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How infectious diseases got left out--and what this omission might have meant for bioethics
Leslie P Francis1, Margaret P Battin, Jay A Jacobson
1Division of Medical Ethics, Salt Lake City, UT 84143, USA. francis1@law.utah.edu
Abstract:
In this article, we first document the virtually complete absence of infectious disease examples and concerns at the time bioethics emerged as a field. We then argue that this oversight was not benign by considering two central issues in the field, informed consent and distributive justice, and showing how they might have been framed differently had infectiousness been at the forefront of concern. The solution to this omission might be to apply standard approaches in liberal bioethics, such as autonomy and the harm principle, to infectious examples. We argue that this is insufficient, however. Taking infectious disease into account requires understanding the patient as victim and as vector. Infectiousness reminds us that as autonomous agents we are both embodied and vulnerable in our relationships with others. We conclude by applying this reunderstanding of agency to the examples of informed consent and distributive justice in health care.
Insights
Bioethics largely ignored infectious diseases, impacting core principles like informed consent and justice. Reconsidering patient agency as both victim and vector is crucial for a more inclusive bioethical framework.
Area of Science:
- Bioethics
- Public Health
- Medical Ethics
Background:
- The emergence of bioethics coincided with a lack of focus on infectious diseases.
- This oversight has potentially skewed the development of key bioethical principles.
Observation:
- Standard bioethical principles (autonomy, harm principle) are insufficient when applied to infectious diseases.
- Infectiousness highlights the embodied and vulnerable nature of individuals within social networks.
Findings:
- Infectious disease necessitates viewing patients as both susceptible individuals (victims) and potential transmitters (vectors).
- A revised understanding of agency, incorporating embodiment and vulnerability, is required for ethical decision-making in healthcare.
Implications:
- Rethinking informed consent and distributive justice in healthcare is essential to adequately address infectious disease scenarios.
- Integrating infectious disease perspectives can lead to more comprehensive and equitable public health policies.
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