title: Antibiotic resistance: An ethical challenge.
abstract: In this paper, we argue that antibiotic resistance (ABR) raises a number of ethical problems that have not yet been sufficiently addressed. We outline four areas in which ethical issues that arise in relation to ABR are particularly pressing. First, the emergence of multidrug-resistant and extensively drug-resistant infections exacerbates traditional ethical challenges of infectious disease control, such as the restriction of individual liberty for the protection of the public's health. Second, ABR raises issues of global distributive justice, both with regard to the overuse and lack of access to antibiotics. Third, the use of antibiotics in veterinary medicine raises serious concerns for animal welfare and sustainable farming practices. Finally, the diminishing effectiveness of antibiotics leads to questions about intergenerational justice and our responsibility for the wellbeing of future generations. We suggest that current policy discussions should take ethical conflicts into account and engage openly with the challenges that we outline in this paper.
authors.affiliation: Division of Biomedical Ethics, Institute of Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 28, 24105 Kiel, Germany. Electronic address: j.littmann@iem.uni-kiel.de.
authors.forename: Jasper
authors.initials: J
authors.lastname: Littmann
authors.affiliation: Division of Biomedical Ethics, Institute of Experimental Medicine, Christian-Albrechts-Universität zu Kiel, Arnold-Heller-Str. 3, Haus 28, 24105 Kiel, Germany.
authors.forename: Alena
authors.initials: A
authors.lastname: Buyx
authors.affiliation: ReAct - Action on Antibiotic Resistance, Department of Medical Sciences, Uppsala University, Box 256, 75105 Uppsala, Sweden.
authors.forename: Otto
authors.initials: O
authors.lastname: Cars
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission; D003140:Communicable Disease Control; D024881:Drug Resistance, Bacterial; D004363:Drug Utilization / Q000941:ethics*; D006291:Health Policy; D006801:Humans; D015047:Zoonoses / Q000453:epidemiology / Q000382:microbiology* / Q000635:transmission
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic resistance; Distributive justice; Ethics; Health policy