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The University of Southampton
Global Network for Anti-Microbial Resistance and Infection Prevention

Antimicrobial resistance and ethics in the wider world

NAMRIP member Dr A.M. Viens is Director of the Centre for Health, Ethics and Law (HEAL)

Antibiotic stewardship, within appropriate ethical, legal and governance mechanisms, is vital. We must devise effective new practices and technologies that can be readily adopt. This requires our understanding of the people, the scenario (be it food production, industry, cleaning services or in the office managing any of these), and of the roles of humans, livestock and other microbe hosts.

AMR is an ethical issue

Dr A. M. Viens co-author, with Dr Jasper Littman (Institute of Experimental Medicine, Christian-Albrechts University Kiel) of a 2015 article: The Ethical Significance of Antimicrobial Resistance, argues, together with his co-author that Antimicrobial Resistance is not purely a technical or medical problem. It presents us with a broad range of ethical problems that must be addressed as part of a successful policy response to emerging drug resistance. It requires contributions from citizens, ethicists, policy makers, practitioners and industry to solve it, involving, as it does, problems like the reservoirs for resistant bacteria created by the fact that around half of the world’s production of antibiotics is still used in animal and fish farming; and the practice in countries where the prohibitive cost of prescribed antibiotics has led to unregulated over-the-counter sales resulting in their uncontrolled use.

Growing awareness of AMR

For years AMR was thought to be a matter for medical and microbiological experts, but it is now recognized that biological, behavioural, economic, environmental and social factors all contribute to its production and propagation. As a result, this raises important ethical and legal questions. There is now is now a much wider public awareness of the threat it poses via initiatives like the ‘Be an Antibiotic Guardian’ campaign, which everyone can join.

What are the ethical issues?

AMR not just a problem that arises from the complications of treating infectious diseases; it is a complex, global challenge affecting the environment, human and animal health, agriculture and the economy. It puts current and future populations at risk. It is going to require a redistribution of resources and a balancing of benefits and burdens, which in turn forces us to make a number of individual and collective sacrifices—often for people thousands of kilometres away - and for future persons as yet not born. The issue includes questions about who is morally responsible for this predicament and whether ascriptions of blame or sanctions should affect who should bear the costs of putting it right.

NAMRIP member Dr A. M. Viens is Director of The Centre for Health Ethics and Law (HEAL) at the University of Southampton. HEAL draws together a range of scholars and practitioners from different disciplines to build upon the broad range of expertise in the field of health care within the University and across local health care services. Through its activities is aims to coordinate responses to public consultations in the field of health ethics and law. Read their blog and find out more

Suggested articles for further reading:- 

The ethical Significance of Antimicrobial Resistance


Is Antimicrobial Resistance a Slowly Emerging Disaster?




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