Bioethics Special Issue: The Ethics of Antibiotic Resistance

Open Access Papers on Antibiotic Resistance

Three OUC research papers have featured in a special issue of Bioethics 'The Ethics of Antibiotic Resistance: Towards an Agenda for Feasible and Justified Global Health Policy.

2019, Vol. 33, Iss. 7
Special Issue:The Ethics of Antibiotic Resistance
Pages: 729-850
Issue Edited by: Christian Munthe Karl de Fine Licht Niels Nijsingh D.G. Joakim Larsson


Giubilini, A., (2019), 'Antibiotic Resistance As A Tragedy Of The Commons: An Ethical Argument For A Tax On Antibiotic Use In Humans', Bioethics, Vol: 33(7): 776–784 [PMC6767468]
To the extent that antibiotic resistance (ABR) is accelerated by antibiotic consumption and that it represents a serious public health emergency, it is imperative to drastically reduce antibiotic consumption, particularly in high‐income countries. I present the problem of ABR as an instance of the collective action problem known as ‘tragedy of the commons’. I propose that there is a strong ethical justification for taxing certain uses of antibiotics, namely when antibiotics are required to treat minor and self‐limiting infections, such as respiratory tract infections, in otherwise healthy individuals. Taxation would allow a reduction in consumption (given certain behavioural economics assumptions) and/or ensure that individuals internalize or compensate for their contribution to the erosion of the common good of antibiotic effectiveness. I suggest that revenue from the tax could be used to fund conservation and innovation strategies. Taxation might be a coercive policy, especially for certain individuals, but the ethical case for coercive policies is very strong when the good to be preserved is important enough and when they force individuals to do something they have a moral obligation to do anyway. I argue that, in the case of mild and self‐limiting infections, individuals have a moral duty of easy rescue and a moral duty of fairness to make their contribution to the preservation of the common good of antibiotic effectiveness by foregoing antibiotics. I also suggest that taxing antibiotics in such cases is an all things considered ethically justified policy even if it would introduce inequalities in access to healthcare.

Persson, I. and Savulescu, J., (2019), 'The Evolution of Moral Progress and Biomedical Moral Enhancement', Bioethics, Vol: 33(7): 814-819 [PMC6766868]
In The Evolution of Moral Progress Allen Buchanan and Russell Powell advance an evolutionary explanation of moral progress by morality becoming more ‘inclusivist’. We are prepared to accept this explanation as far as it goes, but argue that it fails to explain how morality can become inclusivist in the fuller sense they intend. In fact, it even rules out inclusivism in their intended sense of moral progress, since they believe that human altruism and prosocial attitudes are essentially parochial. We also respond to their charge that the possibility of moral enhancement by biomedical means that we have defended in numerous publications assumes that moral attitudes are biologically hard‐wired to an extent that implies that they are resilient to the influence of cognitive or cultural factors. Quite the contrary, we think they are more open to such influence than they seem to do.

Savulescu, J. and Anomaly, J., (2019), 'Compensation for Cures: Why we should pay a premium for participation in challenge studies', Bioethics, Vol: 33 (7: Special Issue: The Ethics of Antibiotic Resistance): 792-797 [PMC6773221
Antibiotic resistance is one of the most pressing public health problems humanity faces. Research into new classes of antibiotics and new kinds of treatments – including risky experimental treatments such as phage therapy and vaccines – is an important part of improving our ability to treat infectious diseases. In order to aid this research, we will argue that we should permit researchers to pay people any amount of money to compensate for the risks of participating in clinical trials, including ‘challenge studies’ that involve deliberately infecting patients. We think that standard worries about paying for participation in risky research are reducible to concerns that can be addressed with the right screening mechanisms.


These papers were made Open Access under Wellcome Trust grants:

Centre for Ethics and Humanities | WT203132 | Open Access papers linked to this grant on EuropePMC

Responsibility and Healthcare | WT104848 | Open Access papers linked to this grant on EuropePMC

For more Open Access papers click here.