If an agent's squalid circumstances undermine accountability, they equally undermine whether the vicious action genuinely expresses the agent's own evaluative identity, collapsing the distinction.
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Shows or reveals something about someone's true character, beliefs, or values through their actions.
Vicious action(virtue ethics)
A morally wrong or evil action that comes from a character flaw or bad habit.
agent(Economics terminology applied to medical ethics)
The party in a principal-agent relationship who is instructed to produce the good or service on the principal's behalf — in the medical context, the doctor