Advertisement

Antibiotic Resistance Due to Modern Agricultural Practices: An Ethical Perspective

  • Joan Duckenfield
Review Paper

Abstract

The use of subtherapeutic doses of antibiotics in food-producing animals has been linked to antibiotic resistant infections in humans. Although this practice has been banned in Europe, the U.S. regulatory authorities have been slow to act. This paper discusses the regulatory hurdles and ethical dilemmas of banning this practice within the context of the risk analysis model (risk assessment, risk management, and risk communication). Specific issues include unethical use of scientific uncertainty during the risk assessment phase, the rejection of the precautionary principle leading to ineffective risk management, and the criticality of risk communication to build consensus and force action. The underlying root cause is a conflict of values (Type I ethical problem) among key stakeholders, which is examined in depth along with an ethical analysis using public health ethical values.

Keywords

Antibiotic resistance Feeding of antibiotics to farm animals Growth promotion agents Risk management Ethical analysis Type I and type II errors 

Notes

Acknowledgments

I would like to acknowledge Freda Patterson, PhD., Assistant Professor of Public Health at Temple University for her guidance in the writing of this manuscript and to thank the anonymous reviewers of an earlier version of this paper for their helpful comments.

References

  1. Anomaly, J. (2009). Harm to others: The social cost of antibiotics in agriculture. Journal of Agricultural and Environmental Ethics, 22(5), 423–435.CrossRefGoogle Scholar
  2. Armstrong, G. L., Conn, L. A., & Pinner, R. W. (1999). Trends in infectious disease mortality in the United States during the 20th century. JAMA: The Journal of the American Medical Association, 281(1), 61–66. doi: 10.1001/jama.281.1.61).CrossRefGoogle Scholar
  3. Baum, N., Gollust, S., Goold, S., & Jacobson, P. (2007). Looking ahead: Addressing ethical challenges in public health practice. Journal of Law, Medicine and Ethics, 35, 657–667.CrossRefGoogle Scholar
  4. Botti, C., et al. (2004). In M. Matuzzi & J. Tickner (Eds.), The precautionary principle: Protecting public health, the environment and the future of our children. Copenhagen: World Health Organization.Google Scholar
  5. Boucher, H. W., Talbot, G. H., Bradley, J. S., Edwards, J. E., Gilbert, D., Rice, L. B., et al. (2009). Bad bugs, no drugs: No ESKAPE! An update from the infectious diseases society of America. Clinical Infectious Diseases, 48(1), 1–12. doi: 10.1086/595011.CrossRefGoogle Scholar
  6. Buttel, F. H. (2003). Internalizing the societal costs of agricultural production. Plant Physiology, 133(4), 1656–1665.CrossRefGoogle Scholar
  7. Callaway, T. R., Anderson, R. C., Edrington, T. S., Elder, R. O., Genovese, K. J., Bischoff, K. M., & Nisbet, D. J. (2003). Preslaughter intervention strategies to reduce food-borne pathogens in food animals. Journal of Animal Science 81(14, Suppl 2), E17–E23.Google Scholar
  8. Caplan, A. (2009). Right to reform. Journal of Clinical Investigation, 119(10), 2862.CrossRefGoogle Scholar
  9. Cohen, M. L. (2000). Changing pattern of infectious disease. Nature, 406, 762.CrossRefGoogle Scholar
  10. Couric, K. (2010). Antibiotic overuse hurting humans? Retrieved 11/27, 2010, from http://www.cbsnews.com/stories/2010/02/09/eveningnews/main6191530.shtml.
  11. Cranor, C. F. (2003). How should society approach the real and potential risks posed by new technologies? Plant Physiology, 133(1), 3–9.CrossRefGoogle Scholar
  12. Dean, W., & Scott, H. (2005). Antagonistic synergy: Process and paradox in the development of new agricultural antibiotic regulations. Agriculture and Human Values, 22, 479–489.CrossRefGoogle Scholar
