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Justifying Antibiotic Resistance Interventions: Uncertainty, Precaution and Ethics

Chapter in book
Authors Niels Nijsingh
D. G. Joakim Larsson
Karl Persson de Fine Licht
Christian Munthe
Published in Jamrozik E., Selgelid M.J. (eds) Ethics and Drug-Resistance: Collective Responsibility for Global Public Health
ISBN 978-3-030-27873-1
ISSN 2211-6680
Publisher Springer
Place of publication Cham, Switzerland
Publication year 2020
Published at Department of Philosophy, Linguistics and Theory of Science
Centre for antibiotic resistance research, CARe
Institute of Biomedicine, Department of Infectious Medicine
Language en
Keywords ABR, AMR, antibiotics, antibiotic resistance, antimicrobial resistance, drug resistance, ethics, bioethics, ethics of risk and uncertainty, precautionary principle, health policy
Subject categories Medical microbiology, Social and Clinical Pharmacy, Technology and social change, Research policy, Health Care Service and Management, Health Policy and Services and Health Economy, Ethics, Practical philosophy, Medical Ethics, Microbiology


This chapter charts and critically analyses the ethical challenge of assessing how much (and what kind of) evidence is required for the justification of interventions in response antibiotic resistance (ABR), as well as other major public health threats. Our ambition here is to identify and briefly discuss main issues, and point to ways in which these need to be further advanced in future research. This will result in a tentative map of complications, underlying problems and possible challenges. This map illustrates that the ethical challenges in this area are much more complex and profound than is usually acknowledged, leaving no tentatively plausible intervention package free of downsides. This creates potentially overwhelming theoretical conundrums when trying to justify what to do. We therefore end by pointing out two general features of the complexity we find to be of particular importance, and a tentative suggestion for how to create a theoretical basis for further analysis.

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