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The Patient as Victim and VectorEthics and Infectious Disease$
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Margaret P. Battin, Leslie P. Francis, Jay A. Jacobson, and Charles B. Smith

Print publication date: 2009

Print ISBN-13: 9780195335842

Published to Oxford Scholarship Online: May 2009

DOI: 10.1093/acprof:oso/9780195335842.001.0001

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Constraints in the Control of Infectious Disease

Constraints in the Control of Infectious Disease

The Patient as Victim and Vector

Margaret P. Battin (Contributor Webpage)

Leslie P. Francis (Contributor Webpage)

Jay A. Jacobson (Contributor Webpage)

Charles B. Smith (Contributor Webpage)

Oxford University Press

In the effort to control infectious disease, many different kinds of constraints have been employed: mandatory testing, required or observed treatment, and quarantine and isolation, among others. Although sometimes justified, these constraints have often been misused, as people were left to die in cholera-infected ships anchored offshore or in plague-stricken villages. This chapter begins with an overview of the ethical issues raised by different types of constraints used to control infectious disease. It then uses the PVV view to argue that constraints can be justified if they meet a set of procedural and substantive guarantees. The procedural guarantees are: that there be an important interest, supported by evidence, that the least restrictive alternative be chosen, that constraints be fully disclosed and transparent, and that there be an opportunity for reconsideration. The basic substantive guarantees are personal security, meeting basic needs for survival and treatment, effective communication, the equitable allocation of burdens, and compensation for loss.

Keywords:   mandatory testing, observed treatment, isolation, plague, constraints, quarantine, patients' rights, procedural guarantees, transparency

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