Procedural accounts like Christman's require only that identification arise through a non-alienating historical process, not that the agent actively secure each identification at every level.
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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
identification(Collective moral responsibility discourse)
A relation between an individual and a group that does not by itself implicate the individual in the intentions or actions of the group.