Evidence map›Paper›PMID 30908114›Full record

ArticleAJOB empirical bioethics

Impartiality and infectious disease: Prioritizing individuals versus the collective in antibiotic prescription.

Bernadine Dao, Thomas Douglas, Alberto Giubilini, Julian Savulescu, Michael Selgelid, Nadira S Faber

Abstract read
In one paragraph

Article in AJOB empirical bioethics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. The ESCMID ethics advisory committee (EEAC): purpose and challenges.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2022
    Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Bernadine Daoa Faculty of Medicine, Nursing and Health Sciences , Monash University , Melbourne , Victoria , Australia.
Thomas Douglasb Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy , University of Oxford , Oxford , United Kingdom.
Alberto Giubilinic Oxford Martin School and Wellcome Centre for Ethics and Humanities , University of Oxford Oxford , United Kingdom.
Julian Savulescub Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy , University of Oxford , Oxford , United Kingdom.
Michael Selgelidd Monash Bioethics Centre , Monash University , Clayton , Victoria , Australia.
Nadira S Faberb Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy , University of Oxford , Oxford , United Kingdom.

Funding

Wellcome Trust 104848Wellcome Trust 104848/Z/14/ZWellcome Trust 203132/Z/16/Z
6 · The paper itself

Abstract

backgroundAntimicrobial 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.

methodsAn 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.

resultsOf 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).

conclusionsParticipants' 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.

Indexed as

Attitude to HealthDrug Resistance, MicrobialAdultAgedAnti-Bacterial AgentsCommunicable DiseasesFemaleHealth PolicyHealth PrioritiesHumansMaleMiddle AgedPublic HealthPublic OpinionSocial ResponsibilitySurveys and QuestionnairesAnti-Bacterial Agentsantibacterial agentsbacterialdrug resistanceDrug resistanceethicsmedical overusemicrobialpatient preference

Identifiers

PMID30908114
PMCPMC6446247

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.