Abstract
Due to the alarming rise of antibiotic resistance, medically unwarranted use of antibiotics has assumed new moral significance. In this paper, a thematic content analysis of focus group discussions was conducted to explore lay people’s views on the moral challenges posed by antibiotic resistance. The most important finding is that lay people are morally sensitive to the problems entailed by antibiotic resistance. Participants saw the decreasing availability of effective antibiotics as a problem of justice. This involves individual as well as collective moral responsibility. Yet, holding agents responsible for their use of antibiotics involves varying degrees of demandingness. In our discussion, these findings are related to the contemporary ethical debate on antibiotic resistance and two proposals for the preservation of antibiotic effectiveness are compared to and evaluated against participants’ views.
Highlights
Antibiotic resistance (AR) develops as a natural process resulting from the exposure of bacteria to antibacterial drugs and selection for resistant mutants
The participants found that the decreasing availability of effective antibiotics leads to justice-related issues; that the situation implies individual as well as collective moral responsibility and that holding agents responsible involves varying degrees of demandingness
Considering that the use of antibiotics contributes to AR and that AR decreases the effectiveness of antibiotics, non-judicious use of antibiotics poses a series of justice-related ethical issues: (Q1) Well, we have a responsibility because it’s kind of unfair that we use up all the resources there are and there is nothing left. . . (G3W3)2
Summary
Antibiotic resistance (AR) develops as a natural process resulting from the exposure of bacteria to antibacterial drugs and selection for resistant mutants. The rapid development of AR is one of the most significant threats to public health globally (WHO, 2015), which is directly related to how antibiotics are used in society (Costelloe et al, 2010). The management of AR is a complex public health issue in which many stakeholders play a role. Most research has focused on public awareness of the use of antibiotics and AR under the assumption that a better understanding of antibiotics can make people act more responsibly (BrookesHowell et al, 2012). The problem with a focus on awareness-raising as a behavioral tool is that public campaigns are seldom developed from an adequate appraisal of the attitudes and beliefs that inform social norms that influence antibiotic use (Hawkings et al, 2007; McDonnell Norms Group, 2008; McCullough et al, 2016).
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