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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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Embedded Autonomy and the “Way-Station Self”

Embedded Autonomy and the “Way-Station Self”

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

Traditional liberal paradigms in bioethics have rested on a misleading picture of the self as a separate individual. This chapter develops a biologicized picture of the self as a “way station”: so to speak, a launching pad and breeding ground of biological organisms, some pathological and many benign, that are transmitted from one human individual to another. Understanding people as way-station selves embedded in a web of infectious disease requires rethinking some of the most basic concepts of bioethics: autonomy, the harm principle, and responsibility, among others. The autonomous agent cannot be seen as an isolated individual, but must be viewed as acting in biological relationships with others. The harm principle's basic idea that intervention is permissible only to prevent people from harming each other must be reshaped by the recognition that there is no easy way to separate actions that harm only the individual him/herself from actions that affect others. Responsibility must be rethought in light of the biological reality that people may infect others unknowingly, and may never know the sources of the infections they contract. Although people may be more or less aware of their susceptibility to infectious disease, there is always a sense in which each person stands in unknown relationships of potential contagion to others.

Keywords:   bioethics, biological organisms, autonomy, harm principle, responsibility, individualism

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