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 may transmit 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, H.I.V./A.I.D.S., and H.P.V. Part IV, beginning with a controversial thought experiment, considers constraint in the control of infectious disease, include pandemics, and Part V 'thinks big' about the global 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

Cr�ticas

"This book is one of those rare 'interdisciplinary' works that truly bridge the disciplines and make original contributions to them all. Whether you come to it from medicine, public health, ethics or law, you'll leave with a deeper understanding of the dilemmas that inhere in trying to control infectious diseases, as well as an original, internationally informed and ethically coherent approach to policymaking on new and old threats to our individual and collective health, from SARS and pandemic influenza to HPV and childhood infections."-Alexander M. Capron, Chair in Healthcare Law, Policy and Ethics, University of Southern California, and Former Director of Ethics, Trade, Human Rights and Health Law, World Health Organization "This well-written, innovative and multidisciplinary text makes a timely and significant contribution to our understanding of the public health challenges posed by the emergence of new and recrudescing multi-drug resistant infectious diseases. The novel concept of 'patient as victim and vector' opens new ways of thinking that will stimulate extensive scholarly debate-and hopefully some effective action-in dealing with such major threats to human life globally. This approach will supplement as yet inadequately operationalized paradigm shifts in thinking and acting that have been proposed to address infectious diseases, which could be considered the major challenge to human well-being and security in the 21st century."-Solomon R. Benatar, Emeritus Professor of Medicine, University of Cape Town, and Professor in Public Health Sciences, University of Toronto "For anyone interested in the subject or in teaching bioethics, this book is unique and essential. The ethical challenges in infectious diseases encompass a complex range of concerns, not only about the individual who suffers such an illness, but also about the impact of the individual's illness on the larger community. There are wonderful examples that illustrate the kind of dilemmas that force one to confront his or her own values with respect to the balance between the rights of individuals and the collective responsibility of health practitioners to find fair solutions to them."- Barry R. Bloom, Dean, Harvard School of Public Health "This new book, the collective effort of philosophers and physicians, well serves a both a statement to the field of bioethics and as a valuable text for students in medicine, public health, and bioethics. It is accessibly--and sometimes elegantly--written, cogent and provocative... With care and unusual modesty, Margaret Battin and her colleagues turn to a range of topics central to the practice of public health.... To watch the authors probe and struggle with the moral dilemmas we all face is more than worth the price of admission."--As reviewed in Bioethical Inquiry

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