How Infectious Diseases Got Left Out – And What This Omission Might Have Meant for Bioethics

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.

Ethics, Pandemics, and the Duty to Treat

“…Indeed, bioethics in the 1970s and 1980s seemed devoid of worry about untreatable infectious disease (Francis et al 2005). Moreover, an adequate response to an influenza pandemic could require people to perform tasks not listed in their job descriptions.…”

Do we need an ethical framework for hospital infection control?

“…Infectious diseases raise a number of difficult ethical issues (for an overview see Francis et al 1 ).…”

Infectious Disease Ethics: Limiting Liberty in Contexts of Contagion

“…Though ethical issues associated with infectious disease have not been a traditional focus of discussion within the discipline of bioethics-and though it has been argued that the topic of infectious disease was for a long time grossly neglected by bioethicists (Selgelid 2005;Francis et al 2005)-this has started to change. AIDS was perhaps an exception all along; it, at least, received substantial discussion among bioethicists since its emergence was first recognized in the early 1980s.…”