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- Ancillotti, Mirko, 1981-, et al.
(författare)
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An Effort Worth Making : A Qualitative Study of How Swedes Respond to Antibiotic Resistance
- 2021
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Ingår i: Public Health Ethics. - : Oxford University Press. - 1754-9973 .- 1754-9981. ; 14:1, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Due to the alarming rise of antibiotic resistance, medically unwarranted use of antibiotics has assumed new moral significance. In this paper, a thematic content analysis of focus group discussions was conducted to explore lay people’s views on the moral challenges posed by antibiotic resistance. The most important finding is that lay people are morally sensitive to the problems entailed by antibiotic resistance. Participants saw the decreasing availability of effective antibiotics as a problem of justice. This involves individual as well as collective moral responsibility. Yet, holding agents responsible for their use of antibiotics involves varying degrees of demandingness. In our discussion, these findings are related to the contemporary ethical debate on antibiotic resistance and two proposals for the preservation of antibiotic effectiveness are compared to and evaluated against participants’ views.
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- Ancillotti, Mirko, 1981-, et al.
(författare)
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Individual moral responsibility for antibiotic resistance
- 2022
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Ingår i: Bioethics. - : John Wiley & Sons. - 0269-9702 .- 1467-8519. ; 36:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Antibiotic resistance (AR) is a major threat to public health and healthcare worldwide. In this article, we analyse and discuss the claim that taking actions to minimize AR is everyone's responsibility, focusing on individual moral responsibility. This should not be merely interpreted as a function of knowledge of AR and the proper use of antibiotics. Instead, we suggest a circumstantial account of individual responsibility for AR, where individuals do or do not engage in judicious antibiotic behaviour with different degrees of voluntariness. Furthermore, we suggest a notion of responsibility as a virtue, in which individuals have the opportunity to develop a sensitivity towards the AR theme and, consequently, are capable of engaging, actively and voluntarily, in judicious antibiotic behaviour. The development of such sensitivity depends on the creation of adequate circumstances, that is individual capacities and availability of resources.
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- Ancillotti, Mirko, 1981-, et al.
(författare)
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Preferences regarding antibiotic treatment and the role of antibiotic resistance : a discrete choice experiment
- 2020
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Ingår i: International Journal of Antimicrobial Agents. - : Elsevier BV. - 0924-8579 .- 1872-7913. ; 56:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To identify preferences of the Swedish public regarding antibiotic treatment characteristics and the relative weight of antibiotic resistance in their treatment choices.Methods: A questionnaire including a discrete choice experiment questionnaire was answered by 378 Swedish participants. Preferences of the general public regarding five treatment characteristics (attributes) were measured: contribution to antibiotic resistance, cost, side effects, failure rate and treatment duration. Latent class analysis models were used to determine attribute-level estimates and heterogeneity in preferences. Relative importance of the attributes and willingness to pay for antibiotics with a lower contribution to antibiotic resistance were calculated from the estimates.Results: All attributes influenced participants’ preferences for antibiotic treatment. For the majority of participants, contribution to antibiotic resistance was the most important attribute. Younger respondents found contribution to antibiotic resistance more important in their choice of antibiotic treatments. Choices of respondents with lower numeracy, higher health literacy and higher financial vulnerability were influenced more by the cost of the antibiotic treatment. Older respondents with lower financial vulnerability and health literacy, and higher numeracy found side effects to be most important.Conclusions: All attributes can be considered as potential drivers of antibiotic use by lay people. Findings also suggest that the behaviour of lay people may be influenced by concerns over the rise of antibiotic resistance. Therefore, stressing individual responsibility for antibiotic resistance in clinical and societal communication has the potential to affect personal decision making.
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- Ancillotti, Mirko, 1981-, et al.
(författare)
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Public awareness and individual responsibility needed for judicious use of antibiotics : a qualitative study of public beliefs and perceptions
- 2018
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHigh consumption of antibiotics has been identified as an important driver for the increasing antibiotic resistance, considered to be one of the greatest threats to public health globally. Simply informing the public about this consequence is insufficient to induce behavioral change. This study explored beliefs and perceptions among Swedes, with the aim of identifying factors promoting and hindering a judicious approach to antibiotics use. The study focused primarily on the medical use of antibiotics, also considering other aspects connected with antibiotic resistance, such as travelling and food consumption.MethodsData were collected through focus group discussions at the end of 2016. Twenty-three Swedes were recruited using an area-based approach and purposive sampling, aiming for as heterogeneous groups as possible regarding gender (13 women, 10 men), age (range 20–81, mean 38), and education level. Interview transcripts were analyzed using qualitative content analysis. The Health Belief Model was used as a theoretical framework.ResultsAntibiotic resistance was identified by participants as a health threat with the potential for terrible consequences. The severity of the problem was perceived more strongly than the actual likelihood of being affected by it. Metaphors such as climate change were abundantly employed to describe antibiotic resistance as a slowly emerging problem. There was a tension between individual (egoistic) and collective (altruistic) reasons for engaging in judicious behavior. The individual effort needed and antibiotics overprescribing were considered major barriers to such behavior. In their discussions, participants stressed the need for empowerment, achieved through good health communication from authorities and family physicians.ConclusionsKnowledge about antibiotic consumption and resistance, as well as values such as altruism and trust in the health care system, has significant influence on both perceptions of individual responsibility and on behavior. This suggests that these factors should be emphasized in health education and health promotion. To instead frame antibiotic resistance as a slowly emerging disaster, risks diminish the public perception of being susceptible to it.
