 |
DOI:10.1093/acprof:oso/9780195335842.001.0001 |
Authors
Affiliations are at time of print publication.
Margaret P. Battin, author
Distinguished Professor of Philosophy and Adjunct Professor of Internal Medicine, University of Utah
Author Webpage
Leslie P. Francis, author
Distinguished Professor of Law and Philosophy, Alfred C. Emery Professor of Law, and Associate Dean for Faculty Research and Development in the College of Law, University of Utah
Author Webpage
Jay A. Jacobson, author
Professor Emeritus of Internal Medicine and Medical Ethics, University of Utah
Author Webpage
Charles B. Smith, author
Professor Emeritus of Medicine, University of Utah
Author Webpage
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