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CARe ethics researchers plead for sustainability in resource allocation for drugs in new Feature Article

A new open access article by CARe’s ethics researchers Christian Munthe, Davide Fumagalli and Erik Malmqvist has been selected as a specially spotlighted Feature Article by the editor of the BMJ produced Journal of Medical Ethics.

The article proposes radical reform of healthcare resource allocation systems to better account for sustainability aspects of drugs, such as pollution from the production of antibiotics, or otherwise deficient supply chains that threaten to undermine healthcare effectiveness. The authors demonstrate that the sustainability challenge of antibiotic resistance is linked to several other structural threats to healthcare by the creation of negative dynamics of resource allocation which deplete future healthcare capacity. This challenge can be met by having a sustainability principle added to established principles for healthcare priority setting and resource allocation. The article describes several forms that such a principle may take, and defends it from an ethical point of view in positive terms, as well as considers and dismisses potential objections. The article hereby complement earlier research in CARe on the ways in which actors can be incentivized to curb antibiotic pollution, and how such action can in principle be ethically justified. This third article carves out specific policy room to allow healthcare institutions to actually take this kind of action in their transactions with drug companies. 


The Features Article status means that the final publication in an issue (planned for January 2021) will also include several invited comments by selected scholars, and a final reply by the authors.


Reference and open access: Munthe, C, Fumagalli, D, Malmqvist, E (2020). Sustainability principle for the ethics of healthcare resource allocation. Journal of Medical Ethics, Early view, doi: