Balancing health and environmental impact in antibiotic resistance policy

• There is an increase of suggestions that healthcare policies should pay more attention to environmental impact. However, this raises a question of how to analyze and manage conflicts between environmental considerations and immediate health considerations. E.g., if drugs are prioritized not only on the basis of need, effect and cost-effectiveness, but also on the environmental impact pattern of its production and/or consumption, single patients may be denied effective therapies due to overarching structural concerns which are difficult to trace back to effects on these or any other single patient. At the same time, the overall environmental health impact of pharmaceutical pollution is recognized to be a major global public health threat, for instance, via its contribution to antibiotic resistance (ABR). While background philosophical theories may in theory answer how to balance these concerns, to produce an actual answer is challenging due to their level of abstraction. At the same time, standard ideas in operational healthcare ethics and public health ethics seem inadequate by themselves, as they capture only parts of the problem but are also problematic to combine, as they are based on conflicting perspectives and ethoses. This makes it difficult to produce an ethical analyses that could facilitate a solution to the problem of how to balance individual health and structural environmental concerns. This paper will use ABR as a case in point to describe this challenge in more detail, and present three rivalling ways forward.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Samhällsfarmaci och klinisk farmaci (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Social and Clinical Pharmacy (hsv//eng)

HUMANIORA  -- Filosofi, etik och religion -- Filosofi (hsv//swe)

HUMANITIES  -- Philosophy, Ethics and Religion -- Philosophy (hsv//eng)

NATURVETENSKAP  -- Geovetenskap och miljövetenskap -- Miljövetenskap (hsv//swe)

NATURAL SCIENCES  -- Earth and Related Environmental Sciences -- Environmental Sciences (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Medicinsk etik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Medical Ethics (hsv//eng)

HUMANIORA  -- Filosofi, etik och religion -- Etik (hsv//swe)

HUMANITIES  -- Philosophy, Ethics and Religion -- Ethics (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

Nyckelord

Bioethics

Public health ethics

Antimicrobial resistance

antibiotic resistance

environmental pharmacology

drugs

social pharmacological

health policy

environmental policy

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