Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription

<strong>Background</strong> Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human healthcare. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing publ...

Full description

Bibliographic Details
Main Authors: Giubilini, A, Dai, B, Faber, N, Douglas, T, Selgelid, M, Savulescu, J
Format: Journal article
Published: Taylor and Francis 2019
_version_ 1797092522849206272
author Giubilini, A
Dai, B
Faber, N
Douglas, T
Selgelid, M
Savulescu, J
author_facet Giubilini, A
Dai, B
Faber, N
Douglas, T
Selgelid, M
Savulescu, J
author_sort Giubilini, A
collection OXFORD
description <strong>Background</strong> Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human healthcare. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of public views or their sensitivity to awareness of AMR risks or the standpoint (self-interested or impartial) taken by participants. <strong>Methods</strong> An online survey was conducted with a sample of the US public (n=158). Participants were asked to indicate what relative priority should be given to individual patients and society-at-large from various standpoints and in various contexts, including antibiotic prescription. <strong>Results</strong> 50.3% of participants thought that doctors should generally prioritise individual patients over society, whereas 32.0% prioritised society over individual patients. When asked in the context of AMR, 39.2% prioritized individuals whereas 45.5% prioritized society. Participants were significantly less willing to prioritise society over individuals when they themselves were the patient, both in general (p=.001) and in relation to AMR specifically (p=.006). <strong>Conclusions</strong> Participants’ attitudes were more oriented to society and sensitive to collective responsibility when informed about the social costs of antibiotic use and when considered from a third-personal rather than first-personal perspective. That is, as participants came closer to taking the perspective of an informed and impartial ‘ideal observer’, their support for prioritizing society increased. Our findings suggest that, insofar as antibiotic policies and practices should be informed by attitudes that are impartial and well-informed, there is significant support for prioritizing society.
first_indexed 2024-03-07T03:47:08Z
format Journal article
id oxford-uuid:bfde4c61-53d7-41dd-8411-3cc44d5a25d6
institution University of Oxford
last_indexed 2024-03-07T03:47:08Z
publishDate 2019
publisher Taylor and Francis
record_format dspace
spelling oxford-uuid:bfde4c61-53d7-41dd-8411-3cc44d5a25d62022-03-27T05:50:39ZImpartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescriptionJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:bfde4c61-53d7-41dd-8411-3cc44d5a25d6Symplectic Elements at OxfordTaylor and Francis2019Giubilini, ADai, BFaber, NDouglas, TSelgelid, MSavulescu, J<strong>Background</strong> Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human healthcare. Doctors considering whether to prescribe antibiotics face an ethical conflict between upholding individual patient health and advancing public health aims. Existing literature mainly examines whether patients awaiting consultations desire or expect to receive antibiotic prescriptions, but does not report views of the wider public regarding conditions under which doctors should prescribe antibiotics. It also does not explore the ethical significance of public views or their sensitivity to awareness of AMR risks or the standpoint (self-interested or impartial) taken by participants. <strong>Methods</strong> An online survey was conducted with a sample of the US public (n=158). Participants were asked to indicate what relative priority should be given to individual patients and society-at-large from various standpoints and in various contexts, including antibiotic prescription. <strong>Results</strong> 50.3% of participants thought that doctors should generally prioritise individual patients over society, whereas 32.0% prioritised society over individual patients. When asked in the context of AMR, 39.2% prioritized individuals whereas 45.5% prioritized society. Participants were significantly less willing to prioritise society over individuals when they themselves were the patient, both in general (p=.001) and in relation to AMR specifically (p=.006). <strong>Conclusions</strong> Participants’ attitudes were more oriented to society and sensitive to collective responsibility when informed about the social costs of antibiotic use and when considered from a third-personal rather than first-personal perspective. That is, as participants came closer to taking the perspective of an informed and impartial ‘ideal observer’, their support for prioritizing society increased. Our findings suggest that, insofar as antibiotic policies and practices should be informed by attitudes that are impartial and well-informed, there is significant support for prioritizing society.
spellingShingle Giubilini, A
Dai, B
Faber, N
Douglas, T
Selgelid, M
Savulescu, J
Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title_full Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title_fullStr Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title_full_unstemmed Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title_short Impartiality and infectious disease: prioritizing individuals versus the collective in antibiotic prescription
title_sort impartiality and infectious disease prioritizing individuals versus the collective in antibiotic prescription
work_keys_str_mv AT giubilinia impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription
AT daib impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription
AT fabern impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription
AT douglast impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription
AT selgelidm impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription
AT savulescuj impartialityandinfectiousdiseaseprioritizingindividualsversusthecollectiveinantibioticprescription