Constraining the use of antibiotics: applying Scanlon's contractualism

Journal of Medical Ethics 38 (8):465-469 (2012)
Decisions to use antibiotics require that patient interests are balanced against the public good, that is, control of antibiotic resistance. Patients carry the risks of suboptimal antibiotic treatment and many physicians are reluctant to impose even small avoidable risks on patients. At the same time, antibiotics are overused and antibiotic-resistant microbes are contributing an increasing burden of adverse patient outcomes. It is the criteria that we can use to reject the use of antibiotics that is the focus of this paper. Scanlon's contractualism explains why antibiotics should not be used to gain small benefits, even when the direct costs of antibiotics are low. We know that some individuals now (and probably more in the future will) carry a burden of irretrievable harm as a consequence of treatment- (antibiotic-) resistant infection. If we accept that the dominant justification for use of antibiotics is to prevent irretrievable harm to an individual or contact, then the use of antibiotics for self-limiting conditions, or for the treatment of individuals with conditions for which antibiotics do not substantially impact on outcomes (eg, in the latter stages of terminal illness), or for access based on preference or willingness to pay (internet or over-the-counter access), or the use of antibiotics as animal growth promoters can be rejected. Scanlon's approach also suggests that, with few new antibiotics in the pipeline and an increasing burden of disease attributable to resistant microbes, control of the spread of antibiotic-resistant microbes should be given increasing priority
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2011-100256
 Save to my reading list
Follow the author(s)
My bibliography
Export citation
Find it on Scholar
Edit this record
Mark as duplicate
Revision history Request removal from index
Download options
PhilPapers Archive

Upload a copy of this paper     Check publisher's policy on self-archival     Papers currently archived: 22,037
External links
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library
References found in this work BETA

No references found.

Add more references

Citations of this work BETA

Add more citations

Similar books and articles
Nicholas Southwood (2009). Moral Contractualism. Philosophy Compass 4 (6):926-937.
Nicholas Southwood (2008). A Deliberative Model of Contractualism. Politics, Philosophy and Economics 7 (2):183-208.
David Alm (2008). Contractualism, Reciprocity, Compensation. Journal of Ethics and Social Philosophy 2 (3):1-23.
Michael Cholbi (2002). A Contractualist Account of Promising. Southern Journal of Philosophy 40 (4):475-91.
Eric Mack (2007). Scanlon as Natural Rights Theorist. Politics, Philosophy and Economics 6 (1):45-73.

Monthly downloads

Added to index


Total downloads

20 ( #197,288 of 1,934,420 )

Recent downloads (6 months)

5 ( #113,194 of 1,934,420 )

How can I increase my downloads?

My notes
Sign in to use this feature

Start a new thread
There  are no threads in this forum
Nothing in this forum yet.