Distributive justice and value trade-offs in antibiotic use in aged care settings.
Antimicrobial resistance
Antimicrobial stewardship
Distributive justice
Value trade offs
Journal
Monash bioethics review
ISSN: 1836-6716
Titre abrégé: Monash Bioeth Rev
Pays: United States
ID NLM: 100973394
Informations de publication
Date de publication:
11 Jul 2024
11 Jul 2024
Historique:
accepted:
07
02
2024
medline:
11
7
2024
pubmed:
11
7
2024
entrez:
11
7
2024
Statut:
aheadofprint
Résumé
Residential aged care facilities (RACF) are sites of high antibiotic use in Australia. Misuse of antimicrobial drugs in RACF contributes to antimicrobial resistance (AMR) burdens that accrue to individuals and the wider public, now and in the future. Antimicrobial stewardship (AMS) practices in RACF, e.g. requiring conformation of infection, are designed to minimise inappropriate use of antibiotics. We conducted dialogue groups with 46 participants with a parent receiving aged care to better understand families' perspectives on antibiotics and care in RACF. Participants grappled with value trade offs in thinking about their own parents' care, juggling imagined population and future harms with known short term comfort of individuals and prioritising the latter. Distributive justice in AMR relies on collective moral responsibility and action for the benefit of future generations and unknown others. In RACF, AMS requires value trade-offs and compromise on antimicrobial use in an environment that is heavily reliant on antimicrobial drugs to perform caring functions. In the context of aged care, AMS is a technical solution to a deeply relational and socio-structural problem and there is a risk that carers (workers, families) are morally burdened by system failures that are not addressed in AMS solutions.
Identifiants
pubmed: 38990508
doi: 10.1007/s40592-024-00191-5
pii: 10.1007/s40592-024-00191-5
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : University of Wollongong
ID : Global Challenges Keystone Grant
Informations de copyright
© 2024. The Author(s).
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