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Is Individual Responsibility a Sufficient Basis for Public Confidence?

Albert R. Jonsen, MD
Arch Intern Med. 1991;151(4):660-662. doi:10.1001/archinte.1991.00400040014004.
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I begin by showing you three slides. The first is of a medieval leper, wearing a distinctive costume and carrying a bell that they were obliged to ring whenever approaching a populated place. Next is a Renaissance Italian physician dressed to care for victims of the bubonic plague, his beaked mask filled with aromatic herbs to exclude the infectious odors, his leather gown resistant to the floating phomites of disease, and carrying a staff to point to the patient's buboes without touching them. Last, this is Dr Lorraine Day, a contemporary San Francisco (Calif) orthopedic surgeon. She is prepared for surgery in a space suit designed to prevent the migration of human immunodeficiency virus (HIV) from her patients to her in blood or in aerosols.

Note the common feature of this millennia of prophylactic fashion—isolation. Each of these separates spatially and by barriers the sufferer of presumed infectious disease from


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