This book-first published a decade before the COVID-19 pandemic erupted-is the first authored volume on ethical issues in infectious disease, monumental for its competence and comprehensiveness. It is augmented here with a new Preface on COVID-19. The book develops an ethical framework for exploring contagious infectious disease, the patient-as-victim-and-vector view, grounded in the biological fact that a person with a communicable infectious disease is not only a victim of thatdisease, but at the same time also a potential vector. The patient may be both threatened, someone made ill or facing death, but also a threat, someone who may transmit an illness that will sicken or kill others. Clinical medicine has tended to see one part of this duality and public health theother; the victim-AND-vector view insists on both, at one and the same time.Against a background of methods from the long human history of contagious infectious disease-quarantine, isolation, cordon sanitaire, surveillance and contact tracing, testing by both archaic and modern methods, lockdown, and immunization-the victim-and-vector view spotlights ethical challenges for clinical medicine, research, public health, and health policy. These insights are probed in the new Preface on COVID-19 and are essential in our continuing struggle to address not only the currentcoronavirus pandemic, but the next, and the next after that.
Preface: Victims, Vectors, and the COVID-19 Pandemic; Part I: Seeing Infectious Disease as Central; 1. Seeing Infectious Disease as Central; 2. The Biological Basics of Infectious Disease; 3. Characteristics of Infectious Disease that Raise Distinctive Challenges for Bioethics; 4. How Infectious Disease Got Left Out of Bioethics; 5. Closing the Book on Infectious Disease: The Mischievous Consequences for Public Health; Part II: Theoretical Considerations; 6. Embedded Autonomy and the Way-Station Self; 7. Thinking about Infectious Disease: The Multiple Perspectives of the PVV View; Part III: Dilemmas Old and New: Health Care Dilemmas Through the Lens of Infectious Disease; 8. Old Wine in New Bottles: Traditional Issues in Bioethics from the Victim/Vector Perspective; 9. From the Magic Mountain to a Dying Homeless Man and His Dog: Imposing Isolation and Treatment in Tuberculosis Care; 10. The Ethics of Research in Infectious Disease: Experimenting on This Patient, Risking Harm to That One; 11. 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 Resistance; 14. Immunization and the HPV Vaccine; Part IV: Constraints and the Question of What We Owe Each Other As Victims and Vectors; 15. A Thought Experiment: Rapid Testing for Infectious Disease in Airports and Places of Public Contact; 16. Constraints in the Control of Infectious Disease; 17. Pandemic Planning: What is Ethically Justified?; 18. Compensation and the Victims of Constraint; 19. Pandemic Planning and the Justice of Health Care Distribution; Part V: Making Use of the PVV View; 20. Thinking Bi: Emerging Global Efforts for the Control of Infectious Disease; 21. The Patient as Victim and Vector Approach as a Critical and Diagnostic Tool for Philosophical Ethics and Public Policy; References.;
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