Abstract
Control measures directed at carriers of multidrug-resistant organisms are traditionally approached as a trade-off between public interests on the one hand and individual autonomy on the other. We propose to reframe the ethical issue and consider control measures directed at carriers an issue of solidarity. Rather than asking “whether it is justified to impose strict measures”, we propose asking “how to best care for a person’s carriership and well-being in ways that do not imply an unacceptable risk for others?”. A solidarity approach could include elevating baseline levels of precaution measures and accepting certain risks in cases where there is exceptionally much at stake. A generous national compensation policy that also covers for costs related to dedicated care is essential in a solidarity approach. An additional benefit of reframing the questions is that it helps to better acknowledge that being subjected to control measures is a highly personal matter.
Highlights
The rise of antimicrobial resistance is a pressing public health problem
The latter requires that people who are found to carry a resistant microorganism are subjected to infection control measures upon hospitalization
We propose to reframe the ethical issue and consider control measures directed at carriers an issue of solidarity
Summary
The rise of antimicrobial resistance is a pressing public health problem. Without effective antibiotics, infections that today are considered mild and easy to treat will pose a serious threat in the future. Policies to control antimicrobial resistance include many strategies, ranging from new drug development to judicious use of the still available stock of effective antibiotics, and preventing the spread of already resistant microorganisms into healthcare related settings—where they can reach those patients who are most vulnerable to infection. The latter requires that people who are found to carry a resistant microorganism are subjected to infection control measures upon hospitalization. Rather than asking “is it justified to impose strict control measures to prevent AMR transmission from carriers to vulnerable others”, one could ask “how can we best care for this person’s carriership and well-being in ways that do not imply unacceptable risk (of transmission) for other patients?”
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