The Patient as Victim and Vector: Ethics and Infectious Disease 2008

This book explores how traditional and new issues in clinical medicine, research, public health and health policy may look different in infectious diseases. The authors argue that both practice and policy must recognise that a patient with an infectious communicable disease is not only a victim of that disease, but also a potential vector - someone who can transmit a disease that will infect or kill others. Bioethics has missed one part of this duality, they document, and public health the other. Part I shows how the patient-centred ethics that bioethics has developed - particularly the concept of autonomy - needs to change in the context of public health, and Part II develops a normative theory that will do so. Part III addresses traditional and emerging issues related to infectious diseases: the ethics of quarantine and isolation, testing, screening, rapid testing, antibiotic use and vaccination, in contexts such as multidrug-resistant tuberculosis, syphilis, hepatitis, HIV/AIDS, and HPV. Part IV, beginning with a controversial thought experiment, considers the limitations of infectious disease control, covers pandemics, and Part V 'thoughts on the big picture ' This volume should have a major impact on the fields of bioethics and public health ethics. It will also be of interest to philosophers, lawyers, health law experts, doctors, and those concerned with global health.