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Don’t let the bedbugs bite: the Cimicidae debacle and the denial of healthcare and social justice

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Of insects that are not carnivorous but that live on the juices of living flesh, such as lice and fleas and bugs, all, without exception, generate what are called ‘nits’, and these nits generate nothing.

Aristotle, The History of Animals, Book V.

Abstract

Although bedbug infestation is not a new public health problem, it is one that is becoming more alarming among healthcare professionals, public health officials, and ethicists given the magnitude of patients who may be denied treatment, or who are unable to access treatment, especially those underserved populations living in low income housing. Efforts to quarantine and eradicate Cimicidae have been and should be made, but such efforts require costly interventions. The alternative, however, can further exacerbate the already growing problems of injustice, i.e., unfair treatment of patients, inaccessibility of needed resources. In the following paper, I examine the ramifications of denying access to medical care, among other healthcare justice dilemmas surrounding bedbug infestations. I also explore the value of health, and how healthcare professionals and public officials often feel as though bedbugs are not a priority because they, themselves, are not diseases, regardless of the fact they cause physical and mental problems that affect a person’s health. I propose recommendations for improving the health and well-being of those vulnerable populations who are facing a difficult and growing public health problem that is currently being ignored in medical and public health ethics literature, regardless of increased media attention and unusual habitats of localized infestations, e.g., Statue of Liberty, New York City.

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Notes

  1. Although the examples of bedbug infestations and their media attention are presented in this paper from a US-centric perspective, the negative effects of bedbugs are not localized, and the ethical framework and recommendations identified may be beneficial to individuals and populations throughout the world who are confronted with this public health problem.

  2. Propoxur (sold as Baygon) is one commercially available chemical that is still effective in killing bedbugs. This chemical is toxic to humans if ingested. Pesticide manufacturers dropped their registration of propoxur, after recognizing that indoor use of certain pesticides would not pass the more stringent testing requirements under the Food Quality Protection Act (FQPA) of 1996.

  3. Ohio Bill To enact sections 3701.137 and 3707.012 of the Revised Code to establish the Bed Bug Awareness, Education, and Prevention Program and to require boards of health to adopt vermin control policies under which bedbug infestations are treated in the same manner as other infestations and to make an appropriation. http://www.legislature.state.oh.us/bills.cfm?ID=129_HB_129 (accessed 13 July 2011)

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Acknowledgments

I would like to thank members and attendees of the European Society for Philosophy of Medicine and Healthcare (ESPMH) for providing support and excellent commentary on this paper. A portion of this paper was presented in Zurich, Switzerland, August 2011 at the ESPMH conference.

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Correspondence to Julie M. Aultman.

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Aultman, J.M. Don’t let the bedbugs bite: the Cimicidae debacle and the denial of healthcare and social justice. Med Health Care and Philos 16, 417–427 (2013). https://doi.org/10.1007/s11019-012-9404-x

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  • DOI: https://doi.org/10.1007/s11019-012-9404-x

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