  13. Department of Health, Education, and Welfare. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Washington, D.C.: OPRR Reports.Google Scholar
  14. Dundon, S. J. (2003). Agricultural ethics and multifunctionality are unavoidable. Plant Physiology, 133(2), 427–437.CrossRefGoogle Scholar
  15. Environmental Defense Fund. (2009). McDonaldsantibiotics. No more playing chicken with antibiotics. Retrieved 11/27, 2010, from http://www.edf.org/page.cfm?tagID=2039.
  16. European Commission Health and Consumer Protection Directorate General. (1999). Opinion of the scientific steering committee on antimicrobial resistance. Google Scholar
  17. European Medicines Agency. (2009). Joint opinion on antimicrobial resistance (AMR) focused on zoonotic infections. Joint opinion on antimicrobial resistance (AMR) focused on zoonotic infections. EFSA Journal, 7(11), 1372. doi: 10.2903/j.efsa.2009.1372.Google Scholar
  18. FAO/OIE/WHO. (2004). Second joint FAO/OIE/WHO expert workshop on non-human antimicrobial usante and antimicrobial resistance: Management options.FAO/OIE/WHO.Google Scholar
  19. Gallagher, J. (2009). Study: Antibiotics problems cost U.S. between $17B and $26B a year. Triangle Business Journal. Retrieved 8/15, 2011 from http://www.bizjournals.com/triangle/stories/2009/10/19/daily4.html
  20. Gorbach, S. (2001). Antimicrobial use in animal feed—time to stop. New England Journal of Medicine, 345(16), 1202.CrossRefGoogle Scholar
  21. Hill, A. B. (1965). The environment and disease: Association or causation? Proceedings of the Royal Society of Medicine, 58, 295–300.Google Scholar
  22. James, H. S. (2003). On finding solutions to ethical problems in agriculture. Journal of Agricultural and Environmental Ethics, 16, 439.CrossRefGoogle Scholar
  23. Joint FAO/OIE/WHO Consultation. (1997). Risk management and food safety, report of a joint FAO/WHO consultation, Rome, Italy, 27 to 31 January 1997. (FAO food and nutrition paper no. 65). Rome: FAO.Google Scholar
  24. Joint FAO/OIE/WHO Expert Workshop. (2003). Non-human antimicrobial usage and antimicrobial resistance: Scientific assessment. FAO/OIE/WHO.Google Scholar
  25. Kass, N. (2001). An ethics framework for public health. American Journal of Public Health, 11, 1776–1782.CrossRefGoogle Scholar
  26. Khachatourians, G. (1998). Agricultural use of antibiotics and the evolution and transfer of antibiotic-resistant bacteria. Canadian Medical Association Journal, 159, 1129–1136.Google Scholar
  27. Klevens, R. M., Morrison, M. A., Nadle, J., Petit, S., Gershman, K., Ray, S., et al. (2007). Invasive methicillin-resistant Staphylococcus aureus infections in the United States. JAMA: Journal of the American Medical Association, 298(15), 1763–1771.CrossRefGoogle Scholar
  28. Levy, S. (2010). Comment docket no. FDA-2010-D-0094. Retrieved 08/15, 2011, from http://www.regulations.gov/#!documentDetail;D=FDA-2010-D-0094-0438.
  29. Marshall, B. M., & Levy, S. B. (2011). Food animals and antimicrobials: Impacts on human health. Clinical Microbiology Reviews, 24(4), 718–733. doi: 10.1128/CMR.00002-11.CrossRefGoogle Scholar
  30. Murray, C., & Lopez, A. (1997). Global mortality, disability, and the contribution of risk factors: Global burden of disease study. Lancet, 349, 1436.CrossRefGoogle Scholar
  31. National Academy of Sciences. (1980). The effects on human health of subtherapeutic use of antimicrobial drugs in animal feeds. Washington, DC: National Academy of Sciences.Google Scholar
  32. National Grain and Feed Association. (2010). Docket no. FDA-2010-D-0094 - draft guidance #209: The judicious use of medically important antimicrobial drugs in food-producing animals; availability. Retrieved 08/15, 2011, from http://www.regulations.gov/#!documentDetail;D=FDA-2010-D-0094-0455.
