The Patient as Victim and Vector Ethics and Infectious Disease

Paperback | November 14, 2008

byMargaret P. Battin, Leslie P. Francis, Jay A. Jacobson

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Bioethics emerged at a time when infectious diseases were not a major concern. Thus bioethics never had to develop a normative framework sensitive to situations of disease transmission. The Patient as Victim and Vector explores how traditional and new issues in clinical medicine, research,public health, and health policy might look different in infectious disease were treated as central. The authors argue that both practice and policy must recognize that a patient with a communicable infectious disease is not only a victim of that disease, but also a potential vector- someone who maytransmit an illness that will sicken or kill others. Bioethics has failed to see one part of this duality, they document, and public health the other: that the patient is both victim and vector at one and the same time. The Patient as Victim and Vector is jointly written by four authors at the University of Utah with expertise in bioethics, health law, and both clinical practice and public health policy concerning infectious disease. Part I shows how the patient-centered ethic that was developed by bioethics-especially the concept of autonomy- needs to change in the context of public health, and Part II develops a normative theory for doing so. Part III examines traditional and new issues involving infectious disease: 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, beginning with a controversial thought experiment, considers constraint in the control of infectious disease, include pandemics, and Part V 'thinks big' about theglobal scope of infectious disease and efforts to prevent, treat, or eradicate it. This volume should have a major impact in the fields of bioethics and public health ethics. It will also interest philosophers, lawyers, health law experts, physicians, and policy makers, as well as those concerned with global health.

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Bioethics emerged at a time when infectious diseases were not a major concern. Thus bioethics never had to develop a normative framework sensitive to situations of disease transmission. The Patient as Victim and Vector explores how traditional and new issues in clinical medicine, research,public health, and health policy might look d...

Margaret P. Battin is a Professor of Philosophy and Medical Ethics. Leslie P. Francis is a Professor of Philosophy and Law. Jay A. Jacobson is a Professor of Internal Medicine. Charles B. Smith is a Professor Emeritus of Medicine. All are at the University of Utah.
Format:PaperbackDimensions:496 pages, 9.25 × 6.13 × 0.68 inPublished:November 14, 2008Publisher:Oxford University PressLanguage:English

The following ISBNs are associated with this title:

ISBN - 10:019533583X

ISBN - 13:9780195335835

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Table of Contents

Preface. Part I: Seeing Infectious Disease as Central1. Seeing Infectious Disease as Central2. The Biological Basics of Infectious Disease3. Characteristics of Infectious Disease that Raise Distinctive Challenges for Bioethics4. How Infectious Disease Got Left Out of Bioethics5. Closing the Book on Infectious Disease: The Mischievous Consequences for Public HealthPart II: Theoretical Considerations6. Embedded Autonomy and the "Way-Station Self"7. Thinking about Infectious Disease: The Multiple Perspectives of the PVV ViewPart III: Dilemmas Old and New: Health Care Dilemmas Through the Lens of Infectious Disease8. Old Wine in New Bottles: Traditional Issues in Bioethics from the Victim/Vector Perspective9. From the Magic Mountain to a Dying Homeless Man and His Dog: Imposing Isolation and Treatment in Tuberculosis Care10. The Ethics of Research in Infectious Disease: Experimenting on This Patient, Risking Harm to That One11. Vertically-Transmitted Infection: Are the Medical and Public Health Responses Consistent?12. Should Rapid Tests for HIV Infection Now Be "Mandatory" During Pregnancy or in Labor?13. Antimicrobial Resistance14. Immunization and the HPV VaccinePart IV: Constraints and the Question of What We Owe Each Other As Victims and Vectors15. A Thought Experiment: Rapid Testing for Infectious Disease in Airports and Places of Public Contact16. Constraints in the Control of Infectious Disease17. Pandemic Planning: What is Ethically Justified?18. Compensation and the Victims of Constraint19. Pandemic Planning and the Justice of Health Care DistributionPart V: Making Use of the PVV View20. Thinking Bi: Emerging Global Efforts for the Control of Infectious Disease21. "The Patient as Victim and Vector" Approach as a Critical and Diagnostic Tool for Philosophical Ethics and Public PolicyReferences.