Chandelier
Senior Member (Voting Rights)
A general thread for discussing ethics in relation to PAIS.
www.viviennematthiesboon.com
OCR from a poster by Professor Matthies-Boon for the 2026 Amsterdam ISLC-PAIS Conference:
What is a Postinfection Ethics?
From within the field of Ethics, there is so much to say about Postinfection Ethics - how it is related to the fields of Public Health Ethics, Bioethics, Infectious Disease Ethics, but also to the strands of thinking in care ethics, virtue ethics and even a Habermasian discursive meta-ethics...
www.viviennematthiesboon.com
What is a Postinfection Ethics?
From within the field of Ethics, there is so much to say about Postinfection Ethics - how it is related to the fields of Public Health Ethics, Bioethics, Infectious Disease Ethics, but also to the strands of thinking in care ethics, virtue ethics and even a Habermasian discursive meta-ethics.
However, for the ISLC-PAIS conference organised by Rob Wüst and Michael Chapman in Amsterdam, I wrote the following short public summary.
Of course there is a lot more to say about this - and anyone (medics, researchers, patients, journalists and policymakers) interested in (aspects of) Postinfection Ethics is of course encouraged to get in touch (see Homepage)
OCR from a poster by Professor Matthies-Boon for the 2026 Amsterdam ISLC-PAIS Conference:
Towards a post-infection ethics:
On the social impact of Post-Acute
Infection Syndromes (PAIS)
Until recently, public health ethics and infectious disease ethics have concentrated on the acute phase of infection, while the longer-term or chronic consequences have received no medical ethical and social ethical consideration.
In light of this gap, I have coined the term "Post-Infection Ethics" (2025): an ethical framework concerned with the enduring medical and social effects of viral and bacterial infections after the acute infection has passed.
Prof. dr. Vivienne Matthies-Boon, Radbaud University - the Netherlands
Although the medical dimensions of Post-Acute Infection Syndromes (PAIS) are quite rightly the central focus of this conference, their social and ethical implications are equally significant.
This issue is likely to become more pressing in the context of climate change, as altered zoonotic relationships and the wider spread of vector-borne diseases, many of which con produco post-infectious sequelae, are expected to increase the incidence of PAIS.
PAIS raises important ethical concerns especially through the frequent psychologisation of patients under an interpretive stance marked by excessive suspicion.
While the critique of medicalisation is well established, psychologisation, understood as the inappropriate extension of psychological explanations to illness that is primarily biomedical has received far less attention.
Psychologisation is not a simple diagnostic mistake.
It generates epistemic and moral harm, and has contributed to often harmful interventions such as Graded Exercise Therapy (GET) and Cognitive Behavioural Therapy (CBT), denials of disability support, and wider forms of stigma, discrimination, and institutional disbelief.
In paediatric settings, such misrecognition has even led to increased chid abuse accusation, as a result of which children have been removed from their families or parents have been placed under state supervision.
Psychologisation has also obscured the severity of the physical social and existential burdens associated with PAIS itself.
Many patients live with persistent pain, profound exhaustion, cognitive impairment and other symptoms that impair their ability to carry out even basic daily activities without provoking post-exertional malaise (PEM).
They not only experience a loss of Identity, but often have little realistic prospect of recovery.
They also experience not just an absence of treatments but also basic structures of care.
And access to care is deeply unequal, as the most severely affected are the least able
to access or receive health care.
Beyond its clinical effects, PAIS also creates many acute social-ethical problems.
Many patients are pushed into severe isolation, yet ordinary social contact can also expose them to reinfection, especially where mask-wearing is stigmatised, with the risk of further health decline.
This thus also raises ethical questions around the harm of individualised responsibility, and indicates the need for a more collective (public health) approach. in addition, disability and unemployment support often remain inadequate, because the fluctuating course and severity of PAIS are still poorly recognised, despite its rapidly rising social and economic costs.
For children and adolescents, prolonged illness may disrupt psychosocial development and educational progress, thereby limiting future opportunities and raising questions of justice and equity.
And the state, meanwhile, has mostly retreated as a significant public health actor in the post-pandemic context, resulting not only in a decline of social solidarity and an increased invisibility of PAIS patients, but also directly contributing to a collective post-pandemic public denial of PAIS.
Taken together, these medical, social, and economic harms show that the chronic consequences of infectious disease constitute a major but neglected ethical challenge.
A Post-Infection Ethics is therefore needed to reorient public health ethics beyond the acute phase and to clarity the obligations owed to those living with the long-term consequences of infection.