Discussion Of The Ethical Problems Arising Out Of Antibiotic Use (Essay Sample)

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Misuse of Antibiotics due to lack of knowledge and the ethical dilemma
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Misuse of Antibiotics due to lack of knowledge and the ethical dilemma
According to the World Health Organization (WHO), there is a persistent misuse of antibiotics on developing countries, which could result in complete resistance by the antibiotic bacteria (World Health Organization, 2012). Since the discovery of penicillin 50 years ago, there is an increasing worry that the inappropriate use of antibiotics in treating common infections could lead to a global emergence of resistant bacterial strains. The overuse of antibiotics culminates not only in antibiotic resistance but also in unpleasant retorts and economic strains on a country’s national health system. Irrational use of antibiotics threatens the therapeutic effectiveness of antibiotics which leads to higher costs of antibiotic treatment and reduced mortality rates in developing country. The newly developed antibiotic medications are usually much more expensive which renders them unattainable for poverty stricken people. One of the major factors identified as having caused the problem of antibiotic resistance is the fact that pharmacists, physicians, as well as patients, lack the necessary knowledge regarding the use of antibiotics. In the case of physicians, they are usually caught up in the ethical dilemma of deciding whether to adhere to the policy that requires them not to prescribe antibiotics in cases where patients suffer from common infections, or fulfill their obligations to patients and relieve their suffering by prescribing antibiotic medication for these common ailments. Studies conducted by the Center for Disease Control and Prevention suggest that the patients, as well as the public at large, do not perceive any link between the so-called “Superbugs” and antibiotic prescription (Center for Disease Control and Prevention, 2009). This paper will attempt to develop an ethically based argument regarding the overuse of antibiotics by identifying the ethical problems arising within antibiotic use and later elaborate on some of the ethical pros and cons of antibiotic overuse. In addition to this, the paper will also suggest a more flexible and informed approach to controlling the inappropriate use of antibiotics through educating physicians as well as the public regarding antibiotic use.
First and foremost, this part of the paper will elaborate on the ethical issues culminating from widespread misuse of antibiotics. According to Neu, (2002), the threat of advancing antibiotic resistance puts the future human generation at the risk of suffering from adverse effects. The repeated and increasing the number of warnings by specialists in microbiology and global health experts, as far as antibiotic misuse is concerned, illustrates just how precarious the situation is. There is a consensus among a large number of scientists that the dawn of a post-antibiotic era could potentially turn from mere speculation to actual reality. Apart from the increased cost and difficulty faced in treating microbial diseases, antibiotic misuse may also result lead to an increase in the risk of performing certain medical procedures that use antibiotics such as chemotherapy and surgical interventions. Allowing the continued misuse of antibiotics would result in a situation where physicians lack the moral obligation to practice safe medical care (Stewart & Costerton, 2001). Normally, doctors prefer to treat patients with antibiotics and dismiss the probable outcome of antibiotic resistance. The assumption is that antibiotic therapy results in a rapid clinical cure without the need to return for follow-up medication. Based on a study conducted by the UK Department of Health, 400 out of 429 medical physicians from five hospitals preferred to use antibiotic treatment for minor infections (U.K Department of Health, 2006). As part of a universal ethical framework, beneficence essentially means ‘do good and avoid evil’. Medical practitioners face the challenge of deciding whether it is good or evil to treat patients with antibiotics at the expense of resistance. Some doctors argue that they apply the principle of nonmaleficence when they decide to treat patients with antibiotics. The nonmaleficence universal ethical principle implies that one cannot, in essence, act if that particular action will result in harm (Verhagen, 2008). Thus, doctors apply the nonmaleficence principle by presuming that using antibiotics in treating viral infection results in the good of alleviating patients’ suffering. The obligation of physicians towards their patients presents a moral dilemma of whether to adhere to the policy of preventing resistance or act bearing in mind that he/she is doing so for the patient’s welfare. Misuse of antibiotics also radically augments the peril of the comeback of pandemic outbreaks and epidemics that could be dealt with in the past. Currently, the drug-resistant tuberculosis infection poses a huge challenge as it continuously raises the morbidity and mortality levels in third world nations (Gold & Moellering, 2006). Thus, current and future generations ought to be careful not to misuse antibiotics.
Apart from the threat of a post-antibiotic future, the misuse of antibiotics also poses the challenge of who bears the accountability to act and patient autonomy in the doctor-patient relationship. The fact that the widespread use of antibiotics in agriculture and healthcare leads to antibiotic resistance, reducing antibiotic consumption would negatively impact both human and animal health (Tenover, 2006). The sustainable use of antibiotics could also be an impossible endeavor and thus human beings may be forced to deal with a continuous and brutal cycle of obsolescence and resistance. In this case, the current generation’s moral obligation would simply entail managing the problem of antibiotic overuse. From the patients’ standpoint, a large number of patients may be uninformed of the fact that antibiotic treatment may be restricted. Patients’ lack of knowledge regarding the inappropriate use of antibiotics results in the ethical concern of patient autonomy. In the traditional doctor-patient consultation, lack of information limits the patient’s control over the form of treatment they would like extended to them and thus they end up consenting to antibiotic treatment even when it is not necessary (World Health Organization, 2001). Without knowledge, a number of ethical questions may be raised. Does using antibiotic therapy undermine patients’ trust in their doctors to do what is best for them? Do patients provide informed consent without the knowledge that a better form of treatment could be extended to them? A physician’s capacity of self-determination may be compromised if he/she is forced to choose between belief in their medical skills and restrictive policies. In developing countries, clinicians rarely discuss with their patients the impact of treating minor infections with antibiotics despite it being their moral responsibility. The need for prompt treatment coupled with patient demand motivates physicians’ decision to use antibiotics. Apart from this fact, patients are also oblivious of to the fact that they can find information regarding antibiotic treatment on the internet. Swartz (2007) elucidates that there is an increasing awareness of antibiotic resistance in developed countries which poses the ethical problem of who ought to decide the best form of therapy to be used on the patient. The violation of patient autonomy arises when doctors feel that they know better than the patient and end up prescribing antibiotics even though they are well aware of the long-term impacts of antibiotic resistance.
Taking into account the cost of antibiotic therapy, there exist a variety of social and economic issues. Apart from the cost of the initial antibiotic treatment and consultation, payers are usually expected to also cover the cost of unfortunate outcomes as well as the probable downstream resistance cost. Notably, there is the possibility of the existence of a variety of payers in dissimilar components of a healthcare structure meeting dissimilar costs, with little consideration of any extra costs they may incur in the future (Wise, 2002). For instance, a universal practice may contain an incentive that restrains antibiotic prescribing, but in the event that it fails the cost of augmented hospitalizations will be extended to a variety of payers in tertiary care. In socialized healthcare structures and administered healthcare institutes, payers are obligated to cover the healthcare cost for individual patients. From a payer’s point of view, antibiotic restrictions are aimed at striking a balance between the cost of the early treatment and the cost of an unfortunate outcome. Despite this fact, there exist concerns regarding the fact that the cost of unfortunate outcome surpasses the initial cost of treatment. It may be unfair for individuals living below the poverty line to have to incur the extra cost of an unfortunate outcome. Apart from increasing the cost of antibiotic therapy, by increasing the chances of complications or treatment letdown, and increasing the recovery time it in addition results in yield losses. Additionally, there are linked economic and social costs that culminate from individual obligations towards their loved ones who may have fallen victim to antimicrobial resistance (AMR) related diseases, which might not be entirely included in cost models (Schito & Marchese, 2009). Unless radical actions are taken to thwart further developme...