Antibiotic resistance is a global threat to public health, as the chances of treating infections decrease when antibiotics lose their effect on bacterial growth. But who is responsible for antibiotic resistance and what is the responsibility?
We may believe that the problem is too big and complex for us as individuals. Antibiotic resistance is a problem for governments and international organizations, we think. Nevertheless, it is not least our individual use of antibiotics that drives the development. For example, we may take antibiotics when it is not really necessary, or perhaps we do not follow the doctor’s prescription but discontinue the antibiotic treatment prematurely and throw leftover pills in the dustbin. Then we go on a journey and spread bacteria that are resistant to the antibiotic that we did not use properly. Or we ignore getting vaccinated because we think that there are antibiotics if we get sick. Well, maybe not for long!
If we have an individual moral responsibility to act with awareness of environmental problems, then it is not unreasonable to think that we also have a responsibility to act with awareness of the antibiotic problem. Mirko Ancillotti (who recently defended his dissertation at CRB) examines this possibility in an article in Bioethics. Do we have an individual moral responsibility for antibiotic resistance and how should the responsibility be understood?
Mirko Ancillotti immediately points out that not all people have the same opportunities to improve their antibiotic behaviour. Apart from the fact that many people lack information about antibiotic resistance, not everyone finds it as easy to change their antibiotic use. Some have less access than others to correctly prescribed treatments, for example, if they live far from a hospital but can easily buy antibiotics without a prescription. In addition, not everyone has the same financial means to stay at home if they are ill.
Another thing that makes it difficult to talk about individual responsibility for antibiotic resistance, is that you can hardly determine how much the pills you threw in the dustbin actually contributed to the problem. We know that people die due to antibiotic resistant bacteria, but it is difficult to determine the consequences of your particular antibiotic behaviour.
For these reasons, Mirko Ancillotti proposes a virtue ethical concept of responsibility. He suggests that we as individuals cultivate personal qualities and habits, which support responsible antibiotic use as a virtue. If I understand him, this means cultivating certain norms about antibiotics use, which we try to meet, such as following the doctor’s prescription, not using antibiotics unless necessary, not persuading the doctor to prescribe antibiotics, and making sure that we are vaccinated. However, since the conditions for acting with this normative sensitivity vary with human circumstances, there is in many cases a need to improve the conditions and institutional support for responsible antibiotic use.
A comparison: We have learned that we should preferably not travel by air, that it is irresponsible and perhaps even shameful to fly if it is not necessary. To be able to meet this new norm, new societal conditions are needed in the form of better international train connections and simpler ticketing systems. In the same way, new normative sensitivities regarding antibiotics can be developed, simultaneously with improving the opportunities for meeting the norms, Mirko Ancillotti suggests.
If you want to read more about Mirko Ancillotti’s virtue ethical concept of an individual responsibility for antibiotic resistance, read the article in Bioethics: Individual moral responsibility for antibiotic resistance.
Pär Segerdahl, Associate Professor at the Centre for Research Ethics & Bioethics and editor of the Ethics Blog.
Ancillotti, M., Nihlén Fahlquist, J., & Eriksson, S. (2021). Individual moral responsibility for antibiotic resistance. Bioethics, 1– 7. https://doi.org/10.1111/bioe.12958
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