  33. National Pork Producers Council. (2010). Where’s science behind FDA antibiotics ‘Guidance’? Retrieved 11/22, 2010, from http://www.nppc.org/News/DocumentSingle.aspx?DocumentID=25859.
  34. National Research Council. (1999). The use of drugs in food animalsbenefits and risks. National Research Council.Google Scholar
  35. Neiwold, T. A. (2007). The nonantibiotic anti-inflammatory effect of antimicrobial growth promoters, the real mode of action. A hypothesis. Poultry Science, 86(4), 605.Google Scholar
  36. Paine, L., Deshpandé, R., Margolis, J. D., & Bettcher, K. E. (2005). Up to code. Harvard Business Review, 83(12), 122–133.Google Scholar
  37. Public Health Leadership Society. (2002). Principles of ethical practice of public health. Retrieved 11/27, 2010, from http://www.apha.org/NR/rdonlyres/1CED3CEA-287E-4185-9CBD-BD405FC60856/0/ethicsbrochure.pdf.
  38. Roberts, R. R., et al. (2009). Hospital and societal costs of antimicrobial-resistant infections in a Chicago teaching hospital: Implications for antibiotic stewardship. Clinical Infectious Diseases, 49, 1175–1184.CrossRefGoogle Scholar
  39. Rollin, B. (2001). Ethics, science, and antimicrobial resistance. Journal of Agricultural and Environmental Ethics, 14(1), 29.CrossRefGoogle Scholar
  40. Sayre, L. (2009). The hidden link between factory farms and human illness. Mother Earth News, 232, 76–83.Google Scholar
  41. Simon, T. (2011). Just who is at risk? The ethics of environmental regulation. Human and Experimental Toxicology, 30(8), 795–819. doi: 10.1177/0960327110379252.CrossRefGoogle Scholar
  42. Sperling, D. (2010). Food law, ethics, and food safety regulation: Roles, justifications, and expected limits. Journal of Agricultural and Environmental Ethics, 23, 267–278Google Scholar
  43. Swann, M., Baxter, K., & Field, H. (1969). Report of the joint committee on the use of antibiotics in animal husbandry and veterinary medicine. United Kingdom: HMSO.Google Scholar
  44. Union of Concerned Scientist. (2008) Hogging it!: Estimates of antimicrobial abuse in livestock. Retrieved December 15, 2008, from http://www.ucsusa.org/food_and_agriculture/solutions/wise_antibiotics/.
  45. United States Government Accountability Office (GAO). (2004). Antibiotic resistance: Federal agencies need to better focus efforts to address risks to humans from antibiotic use in animals. Washington, DC: United States Government Accountability Office (GAO).Google Scholar
  46. U.S. Department of Health and Human Services, Food and Drug Administration Center for Veterinary Medicine. (2010). The judicious use of medically important antimicrobial drugs in food-producing animals. draft guidance. No. 209). Washington, DC: US Government.Google Scholar
  47. Vose, D., Acar, J., Anthony, F., Franklin, A., Gupta, R., Nicholls, T., Tamura, Y., Thompson, S. Threlfall, E. J., van Vuuren, M., White, D. G., Wegener, H. C., & Costarrica, M. L. (2001). Antimicrobial resistance: Risk analysis methodology for the potential impact on public health of antimicrobial resistant bacteria of animal origin. Revue Scientifique Et Technique De l Office International Des Epizooties, 20(3), 811–827.Google Scholar
  48. World Health Organization. (2003). Impacts of antimicrobial growth promoter termination in Denmark: The WHO international review panel’s evaluation of the termination of the use of antimicrobial growth promoters in Denmark. Paper presented at the Impacts of Antimicrobial Growth Promoter Termination in Denmark: The WHO International Review Panel’s Evalutation of the Termination of the use of Antimicrobial Growth Promoters in Denmark, Foulum, Denmark. Retrieved from http://whqlibdoc.who.int/hq/2003/WHO_CDS_CPE_ZFK_2003.1.pdf.

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  1. 1.Temple UniversityPhiladelphiaUSA

Personalised recommendations