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The international dimensions of antimicrobial resistance: contextual factors shape distinct ethical challenges in South Africa, Sri Lanka and the United Kingdom

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journal contribution
posted on 17.04.2019, 14:26 by Eva M. Krockow, Carolyn Tarrant
Antimicrobial resistance (AMR) describes the evolution of treatment-resistant pathogens, with potentially catastrophic consequences for human medicine. AMR is driven by the over-prescription of antibiotics, and could be reduced through consideration of the ethical dimensions of the dilemma faced by prescribers. This dilemma involves balancing apparently opposed interests of current and future patients and unique contextual factors in different countries, which may modify the core dilemma. We describe three example countries with different economic backgrounds and cultures—South Africa, Sri Lanka and the United Kingdom. Then we discuss how country-specific factors impact on the prominence of different ethical dimensions of the dilemma (equality of present and future generations; rule of rescue; prescribing autonomy and conflicts of interest; consensus on collective action). We conclude that a nuanced understanding of national prescribing dilemmas is critical to inform design of effective stewardship approaches.

Funding

This research was funded by the Global Challenges Research Fund ‐ Grant No. ES/P004784/1 awarded by the Economic and Social Research Council (ESRC) on behalf of the Research Councils UK (RCUK).

History

Citation

Bioethics, 2019, 33(7) Special Issue: The Ethics of Antibiotic Resistance pp. 756-765

Author affiliation

/Organisation/COLLEGE OF LIFE SCIENCES/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

Bioethics

Publisher

Wiley

issn

0269-9702

Acceptance date

08/03/2019

Copyright date

2019

Available date

14/09/2019

Publisher version

https://onlinelibrary.wiley.com/doi/full/10.1111/bioe.12604

Language

en