This chapter explores the question of whether or not individual agents are under a moral obligation to reduce their ‘antimicrobial footprint’. An agent’s antimicrobial footprint measures the extent to which her actions are causally linked to the use of antibiotics. As such, it is not necessarily a measure of her contribution to antimicrobial resistance. Talking about people’s antimicrobial footprint in a way we talk about our carbon footprint may be helpful for drawing attention to the global effects of individual behaviour (...) and for highlighting that our choices can collectively make a real difference. But can we be morally obligated to make a contribution to resolving a collective action problem when our individual contributions by themselves make no discernible difference? I will focus on two lines of argument in favour of such obligations: whether a failure to reduce one’s antimicrobial footprint is unfair and whether it constitutes wrongdoing because it is harmful. I conclude by suggesting that the argument from collective harm is ultimately more successful. (shrink)

Antimicrobial resistance is a growing public health concern and is associated with the over- or inappropriate use of antimicrobials in both humans and agriculture. While there has been reco- gnition of this problem on the part of agricultural and public health authorities, there has none- theless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production (...) and the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno-scientific risk analyses of antimicro- bial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethi- cal norms of practice, are key factors to both the problem of and the solution to the current over-reliance on antimicrobials in food production. (shrink)

Antimicrobial resistance is a growing public health concern and is associated with the over - or inappropriate use of antimicrobials in both humans and agriculture. While there has been recognition of this problem on the part of agricultural and public health authorities, there has nonetheless been significant difficulty in translating policy recommendations into practical guidelines. In this paper, we examine the process of public health policy development in Quebec agriculture, with a focus on the case of pork production and (...) the role of food animal veterinarians in policy making. We argue that a tendency to employ strictly techno- scientific risk analyses of antimicro- bial use ignores the fundamental social, economic and political realities of key stakeholders and so limits the applicability of policy recommendations developed by government advisory groups. In particular, we suggest that veterinarians’ personal and professional interests, and their ethical norms of practice, are key factors to both the problem of and the solution to the current over -reliance on antimicrobials in food production. (shrink)

Hospital acquired infections (HAIs), especially ventilator associated respiratory infection (VARI) cause significant morbidity and mortality, and disproportionally so in low and middle-income countries (LMICs), including Vietnam, where infection control in hospitals is often neglected. The management of HAIs in these settings is challenging because of the high proportions of antimicrobial drug resistance and limitations of laboratory diagnostics, financial and human resources in terms of knowledge and skills for antimicrobial stewardship and infection prevention and control.

Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.

Antimicrobial resistance (AMR) is a global public health disaster driven largely by antibiotic use in human health care. 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. Methods: An online survey was conducted with a sample of the U.S. 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. Results: Of the participants, 50.3% thought that doctors should generally prioritize individual patients over society, whereas 32.0% prioritized 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 prioritize society over individuals when they themselves were the patient, both in general (p = .001) and in relation to AMR specifically (p = .006). Conclusions: 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-person rather than first-person 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. (shrink)

The U.S. FDA has issued emergency use authorizations for monoclonal antibodies for non-hospitalized patients with mild or moderate COVID-19 disease and for individuals exposed to COVID-19 as post-exposure prophylaxis. One EUA for an oral antiviral drug, molnupiravir, has also been recommended by FDA’s Antimicrobial Drugs Advisory Committee, and others appear likely in the near future. Due to increased demand because of the Delta variant, the federal government resumed control over the supply and asked states to ration doses. As future variants (...) with increased infectivity and/or severity emerge, further rationing may be required. We identify relevant ethical principles and priority groups for access to therapies based on an integrated approach to population health and medical factors. Using priority categories to allocate scarce therapies effectively operationalizes important ethical values. This strategy is preferable to the current approach of categorical rules based on vaccination, immunocompromise status, or older age, or the ad hoc consideration of clinical risk factors. (shrink)

Factory farming continues to grow around the world as a low-cost way of producing animal products for human consumption. However, many of the practices associated with intensive animal farming have been criticized by public health professionals and animal welfare advocates. The aim of this essay is to raise three independent moral concerns with factory farming, and to explain why the practices associated with factory farming flourish despite the cruelty inflicted on animals and the public health risks imposed on people. I (...) conclude that the costs of factory farming as it is currently practiced far outweigh the benefits, and offer a few suggestions for how to improve the situation for animals and people. (shrink)

Nanoparticles have been used in numerous fields, various branches of science and engineering. These were used as a modification and to enhance the activity such as dentistry and oral investigation. The current survey uncovers that graphene oxide has been used to set up a variety of functionalized nanoparticles and progressed nanocomposites carriers. Graphene oxide shows potential in a variety of research examinations, for instance, tooth bleaching, antimicrobial activity, tooth erosion, teeth implants, toothaches, drug delivery at a specific site. All these (...) usages of graphene oxide to biomedicine are excellent, and consoling Graphene oxide use in dental science has given amazing outcomes in antimicrobial activity, bone tissue building, regenerative dental, advancing dentistry biological materials, and in the treatment of oral cancer. The biocompatibilities of graphene oxide and its nanomaterial make them approaching units in bone regeneration, osseointegration, and cell multiplication. Furthermore, its antibiofilm and antiadhesion action encouraged researchers to formulate graphene oxide for biofilm. Nanostructures are utilized advancements or exploration of dentistry, and nanocomposite is employed for oral ailment preventive drugs, prostheses, and teeth implantation. Nanomaterials are further utilized as an oral liquid, mouth wash, or medication, forestalling and facilitating some oral malady and keep up oral wellbeing. (shrink)

With the advent of the “Clean India” campaign in India, a renewed focus on cleanliness has started, with a special focus on sanitation. There have been efforts in the past to provide sanitation related services. However, there were several challenges in provisioning. Provision of sanitation is a public health imperative given increased instances of antimicrobial resistance in India. This paper focuses on sanitation provisioning in the city of Mumbai, especially in the slums of Mumbai. The paper compares and contrasts different (...) models of sanitation provision including supply-led provisioning of sanitation by the Indian government to demand-led provisioning of sanitation through a World Bank funded “Slum Sanitation Program” (SSP). The paper also outlines a comparative perspective on the implementation and usage of toilet blocks. The author presents the theory of social networks and positive peer pressure and argues that these will amplify the effect of other incentives. With the help of an illustration, this paper concludes that the sustainable sanitation policy should look at facilitating and creating the infrastructure as a network and not strictly at building toilet blocks. (shrink)