The international dimensions of antimicrobial resistance: Contextual factors shape distinct ethical challenges in South Africa, Sri Lanka and the United Kingdom

Krockow Eva M.; Tarrant Carolyn

摘要

Abstract > Antimicrobial resistance ( <fc>AMR</fc> ) describes the evolution of treatment‐resistant pathogens, with potentially catastrophic consequences for human medicine. <fc>AMR</fc> is driven by the over‐prescription of antibiotics, and could be reduced through consideration of the ethical dimensions of the dilemma faced by doctors. This dilemma involves balancing apparently opposed interests of current and future patients, and unique contextual factors in different countries, which may modify the core dilemma. We describe three example countries with different economic backgrounds and cultures—South Africa, Sri Lanka and the United Kingdom. Then we discuss how country‐specific factors impact on the prominence of various ethical dimensions of the dilemma (visibility and moral equality of future generations; Rule of Rescue; prescribing autonomy and conflicts of interest; consensus on collective action). We conclude that a nuanced understanding of national prescribing dilemmas is critical to inform the design of effective stewardship approaches. </abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><Abstract Type =“Main”XML：ID =“Bioe12604-Abs-Abs 0001”XML：Lang =“En”> <标题类型=“main”>摘要</标题> >抗微生物电阻（<FC> AMR < / FC>）描述了治疗抗性病原体的演变，具有对人类医学的潜在灾难性后果。 <FC> AMR </ FC>由抗生素的过度处方驱动，可以通过考虑医生面临的困境的道德尺寸来减少。这种困境涉及平衡当前和未来患者的明显相反的兴趣，以及不同国家的独特语境因素，可能会修改核心困境。我们描述了三个具有不同经济背景和文化 - 南非，斯里兰卡和英国的示例国家。然后我们讨论了国家特定因素如何影响困境的各种道德方面的突出（后代的知名度和道德平等;救援规则;规定自主权和利益冲突;关于集体行动的共识）。我们得出结论，对国家规定困境的详细了解至关重要，以为有效的管理方法设计。 </ p> </ abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" >著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-14793/'>《Bioethics》</a> <b style="margin: 0 2px;">|</b><span>2019年第7期</span><b style="margin: 0 2px;">|</b><span>共10页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Krockow Eva M.&option=202" target="_blank" rel="nofollow">Krockow Eva M.;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Tarrant Carolyn&option=202" target="_blank" rel="nofollow">Tarrant Carolyn;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> <p>University of Leicester College of Medicine Biological Sciences and PsychologyLeicester United Kingdom of Great Britain and Northern Ireland;</p> <p>University of Leicester College of Medicine Biological Sciences and PsychologyLeicester United Kingdom of Great Britain and Northern Ireland;</p> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li > <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span><a href="https://www.zhangqiaokeyan.com/clc/15.html" title="生物科学">生物科学;</a></span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=antibiotic stewardship&option=203" rel="nofollow">antibiotic stewardship;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=antibiotics&option=203" rel="nofollow">antibiotics;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=antimicrobial resistance&option=203" rel="nofollow">antimicrobial resistance;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=conflict of interests&option=203" rel="nofollow">conflict of interests;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=hospitals&option=203" rel="nofollow">hospitals;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Rule of Rescue&option=203" rel="nofollow">Rule of Rescue;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=veil of ignorance&option=203" rel="nofollow">veil of ignorance;</a> </p> <div class="translation"> 机译：抗生素管理;抗生素;抗菌抵抗;利益冲突;医院;救援规则;无知的面纱; 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