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J Int Med Res. 2017 Dec;45(6):1787-1793. doi: 10.1177/0300060517697595. Epub 2017 May 1.

Toward a bioethical framework for antibiotic use, antimicrobial resistance and for empirically designing ethically robust strategies to protect human health: a research protocol.

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1 Instituto de Bioética, Universidade Católica Portuguesa, Porto, Portugal.
2 UNESCO Chair in Bioethics, Institute of Bioethics, Universidade Católica Portuguesa, Porto, Portugal.


Introduction Antimicrobial resistance (AMR) is a challenging global and public health issue, raising bioethical challenges, considerations and strategies. Objectives This research protocol presents a conceptual model leading to formulating an empirically based bioethics framework for antibiotic use, AMR and designing ethically robust strategies to protect human health. Methods Mixed methods research will be used and operationalized into five substudies. The bioethical framework will encompass and integrate two theoretical models: global bioethics and ethical decision-making. Results Being a study protocol, this article reports on planned and ongoing research. Conclusions Based on data collection, future findings and using a comprehensive, integrative, evidence-based approach, a step-by-step bioethical framework will be developed for (i) responsible use of antibiotics in healthcare and (ii) design of strategies to decrease AMR. This will entail the analysis and interpretation of approaches from several bioethical theories, including deontological and consequentialist approaches, and the implications of uncertainty to these approaches.


Antimicrobial resistance (AMR); bioethics; decision-making processes; global health; healthcare; hospitals; public health

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