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- Bülow, William, et al.
(författare)
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Why unethical papers should be retracted
- 2021
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Ingår i: Journal of Medical Ethics. - : BMJ Publishing Group Ltd. - 0306-6800 .- 1473-4257. ; 47:12
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of retracting published papers is to maintain the integrity of academic research. Recent work in research ethics has devoted important attention to how to improve the system of paper retraction. In this context, the focus has primarily been on how to handle fraudulent or flawed research papers, and how to encourage the retraction of papers based on honest mistakes. Less attention has been paid to whether papers that report unethical research – for example, research performed without appropriate concern for the moral rights and interests of the research participants – should be retracted. The aim of this paper is to examine to what extent retraction policies of academic journals and publishers address retractions of unethical research and to discuss critically various policy options and the reasons for accepting them. This paper starts by reviewing retraction policies of academic publishers. The results show that many journals do not have explicit policies for how to handle unethical research. Against this background, we discuss four normative arguments for why unethical research should be retracted. In conclusion, we suggest a retraction policy in light of our empirical and normative investigations.
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- Elliott, Tracey, et al.
(författare)
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Perceptions on the prevalence and impact of predatory academic journals and conferences : A global survey of researchers
- 2022
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Ingår i: Learned Publishing. - : John Wiley & Sons. - 0953-1513 .- 1741-4857. ; 35:4, s. 516-528
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Tidskriftsartikel (refereegranskat)abstract
- A global survey of researchers was conducted to gather perceptions on the prevalence and impact of predatory academic journals and conferences. The survey was open and inclusive in nature, with 1872 researchers, from a wide array of geographic regions, disciplines and academic career stages, voluntarily participating. Both quantitative and qualitative data were collected and analysed. The survey revealed that over 80% (1537 of 1859) of respondents perceive predatory practices are already a serious problem or on the rise in their country of work, and risk infiltrating and undermining the research enterprise if left unchallenged. At least 24% (445 of 1872) of respondents admitted they had already published in a predatory journal, participated in a predatory conference, or did not know if they had. Over 87% of respondents who had published (174 of 199) or participated (60 of 64) indicated that a lack of awareness of predatory practices was the main reason. Those in lower-middle and upper-middle-income countries were more likely to indicate they had engaged in these activities than those in high-income ones, with some disciplines appearing to engage more than others. Individual impact was mixed: some indicated no impact while others noted a range of negative and detrimental feelings.
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| 10. |
- Engelbak Nielsen, Zandra, et al.
(författare)
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Are cancer patients better off if they participate in clinical trials? : A mixed methods study
- 2020
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Ingår i: BMC Cancer. - : Springer Science and Business Media LLC. - 1471-2407. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundResearch and cancer care are closely intertwined; however, it is not clear whether physicians and nurses believe that clinical trials offer the best treatment for patients and, if so, whether this belief is justified. The aim of this study was therefore: (i) to explore how physicians and nurses perceive the benefits of clinical trial participation compared with standard care and (ii) whether it is justified to claim that clinical trial participation improves outcomes for cancer patients.MethodsA mixed methods approach was used employing semi-structured interviews with 57 physicians and nurses in oncology and haematology and a literature review of the evidence for trial superiority, i.e. the idea that receiving treatment in a clinical trial leads to a better outcome compared with standard care. Inductive thematic analysis was used to examine the interview data. A literature review comprising nine articles was conducted according to a conceptual framework developed by Peppercorn et al. and evaluated recent evidence on trial superiority.ResultsOur findings show that many physicians and nurses make claims supporting trial superiority, however very little evidence is available in the literature comparing outcomes for trial participants and non-participants that supports their assertions.ConclusionsDespite the recent rapid development and use of targeted therapy and immunotherapy, we find no support for trial participation to provide better outcomes for cancer patients than standard care. Hence, our present results are in line with previous results from Peppercorn et al. A weaker version of the superiority claim is that even if a trial does not bring about a direct positive effect, it brings about indirect positive effects. However, as the value of such indirect effects is dependent on the individual’s specific circumstances and preferences, their existence cannot establish the general claim that treatment in trials is superior. Belief in trial superiority is therefore unfounded. Hence, if such beliefs are communicated to patients in a trial recruitment context, it would provide misleading information. Instead emphasis should be on patients volunteering to give an altruistic contribution to the furthering of knowledge and to the potential benefit of future patients.
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