July 22, 2022

The new precision stewards? A research agenda for ethical, legal and social aspects of antimicrobial resistance

By Colette Gallagher

In this blog synopsis,  Karen Meagher, Ph.D., Assistant Professor and Associate Director of Public Engagement for Mayo Clinic Biomedical Ethics Research Program writes about the ethical aspects of antimicrobial resistance.

If only traditional susceptibility testing took less time. If only there was a way to get the most personalized microbial profile into the hands of treating clinicians faster. Then the devastating conflict between missing sepsis or generating a new superbug ― between saving this patient or sparing future generations ― would dissolve. Narrow-spectrum tailored treatment would become the standard of care…

Key points include:

Meeting patient needs given the rise of “superbugs”: Current U.S. patient burdens for resistant infections estimate that we have the opportunity to save 35 million or more lives per year, shorten hospital stays, and recoup some piece of the $35 billion in annual economic losses, including lost wages.

New technologies, new hope: The promise of “precision stewardship” is that advances in molecular technology will increase the capacity to get each patient the right drug, at the right dose, at the right time, for their infection.

Tempering hope with humility in the face of complex causes: And yet, already, precision methods have also raised social and ethical challenges ― as technological advances often do. Like other public health challenges, the social determinants of resistance are complex, intertwined, and require coordination that confounds the capacity of many policy levers.

 Building a multidisciplinary research agenda: The U.S. Human Genome Project has a companion investment in research on the ethical, legal and social implications of genetics, spanning decades. More recently, a variety of efforts to organize something akin to an ethical, legal and social implications agenda for antimicrobial resistance have been organized.

Fostering new collaborations: A mutual capacity for expanding our evidence base and critically examining public health and ethical imperatives suggests an exciting future for the ethical, legal and social implications of AMR collaboration.

The full blog post originally appeared on Science Speaks, the blog of the Infectious Diseases Society of America and the HIV Medicine Association.

Dr. Meagher’s research focuses on the ethics of human and pathogen genomics, including population health implications. She welcomes inquiries about exploring new opportunities for collaboration.

Disclaimer: This work was made possible by the Center for Individualized Medicine at Mayo Clinic. The views here are those of the author and do not reflect the positions of Mayo Clinic.

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Tags: Bioethics, center for individualized medicine, individualized medicine, mayo clinic, Precision Medicine

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